Patient Advocates for Wellmark Blue Cross Blue Shield - Find one today.
Supporting and empowering Wellmark Blue Cross Blue Shield patients in Iowa and South Dakota.
Wellmark Blue Cross Blue Shield has been serving Iowa and South Dakota residents since 1939, but deciphering their authorization requirements and multi-stage appeal process can feel like trying to harvest an entire field without modern equipment. Your Solace advocate understands the intricacies of Wellmark's policies—from securing prior authorizations to challenging denied claims and coordinating specialty care across the Midwest's diverse landscapes. They'll untangle the paperwork thicket, manage the relentless follow-up calls, and dismantle the bureaucratic obstacles so you can focus on your health instead of struggling with insurance complexities.
Best of all, most patients pay nothing out of pocket.
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About
Wellmark Blue Cross Blue Shield is the leading health insurance provider in Iowa and South Dakota, serving more than 2 million members across both states. With deep roots in the Midwest dating back to 1939, Wellmark offers a variety of health insurance plans including traditional, high-deductible, standard, and value-based options through networks including Wellmark Health Plan of Iowa, Alliance Select, and Blue Select. While they provide access to extensive provider networks both locally and nationally through the BlueCard Network, members often encounter challenges with their authorization and appeal processes, which differ between Iowa and South Dakota. Their prior authorization system requires careful attention to deadlines and documentation requirements, with many members needing to track their authorization status through Wellmark's online portal, myWellmark. For appeal submissions, each state has its own process and forms, creating additional complications for members trying to contest denied claims or services.
What problems can a Wellmark Blue Cross Blue Shield patient advocate help you with?
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Get the clarity you need to make sense of your care and take charge of your health.
We’ll make the calls (and the callbacks) so you can spend more time doing what you love.
Keep your care affordable with lower medical bills and access to local financial help.
Advocates review coverage, handle preauthorizations, and even help with appeals.
Stay on top of the cutting-edge treatment options and leave no stone unturned.
Advocates coordinate your care team so your health never falls through the cracks.
Get the tools and answers you need to make informed decisions about your care.
Advocates help you overcome your healthcare hurdles—no matter how big they might be.
Solace has helped over 14,000 patients and families
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Wellmark Blue Cross Blue Shield Appeals with a Patient Advocate
Wrestling with Wellmark's separate appeal frameworks for Iowa and South Dakota demands expert knowledge of state-specific requirements. Wellmark maintains distinct procedures for each state—with different forms, submission methods, and review protocols that can confuse even the most organized patients. Your Solace advocate constructs persuasive appeals tailored to your state's requirements, assembles thorough medical evidence, and presents your case using terminology that aligns with Wellmark's review criteria. They monitor submission deadlines and ensure your appeal advances through the correct channels, whether you need a first-level review or must escalate to an external assessment by independent reviewers in Iowa or South Dakota.
Beyond appeals, your Solace advocate serves as your personal guide through Wellmark's entire system. They help you secure necessary prior authorizations before procedures to prevent surprise denials, explain how to maximize your benefits within Wellmark's various networks, and coordinate communication between your healthcare providers and Wellmark's medical teams. When facing network limitations, they can help you find in-network specialists or request exceptions for out-of-network care when medically necessary. They also decode your benefits package to uncover hidden coverage options you might not know exist, from transportation reimbursement to specialty programs for chronic conditions. Throughout every interaction, they translate insurance jargon into plain language so you can make informed decisions about your care.
A Solace advocate becomes your personal bulldozer, plowing through Wellmark's administrative barricades to uncover the benefits you've paid for and rightfully deserve.
The Solace care team model
With Solace, you get both a patient advocate and a supporting physician, which we refer to as your “care team”.
Your advocate will be there to manage the day to day aspects of your care: coordinating with doctors, researching potential solutions and communicating updates to you.
Your supporting physician can unlock resources for you and your advocate that might otherwise be out of reach.
We’ve Got Answers
Still unsure how an advocate can help? Explore these answers to the questions we’re asked the most.
How are Solace advocates qualified to help?
Advocates on Solace are experienced physicians, nurses, pharmacists, and other healthcare professionals from a wide range of backgrounds. 98% of Solace patients report better healthcare outcomes after working with an advocate.
What else can a Solace advocate help me with?
What can a Solace advocate not do?
We know our advocates sound like miracle workers, but they have limits. They can’t prescribe medications or diagnose an illness, for instance. They can’t replace your doctor, but they can break down the barriers standing between you and the quality care you deserve.