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Alerts
  • Children’s Long-Term Support (CLTS) Program Providers and County Waiver Agencies: The CLTS Operations Team is available for your questions about submitting prior authorizations (PAs) or claims for CLTS services. Reach the CLTS Operations Team at 844-942-5870 or CLTSOperations@gainwelltechnologies.com.
  • Attention CLTS Providers: The CLTS Prior Authorization Conversion is still processing. If you have any difficulties submitting claims, please contact the CLTS Operations Team at 844-942-5870 or CLTSOperations@gainwelltechnologies.com.

HMO Providers


This page provides resources and general information for Medicaid providers that are enrolled, or seeking to enroll, with a BadgerCare Plus or Medicaid SSI HMO.

For information specific to members, visit the Wisconsin Department of Health Services(DHS) site.


Provider Enrollment Information
This page provides a complete description for how providers can enroll with Wisconsin Medicaid.
ForwardHealth Provider Enrollment Assistance
ForwardHealth Provider Services Call Center 800-947-9627

The call center is available Monday through Friday, 7 a.m. — 6 p.m. (Central time, with the exception of state-observed holidays).
Providers should call Provider Services for enrollment, policy, and billing questions.

How to Enroll With an HMO
To enroll in an HMO network, contact the plan’s provider relations team.
Contact information can often be found on the HMO’s website.
Member HMO Enrollment Verification
Member enrollment verification on the Portal offers real-time member enrollment verification for all ForwardHealth programs.
For managed care policy, contact the appropriate managed care organization.
ForwardHealth Updates
ForwardHealth Updates announce changes in policy and coverage, prior authorization requirements, and claim submission requirements. They communicate new initiatives from DHS or new requirements from the Centers for Medicare & Medicaid Services and the Wisconsin state legislature.
ForwardHealth Online Handbook
Providers should refer to the ForwardHealth Online Handbook for current ForwardHealth policy and provider-specific information for services and benefits.
Request Portal Access
Providers are strongly encouraged to receive access to and use the secure ForwardHealth Portal. Registering with the ForwardHealth Portal will ensure providers have access to ForwardHealth Updates.
Claim Submission and Provider Appeal Tips

Verify Member Enrollment. Providers should make sure to submit all claims to the appropriate HMO. They can verify a member’s HMO enrollment on the ForwardHealth Portal.

HMO contracts set filing guidelines for claims submissions, reconsiderations, and appeals.

Providers must submit claims completely, accurately, and timely to their HMO to avoid claim denials.

Providers must appeal to the HMO first. Providers can only appeal to DHS after exhausting the HMO appeal process. Providers that do not exhaust the HMO appeal process will have their appeal rejected by DHS.

ForwardHealth Provider Appeals Page
The Provider Appeals page contains instructions on filing a provider appeal including references to appeal rights allowed to providers who contract with HMOs, references to the BadgerCare Plus and Medicaid SSI HMO contract, responsibilities of the HMOs to BadgerCare Plus and Medicaid SSI HMO providers, and guidance instructing providers to access each HMO’s provider handbook for HMO-specific processes.
Member HMO Enrollment Verification
Member enrollment verification on the Portal offers real-time member enrollment verification for all ForwardHealth programs.
Provider Services and Resources Reference Guide
A list of services and resources available to providers and members with contact information and hours of availability.
Provider-Specific Resources by Provider Type
This page lists resources and information organized by provider type including medical necessity criteria, targeted trainings, relevant ForwardHealth topics, and other materials.
BadgerCare Plus and Medicaid SSI HMO Contract
This page provides the current BadgerCare Plus and Medicaid SSI contract and amendments.
HMO Billing Contact Information 

HMO 

Contact Name 

Phone 

Email/Web Contact 

Anthem 

Provider Relations 

855-558-1443 

https://providers.anthem.com/wisconsin-provider/contact-us

Chorus Community Health Plans (CCHP) 



800-482-8010 

https://chorushealthplans.org/for-providers/provider-overview

Dean 

Customer Service Center 

608-828-1301 or  
800-279-1301
https://www.deancare.com/providers

GHC-EC 

Margie Ignarski, 
Director of Operations
715-852-2091 

mignarski@group-health.com

GHC-SCW 

Claims Department 

608-251-4526 

claimsdepartment@ghcscw.com

iCare 

Denise Mays 

414-231-1084 

dmays@icarehealthplan.org

My Choice Wisconsin SSI Medicaid 

My Choice Wisconsin (MCW) was acquired by Molina on Sept. 1, 2023. Effective July 1, 2024, former MCW members are now identified as Molina members. Please refer to Molina for contact information.
(Molina) 

(Molina) 

(Molina) 

My Choice Wisconsin BadgerCare Plus  

My Choice Wisconsin (MCW) was acquired by Molina on Sept. 1, 2023. Effective July 1, 2024, former MCW members are now identified as Molina members. Please refer to Molina for contact information.
(Molina) 

(Molina) 

(Molina) 

MercyCare 

Claims Processing:
Betsy Fulmer 
608-752-3431 

bfulmer@mhemail.org

MHS 

Joanne Jackson, 
Director of Operations 
414-773-4149 

jojackson@mhswi.com

Molina 

Claims Processing, Deanna Deubig 
414-260-9087 

Deanna.Deubig@MolinaHealthcare.com

NHP 

Joanne Jackson, 
Director of Operations 
414-773-4149 

jojackson@mhswi.com

Quartz 

Quartz Customer Service 

800-362-3310 

customerservice@quartzbenefits.com

Security 

Claims Processing: 
April Bores 
715-221-9412 

bores.april@securityhealth.org

UHC 

Provider Call Center 

877-651-6677 

https://www.uhcprovider.com/en/health-plans-by-state/wisconsin-health-plans/wi-comm-plan-home.html


What's New?
A summary of what is new for managed care organizations:


2025 HMO Quality Guide
 2025 BadgerCare Plus/Medicaid SSI D-SNP Contract
 
 



 
 
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