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Provider Enrollment Information
 
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Providers Are Required to Enroll in Wisconsin Medicaid to Be Reimbursed

To be reimbursed for services provided to members enrolled in Wisconsin Medicaid, BadgerCare Plus, or SeniorCare, providers are required to be enrolled in Wisconsin Medicaid as described in Wis. Admin. Code ch. DHS 105.

How to Enroll in Wisconsin Medicaid

To enroll in Wisconsin Medicaid, providers are required to complete the application process. Failure to complete the enrollment application process will cause a delay, and may cause denial, of enrollment. Providers have 10 calendar days to complete an application on the ForwardHealth Portal once they begin it. As part of the enrollment application, providers are required to sign a provider agreement with the Wisconsin Department of Health Services (DHS).

Providers sign the provider agreement electronically by selecting the box acknowledging and agreeing to the terms of the agreement. By electronically signing the provider agreement, the provider attests that the provider and each person employed by the provider, for the purpose of providing services, holds all licenses or similar entitlements and meets other requirements specified in Wis. Admin. Code chs. DHS 101–109 and required by federal or state statute, regulation, or rule for the provision of the service.

How ForwardHealth Uses Personal Information

Personally identifiable information about Medicaid providers, persons with ownership or control interest in the provider, managing employees, agents, or other provider personnel is only used for purposes directly related to Medicaid administration, such as determining the enrollment of providers and monitoring providers for waste, fraud, and abuse. All information provided is protected under federal and/or state confidentiality laws.

Failure to supply the information requested on the application may result in denial of Medicaid payment for the services.

Duration of the Provider Agreement

The provider agreement remains in effect as long as the provider is enrolled in Wisconsin Medicaid.

Termination of Enrollment

A provider's enrollment in Wisconsin Medicaid may be terminated in one of the following ways:

  • By the provider as specified in Wis. Admin. Code § DHS 106.05
  • By DHS upon grounds set forth in Wis. Admin. Code § DHS 106.06
 
 
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