MedicaidAdministrativeMedium impact
Clarification of the Timely Filing Claims Submission Process
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Sep 1, 2018
We identified it
Jun 20, 2026
Summary
Wisconsin Medicaid and BadgerCare Plus clarified the timely filing appeals process for claims submitted after the 365-day deadline. Providers must now use specific forms (F-13047, F-13046, F-01234) and meet strict deadlines ranging from 90-455 days depending on the exception type.
Action Required
Immediately: Billing team must download and use current versions of required forms - Timely Filing Appeals Request form F-13047 (08/15), Adjustment/Reconsideration Request form F-13046 (08/15), and Explanation of Medical Benefits form F-01234 (04/2018). Update timely filing procedures to include proper documentation for each of the eight exception categories and ensure submissions to ForwardHealth Timely Filing at 313 Blettner Blvd, Madison WI 53784 meet specific deadlines (90-455 days based on exception type). Train staff on exception-specific requirements to avoid claim denials.