MedicaidAdministrativeHigh impact
HIPAA contingency plan: options for billing services and providers who will not be ready to submit HIPAA-compliant electronic claims
Wisconsin Medicaid (ForwardHealth)·WI·Billing
Effective date
Oct 13, 2003
We identified it
Jun 20, 2026
Summary
Wisconsin Medicaid is transitioning to HIPAA-compliant electronic claims submission starting October 13, 2003. Providers who aren't ready can use free Provider Electronic Solutions (PES) software or continue using pre-HIPAA electronic formats temporarily, but must use national medical codes for all claims dated October 1, 2003 and after.
Action Required
By October 13, 2003: Wisconsin Medicaid providers must either implement HIPAA-compliant electronic claims submission or use approved transition options. Billing team must: 1) Download free PES software from www.dhfs.state.wi.us/medicaid/ for permanent HIPAA compliance, OR 2) Continue using pre-HIPAA formats (HCFA 1500, UB-92) with modified billing instructions per attachments 1-3. 3) Switch to national medical codes for all claims with dates of service October 1, 2003 and after. 4) Note that retail pharmacy claims cannot use pre-HIPAA formats and free EZ-LINK/Pace software will stop working October 10, 2003.