We are committed to supporting you in providing quality care and services to the members in our network. Here you will find frequently used forms, PDFs, provider manuals and guides, prior authorization information, practice policies, and support for delivering benefits to our members.
Provider forms are located in our online library for easy access.
Wellpoint offers training and tutorials to support providers in continuing their education. We will add presentations, videos and other training documentation as they become available.
Wellpoint provider manuals and guides provide key administrative information, including quality improvement and utilization management programs, quality standards for participation, claims appeals, and reimbursement and administration policies.
Wellpoint makes determinations based on selected inpatient or outpatient medical services including surgeries, major diagnostic procedures and referrals to validate medical necessity.
Many of the tools you need — such as eligibility and benefits inquiries, claims submission, claim status inquiry, and authorizations — can now be accessed by logging into your account on the Availity Portal.