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Provider Enrollment Information
 
Provider Application Fee

Submit Application Fee or Hardship Request

Provider organizations are assessed a provider application fee when they apply for Wisconsin Medicaid enrollment. This includes newly enrolling providers, providers who are re-enrolling after their previous enrollment with Wisconsin Medicaid lapsed, and providers who are revalidating. The fee is established by the Centers for Medicare and Medicaid Services (CMS) and is used to offset the cost of federally mandated screening activities associated with the ACA. The application fee is currently $586. Providers should note that CMS may adjust the fee on January 1 of each year.

Note:The list of provider organizations assessed an application fee is subject to change.

Provider application fees do not apply to individual providers or professional provider groups. For complete information regarding the provider organizations that will be assessed the application fee, refer to the Provider Enrollment Information home page. Application fee information is located within the Information for Specific Provider Types page under each provider type link.

Providers who are currently enrolled in or are in the process of enrolling in Medicare or another state's Medicaid or Children's Health Insurance Program (CHIP) are also not required to pay ForwardHealth the application fee. Instead, ForwardHealth will verify the provider's enrollment in Medicare or with the other state and confirm that the provider has paid the application fee.

Application Fee Payments Made via the Portal

At the end of the provider enrollment and revalidation applications, providers can submit their application fee to complete enrollment or revalidation. Alternatively, providers may pay the application fee within 10 business days after the application is submitted by clicking the Submit Application Fee or Hardship Request link above.

ForwardHealth will not accept paper checks or cash for application fee payments.

ForwardHealth will not start processing an application until the application fee is paid. If ForwardHealth does not receive the payment within 10 business days after the application is submitted, the application will be denied. If an application fee is not paid due to insufficient funds, the application will also be denied.

Provider Application Fees Non-Refundable

Once a provider has submitted an application and paid the application fee, the fee is non-refundable, with the following exceptions:

  • If an application is denied as a result of a temporary moratorium on enrollment of new providers or provider types imposed by CMS or Wisconsin Medicaid.
  • If an application is denied before any initiation of the screening process.

In either exception, the application fee will be refunded in full to the provider.

Hardship Exception Requests

Providers may request a hardship exception to the application fee only at the time they are newly enrolling, re-enrolling, or revalidating on the Portal. Wisconsin Medicaid must receive a hardship request within 10 business days of the application's submission date. Providers can use the Submit Application Fee or Hardship Request link above if submitting the hardship request within 10 business days of their submission date. Instructions related to the hardship request are given during the payment process.

Providers are required to describe the hardship and why the hardship deserves an exception. The Centers for Medicare and Medicaid Services will evaluate the hardship request within 60 days and send a letter to the provider indicating whether or not the request has been approved. Providers will not be enrolled, re-enrolled, or revalidated until CMS reviews and makes a decision regarding the hardship request. If CMS does not approve the request, providers will have an additional 10 business days from the date on the return letter to pay the application fee; otherwise, the provider will be denied enrollment in Wisconsin Medicaid.

 
 
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