Provider resources overview

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 manuals and guides

Wellpoint provider manuals and guides provide key administrative information, including the quality improvement program, the utilization management program, quality standards for participation, claims appeals, reimbursement and administration policies.

Provider manuals and guides

Forms

Provider forms are located in our online library for easy access.

Forms

Training academy

Wellpoint Washington, Inc. offers training and tutorials to support providers in continuing their education. Presentations, videos and other training documentation will be added as they become available.

Training academy

Learn about the Availity Portal

Many of the tools you need — such as eligibility and benefits inquiry, claims submission, claims status inquiry, and authorizations — can now be accessed by logging into your account on the Availity Essentials .

Learn about Availity

Prior authorizations

Wellpoint makes determinations based on selected inpatient or outpatient medical services including surgeries, major diagnostic procedures and referrals to validate medical necessity.

Prior authorization requirements

Behavioral health

Wellpoint behavioral health provider network includes psychiatrists, psychologists, social workers, psychiatric nurses, and other mental health and employee assistance health care professionals. Our facility network includes hospital inpatient units, residential treatment centers, partial hospitalization programs, and intensive outpatient services and programs.

Behavioral health resources