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Welcome to Wellmark

Thank you for becoming a participating provider in Wellmark's networks. Next, we recommend completing the following steps, in order, so you can easily and efficiently work with Wellmark.

 

Important: Please do not complete these steps until you have received the welcome letter confirming your participation in Wellmark's networks.

Get secure provider portal access

This must be completed before you can move to the next sections on this page.

 

Register for Wellmark.com to access secure resources that allow providers to:

  • Make claims status inquiries
  • Check member information
  • Access the provider guide
  • View educational webinars
  • Reference provider fee schedules (participating providers only)

Submit claims

Electronic Claim Transaction Registration/Enrollment Forms

Wellmark uses Availity for electronic data interchanges (EDI) transactions including:

  • Electronic claim submissions (837)
  • Electronic remittance advices (ERA) (835)
  • Requests and responses for eligibility and benefits (270/271)

With the transition to Availity, an electronic claim transaction registration packet is no longer required to submit claims. Providers must still enroll for electronic remittance advices (ERAs). To enroll for ERAs, contact your clearinghouse. If you do not have a clearinghouse, log in to Availity and complete the ERA registration.

 

Log in to Availity

 

Don't have an Availity account? Register here .

 

See the Availity frequently asked questions pdf image for more information.

Set up Electronic Funds Transfer (EFT)

Wellmark participating providers have a contractual requirement to enroll in Electronic Funds Transfer. Complete the Electronic Funds Transfer (EFT) Enrollment form.

 

Be sure to contact your financial institution(s) to make certain they are aware of the CAQH CORE (Council for Affordable Quality Healthcare, Committee on Operating Rules for Information Exchange) EFT and ERA operating rules. The appropriate arrangements will need to be made between you and your financial institution to accommodate the delivery of the CORE required minimum CCD+ (Cash Concentration or Disbursement including an addenda record) Data Elements necessary for re-association of the EFT payment with the ERA. CAQH CORE has developed a sample letter for providers to utilize when reaching out to their financial institutions. Please refer to the Committee on Operation Rules for Information Exchange for additional information pertaining to re-association.

 

Frequently Asked Questions on EFT pdf image

 

If you have questions regarding a missing or invalid EFT payment, please use the Ask & Track a Question tool to submit an inquiry.

Use the resources

  1. Get to know your designated Wellmark Business Partner using the maps below:
  2. Bookmark the following webpages that you will frequently use when working with us.
Webpage Description
Check member information tool Verify member benefits using this tool.
Provider guide Use the provider guide to get a detailed look at Wellmark's policies and guidelines.
Manage Authorizations Submit medical and drug authorizations and get related resources, such as medical policies and user guides.
Check a claim tool Use this tool to check claim receipt and status or to submit an inquiry on a finalized claim through the Ask and Track a question function.

 

Stay updated

  1. Register for the Wellmark Information Notification System (WINS) to receive real-time communications on topics that may impact the way you do business with Wellmark.
  2. Participate in monthly webinars designed to help you serve your patients more easily and efficiently.
  3. Subscribe to BlueInkSM, Wellmark's flagship provider publication. Published bimonthly, the in-depth articles are written to help you work more efficiently with Wellmark. Subscribe to get delivered to your inbox, or read the latest issue now.

Credentialing

E-credentialing (E-cred) Central can be used to submit applications for credentialing, re-credentialing and non-participating providers. It is also used to submit change requests and complete directory validation requests that keep your organization's provider data current.

Questions?

Please refer to our Contact Us pages:


» Register now

[X]

I need secure access to:

Tools and resources related to:

  • Claims
  • Payment
  • Benefits
  • Authorizations

Take me there.

Or

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

Take me there.


Technical Assistance


Call us:

800-407-0267

Monday through Friday
7:00 a.m. – 5:30 p.m. CST


Quick Links

» Claims/Benefits Lookup
» E-credentialing Central
» Manage Authorizations
» Provider Guide
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