Traditional MedicareAdministrativeHigh impact
Send provider-based billing claims to Medicare for Part B services, BadgerCare eligibility not affected by employment status, Commercial health insurance cost-sharing, and What's new on the Medicaid's Web site
Wisconsin Medicaid (ForwardHealth)·WI·Billing
Effective date
Jan 1, 2001
We identified it
Jun 20, 2026
Summary
Starting January 2001, Wisconsin Medicaid will extend provider-based billing to include Medicare Part B services, requiring providers to submit completed claim forms with documentation to Medicare for services already reimbursed by Medicaid. Providers must respond within 120 days with proof of billing and payment status, or face payment withholding.
Action Required
Within 120 days of receiving Provider-Based Billing Summary: Submit documentation to Wisconsin Medicaid proving accurate billing to responsible insurance companies and receipt/denial of reimbursement. Failure to respond within 120 days will result in Wisconsin Medicaid withholding future payments equal to original Medicaid payment amount. Billing team must establish tracking system for provider-based billing claims and ensure timely submission of required documentation.