MedicaidAdministrativeMedium impact
Enrollment Verification System Enhancement
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Sep 1, 2009
We identified it
Jun 20, 2026
Summary
Wisconsin's Enrollment Verification System now allows providers to verify member enrollment for dates more than 365 days in the past, removing the previous one-year limitation. This enhancement helps with retroactive enrollment inquiries but does not change the 365-day timely filing requirements for claims.
Action Required
Immediately: Billing team should update procedures to utilize the enhanced enrollment verification system for historical enrollment checks beyond 365 days when processing retroactive claims or enrollment inquiries. Remember that claims over 365 days still require Timely Filing Appeals Request form F-13047. Train staff on the one-year maximum span limit per verification request.