ALERT: Effective July 1, 2024, My Choice Medicaid SSI and BadgerCare Plus has transitioned to Molina Healthcare of Wisconsin. View Molina’s Medicaid provider page here.
Effective January 1, 2025, the Molina and My Choice Wisconsin Medicare products will be combined. The combined Medicare Dual Advantage product will be administered through legacy My Choice Wisconsin channels and platforms. View the latest updates here.
Caring Starts with Finding the Information You Need
My Choice Wisconsin providers can find important information about programs, authorizations, billing and reimbursements, and so much more. You can use the category filter to access specific types of documents or you can search the full library.
Commonly referenced document:
- Provider Handbook (Family Care, Partnership, SSI, Dual Advantage)
- My Choice Wisconsin Provider Orientation (YouTube)
Can’t find what you need? Contact My Choice Wisconsin’s helpful Customer Service staff.
Resource Downloads for Providers
You will need Adobe Acrobat Reader to view and print PDF files. Download A Free Copy. If you need materials in other formats or languages, visit Help In Other Languages.
Medicare Skilled Nursing Facility (SNF) Prior Authorization Resource
April 12, 2022 | pdf (276.39 KB) | Authorizations, Prior Authorization Resource
Medline Order Form
October 18, 2020 | pdf (297.63 KB) |
Use this form to order Medline disposable medical supplies.
MIDAS Provider Portal User Guide for EVV Services
May 17, 2021 | pdf (790.74 KB) | Claims Information
MIDAS Provider Training – Adding Users & Admin Rights
October 23, 2020 | pdf (155.03 KB) | Authorizations
My Choice Wisconsin BadgerCare Plus Claims Appeal Form
May 19, 2021 | pdf (110.12 KB) | BadgerCare Plus, Claims Information
Neurocognitive Disorders: Delirium and Dementia Prevention and Wellness Practice Guideline
August 9, 2024 | pdf (255.01 KB) | Practice Guidelines
Out-of-Network Provider Referral Prior Authorization Request Form
April 22, 2022 | pdf (608.33 KB) | Authorization Request Form, Authorizations
Outpatient Behavioral Health Treatment and Services Prior Authorization Request Form
April 22, 2022 | pdf (298.33 KB) | Authorization Request Form, Authorizations
Outpatient Procedure Prior Authorization Exception List
August 23, 2024 | pdf (800.86 KB) | Authorizations
Outpatient Therapy/Cardiac/Pulmonary Rehab Prior Authorization Request Form
April 22, 2022 | pdf (243.81 KB) | Authorization Request Form, Authorizations
Pain Prevention and Wellness Practice Guideline
August 9, 2024 | pdf (239.27 KB) | Practice Guidelines
Physician Home & Domiciliary Visit Prior Authorization Resource
May 19, 2023 | pdf (141.48 KB) | Authorizations, Prior Authorization Resource
Physician-Administered Medication Prior Authorization Request Form
April 22, 2022 | pdf (647.96 KB) | Authorization Request Form, Authorizations
Pneumococcal Disease Prevention and Wellness Practice Guideline
August 9, 2024 | pdf (228.67 KB) | Practice Guidelines
Pressure Ulcer Prevention and Wellness Practice Guideline
August 9, 2024 | pdf (245.40 KB) | Practice Guidelines
Prior Authorization Reference Document (Requirements by Program)
August 18, 2024 | pdf (615.41 KB) | Authorizations
Prior Authorization Reopening Request Form
April 22, 2022 | pdf (172.00 KB) | Authorization Request Form, Authorizations
Procedure and Imaging Prior Authorization Request Form
April 22, 2022 | pdf (240.11 KB) | Authorization Request Form, Authorizations
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