Forms and resources

Forms

• Offshore Services Consent Request and Attestation
• Claim Supporting Documentation Submission Form
• Waiver of Liability
• Medicare Advantage Provider Appeal Form

Resources

• Wellmark Advantage Health Plan^SM Provider Manual - detailed information on eligibility, reimbursement, billing, utilization management, appeals and more.
• Wellmark Advantage^SM Claims Filing Guide
• Wellmark Advantage^SM Quick Reference Guide - find the Wellmark Advantage answers you need.

Log in to the provider portal, scroll down to the Wellmark Advantage Health Plan section and click on Wellmark Advantage Health Plan Provider Portal to check eligibility and claim status and manage authorization for Wellmark Advantage members.