Wellmark’s Electronic Prior Authorization (ePA) solution enables providers and electronic health records to integrate prior authorization workflows into their existing systems. This API-driven solution helps reduce administrative burden, minimize manual fax and phone processes and improve efficiency by creating a more connected authorization experience for providers and their patients.
Key capabilities include:
- Electronic submission of prior authorization requests.
- Secure exchange of clinical documentation.
- Real-time status inquiries and updates when available.
- Integration with existing provider and vendor workflows.
- Reduced reliance on manual authorization processes.
These capabilities are powered by three separate APIs:
- Coverage requirements discovery (CRD): Is prior authorization required?
- Documentation templates and rules (DTR): If yes, what do I need to submit, or questions do I need to answer to obtain the prior authorization?
- Prior authorization support (PAS): The actual prior authorization request/submission.
Coming soon: information for getting started with ePA.
Please call Wellmark at 800-407-0267 or email us at techsupport@wellmark.com for assistance with any questions or technical issues.