• Eligibility Categories
  • Introduction
  • Medicaid Recipients
  • BadgerCare Recipients
  • Wisconsin Well Woman Medicaid
  • Limited Benefit Categories
    • Introduction
    • Family Planning Waiver Program
    • Presumptive Eligibility for Pregnant Women Benefit
    • Tuberculosis-Related Services-Only Benefit
    • Qualified Medicare Beneficiary-Only Recipients
    • Specified Low Income Medicare Beneficiaries
    • Qualifying Individual 1 Recipients
    • Qualified Disabled Working Individual Recipients
• Medicaid Identification Cards
  • Introduction
  • Forward Cards
    • Introduction
    • Forward Card Features
    • Identification Number Changes
    • Recipient Name Changes
    • Deactivated Cards
    • Defective Cards
    • Lost Cards
    • Managed Care Organization Enrollment Changes
  • Temporary Medicaid Cards
  • Presumptive Eligibility for Pregnant Women Temporary Cards
  • Presumptive Eligibility for the Family Planning Waiver Program Temporary Cards
• Eligibility Verification Methods
  • Introduction
  • 270/271 Transactions
  • Automated Voice Response System
    • Introduction
    • Dates of Services
    • Hours
  • Commercial Eligibility Verification Vendors
    • Introduction
    • Magnetic Stripe Card Readers
    • Personal Computer Software
    • Internet Access
  • Provider Services
    • Introduction
    • Hours
  • Recipient Forgets Identification Card
• Eligibility Rights
  • Introduction
  • Prompt Decisions on Eligibility
  • Requesting Retroactive Eligibility
  • Appealing Eligibility Determinations
    • Introduction
    • Claims for Appeal Reversals
  • Freedom of Choice
  • Notification of Discontinued Benefits
• Eligibility Responsibilities
  • Introduction
  • Prior Identification of Eligibility
  • Loss of Medicaid Eligibility — Financial Liability
  • Reporting Changes to Caseworkers
• Copayment Requirements
  • Introduction
  • Copayment Exemptions
  • Copayment Amounts
  • Copayment Limitations
  • Copayment Refund/Collection Requirement
• Special Eligibility Circumstances
  • Retroactive Eligibility
    • Introduction
    • Reimbursing Recipients in Cases of Retroactive Eligibility
  • Spenddown to Meet Medicaid Financial Eligibility Requirements
  • Persons Detained by Legal Process
  • Recipients Traveling Out of State
  • Non-U.S. Citizens — Emergency Services
  • Medicaid Recipients from Other States
• Misuse and Abuse of Benefits
  • Introduction
  • Examples of Misuse and Abuse
  • Requesting Additional Proof of Identity
  • Notifying Wisconsin Medicaid
  • Providers May Refuse to Provide Services
  • Recipient Lock-In Program
    • Introduction
    • Providers May Make Referrals
• Appendix
  • Appendix 1 — Limited Benefit Categories
  • Appendix 2 — Quick-Entry Guide for the Automated Voice Response System
  • Appendix 3 — Eligibility Verification Vendors
  • Appendix 4 — Certification of Emergency for Non-U.S. Citizens Form Completion Instructions
  • Appendix 5 — Certification of Emergency for Non-U.S. Citizens
• PDF

Select a section » Certification and Ongoing Responsibilities Claims Information Coordination of Benefits Covered and Noncovered Services Informational Resources Managed Care Prior Authorization Recipient Eligibility

 

 

Recipient Eligibility

Appendix

Appendix 3 — Eligibility Verification Vendors

Wisconsin Medicaid has certified several eligibility verification vendors that offer real-time, up-to-date access to Wisconsin Medicaid eligibility files to ensure that providers have access to the most current recipient eligibility information.

These vendors sell magnetic stripe card readers, personal computer software, and other services. They also provide ongoing maintenance, operations, and upgrades of their systems. Medicaid providers are responsible for the costs of using these eligibility verification methods.

Note:

Providers are not required to purchase services from a commercial eligibility verification vendor. For more information on other ways to verify recipient eligibility or for questions about the Forward cards, contact Provider Services at (800) 947-9627 or (608) 221-9883 or visit the Medicaid Web site.

For more information regarding the card readers or software, contact a vendor from the following list. Providers may call more than one vendor to obtain a variety of price quotations. For the most current listing, refer to the Medicaid Web site.

Name	Address	Telephone/Fax	Web Address
Healthcare Data Exchange, LLC	65 Valley Stream Pkwy Malvern PA 19355	(610) 219-1600 Fax (610) 219-1384	www.hdx.com/
Medifax-EDISM, Inc.	1283 Murfreesboro Rd Nashville TN 37217	(800) 444-4336	www.medifax.com/
Passport Health Communications, Inc.	720 Cool Springs Blvd Ste 450 Franklin TN 37067	(888) 661-5657 (615) 661-5657 Fax (615) 376-3552	www.passporthealth. com/
Emdeon Corporation	669 River Dr Center 2 Elmwood Park NJ 07407	(201) 703-3400 Fax (201) 703-3401	www.webmd.com/ corporate/
Wisconsin Health Information Network (WHIN)	11217 W Forest Home Ave Franklin WI 53132	(800) 331-9446 (414) 448-1100 Fax (414) 448-1202	www.whin.net/
Independent Physicians Network	Ste 300 6767 W Greenfield Ave Milwaukee WI 53214	(414) 771-6177 Fax (414) 771-1159	www.ipn-wi.com/

Next — Appendix 4 — Certification of Emergency for Non-U.S. Citizens Form Completion Instructions
Previous — Appendix 2 — Quick-Entry Guide for the Automated Voice Response System