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

 

Use 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.

Manuals, policies, and guidelines

 

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 Essentials, fax, or phone.

Learn about Availity Essentials

 

Availity Essentials 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 Guidelines (CUMG) help us determine if a procedure is medically necessary.

Explore more provider resources

Referrals 

 

Healthcare Effectiveness Data and Information Set (HEDIS®) 

 

Medical management model 

 

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.

 

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