Background:

Effective with Dates of Service September 1, 2024, My Choice Wisconsin will begin using WPS exclusively as our third-party administrator (TPA) to process claims and authorizations for My Choice Wisconsin Family Care program members.

The authorization in MIDAS will be updated to reflect the correct TPA for claim submission. All claims sent to TriZetto for Family Care members with dates of service before September 1, 2024, will be processed by TriZetto. All claims with dates of service of September 1, 2024, and forward must be submitted to WPS. Family Care claims can be submitted to WPS the following ways:

• Electronically via Payer ID is SX022.
• Direct entry in the MIDAS portal: mcfc-midas.com/default.asp
• Mail to:
  My Choice Wisconsin
  C/O WPS Health
  P.O. Box 211595
  Eagan, MN  55121

• Via Fax: 1-608-327-6332

There are no changes to the current process for My Choice Wisconsin Family Care Partnership and Medicare Dual Advantage programs.  These claims should still be submitted to TriZetto for processing.

Provider Action Needed:

• Beginning September 1, 2024, dates of service, submit all My Choice Wisconsin Family Care claims to WPS.
• Please review the applicable authorization in MIDAS to identify the appropriate TPA for claim submission.

Questions?

If you have questions regarding claims submitted to WPS please contact us the claims department at their new e-mail address [email protected]. If you have questions on your contract or how to utilize MIDAS for claims submissions to WPS, please contact your Provider Relations representative or email us at [email protected].