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Availity is Wellmark’s EDI clearinghouse and provider claims portal

Welcome! Wellmark Blue Cross and Blue Shield has partnered with Availity to make it easier for you to manage health care for your members online. You can access this page anytime without a user ID or password to learn about the secure Availity platform and how to begin using it.

EDI Capabilities

Availity now serves as the no-cost intelligent electronic data interchange (EDI) partner for submitting HIPAA-compliant transactions to Wellmark.

Wellmark supports the following HIPAA transactions through Availity:

  • 270/271 Eligibility and benefits: Check coverage for a patient.  
  • 837 P, I, D Claim submission: Submit a professional, institutional, or dental claim. 
  • 276/277 Claim status: Check the status of a claim. 
  • 835 Remittance Advice: Availity can support Wellmark remittances in addition to your other ERAs managed through Availity.
  • 999 Implementation Acknowledgement: Availity notifies you when it receives the transmission file and notes whether it had X12 or HIPAA syntax errors.

If you are submitting through a non-Availity clearinghouse, ensure it is connected with Availity.

New Availity Batch EDI Trading Partners

To begin submitting to Availity, start by registering for an account on Availity Essentials (see instructions below). During that process, you will be automatically enrolled in Availity’s EDI Clearinghouse for Direct Submitters solution.

Note: To submit via Availity’s EDI Clearinghouse, you must have a third-party practice management or revenue cycle management system capable of generating batch files. The batch file is submitted to Availity either by uploading the file in Availity Essentials or through a Secure File Transfer Protocol (SFTP) connection. Your software vendor should be able to help you set up your system to connect with Availity.

Existing Availity Batch EDI Trading Partners

If you’re currently sending EDI transactions for other health plans via a secure FTP account with Availity, you will be able to send EDI transactions for Wellmark through Availity. Log in to Availity Essentials with your existing login and select Enrollments > Transaction Enrollment. Use the following information to set up your enrollments:

Payer Name and ID

  • Payer Name: Wellmark
  • The payer IDs are 88848 (for MEDICAL and/or FEP DENTAL) and 88851 (for DENTAL)

837 and 835 (Electronic Remittance Advice-835) Enrollment

  • Providers that have a direct connection can use Availity to manage their ERA accounts.
  • Providers using a third party for ERAs must contact their choice of clearinghouse or billing service to enroll. 

How to submit transactions via EDI or Availity Essentials

New Availity Direct Data Entry Portal Users

You can use Availity Essentials to submit professional, institutional, or dental claims to Wellmark via on-line direct data entry screens.

Existing Availity Direct Data Entry Portal Users

Wellmark is available in your drop downs for you to use Availity Essentials to submit professional, institutional, or dental claims to Wellmark via on-line direct data entry screens.

Register for Availity

EDI users and Wellmark secure portal users must register for Availity Essentials. If you are not currently registered, simply:

  • Access the registration page.
  • Enroll in a 30-minute training session on registration.
  • When you are ready, click the Register Today  button below.

Here’s what you may need for registration: 

  • Physical and billing addresses
  • Tax ID (EIN or SSN)
  • NPI
  • Primary specialty/taxonomy
  • Check or EFT information from a health plan that you submit to (recommended)

Important: By registering, you agree to be one of the administrators for your organization. If that is not you, please forward this information to the right person.

Registering additional users in your organization

After you complete your registration, you can add additional users. From Availity Essentials, click Help & Training | Find Help. Select Administrator and then select the Adding Users help topic. This explains how to add one user at a time or upload multiple users from a spreadsheet.

How to submit transactions via EDI or Availity Essentials
Register Today