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Practitioners

How the Process Works

Apply for Participation

Eligibility

Enrollment Forms

Participation Agreements

Submitting Forms

Credentialing

Update Your Information

Forms

Facilities/Entities

How the Process Works

Apply for Participation

Credentialing

Update Your Information

Forms

Enrollment of Practitioners

Apply For Participation: Eligibility

To complete the enrollment process, the answers to Step #1 and #2 must be yes.

Step 1) Do I practice at an eligible location?

Providers are eligible to particpate in Wellmark provider networks according to the criteria below. Not all providers are eligible for all networks.

Network	Product	Practice Location	Answer
Indemnity	Blue Traditions Classic Blue^®	Practice must have an Iowa address	Yes No
PPO	Alliance Select^SM	Practice must have an Iowa address	Yes No
TPA	Select First^TM	Practice must have an Iowa address or be located in counties bordering Iowa	Yes No
HMO	Blue Access^SM Blue Choice^® Blue Advantage^®	Practice must have an Iowa address or be located in counties bordering Iowa	Yes No
Military Health System	TRICARE	Practice must have an Iowa address excluding Clinton and Scott Counties in Iowa	Yes No
Medicare Advantage PPO	MedicareBlue PPO	Practice must have an Iowa address or be located in Illinois, Wisconsin, or Missouri counties bordering Iowa	Yes No

a. If the answer is "yes" to at least one network, you may enroll.
b. If the answer is "no" for any network, you are not eligibile to participate in that network.
c. If the answer is "no" to each of the networks, you are not eligible to participate.

Step 2) Wellmark contracts only with the following provider types. However, not all provider types are eligible for all Wellmark networks.

Advanced Registered Nurse Practitioner (ARNP)
- Nurse Practitioner (NP)
- Certified Clinical Nurse Specialist (CNS)
- Certified Nurse Midwife (CNM)
- Certified Registered Nurse Anesthetist (CRNA)
Audiologist (Aud)
Doctors of Chiropractic (DC)
Doctors of Dental Surgery (DDS)
Doctors of Optometry (OD)
Doctors of Osteopathic Medicine (DO)
Doctors of Podiatric Medicine (DPM)
Licensed Independent Social Worker (LISW)
Licensed Marriage and Family Therapist (LMFT)
Licensed Mental Health Counselor (LMHC)
Medical Doctor (MD)
Occupational Therapist (OT)
Physical Therapist (PT, LPT)
Physician Assistant (PA)
Psychologist (Ph.D., Psy.D., Ed.D.)
Speech Pathologist (SLP)

If you are not one of the listed practitioner types, you are not eligible to participate in Wellmark networks.

Step 3) Providers can participate in none, some, or all of Wellmark’s provider networks, and in the TRICARE network. To learn more about the TRICARE program, visit the TriWest Web site.

If you choose not to participate in any Wellmark network, but want to submit claims and answered “yes” to question 1 and 2, continue to the Step 5 under Enrollment Forms.

Step 4) Questions regarding reimbursement methodologies?

Contact Provider Relations by phone at 515-245-5167.

Continue to Enrollment Forms

Copyright© 2008 Wellmark, Inc. All Rights Reserved.
Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota. Blue Cross®, Blue Shield®, and the Cross® and Shield® symbols are registered marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.