Welcome to Wellmark

1.

Register to access the Wellmark Provider Portal

Before you can move to the next steps on this page, you must register for the Wellmark Provider Portal.

With the Wellmark Provider Portal, you can:

• Send Wellmark medical and drug authorization requests
• Submit claims
• Check claim status
• View clinician fee schedules
• Check member eligibility, benefits and accumulations
• View and download online provider claim remittances (PCRs)

Register

Login

Note: Provider Portal and E-cred Central have separate logins with unique usernames and passwords. Log in to E-cred Central

2.

Register to access claims and electronic transactions

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)

Questions? Check out our Availity FAQs.

Register for Availity

Log in to Availity

3.

Set up Electronic Funds Transfer (EFT) for payment

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

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

Question? Read our EFT FAQs.

4.

Get the resources

Bookmark the following webpages you will frequently use when working with us.

• Check member information tool – Verify member benefits.
• Provider guide – Get a detailed look at Wellmark’s policies and guidelines.
• Manage authorizations – Submit medical and drug authorizations and get resources, such as medical policies and user guides.
• Check a claim tool – Check claim receipt and status or submit an inquiry on a finalized claim through the Ask and Track a Question function.

5.

Stay updated

1. Register for the Wellmark Information Notification System (WINS) to receive real-time communications on changes that may impact the way you do business with Wellmark.
2. Blue Ink^SM, 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.
3. Participate in webinars designed to help you serve your patients more easily and efficiently.

6.

Submit credentialing and change requests

Use E-credentialing (E-cred) Central 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 updated.