Dear Valued Provider:

Background:
As previously communicated, for Dates of Service September 1, 2024, and after, My Choice Wisconsin began using WPS exclusively as our third-party administrator (TPA) to process claims and authorizations for My Choice Wisconsin Family Care program members.

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.

Provider Action Needed for Providers New to WPS:

• Providers submitting claims to WPS for the first time will not automatically be set up with Direct Deposit. To set up direct deposit, go to: https://www.wpshealth.com/resources/provider-resources/edi/enrollment.shtml.  Click on Enroll for Electronic Transactions and follow the prompts to Enroll in Electronic Funds Transfer.
• If you will be receiving payment by check, please review your billing address in the MIDAS Provider Portal.  If the address in MIDAS is not correct, your payment will not go to the correct address.  To update your address, complete a Provider Information Update Form (applicable sections only)and return to [email protected].

The authorizations in MIDAS were 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 after 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.

Questions?

• For questions regarding your contract or how to utilize MIDAS for claims submissions to WPS, please contact your My Choice Wisconsin representative or email us at [email protected].  Please include your business name and tax ID when reaching out so that we may triage your request appropriately.
• For questions regarding claims submitted to WPS, please contact the Claims Department at their new e-mail address[email protected].