Printer-Friendly Page

Working with Wellmark.com

Welcome to Working with Wellmark.com, your source for news, information and tips for making the most of the resources available on our secure provider website. This page is designed for all providers with secure access to Wellmark.com. General users will learn about easy-to-use Web tools, while designated security coordinators (DSCs) will learn how to manage security roles within their organization.

• News 
• Web Tools and How-to Videos
• Resources for DSCs
• Information and Web Security 

News

Medical policy notices migrating exclusively to WINS

If you rely on the bimonthly BlueInk provider publication to learn about medical policy updates, please know that this section is scheduled to be removed from the magazine. Instead, news regarding all medical policy updates will be communicated solely through the Wellmark Information Notification System (WINS). Because WINS messages are real-time, you'll hear about the latest policy changes as soon as they are released. If you haven't done so already, please register for WINS and encourage your colleagues to do the same.

Give your keyboard a rest — import claim details into your inquiry

Need to follow up on a claim? Always start with the Check a Claim tool. Whether you need to send a claim correction, request a denial review, or provide supporting documentation, this should always be your first stop. Just select your claim in the tool, and then choose “Inquire or Submit Documents on this Claim” from the drop down menu. This will launch the Ask and Track a Question tool with all the relevant details imported directly into your inquiry. This saves you time and reduces the likelihood for human error. If you start with the Ask and Track a Question tool instead of going through the Check a Claim tool first, you will have to enter all the information into each field manually.

Please do not type the claim details (member ID, claim number, etc.) into the “comments” box. And remember, only one claim or one general question is allowed per inquiry.

Web Tools and How-to Videos

Put down the phone. Chances are the information you’re looking for is online. Listed in order of popularity, the resources featured below show you how to make the best use of our secure Web tools. Many are also included in our Provider Video Gallery.

• Check claim status video  (2:44 min.)
• Follow up on a denied claim with attachments video  (3:06 min.) 
• Check benefit accumulations video  (3:30 min.)
• Resolve possible workers’ compensation claims video  (3:18 min.)
• Get pre-service authorization resource page. 
• Request pre-service review for out-of-area members video  (4:05 min.)
• Create and submit a new claim video . (12 min.) 

Resources for DSCs

Designated security coordinators play a unique role in Wellmark’s Web security protocol. There are two types of DSCs. The “main DSC” has several responsibilities, including signing Wellmark’s usage agreement on behalf of his or her organization. The second type is simply known as “DSCs.” Each organization has one main DSC, but he or she can assign the DSC role to any number of individuals. Both types of DSCs can assign roles to other users to access certain tools and resources on Wellmark.com. To be effective in their role and maintain their organization’s security access, DSCs should be familiar with the following:

• Provider DSC Responsibilities 
• Guide  for managing user profiles, security roles, and NPI access
• Provider security roles and common tasks 
• Access agreement terms and conditions for Iowa or South Dakota
• Tool for updating user security  for your office or practice 

Information and Web Security

We all understand the need to protect our patients’ privacy while serving them efficiently. The following resources help keep providers and our members informed about this important topic:

• What is privacy?
• Health Insurance Portability and Accountability Act (HIPAA) administrative simplification provisions 
• Wellmark’s privacy practices notice  regarding use and disclosure of medical information
• Wellmark’s website privacy statement for visitors to Wellmark.com