Resources overview

 

We are committed to supporting you with the necessary resources to facilitate providing quality care and services to the members in our health plan.

Provider resources

 

Utilize our selection of resources to access frequently used forms, reference materials, provider manuals and guides, prior authorization information, clinical practice policies, and other support for delivering benefits to our members.

Forms

 

From office administration to patient care — our Forms page offers quick access to the documents you use the most.

Training Academy

 

The Training Academy offers webinars, CME courses, orientations, tutorials, and more to support providers in continuing their education.

Policies, guidelines and manuals

 

Our provider manuals and guides provide key information and support for delivering benefits to our members. 

Prior authorizations

 

Check which services require prior authorization using the Precertification Lookup Tool and submit requests through Availity, fax, or phone.

Learn about Availity Essentials

 

Availity simplifies provider transactions such as prior authorization requests, electronic data exchange, claim submission and status, and member benefit and eligibility inquiries.

Medical Policies and Clinical UM Guidelines

 

Medical Policies and Clinical Utilization Management (UM) Guidelines help us determine if a procedure is medically necessary.

Availity access


The Availity website offers healthcare professionals free access to real-time information and instant responses in a consistent format, regardless of the payer.

 

With Availity, you can:

 

  Request authorizations

  Submit claims

  Confirm eligibility

Don't have an Availity account?

 

Register free now     

Additional information

 

Referrals 

 

Patient360 

 

Healthcare Effectiveness Data and Information Set (HEDIS®) 

 

Medical management model 

 

Quality management 

 

Electronic visit verification 

 

STAR+PLUS resources 

 

Vaccination resources 

 

 

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Interested in becoming a provider in the Wellpoint network?

 

We look forward to working with you to provide quality service for our members.

 

Join our network