Before you start
Use this guide when Wellmark — Iowa and South Dakota is a required Local / Host Plan for your practice or claim-service location. Your practice coordinates registration and any required clinician records so the payer can process affected claims. Registration is separate from joining a network and does not guarantee reimbursement. Not sure which plan applies? First identify your required Local / Host Plan. Use this route for a practice or service location in Wellmark’s Iowa/South Dakota geographical plan area. Holding a license in either state alone does not establish the location requirement. If your location is unclear, confirm it with Wellmark first.Registration steps
1
Open the practitioner application entry
Open Wellmark’s credentialing page, expand Practitioner, and select E-cred Central. Practitioner groups use this entry too. Although the surrounding site discusses joining the network, the tool also handles nonparticipating applications.
2
Arrange access for your practice
Open E-cred Central. Check with your practice’s existing administrator before creating another account.For a first-time organization registration, Register opens Step 1: Register Yourself as Primary OSC. The person registering becomes the primary Organization Security Coordinator. Supply the requested contact information and practice TIN only if you are the appropriate person to manage that access.
3
Complete the nonparticipating application
In E-cred Central, use the Application Tool for a nonparticipating application, not a network contract. Enter the requested practice and clinician information. Wellmark requires licensure in the state of the practice address and an NPI.Follow the current application prompts. If you cannot find the nonparticipating route or associate the clinicians with your practice, ask Wellmark before selecting a network-participation option.
4
Check the determination and claim timing
Use Wellmark’s Submission Status Tracker and retain the determination email. Its provider guide, page 44 instructs nonparticipating providers to wait two business days after receiving the notification letter before submitting claims.Tell Thrizer support the notification date when requesting review of affected claims. This is Wellmark’s timing instruction, not confirmation that Thrizer has held your claims.