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.

  BadgerCare Plus member claims are processed by our TPA, SCAS Management Group (SMG). If you have a specific billing and/or claims inquiry, please call (414) 755-3619 or (855) 530-6790 to speak with a claims representative. For all claims and appeals contact information, see our Quick Reference Contact Sheet.

   

  Cognizant Claims Mailing Address (New and corrected claims) My Choice Wisconsin P.O. Box 7000 Columbia, MD 21045-7000 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

  BadgerCare Plus Claims Mailing Address (New and corrected claims) Trilogy Health Networks P.O. Box 1171 Milwaukee, WI 53201 Medical and Behavioral Health Claims Appeals My Choice Wisconsin Health Plan Provider Appeals Department P.O. Box 70491 Milwaukee, WI 53207 Fax: 414-448-6710

  Medicare Only – Partnership / Dual Advantage Pharmacy – Elixir Toll-free: 844-550-6814 BIN: 012312 PCN: PartD

  Partnership / SSI / Dual Advantage Dental – DentaQuest DentaQuest processes dental claims and authorizations.  Toll-free: 855-453-5287  Website: www.dentaquest.com   Partnership / SSI / Dual Advantage Vision – EyeQuest  EyeQuest processes vision claims and authorizations.  Toll-free: 844-824-2014 Website: www.dentaquest.com/vision/

  BadgerCare Plus – For Dental/Vision claims and appeals information, see the Quick Reference Contact Sheet.

  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 or BadgerCare Plus members, you may submit a second level appeal to the State of Wisconsin at:

  BadgerCare Plus and Medicaid SSI Managed Care Unit – Provider 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.

  Family Care, Partnership, SSI, and Dual Advantage
  Email: shfamccontracts@mychoicewi.org
  Toll-free: 1-800-963-0035
  Hours: Monday-Friday, 8:00 am – 4:30 pm

  BadgerCare Plus
  Email: providerrelations@trilogyhealthinsurance.com
  Toll-free: 1-855-530-6790
  Hours: Monday-Friday, 8:00 am – 5:00 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

  Partnership, SSI, and Medicare Dual Advantage 

  • Complete the My Choice Wisconsin form for the 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
  • For Dental Prior Authorizations contact: DENTAQUEST of WI 
    • Phone: 855-453-5287 
    • Fax: (262) 834-3589 or  
    • Complete a direct entry on the web (login ID and password required)
  • For Vision Prior Authorizations (DOS 11/1/22 and later) contact: EYEQYEST
    • Phone: 844-824-2014
    • Fax: 888-696-9552
    • Complete a direct entry on the web (login ID and password required)

  BadgerCare Plus
  For Authorization contact information, see the Quick Reference Contact Sheet.
• 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.
  • If you have a member-related incident or concern for a My Choice Wisconsin BadgerCare Plus member, contact our BadgerCare Plus Customer Service department at 1-855-530-6790.