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
Get faster service with the right ID number
While the vast majority of claims and benefit information is available to you through our online tools, we know that some claims and benefit details can be confusing. Sometimes you just have to push aside the mouse and pick up the phone. Just remember to enter the member ID number when you call. Why? A recent internal survey determined that more than half of transferred provider calls were caused by the provider not entering an ID number into our automated system. The member ID number is key to routing you to the appropriate resource within Wellmark. So don’t close that window on your computer before picking up the phone. Having the member ID number handy will ensure that your question is handled by the appropriate department without having to transfer your call.
Streamlined search options help you find your claims
After careful analysis to determine the most efficient way to find pended claims, Wellmark has made some changes to the Check a Claim tool’s interface. Specifically, we discovered providers were most successful in finding what they need when using two key search criteria — Billing Provider Number and Date of Service. Now, only those two fields are displayed. This also helps reduce confusion between the Member Claim Search and the Provider Pended Claim Search options. If you have the claim number and patient information, simply use the Member Claim Search option. Otherwise, use the Provider Pended Claim Search to generate a list of your claims being processed.
Enhancement eliminates need to request Web inquiry status
Providers now have an easier way to get the status of inquires submitted through the Ask and Track a Question tool. When the inquiry relates to a simple topic, such as locating a duplicate claim, a response is usually ready relatively quickly. For more complex inquiries, such as those pertaining to claims adjustments, you will now receive an email informing you that the status has been updated and indicating that more time is needed. These “interim” email responses include a link to more details about the steps Wellmark has taken to research or elevate the inquiry. The enhancement is expected to improve efficiencies for both providers and Wellmark. Now that providers no longer have to send additional inquiries or call provider services for an update on the status of their inquiry, Wellmark will have more time to devote to working on escalated cases.
Credentialing Submission Tracker a big hit with providers
Wellmark’s Network Administration team is reporting a big win for providers. Since the new Credentialing Submission Tracker page went live in early September, there have been considerably fewer calls and emails from providers asking for the status of their provider applications, recredentialing submissions and change requests. That’s because the new online tool provides these updates within seconds! Just enter up to 10 national provider identifier (NPI) numbers, click “Next,” and the real-time status of your submissions will appear in less time than it takes to reach for the phone. What’s more, the new tool even provides you with the current average processing time, which gives you a general idea of when to expect a final response from Wellmark. Tell your coworkers who work with credentialing submissions to check it out today!
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:
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