Authorizations
Authorization processes, secondary coverage, and non-covered services information can be found here. All authorization-related forms are in the resource library below. For other important information about programs, claims, and much more search our full Provider Resource Library; you may use the search feature to find resources by program, find a specific document or use the “Document Types” filter to limit to category-specific documents.
As of November 2, 2020, the Wisconsin Department of Health Services begins implementing electronic visit verification for Medicaid-covered personal care services. Providers can find more information on our new EVV webpage and the DHS EVV website.
Commonly referenced documents
- Prior Authorization Reference Document
- Temporary Prior Authorization Changes during COVID-19 Health Emergency
- Outpatient Procedure Prior Authorization Exception List
BadgerCare Plus commonly referenced documents
**BadgerCare Plus providers: Effective August 1, 2021, referrals from a Primary Care Provider (PCP) to an in-network Specialist are no longer required. Read more here. Updated forms will be in the provider libraries on August 1st.
**SSI, Partnership, and Medicare Dual Advantage have temporary prior authorization changes due the COVID-19 health emergency. Please be aware of these changes.
BADGERCARE PLUS PROVIDERS: Please ensure your authorization/form/guide says BadgerCare Plus. You can find all BadgerCare Plus documents by using the “Document Types” filter and choosing “BadgerCare Plus” from the drop-down list.
Adult Family Home (AFH) Application Form / Re-Certification Form
October 23, 2020 | pdf (723.75 KB) |
Authorization Portal User Guide
September 23, 2019 | pdf (882.45 KB) | Authorizations, Provider Manuals & Policies
BadgerCare Plus Authorization Form
May 27, 2021 | pdf (130.46 KB) | BadgerCare Plus, BadgerCare Plus Authorizations
BadgerCare Plus Behavioral Health Day Treatment Partial Hospitalization
May 27, 2021 | pdf (61.52 KB) | BadgerCare Plus, BadgerCare Plus Authorizations
BadgerCare Plus Behavioral Health Discharge Information
May 27, 2021 | pdf (58.76 KB) | BadgerCare Plus, BadgerCare Plus Authorizations
BadgerCare Plus Behavioral Health Inpatient Admission
May 27, 2021 | pdf (61.28 KB) | BadgerCare Plus, BadgerCare Plus Authorizations
BadgerCare Plus Behavioral Health Neuropsychological Testing
May 27, 2021 | pdf (65.71 KB) | BadgerCare Plus, BadgerCare Plus Authorizations
BadgerCare Plus Behavioral Health Outpatient Treatment
May 27, 2021 | pdf (64.76 KB) | BadgerCare Plus, BadgerCare Plus Authorizations
BadgerCare Plus Behavioral Health Prior Authorization List
June 2, 2021 | pdf (176.31 KB) | BadgerCare Plus, BadgerCare Plus Authorizations, Provider Manuals & Policies
BadgerCare Plus Medical Face-to-Face Encounter Form
May 27, 2021 | pdf (183.51 KB) | BadgerCare Plus, BadgerCare Plus Authorizations
BadgerCare Plus Medical Notification of Pregnancy Form
May 27, 2021 | pdf (55.43 KB) | BadgerCare Plus, BadgerCare Plus Authorizations
BadgerCare Plus PCP Notification of Change Form
May 27, 2021 | pdf (135.27 KB) | BadgerCare Plus, BadgerCare Plus Authorizations
BadgerCare Plus Provider Appeal Form
May 19, 2021 | pdf (110.12 KB) | BadgerCare Plus, Claims Information
BadgerCare Plus Provider Handbook
May 26, 2021 | pdf (1.01 MB) | BadgerCare Plus, Provider Manuals & Policies
Breast Cancer Screening Clinical Practice Guideline
November 1, 2020 | pdf (159.47 KB) | Clinical Guideline
Care Team Resources for Member Education and Empowerment
January 11, 2021 | pdf (147.37 KB) | Provider Manuals & Policies
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