MedicaidAdministrativeHigh impact
Preparing for ForwardHealth interChange Implementation
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
We identified it
Jun 20, 2026
Summary
Wisconsin's ForwardHealth is implementing a new interChange system that requires all healthcare providers to use National Provider Identifiers (NPIs) instead of Medicaid provider numbers for claims submission and prior authorizations. Providers must also set up new ForwardHealth Portal accounts and complete trading partner profiles to continue electronic transactions.
Action Required
Before implementation: 1) Billing team must obtain NPIs for all providers who don't have them and report to ForwardHealth, 2) Test small number of claims using only NPI and related data to verify system compatibility, 3) Set up ForwardHealth Portal provider accounts and request PINs, 4) Complete new Trading Partner Profiles and establish trading partner accounts, 5) Conduct authorization testing for all electronic transactions, 6) Designate trading partners to receive 835 transactions. Claims submitted with old Medicaid provider numbers will be denied or returned unprocessed.