Claims overview
Filing your claims should be simple. That’s why Wellpoint Iowa, Inc. uses Availity, a secure and full service website that offers a claims clearinghouse and real-time transactions at no charge to health care professionals. Visit Availity's website to submit claims, check status, verify eligibility and much more.
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Claims resources
EDI
Electronic data interchange (EDI) is the electronic exchange of data between a health care provider and a payer. EDI offers a fast, secure way of exchanging information such as eligibility, benefits, and claim status or submission.
Claims submissions and disputes
You have the right to request an appeal of a claim decision. You may request this appeal on your own behalf or on behalf of a covered member.
Reimbursement policies
These policies outline the basic terms for reimbursement of services covered under our members’ benefits plans. You’ll also find definitions of terms used in the policies and a disclaimer for their use.
Provider manuals
You can find claims contact information, claim submission guidelines and pharmacy claim instructions in our Medicare and Medicaid provider manuals.
System configuration updates
This document provides information regarding known claims issues and is updated weekly on Fridays. Please contact Provider Services with any questions or concerns.
Archives
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Policies, Guidelines & Manuals
- Referrals
- Forms
- Provider Training Academy
- Pharmacy Information
- Electronic Data Interchange
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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