Contact Us
Plans and Services Health and Wellness About Wellmark Member Employer Broker Provider
Home Provider
» Working with Wellmark.com
» Hot Topics
» Claims and Payment
» Medical Policies and Authorizations
» Health Management
» Medical, Dental, and Pharmacy
» Credentialing and Contracting
» Quality and Transparency
» Communications and Resources
» Health Care Reform for Providers
printer friendly Printer-Friendly Page
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

You may have already noticed that the Working with Wellmark.com page is updated around the middle of each month. This is your place for regular updates about resources and tools available on our secure website. But did you know that we have another page that you may find just as useful? The Network Engagement Hot Topics page is updated on or around the first of every month and it includes a wide variety of news about issues that may impact your business. Whether you work with claims, billing, pre-service review, or other administrative issues, be sure to check this page each month. A /_images/Icons/video.gif icon will appear each time the page is updated.

NewsNews

Secure web inquiry enhancement means no more faxing

Thanks to your feedback, we’ve made an important enhancement to our Ask and Track a Question tool. Providers now have the ability to submit file attachments directly to their secure web inquiries. That means no more faxes or postage! The enhancement also means you’re more likely to get a faster response from Wellmark, because electronic files help eliminate the delays caused by physically handling faxed or mailed documents.

 

To see how easy this new feature is, check out our latest instructional video /_images/Icons/video.gif. This three-minute animation walks you through the steps of uploading a document to a secure web inquiry about a denied claim.

 

Our Online PCRs were designed with you in mind

One of our most important web enhancements of the last year was our electronic provider claims remittances (Online PCRs). In 2014, providers began seeing some changes in these documents. The most notable is that many providers now access two Online PCRs each week – one for members with coverage carried over from our prior plans, and another for members covered by our new Affordable Care Act-compliant products. How can you tell the difference? Just look at the ID numbers. Those beginning with the letter “W” followed by eight digits belong to members with ACA-compliant plans.

 

One thing that hasn’t changed is that the only way to access PCRs is electronically; customer service is not able to mail or fax your PCRs. Just log in to the secure provider page of Wellmark.com and click "View Provider Claim Remittance (PCR)."

Secure Web ToolsWeb Tools and How-to Videos

Put down the phone. Chances are the information you’re looking for is online. Start saving time with the tools below so you can concentrate on what matters most—the health of your patients.

 

Check the status of a claim .

  • Learn how to use our most popular tool in this video . (2:44 min.)

Follow up on a denied claim .

  • This video  also features Web attachments. (3:06 min.)

Indicate whether a claim was work related .

Check benefit accumulations .

  • This video  makes it easy to understand how. (3:30 min.)

Download provider claims remittance   (PCR).

Create and submit a new claim .

  • This video  shows you how.
    (12 min.)

Request pre-service review for out-of-area members 

  • It’s easy as “1, 2, 3” in this video . (4:05 min.)

 Get pre-service authorization.

  • Visit our page of comprehensive guides and quick reference documents.

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:

 


Technical Assistance


Call us:

800-407-0267

Monday through Friday
7:00 a.m. – 5:30 p.m. CST


Don't have access?

Register today!


Follow Up on a Denied Claim Video
FacebookTwitterInstagrampinterestLinked InYou Tube