Contact Info for Providers in the My Choice Wisconsin Network

Additional Contact Support

• Claims & Appeals

  Partnership, SSI, Dual Advantage, and legacy Care Wisconsin Family Care member claims are processed by our Third Party Administrator (TPA), Cognizant. If you have a specific billing and/claims inquiry, please call 1-855-878-6699 to speak with a claims representative.

  All other Family Care claims are processed by our TPA, WPS. If you have a specific billing and/claims inquiry, please call 1-800-223-6016 to speak with a claims representative.

  Cognizant Claims Mailing Address (New and corrected claims) My Choice Wisconsin P.O. Box 226897 Dallas, TX 75222-6897 Claims Appeals Attn: Claims Appeals 1617 Sherman Ave. Madison, WI 53704	WPS Claims Mailing Address (New and corrected claims) My Choice Wisconsin C/O WPS Health P.O. Box 211595 Eagan, MN  55121 Claims Appeals Attn: Claims Appeals 10201 W Innovation Dr. Wauwatosa, WI  53226
  Pharmacy – Elixir Toll-free: 844-550-6814 BIN: 012312 PCN: PartD
  Dental – Dental Professionals of Wisconsin DPOW processes dental claims and authorizations Toll-free: 877-389-9870 Website: mydentalpro.net Medicare supplemental dental benefit claims for members of Medicare Dual Advantage are submitted to My Choice Wisconsin at the Madison address listed on the authorization.

  If you disagree with our appeal decision for Family Care or Partnership members, you may submit a second level appeal to the State of Wisconsin at:

  Email: DHSLTCProviderAppeals@dhs.wisconsin.gov
  Fax: (608) 266 – 5629
  Or Mail: Provider Appeal Investigator
  Division of Medicaid Services
  1 West Wilson Street, Room 518
  P.O. Box 309
  Madison, WI  53701-0309

  If you disagree with our appeal decision for SSI members, you may submit a second level appeal to the State of Wisconsin at:

  SSI Managed Care Unit – Appeals
  P.O. Box 6470
  Madison, WI  53716-6470
• Contracts & Service Agreements

  Our Provider Services Contracting Specialists are happy to help you with any questions or comments about contracts or service agreements.

  Email: pscs@carewisc.org
  Toll-free: 1-800-963-0035
  Hours: Monday-Friday, 8 AM – 4:30 PM
• Authorizations

  Family Care 

  • Authorization is required prior to rendering ALL services for Family Care
  • Contact the member’s care team to get an authorization
  • If you cannot reach the member’s care team, contact our Customer Service team at 1-800-963-0035

  SSI, Partnership, and Medicare Dual Advantage 

  • Use the My Choice Wisconsin form appropriate service and fax to (608) 210-4050. Forms can be found in the Authorizations Library or in the Provider Resource Library. 
  • You may request a drug coverage determination by phone or by submitting the appropriate form via fax or mail. Contact information is below. To submit electronically, use our online system PromptPA. 
    • Phone:  1-800-963-0035
    • Fax:  (608) 245-3096
    • Address:  My Choice Wisconsin
      Pharmacy Services Department
      1617 Sherman Avenue
      Madison, WI 53704
• Member-Related Incidents
  • My Choice Wisconsin requires providers to report all critical member incidents such as abuse or neglect, financial exploitation, or injury, as well as any concerns related to members.
  • If you have a member-related incident or concern, contact the member’s care team or call our Customer Service department toll-free at 1-800-963-0035.