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.
Monthly Quick Tip
Is your main DSC retiring or leaving your organization? Making this change is easy. All he or she needs to do is use the User Maintenance tool to reassign the main DSC role to another user who has accepted the terms and conditions outlined in the access agreement. If your main DSC has left the organization without assigning this role another user, act quickly so you don’t lose access to Wellmark.com. Please ask a representative from your organization to contact Wellmark at WebSecurity@Wellmark.com.
Real-time WINS messages to start in early July
Registration is now open for the new Wellmark Information Notification System (WINS). When you sign up for this new email notification service, you get only the news you want delivered right to your inbox. With 11 different categories of information available, staying current on policies, processes and provider news has never been easier. If you have secure access to Wellmark.com, you can register today. If you don’t have access to our secure site, please talk to a designated security coordinator in your organization or visit www.Wellmark.com/provider/WINS.
Don’t go back. Just "drop down."
When using internet-based applications like the Check a Claim or Check Member Information tools, it’s natural to click your browser’s back button to return to the previous screen. However, our secure tools don’t actually behave this way. Conventional Web applications allow your web browser to load the prior page from a cached version on your computer. Because pages in our online tools contain protected health information, we don’t allow these pages to be cached. That’s why you might find yourself having to “start over” when using your browser’s back button. Instead, save time by using the options available in the drop down menu in the upper right portion of the tool. For example, selecting “Repeat Claims Search” will save you the trouble of entering information such as the member ID or the dates of service. Many of these drop down menus are featured in the instructional videos at www.Wellmark.com/ProviderVideos.
Important utilization management reminder
When Starting July 1, 2014 failure to complete certain required pre-service review requests for out-of-area members may result in payment reductions. This applies to skilled nursing facility services, acute rehab services, and behavioral health and/or chemical dependency services. Also, providers must hold these members harmless from balance billing. Fortunately, we’ve made the process of requesting pre-service review for out-of-area members as easy as 1, 2, 3. Just visit our dedicated Web page or watch the instructional video.
Web 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 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 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: