MedicaidAdministrativeHigh impact
Changes in UnitedHealthcare Enrollment for Members Enrolled in the BadgerCare Plus Standard Plan and the BadgerCare Plus Benchmark Plan
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Nov 1, 2012
We identified it
Jun 20, 2026
Summary
UnitedHealthcare will stop serving BadgerCare Plus Standard Plan and Benchmark Plan members in Southeast Wisconsin (6 counties) effective November 1, 2012. Affected members will transition to fee-for-service billing, and providers must verify enrollment status on each date of service and follow new prior authorization rules.
Action Required
By November 1, 2012: Billing team must verify member enrollment status on each date of service using Wisconsin's Enrollment Verification System before providing services. Update billing procedures to submit claims to BadgerCare Plus fee-for-service instead of UnitedHealthcare for affected members. Honor UHC prior authorizations through January 31, 2013, then submit new PA requests to fee-for-service. For advanced imaging services, obtain PA through MedSolutions for dates of service after December 1, 2012. Contact Provider Services at (800) 947-9627 for claims submission issues.