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Wisconsin Well Woman Program Releasing Updated Reporting Forms November 2023

This November, the Wisconsin Well Woman Program (WWWP) will release revised versions of the following three reporting forms. Providers must complete the most recent versions of these forms when submitting claims for reimbursement:

  • Breast and Cervical Cancer Screening Activity Report (ARF), F-44723
  • Breast Cancer Diagnostic and Follow Up Report (DRF), F-44724
  • Cervical Cancer Diagnostic and Follow Up Report (DRF), F-44729

The submission process for these forms will not be affected if they were submitted prior to November 13, 2023.

On and after November 13, 2023, the previous versions of these forms (dated 10/2008) will no longer be available.

WWWP encourages providers to attend a meeting for more information about what has been updated on the forms and how to complete the forms:

  • Morning meeting, November 7, 2023, 10:00 a.m. Click here to register.
  • Afternoon meeting, November 7, 2023. 2:00 p.m. Click here to register.
Please reach out to Nichole Peplinski (Nichole.Peplinski@dhs.wisconsin.gov) or Courtney Dickinson (Courtney.Dickinson@dhs.wisconsin.gov) with any questions you have about the updated forms or upcoming training.
 
 
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