Provider Forms

Register for the Maddy Provider Portal

The Maddy Provider Portal allows you to check claim status, verify patient eligibility, view coverage information, submit and check status of authorizations, send and receive secure messages and send claim resubmissions.

Forms

Claim Resubmission Form (Also available online through our new Provider Portal! Register here) (Please allow 60 days to process your correspondence.)
Cologuard Order Requisition Form
HIPAA authorization for providers
Medication Testing - Hydroxychloroquine
Medication Testing - Methotrexata
Medication Testing - Vectra DA
Preauthorization / Prior Authorization Request Form
Preauthorization / Prior Authorization for Behavioral Health Form
Preauthorization / Prior Authorization Oncology Request
Provider Update Form
Psychological/neuropsychological testing request for authorization

Customer Service

800-279-4000

Call us Monday through Friday - 7:30 a.m. to 5:00 p.m. CST

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For WEA Member Benefits (auto and home insurance & retirement services), call 800-279-4010

Customer Service