Welcome to Wellmark
Thank you for becoming a participating provider in Wellmark's networks. Next, complete the following steps – in the order they are listed – so you can easily and efficiently work with Wellmark.
Log in to the Wellmark Provider Portal
With the Wellmark Provider Portal, you can:
- Send Wellmark medical and drug authorization requests
- Submit claims and check claim status
- View clinician fee schedules
- Check member eligibility, benefits and accumulations
- View and download online provider claim remittances (PCRs)
Before you can move to the next steps on this page, you must register for the Provider Portal.
Note: Provider Portal and E-cred Central have separate logins with unique usernames and passwords. Log in to E-cred Central Secure Site.
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)
See the Availity frequently asked questions PDF File for more information.
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 Secure Site.
Be sure to contact your financial institution(s) to make certain they are aware of the CAQH CORE External Link (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 External Link for providers to utilize when reaching out to their financial institutions. Please refer to the Committee on Operation Rules for Information Exchange External Link 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 Secure Site to submit an inquiry.
Get the resources
Bookmark the following webpages you will frequently use when working with us.
- Check member information tool Secure Site – Verify member benefits.
- Provider guide Secure Site – 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 Secure Site – Check claim receipt and status or submit an inquiry on a finalized claim through the Ask and Track a Question function.
- Register for the Wellmark Information Notification System Secure Site (WINS) to receive real-time communications on topics that may impact the way you do business with Wellmark.
- Subscribe to BlueInkSM External Link, 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.
- Participate in webinars Secure Site designed to help you serve your patients more easily and efficiently.
Submit credentialing and change requests
Use E-credentialing (E-cred) Central Secure Site 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.