WWWP Policy and Procedures Manual
The information found on this page explains WWWP policy and procedures.
Local WWWP coordinating agencies and providers will
find this information particularly helpful.
Wisconsin Well Woman Program Policy and Procedures Manual
WWWP Policy and Procedures Manual
(PPH 43029) (PDF, 257 KB)
** Effective February 1, 2006, some of the WWWP guidelines have
changed. Please consult your local
coordinating agency (PDF, 26 KB) for details.
Appendix 1 - The Program
Appendix 2 - Income Eligibility
Appendix 3 - Enrollment
Appendix 4 - Provider Participation
Appendix 5 - Reports
Appendix 6 - Covered Services and Reimbursements
Appendix 7 - Screening and Diagnostic Reporting Forms
Appendix 8 - Claims Submission
- Health Insurance Claim Form
(CMS 1500) (exit DHS)
- Form CMS-1450 (UB-92)
The UB-92 form and instructions are used by institutional and other
selected providers to complete a Medicare, Part A paper claim for
submission to Medicare Fiscal Intermediaries. The paper UB-92 (Form
CMS-1450) is neither a government printed form nor distributed by
the CMS. National
Uniform Billing Committee (exit DHS) is responsible for the design of the
form. You may obtain copies of the paper UB-92 (Form CMS-1450) from
the Standard Register Company, Forms Division. Their phone number
may be found in your local yellow pages.I. To obtain an electronic copy of Form CMS-1450 (UB-92),
click here (exit DHS)
II. To obtain printing specifications for Form CMS-1450 (UB-92), click
here (exit DHS)
III. To obtain a copy of the most recent Form CMS-1450 (UB-92)
instructions, click
here (exit DHS)
Appendix 9 - Case Management
Appendix 10 - Screening Tools and Guidelines
Appendix 11 - Program Contacts
Appendix 12 - Resources
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Last revised: September 23, 2008
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