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Manage Authorizations

Some medical services, procedures, durable medical equipment (DME), and drugs require approval before they can be covered by your patients' benefits.


View important details about authorization


Out-of-Area Member Authorizations


Start the Authorization Process

Step 1

Verify if authorization is required.


Use the medical or drug authorization table to determine if you need authorization.


Medical Authorization Table (Procedures, Imaging, and DME)

Drug Authorization Table (Medications and drugs)


Step 2 Submit an authorization request


Submitting online using Wellmark's secure tools is easy and only takes a few minutes.


Log in to submit an authorization request





Step 3

Check the status of an authorization


Log in to check the status or see if further action is needed.





Learn more about response times and notifications


Note: Upon receiving approval, you will be given an authorization number. Please reference this number on all claims related to the specific procedure or service requiring prior approval. Also, remember that services determined as not medically necessary, or investigational or experimental, are the liability of the provider.



User Guides & Resources

Medical Authorization User Guide (Jiva) pdf

Jiva quick guide for submitting inpatient (IP) requests pdf

Jiva quick guide for submitting outpatient (OP) requests pdf

Jiva quick guide for submitting out of network (OON) requests pdf

InterQual® clinical review training video Play Video

Drug Authorization User Guide (NovoLogix) pdf

NovoLogix FAQ pdf

NovoLogix Training Video Play Video


Related Links

Imaging Services Pre-Authorization Code Groupings secure

Important Authorization Terms

InterQual® Criteria and SmartSheetsTM

Medical Policies A-Z

Medical Policy Overview

Pre-Service Review for Out-of-Area Members secure

Prior Approval for Federal Employee Program (FEP) Members

Radiology pre-authorization requests Q&A secure

SmartSheetsTM secure

Utilization management-related webinars secure

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Tools and resources related to:

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  • Application Tool
  • Change Request Tool
  • Recredentialing Tool
  • Provider Directory Update Tool
  • Submission Status Tracker
  • Submission History Tool
  • View my Organization
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Quick Links

» Authorization Tables
» Manage Authorizations
» Drug Information
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» Medical Policies A-Z
» Provider Guide
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