File a claims appeal for Wellmark review. If you would like to appeal a denied claim to see if a different outcome is possible, you must file a written appeal within 180 days of the date of the decision. If the situation is medically urgent, your doctor can call to make a verbal appeal. To appeal a claim in Iowa: To appeal a claim in South Dakota:

Choose the form based on the state you're insured through, regardless of where services were received. Appoint an individual, such as a caregiver or provider, to submit claims or appeals on your behalf.

Follow the steps below to submit an appeal request to Wellmark Advantage Health Plan. What type of appeal? Standard Expedited. (if Yes, What is the name of the drug?) Drug Name: C. What are you appealing? What would you like us to review again? Write in the space below and be sure to attach supporting documents. (750 Character Limit)

If you have received an overpayment recovery request and do not agree with our reasons for requesting the refund, submit an overpayment recovery appeal. Easily find and download forms, questionnaires and other documentation you need to do business with Wellmark in one, convenient location. Browse provider forms.

Wellmark is the leading health insurance company in Iowa and South Dakota. Find individual and family plans and resources for Employers, Providers, and Producers.

Become a credentialed provider in Wellmark's network to file claims and submit medical and drug authorizations. Or view forms and resources without logging in.

If you believe that Wellmark has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Wellmark Civil Rights Coordinator, 1331 Grand Avenue, Station 3E417, Des Moines, IA 50309-2901, 515-376-6500, TTY 888-781-4262, Fax 515-376-9055, E...

This form is to be completed by you, as a covered member, or your authorized representative, if you have designated one, if you disagree with a benefit determination and request a review of a claim for benefits.

Approved: You will be notified by mail or email of the decision or view the authorization in myWellmark within 24 hours of the decision being made. Denied: You and your provider will be contacted via telephone and a letter will be mailed. Appeal instructions will be provided.

The Wellmark Provider Guide provides resources for the policies and procedures for Practitioners, Facilities and Providers doing business with Wellmark.