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Medical Policies and Authorizations


Authorization Tables

View medical policies and criteria used by Wellmark, and learn whether authorization is required.

   Manage Authorizations

Submit and review medical and drug authorizations.

Authorizations for Out-of-Area Members

Verify benefits, read applicable medical policies and initiate an authorization request.

   Important Authorization Terms

Learn about the various types of authorizations, and find out how and when to get the approvals you need.


Medical Policies A-Z
Determine which treatment, procedure, service or supply may be eligible for coverage.


Medical Policy Overview

Learn how medical policies are developed and used at Wellmark.

Federal Employee Program (FEP)

Find out which treatments, procedures, services, or supplies require prior approval for FEP members.

   InterQual® Criteria and SmartSheets™

Find out how to access the criteria used in medical authorizations.


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Tools and resources related to:

  • Claims
  • Payment
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  • Authorizations

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E-credentialing Central to access these tools:

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

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Quick Links

» Authorization Tables
» Manage Authorizations
» Drug Information
» Find a Provider or Facility
» Forms
» Medical Policies A-Z
» Provider Guide
» Submission Status Tracker
» WINS - instant updates

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