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Patient Name (Last, First, Middle Initial) Certificate Holder Identification Number Certificate Holder Name (Last, First, Middle Initial) Patient’s Gender Relationship to Certificate Holder ?M ?F ? Self ? Spouse ? Dependent Address Provider Telephone Number City, State, ZIP Code Diagnosis Code Requesting Provider (Last, First, Middle Initial) Servicing Provider (Last, First, Middle Initial) Address Address City, State, ZIP Code City, State, ZIP Code Patient’s Date of Birth / / Pro ...

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What happens if prior authorization is denied?

If your prior authorization gets denied, you and your provider will get notified about the denial. You or your provider can contact the insurance for more information. Your provider can try to send in more documentation for reconsideration of coverage or change the therapy.

Does Wellmark require prior authorization?

Some groups have specific authorization requirements. Always verify your benefits at myWellmark.com. Prior approvals are valid for a specific length of time. If theres a service date change and the new date remains within the defined authorization period, its not necessary to update or complete a new prior approval.

What states does Wellmark cover?

Health insurance plans in Iowa and South Dakota | Wellmark.

What triggers a prior authorization?

The prior authorization process begins when a service prescribed by a patients physician is not covered by their health insurance plan. Communication between the physicians office and the insurance company is necessary to handle the prior authorization.

Is Wellmark the same as BCBS?

Wellmark, Inc. is a mutual insurance company and independent licensee of the Blue Cross Blue Shield Association. Since were owned by our friends and neighbors, we know whats important to them.

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