Contact Info for Providers in the My Choice Wisconsin Network

Additional Contact Support

• Claims & Appeals

  Partnership, 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 7000 Columbia, MD 21045-7000 Claims Appeals My Choice Wisconsin by Molina Healthcare Attn: Claims Appeals 5117 W. Terrace Drive, Suite 100 Madison, WI 53718

  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

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

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

  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
• 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, and Dual Advantage
  Email: shfamccontracts@mychoicewi.org
  Toll-free: 1-800-963-0035
  Hours: Monday-Friday, 8:00 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

  Partnership 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 by Molina Healthcare
      Pharmacy Services Department
      5117 W. Terrace Drive, Suite 100
      Madison, WI 53718
  • 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)
• 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.