Quality management
Wellpoint maintains a comprehensive quality management (QM) program to objectively monitor and systematically evaluate the care and service provided to members. The scope and content of the program reflects the demographic and epidemiological needs of the population served. Studies are planned across the continuum of care and service, with ongoing proactive evaluation and refinement of the program.
Related information
Healthcare Effectiveness Data & Information Set (HEDIS®)
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub
- Learn about Availity
- Precertification lookup tool
- Precertification requirements
- Claims overview
- Member eligibility & pharmacy overview
- Policies, guidelines & manuals
- Referrals
- Forms
- Training academy
- Pharmacy information
- Electronic data interchange (EDI)
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We look forward to working with you to provide quality services to our members.
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