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Provider Enrollment Information
 
Provider Addresses

ForwardHealth has the capability to store the following types of addresses and contact information:

  • Practice location address and related information—This address is where the provider's office is physically located and where records are normally kept. Additional information for the practice location includes the provider's office telephone number and the telephone number for members' use. With limited exceptions, the practice location and telephone number for members' use are published in a provider directory made available to the public.
  • Mailing address—This address is where ForwardHealth will mail general information and correspondence. Providers should indicate accurate address information to aid in proper mail delivery.
  • Prior authorization (PA) address—This address is where ForwardHealth will mail PA information.
  • Financial addresses—Two separate financial addresses are stored for ForwardHealth. The checks address is where ForwardHealth will mail paper checks. The 1099 mailing address is where ForwardHealth will mail IRS Form 1099.

Providers may submit additional address information or modify their current information using the demographic maintenance tool.

Note: Providers are cautioned that any changes to their practice location on file with Wisconsin Medicaid may alter their zip+4 code information required on transactions. Providers may verify the zip+4 code for their address on the U.S. Postal Service website.

 
 
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Wisconsin Department of Health Services
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