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.
Utilization Management Tool guides streamlined
Good news! Wellmark has streamlined the user guides for the Utilization Management Tool. All three guides below are now considerably shorter — one was reduced to nearly half its original length. Additional sections and subsections were added to each guide, while existing sections were renamed to be more intuitive for the user. Finally, the table of contents in each guide is now interactive, taking you exactly where you want to go with the click of a mouse.
Utilization Management Tool Inpatient User Guide
Utilization Management Procedures and DME User Guide
Utilization Management Tool Out of Network Request User Guide
Check out the updated user guides by logging on to the secure Provider portal of Wellmark.com today!
File attachment feature eliminates the need for most faxes
Spending too much time at the fax machine? If so, remember that the Ask and Track a Question tool allows you to send file attachments. Even better, the files you send can be automatically associated with the claim you’re working on in the Check a Claim tool. Just select “Inquire or submit documents on this claim” from the dropdown menu. To see how easy this new feature is, check out our instructional video . The Check Member Information tool also allows access to this helpful feature in the dropdown menu in the upper right of your screen.
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: