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)
- BadgerCare Plus Provider Handbook
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.
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.
General Services Claim Form Instructions
November 2, 2020 | pdf (164.90 KB) | Claims Information
Home Health Prior Authorization Request Form
November 2, 2020 | pdf (238.12 KB) | Authorization Request Form, Authorizations
Hospice Prior Authorization Request Form
October 23, 2020 | pdf (633.87 KB) | Authorization Request Form, Authorizations
How to Obtain a Copy of Your Explanation of Benefits (EOB)
November 2, 2020 | pdf (177.72 KB) | Claims Information
Inpatient Admission Prior Authorization Request Form
October 23, 2020 | pdf (216.48 KB) | Authorization Request Form, Authorizations
MCW Family Care – Authorization for Release of PHI (ROI) AUTH001
January 25, 2021 | pdf (111.14 KB) | Compliance & Privacy
Used by Family Care to obtain to release information to another or to authorize another entity to release information to MCW Family Care.
MCW Health Plan – Authorization for Family Non-Medical Release of Information (ROI) AUTH005
January 25, 2021 | pdf (109.82 KB) | Compliance & Privacy
Used by the Health Plan to capture family, friends, or others that the member chooses to allow the sharing of information between the health plan and these individuals.
MCW Health Plan – Authorization for General Release of Information – prefilled (ROI) AUTH003
January 25, 2021 | pdf (193.35 KB) | Compliance & Privacy
Same as AUTH002 but prefilled with My Choice Wisconsin Health Plan information as the receiver of the PHI from another entity. AUTH002: Used by the Health Plan (Partnership, SSI, Dual Advantage, BadgerCare Plus) to obtain authorization to release information to another entity/provider or for another entity/provider to release information to the MCW Health Plan.
MCW Health Plan – Authorization for General Release of Information (ROI) AUTH002
January 25, 2021 | pdf (106.37 KB) | Compliance & Privacy
Used by the Health Plan (Partnership, SSI, Dual Advantage, BadgerCare Plus) to obtain authorization to release information to another entity/provider or for another entity/provider to release information to the MCW Health Plan.
MCW Health Plan – Authorization for Multi-Provider Release of Information (ROI) AUTH004
January 25, 2021 | pdf (104.56 KB) | Compliance & Privacy
Used by the Health Plan (typically with a new member) to capture multiple providers/entities on one release; authorizes the listed providers/entities to release information to MCW Health Plan.
Medicaid Crisis Stabilization Program Prior Authorization Resource
November 2, 2020 | pdf (129.38 KB) | Authorizations, Prior Authorization Resource
Medicaid Home Health Services Prior Authorization Resource
October 23, 2020 | pdf (138.16 KB) | Authorizations, Prior Authorization Resource
Medicaid Hospice Prior Authorization Resource
October 12, 2020 | pdf (158.95 KB) | Authorizations, Prior Authorization Resource
Medicaid Personal Care Worker Prior Authorization Form
October 23, 2020 | pdf (210.16 KB) | Authorizations
Medicaid Skilled Nursing Facility (SNF) Prior Authorization Resource
October 23, 2020 | pdf (176.53 KB) | Authorizations, Prior Authorization Resource
Medicaid SSI – Personal Care Prior Authorization Resource
January 12, 2021 | pdf (634.30 KB) | Authorizations, Prior Authorization Resource
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