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Submitting Electronic Claims

Electronic Claim Transaction Registration/Enrollment Forms

Wellmark uses Availity for electronic data interchanges (EDI) transactions including:

  • Electronic claim submissions (837)
  • Electronic remittance advices (ERA) (835)
  • Requests and responses for eligibility and benefits (270/271)

With the transition to Availity, an electronic claim transaction registration packet is no longer required to submit claims. Providers must still enroll for electronic remittance advices (ERAs). To enroll for ERAs, contact your clearinghouse. If you do not have a clearinghouse, log in to Availity and complete the ERA registration.

 

Log in to Availity

 

Don't have an Availity account? Register here .

 

See the Availity frequently asked questions pdf image for more information.

 

Set up Electronic Funds Transfer (EFT)

Wellmark participating providers have a contractual requirement to enroll in Electronic Funds Transfer. Complete the Electronic Funds Transfer (EFT) Enrollment  pdf form.

 

Be sure to contact your financial institution(s) to make certain they are aware of the CAQH CORE (Council for Affordable Quality Healthcare, Committee on Operating Rules for Information Exchange) EFT and ERA operating rules. The appropriate arrangements will need to be made between you and your financial institution to accommodate the delivery of the CORE required minimum CCD+ (Cash Concentration or Disbursement including an addenda record) Data Elements necessary for re-association of the EFT payment with the ERA. CAQH CORE has developed a sample letter for providers to utilize when reaching out to their financial institutions. Please refer to the Committee on Operation Rules for Information Exchange for additional information pertaining to re-association.

 

Frequently Asked Questions on EFT pdf image

 

If you have questions regarding a missing or invalid EFT payment, please use the Ask & Track a Question tool to submit an inquiry.


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