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.

 


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Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota.
 
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