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Submitting Electronic Claims

Register to securely submit electronic claims to Wellmark:

• Electronic Data Interchange FAQ
• Registration Instructions and Forms  
  Includes:
  • Electronic Transaction Registration Form for the following transactions:
    • 837
    • 270
    • 276
    • 278
    • 820
  • Signature and Audit Agreement
  • Provider Authorization for Electronic Transactions Via Third Party
  • Submitter Change of Address Request Form
  • Cancellation Request
• Forms for 835 and EFT:
  • Electronic Remittance Advice (ERA)/835 Enrollment Form 
  • EFT Enrollment Form 

Log in to learn more , including

• What Happens After You Submit a Claim?
• Testing with Wellmark
• Requirements for Testing Claims Electronically 
• Additional Information Regarding Testing