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Working with Wellmark.com

Welcome to Working with Wellmark.com, your source for news, information and tips for making the most of the resources available on our secure provider website. This page is designed for all providers with secure access to Wellmark.com. General users will learn about easy-to-use Web tools, while designated security coordinators (DSCs) will learn how to manage security roles within their organization.

InnovationMonthly Quick Tip

Check the ID to find claims. The member might have an ACA plan.
Are you having difficulty finding an inpatient claim using our online tools? If so, check the member ID. Those which begin with “W” after the three-letter alpha prefix belong to one of Wellmark’s Affordable Care Act (ACA) health insurance plans and have different search criteria for inpatient claims. When using the Check a Claim tool, make sure to enter the entire date span (“From – To Dates of Service”) into the search criteria. When using the View Provider Claim Remittance (PCR) tool to find claims belonging to members whose ID begins with “W,” try the “All My Providers” option from the drop down menu. Still can’t can find what you’re looking for? Contact your designated security coordinator to ensure you have access to the appropriate National Provider Identifier (NPI) numbers under your organization’s Tax Identification Number (TIN).

 

NewsNews

Which projects received awards to improve community health?
In July, we asked providers to help us identify 10 local initiatives that would each benefit from $7,500 as part of our 75th Anniversary celebration. Thanks to an overwhelming response, Wellmark decided to expand this effort to include six additional projects in Iowa and South Dakota to also receive $7,500. The final 16 projects were chosen from more than 100 entries because they demonstrated a long-lasting impact on making the healthy choice the easy choice, and improving overall community health and wellness in their communities. The public also had the chance to weigh in on their favorite projects. More than 84,000 votes were received during the 19-day voting period, which ended on Sept. 7. To learn about the 16 winning projects, please read our news release or watch a short video. And thank you for helping us celebrate our 75 years of service by recommending projects in your area!

Instructional videos now available within tools

Have a question on how to use our online tools? We’ve made it even easier for you to learn how to save time online. The Check a Claim and Check Member Information tools now have convenient links to our popular how-to video series. Each tool includes links to the short clips that pertain to that tool, as well as a link to our library of other instructional videos.

Secure Web ToolsWeb Tools and How-to Videos

Put down the phone. Chances are the information you’re looking for is online. Listed in order of popularity, the resources featured below show you how to make the best use of our secure Web tools. Many are also included in our Provider Video Gallery.

  • Check claim status video . (2:44 min.)
  • Follow up on a denied claim with attachments video . (3:06 min.) 
  • Check benefit accumulations video . (3:30 min.)
  • Resolve possible workers’ compensation claims video . (3:18 min.)
  • Download provider claims remittances (PCR) presentation .
  • Get pre-service authorization resource page
  • Request pre-service review for out-of-area members video . (4:05 min.)
  • Create and submit a new claim video . (12 min.) 

Resources for DSCsResources for DSCs

Designated security coordinators play a unique role in Wellmark’s Web security protocol. There are two types of DSCs. The “main DSC” has several responsibilities, including signing Wellmark’s usage agreement on behalf of his or her organization. The second type is simply known as “DSCs.” Each organization has one main DSC, but he or she can assign the DSC role to any number of individuals. Both types of DSCs can assign roles to other users to access certain tools and resources on Wellmark.com. To be effective in their role and maintain their organization’s security access, DSCs should be familiar with the following:

Information and Web SecurityInformation and Web Security

We all understand the need to protect our patients’ privacy while serving them efficiently. The following resources help keep providers and our members informed about this important topic:

 


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