wisconsin.gov Home State Agencies Subject Directory Department of Health Services
Search
Welcome  » April 21, 2014 9:41 AM
Login


 
Print

Managed Care : Provider Information

Topic #411

Referrals

Non-network providers may at times provide services to BadgerCare Plus HMO and Medicaid SSI HMO enrollees on a referral basis. Non-network providers are always required to contact the enrollee's HMO or SSI HMO. Before services are provided, the non-network provider and the HMO or SSI HMO should discuss and agree upon billing procedures and fees for all referrals. Non-network providers and HMOs or SSI HMOs should document the details of any referral in writing before services are provided.

Billing procedures for out-of-plan referrals may vary depending on the HMO or SSI HMO. For specific billing instructions, non-network providers should always contact the enrollee's HMO or SSI HMO.



 
 Select from the following options 
Advanced Search    Updates and handbooks
 Sections and Chapters 


About  |  Contact  |  Disclaimer  |  Privacy Notice
Wisconsin Department of Health Services
   Production PROD_WIPortal_M426D1_7-7