XLV

BCBS Prefix XLV

Wellmark Blue Cross and Blue Shield

South Dakota/Iowa • High-Deductible Health Plan (HDHP), Traditional Indemnity, HMO

Billing essentials

Provider phone
(800) 552-3993
Electronic payer ID
88848
Claims mailing address
P.O. Box 14509, Des Moines, IA 50306-3509
Timely filing limit
180 daysCompare all plans
Prior authorization phone
(800) 552-3993
Provider website
https://www.wellmark.com

Coverage under prefix XLV

HDHP

HDHP coverage under this prefix means the member carries a higher annual deductible in exchange for lower monthly premiums. Claims are processed normally but the member's cost-sharing will be higher than standard plans until the deductible is met. Preventive services are typically the exception and are covered at no cost to the member.

Traditional Indemnity

This is a traditional indemnity prefix. Unlike managed care plans (HMO, PPO, EPO), indemnity plans do not use provider networks. There are no referral requirements and no restrictions on which providers the member can see. Submit claims to the payer listed above for reimbursement at the plan's allowed rate.

HMO

This is a Health Maintenance Organization (HMO) prefix. HMO plans have stricter routing requirements than PPO plans. Members select a PCP who manages their care and issues referrals. Claims for specialist services should include the referral number. Out-of-network claims will typically be denied unless emergency criteria are met.

About Wellmark Blue Cross and Blue Shield

Health insurance company serving Iowa and South Dakota with commercial and other plans.