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New Requirements for Certain Claims and Claim Adjustments with Other Commercial Health Insurance Indicated

Wisconsin Medicaid (ForwardHealth)·WI·Billing
Effective date
Jun 16, 2014
We identified it
Jun 20, 2026
Days to comply

Summary

Starting June 16, 2014, Wisconsin Medicaid and BadgerCare Plus require electronic claims with other commercial insurance to include detail-level other insurance information if the primary insurer processed it at the detail level. New Portal panels are being added to capture header, detail, and EOB information for other insurance carriers.

Action Required

Action needed
By June 16, 2014: Billing team must update electronic claim submission process for Wisconsin Medicaid/BadgerCare Plus to include detail-level other insurance information when primary insurance processed at detail level. Learn new Portal panels: Other Insurance Header Information, Other Insurance Detail Information, and Other Insurance EOB Information. Update PES dental claim submissions. Attend scheduled ForwardHealth training sessions. Download updated Portal user guides and PES manual when available.