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Welcome  » April 25, 2024 2:29 AM
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Alerts
  • Change Healthcare (CHC) has begun submitting some batch X12 electronic transactions to ForwardHealth. The volume of backlogged claims held by CHC and the amount of time it will take CHC to send them is unknown. Once claims are acquired from CHC, ForwardHealth will process them in the order received.

    Visit the Change Healthcare Service Interruption: Resources page for more information on the security incident and for ForwardHealth resources.

  • Multi-factor authentication (MFA) is now required for the secure ForwardHealth Portal. Providers are encouraged to refer to the ForwardHealth Multi-Factor Authorization Instruction Sheet for help setting up MFA preferences.
    Providers may contact their Portal account administrator or call the ForwardHealth Portal Help Desk at 866-908-1363. Note: This is a project-specific announcement and is not related to the Change Healthcare disruption.
IRIS Forms List

IRIS Forms List


Category Form Number Title Direct Link to Form
BA/OTE F-01205B IRIS Participant Education: Budget Amendments www.dhs.wisconsin.gov/library/f-01205b.htm
BA/OTE F-01205C IRIS Participant Education: One-Time Expense Requests www.dhs.wisconsin.gov/library/f-01205c.htm
BA/OTE F-01206 IRIS One-Time Expense Request www.dhs.wisconsin.gov/forms/f0/f01206.docx
BA/OTE F-01206A IRIS One-Time Expense Vendor Bid Comparison www.dhs.wisconsin.gov/forms/f0/f01206a.docx
BA/OTE F-01206B IRIS One-Time Expense Request — Ramp www.dhs.wisconsin.gov/forms/f0/f01206b.docx
BA/OTE F-01210 IRIS Budget Amendment Request www.dhs.wisconsin.gov/forms/f0/f01210.docx
BA/OTE F-01210A IRIS Budget Amendment Provider Quote Comparison www.dhs.wisconsin.gov/forms/f0/f01210a.docx
BA/OTE F-01210B IRIS Budget Amendment Annual Verification (BAAV) Request www.dhs.wisconsin.gov/forms/f01210b.docx
BA/OTE F-01213 Accessibility Assessment Request www.dhs.wisconsin.gov/forms/f0/f01213.docx
Background Check F-01246 Background Information Disclosure Addendum — IRIS www.dhs.wisconsin.gov/forms/f0/f01246.docx
Background Check F-01352 Background Check Appeal Request — IRIS Program www.dhs.wisconsin.gov/library/f-01352.htm
Contractor Oversight F-02432 IRIS Program HIPAA Breach and Unauthorized Disclosure Reporting www.dhs.wisconsin.gov/forms/f02432.docx
Enrollment and Disenrollment F-00075 IRIS Authorization www.dhs.wisconsin.gov/library/f-00075.htm
Enrollment and Disenrollment F-01309 IRIS Program Orientation and Enrollment Checklist www.dhs.wisconsin.gov/library/f-01309.htm
Enrollment and Disenrollment F-01319 IRIS Involuntary Disenrollment Request www.dhs.wisconsin.gov/forms/f0/f01319.docx
Enrollment and Disenrollment F-01319B IRIS Denial of Enrollment Request www.dhs.wisconsin.gov/forms/f01319b.docx
Fiscal Reporting F-02021 IRIS — Certified Public Accountant (CPA) Audit Checklist www.dhs.wisconsin.gov/forms/f02021.docx
Fiscal Reporting F-02047 IRIS Financial Reporting Template www.dhs.wisconsin.gov/forms/f02047.xlsx
IRIS Quality F-01200 IRIS Program Cost Share Repayment Agreement www.dhs.wisconsin.gov/forms/f0/f01200.docx
IRIS Quality F-01212 Grievance — IRIS Program www.dhs.wisconsin.gov/forms/f0/f01212.docx
IRIS Quality F-01261 Fraud Statement — IRIS Program www.dhs.wisconsin.gov/forms/f0/f01261.docx
IRIS Quality F-01310A IRIS Program Conflict of Interest Disclosure — Participant www.dhs.wisconsin.gov/forms/f0/f01310a.docx
IRIS Quality F-01314 IRIS Program Employment Checklist www.dhs.wisconsin.gov/forms/f0/f01314.docx
IRIS Quality F-01558 Risk Agreement — IRIS Program www.dhs.wisconsin.gov/forms/f0/f01558.docx
IRIS Quality F-01689 Participant-Hired Worker 40-Hour Health and Safety Assurance Exception Request — IRIS Program www.dhs.wisconsin.gov/forms/f01689.docx
IRIS Quality F-01947 IRIS Participant Education Manual: Acknowledgement www.dhs.wisconsin.gov/forms/f01947.docx
IRIS SDPC F-01205J IRIS Participant Education: Self-Directed Personal Care www.dhs.wisconsin.gov/library/f-01205j.htm
IRIS SDPC F-01258 IRIS Self-Directed Personal Care (SDPC) Disclosure Statement www.dhs.wisconsin.gov/forms/f0/f01258.docx
IRIS SDPC F-01319D IRIS Self-Directed Personal Care (SDPC) Involuntary Disenrollment Request www.dhs.wisconsin.gov/forms/f01319d.docx
IRIS SDPC F-01566 IRIS Self-Directed Personal Care (SDPC) — My Cares www.dhs.wisconsin.gov/forms/f01566.docx
Notice of Action F-00236B Request for a State Fair Hearing — IRIS www.dhs.wisconsin.gov/library/f-00236b.htm
Notice of Action F-01204 Notice of Action — IRIS Program www.dhs.wisconsin.gov/library/f-01204.htm
PHW/Provider F-01201 IRIS Participant-Hired Worker Set-Up www.dhs.wisconsin.gov/forms/f0/f01201.docx
PHW/Provider F-01201A IRIS Participant-Hired Worker Relationship Identification www.dhs.wisconsin.gov/forms/f0/f01201a.docx
PHW/Provider F-01201C IRIS Participant Employer/Participant-Hired Worker Agreement www.dhs.wisconsin.gov/forms/f0/f01201c.docx
PHW/Provider F-01203 IRIS Provider Education — Health and Safety — Incident Reporting www.dhs.wisconsin.gov/forms/f01203.docx
PHW/Provider F-01240 IRIS Critical Incident Reconciliation www.dhs.wisconsin.gov/forms/f0/f01240.docx
PHW/Provider F-01312 IRIS Provider Application www.dhs.wisconsin.gov/forms/f0/f01312.docx
Systems F-01578 Wisconsin Self-Directed IT System (WISITS) — Request for User Set Up www.dhs.wisconsin.gov/forms/f0/f01578.docx
Systems F-01578A IRIS SharePoint – Request for User Setup www.dhs.wisconsin.gov/forms/f0/f01578a.docx
Systems F-02488 IRIS Monthly Rate of Service (MROS) Discrepancy Resolution www.dhs.wisconsin.gov/forms/f02488.xlsx
Systems F-00476 CARES Automated Systems Access Request www.dhs.wisconsin.gov/library/f-00476.htm
Transfer F-01293D IRIS Fiscal Employer Agent (FEA) Transfer Checklist www.dhs.wisconsin.gov/forms/f01293d.docx
Transfer F-01569 IRIS Consultant Agency (ICA) Transfer Checklist www.dhs.wisconsin.gov/forms/f0/f01569.docx
 
 
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