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WellSky Claims Processing System

Individual entering data into a computer while seated at a desk.

As part of the Division’s Current 2 Future Initiative, DDD selected a vendor, WellSky, to update its claims system.

The WellSky system uses

  • The Healthcare Common Procedure Coding System (HCPCS), and
  • Standard Centers for Medicare & Medicaid Services (CMS) & claim forms

WellSky uses standard HIPAA Transactions and Code Sets (TCS) instead of DDD-specific billing codes.

Vendors must use official national claim forms through the WellSky system. Vendors have three options to submit claims:

  1. Submit an electronic 837 form
  2. Enter claims manually in WellSky for each authorization
  3. Submit a CMS 1500 form in paper form

Codes and Billing Units

Vendors must use the proper HCPCS/CPT codes. Most HCPCS/CPT codes are billed in 15-minute increments.

Frequently Asked Questions

The Division has a Frequently Asked Questions (FAQ) document. Qualified Vendors should check the FAQ before sending a new question. The question may already be answered there.

Updated WellSky System Issues/Updates/Fixes

Frequently Asked Questions

Required Action

Qualified Vendors will have access to three user accounts for submitting claims. The vendor’s contract main contact or designee must assign these billing users in the FOCUS system. The contract main points of contact or designee can assign these users following these three steps:

  1. Log in to Focus and open Admin Tools.
  2. Select “Users” at the top of the page.
  3. In the "Access to WSHS" column, click "Assign" for up to three people.

These users will then be able to access the WellSky claims system

Qualified Vendors will issues relating to their login or password should contact [email protected].

Resources

Training

The Division’s Provider Relations team conducts WellSky training sessions.

If you are listed as a designated WellSky user but have not attended training, please email [email protected] and ask to be added to the list for upcoming trainings.

Training details

  • All training sessions are held virtually using Google Meet
  • You must have a computer to attend
  • WellSky training is required before you can submit claims.

If you do not attend training and do not get access to WellSky, your claims payments may be delayed.

837 Certification

An 837 Certification Form must be submitted to and approved by DDD before a user will gain access to the parallel prod environment.

Only those providers that will be submitting electronic 837s need to be certified. If a third-party biller represents multiple DDD agencies, they only need to submit one Certification Form.

Troubleshooting Guides:

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