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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
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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)
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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
Medical 
Drug
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Check the status of an authorization
Log in to check the status or see if further action is needed.
Medical
Drug
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.
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User Guides & Resources
Medical Authorization User Guide (Jiva) 
Jiva quick guide for submitting inpatient (IP) requests
Jiva quick guide for submitting outpatient (OP) requests
Jiva quick guide for submitting out of network (OON) requests
InterQual® clinical review training video 
Drug Authorization User Guide (NovoLogix)
NovoLogix FAQ
NovoLogix Training Video
Related Links
Imaging Services Pre-Authorization Code Groupings 
Important Authorization Terms
InterQual® Criteria and SmartSheetsTM
Medical Policies A-Z
Medical Policy Overview
Pre-Service Review for Out-of-Area Members
Prior Approval for Federal Employee Program (FEP) Members
Radiology pre-authorization requests Q&A
SmartSheetsTM
Utilization management-related webinars
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