Pre-Notification & Emergencies

Network:

Alliance Select

Group Number:

56851-0319 GreenState PPO

56851-0419 GreenState HDHP

56851-0309 Insurance PPO

56851-0409 Insurance HDHP

56851-0329 Trust PPO

56851-0429 Trust HDHP

Website:

https://www.wellmark.com/

Support:

1.800.524.9242

Claim Submission Address:

Wellmark BC/BS of IA

Station 39

636 Grand Avenue

Des Moines, IA 50309-2565

Find a Doctor

Many services require a notification to or a review by Wellmark.  If you do not follow notification requirements properly, you may have to pay for services yourself, so the information in this section is critical. For a complete list of services subject to notification or review, visit www.Wellmark.com or call the Precertification line at 800-558-4409.

 

Services for which you are required to notify your administrator in advance include:

  • hospitalization

  • home health care

  • skilled nursing facility confinement

  • hospice care

  • organ transplants

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If you receive any of the above services from an in-network physician or at an in-network facility, you are encouraged, but not required, to notify administrators in advance.

 

If you are unsure whether advance notification is required for a particular service, call member services at 800-524-9242.

 

In an Emergency

In a true emergency situation, visit the nearest Emergency Room for care. Your services will be covered at the in-network rate, regardless of whether you use an in-network or out-of-network hospital. Emergency Room care for non-emergency situations is not a covered expense.

 

If you are admitted to the hospital from the Emergency Room, you or your doctor must call Wellmark’s Customer Service Department and notify them of your admission within 48 hours. If you are unable to call, someone else can call for you.