Claims and payment

Set up Electronic Funds Transfer (EFT) for payment

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

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.

Provider Payments and Remits FAQs

Payment and coding policies

Learn more about Wellmark's payment and coding policies.

Appeals and inquiries

Learn about Wellmark's post-service appeals and preservice inquiries processes.

Ancillary claims

Learn the claims filing guidelines for ancillary services, including independent clinical laboratories, durable medical equipment suppliers and orthotics and prosthetics.