Providers
Welcome, Wellpoint providers
We’re here to work with you on behalf of the many Group Insurance Commission (GIC) members who have chosen Wellpoint health plans.
The Wellpoint health plans
We offer three health plans for non-Medicare GIC members and one plan for Medicare retirees.
For an overview and comparison of the Wellpoint plans, visit Explore our health plans.
For benefit information and plan materials for a particular Wellpoint plan:
Claims, eligibility, and reimbursement
For information about filing claims, eligibility, reimbursement policies, and electronic claims, visit Claims, eligibility, and reimbursement.
Medical policies and clinical UM guidelines
For information about Wellpoint's medical policies, clinical UM guidelines, and clinical criteria, visit Medical policies.
Enhanced Personal Health Care (EPHC)
Wellpoint's value-based, patient-centered care program provides support for making changes to the delivery system that drives better care.
About provider tiering
Wellpoint uses group tiering to tier providers in some of its health plans. The tier placement for each group is based on the group's contractual relationship with Wellpoint. Member copays are determined by the tier placement of the group.
Providers submitting claims from different groups will be subject to the copays associated with the tier of each of those groups. The copay for a visit will depend on which of the two groups billed for the services. For providers who work for more than one group, the group with the highest tier will determine the provider's tier listed in Find Care.
For more information:
Group tiering for physicians FAQ