Wellmark BCBS Provider Resources
Wellmark BCBS will be expanding the collaboration with EviCore by Evernorth soon. Beginning fall of 2024, Wellmark BCBS commercial members will also require prior authorization on select cardiac implantable devices through EviCore. Just like for Molecular Testing and Cardiac & Radiology Imaging services, providers will be able to request these authorizations via an online portal at EviCore, which is directly linked from the Wellmark BCBS authorization table.
Cardiac Implantable Devices (CID)
Cardiovascular
Radiology
Laboratory Management
EviCore is in partnership with Wellmark BCBS to provide authorization services for select commercial Wellmark members.
Wellmark commercial members 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. Please see Lab codes and guidelines for the procedures that will require authorization or applies a claims policy.
Beginning February 12, 2024, EviCore will also begin accepting prior authorization requests for select Radiology & Cardiovascular Imaging services for dates of service beginning March 1, 2024 and after. Please see Radiology & Cardiovascular Imaging code List for the procedures that will require authorization.
Need Help?
Registration Instructions
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.