The majority of Jiva^TM log-in and authorization request submission issues have now been resolved. Utilizing Jiva is the most effective means of submitting and having authorization requests processed and approved. If you are having issues submitting authorization requests in Jiva, contact Wellmark Technical Support at 800-407-0267.

Wellmark is only accepting faxed medical authorization requests that are defined as expedited. Requests are considered expedited when a delay in medical care or treatment can:

• Seriously jeopardize the life or health of the member or the member's ability to regain maximum function, OR
• Subject the member to severe pain that cannot be adequately managed without the care or treatment requested.

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

	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)
	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 Jiva Guidance and Troubleshooting Drug
	Check the status of an authorization   Log in to check the status or see if further action is needed.   Medical Jiva Guidance and Troubleshooting 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.

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 SmartSheets^TM

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

SmartSheets^TM

Utilization management-related webinars