Contact Us
Home Provider Medical Policies and Authorizations
» Working with Wellmark.com
» News
» Blue Card
» Claims and Payment
» Medical Policies and Authorizations
» Health Management
» Medical, Dental, and Pharmacy
» Credentialing and Contracting
» Quality and Transparency
» Communications and Resources
printer friendly Printer-Friendly Page
Utilization Management Tool

The Utilization Management (UM) Tool is used to submit pre-service review requests to Wellmark for certain services, procedures, or durable medical equipment (DME). Powered by McKesson's Clear Coverage™, the UM tool is interactive and uses real-time data. Submitting a request is easy and only takes a few minutes.

 

To learn more or get started with a pre-service review request, log in to the secure UM Tool page secure.

 

Need to know whether your service, procedure, or DME requires review? Start with the Authorization Table. For medications, check the Pharmacy Prior Authorization List.

 

If you do not participate in Wellmark networks and practice outside Iowa and South Dakota, please log in to your local Blue Cross Blue Shield Plan’s website and navigate to the out-of-state pre-service review information page. Note: Wellmark does not require pre-service authorization for diagnostic imaging services for our members receiving services from providers who do not contract with Wellmark.

 


Register now

[X]

I need secure access to:

Tools and resources related to:

  • Claims
  • Payment
  • Benefits
  • Utilization Management

Take me there.

Or

E-credentialing Central to access these tools:

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

Take me there.


Quick Links

» Authorization Table
» Submission Status Tracker
» Drug Information
» Education
» Find a Doctor or Hospital
» Forms
» ICD-10
» Medical Policies
» Provider Guide
» WINS
FacebookTwitterInstagrampinterestLinked InYou Tube