Wellmark BCBS Provider Resources
Wellmark will be expanding the collaboration with eviCore healthcare soon. Beginning within the first quarter of 2024, Wellmark commercial members will also require prior authorization on select advanced imaging and cardiac imaging services through eviCore. Just like for Molecular Testing, providers will be able to request these authorizations via an online portal at eviCore, which is directly linked from the Wellmark provider portal.
A new way to authorize molecular lab testing for Wellmark members.
Starting October 1, 2023, prior authorization for molecular testing lab services is required from eviCore.
Wellmark is collaborating with eviCore healthcare to provide utilization management services for molecular testing procedures. Beginning October 1, 2023, Wellmark commercial members now require prior authorization on select molecular testing procedures. Molecular testing services performed without prior authorization may not be reimbursed, and you may not seek reimbursement from members. However, molecular testing procedures performed in conjunction with an inpatient stay, observation or emergency room visit are not subject to authorization requirements.
There are currently no General Resources.
eviCore highly recommends providers take full advantage of the online capabilities at https://www.evicore.com/provider
Here you can request prior authorization, review our nationally accepted evidence-based guidelines, and receive announcements about program updates. Access requires only your email address and a brief registration.