MedicaidAdministrativeMedium impact
Eligibility Information Immediately Available in interChange for Real-Time Eligibility Determinations
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Sep 24, 2016
We identified it
Jun 20, 2026
Summary
ForwardHealth implemented real-time eligibility verification for BadgerCare Plus and Family Planning Only Services, allowing immediate access to member eligibility information through interChange and EVS. Providers can now verify eligibility in real-time and must accept new temporary ID cards as valid coverage verification.
Action Required
By September 24, 2016: Front desk and billing staff must update procedures to accept new temporary ID cards for BadgerCare Plus and Family Planning Only Services as valid coverage. Train staff to verify eligibility through Wisconsin's EVS system before providing services. If EVS verification fails but patient has valid temporary ID card, photocopy the card and wait up to one week before submitting claims. Contact Provider Services at 800-947-9627 if claims are denied due to enrollment discrepancies.