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Provider Enrollment Information
 
Provider Application Fee
Pay Application Fees on the ForwardHealth Portal

At the end of the provider enrollment and revalidation applications, providers can submit their application fee to complete enrollment or revalidation; otherwise, providers may pay the application fee through the Portal within 10 business days after submitting their application. If a provider does not pay the application fee within 10 business days after submitting their application, then their application will be denied, and a new enrollment application must be completed.

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

Submit Application Fee or Hardship Request.

Application Fee Amount

The application fee is currently $586. The federal Centers for Medicare & Medicaid Services (CMS) establishes the fee, which is used to offset the cost of federally mandated screening activities associated with the Affordable Care Act. CMS may adjust the fee on January 1 of each year.

Provider Organizations Are Required to Pay Application Fees

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. Provider application fees do not apply to individual providers or professional provider groups.

Application fee information (whether or not an application fee is required for specific provider types) is located within the Information for Specific Provider Types page under each provider type.

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

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 are not required to also 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 organization has paid the application fee.

Timely Application Fee Payment Affects Application Processing Time

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 provider submits the application, the application will be denied. If an application fee is not paid due to insufficient funds, the application will be denied.

Provider Application Fees Are Non-Refundable

Once a provider has submitted an application and paid the application fee, the fee is non-refundable, unless ForwardHealth denies the application due to a temporary moratorium on enrollment of new providers or provider types imposed by CMS or Wisconsin Medicaid.

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 ForwardHealth Portal. ForwardHealth must receive a hardship request within 10 business days of the application's submission date.

Providers can submit hardship requests through the Portal if submitting the hardship request within 10 business days of their application submission date. The payment process includes instructions for submitting hardship requests.

Providers are required to describe the hardship and why the hardship deserves an exception. Starting a new business is not a sufficient reason for receiving a hardship exception. CMS will evaluate the hardship request within 60 days and send a letter to the provider indicating whether or not it has approved the request.

Providers will not be enrolled, re-enrolled, or revalidated until CMS reviews and makes a decision regarding the hardship request. If CMS denies the request, providers will have an additional 10 business days from the date on the return letter to pay the application fee, or ForwardHealth will deny the provider enrollment in Wisconsin Medicaid.

 
 
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Wisconsin Department of Health Services
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