Mercy Managed Care

Wellmark

Website:  www.wellmark.com

Billing guides, practitioner guides, and specialty guides are available at:
http://www.wellmark.com/e_business/provider/prov_guides.htm
As the website is frequently updated, please go to the source for the most current information.

Prior approval requests can be submitted online at https://ebusiness.wellmark.com/provider/papp/PlanMemberLookup.asp

Services that require prior approval can be found at
http://www.wellmark.com/e_business/provider/PriorApproval.htm

Although Iowa recognizes PA billing, not all states do.  All claims go through Iowa, but then work with the out of state plan (home plan).  The contract benefit must be covered from the home plan to pay for a PA.  Some plans such as Alabama, Illinois and, possibly New York, do not recognize PA's so the member should not see a PA in that instance.  If the PA has their own billing number with Wellmark, they fall under the Wellmark PA fee schedule.  If no billing number, they bill and are paid under the supervising provider.   Again this is Iowa’s policy, and the claim still won't pay if the home plan doesn't allow PA's.

Address:
Wellmark Blue Cross and Blue Shield of Iowa
636 Grand Avenue
Des Moines, IA 50309-2565

Phone:  800.362-2218
Fax:  515-245-4620

Contact Person:  Sally Christianson, Provider Relations Manager   
Phone:  515-245-4814
E-mail: christiansonS@wellmark.com

Claims Mailing Address:
Station 39
PO BOx 9291
Des Moines, IA 50306-9231

Phone Numbers:

  • Changes to an existing provider number, Phone: 800.708.1342
  • To obtain enrollment material/review critieria, Phone:  800.708.1342
  • Electronic claims submission, Phone: 800.407.0267
  • Out-of state patient eligibility, Phone: 800.676.2583
  • Federal employee claims, Phone: 800.532.1537
  • Hawk-I, Phone: 800.257.8563
  • Capitation, Phone: 515-235.4333
  • Other provider concerns, Phone: 515.245.5167
  • Claims Status/Benefits/Eligibility, Phone: 800.362.2218
  • Wellmark Health Plan of Iowa, Phone: 800.355.2031
  • Health Management, Individual Case Management, Home Health/Hospice, Phone: 800.552.3993

 

Please contact Kristi Larsen at 641.422.6986 with any questions/comments regarding this web page.