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New Minimum Fee Schedule for Home and Community-Based Services


The Wisconsin Department of Health Services (DHS) has created a minimum fee schedule (MFS) for home and community-based services (HCBS) in Wisconsin. The minimum fee schedule is a list of the minimum rates managed care organizations (MCO) can pay providers of certain adult long-term care services.

View Minimum Fee Schedule

Reducing the Number of Missed Appointments-Medicaid SSI and BC+

 

The following suggestions will reduce missed appointments for all patients, including BadgerCare Plus members. When scheduling appointments, providers should explain to members the importance of keeping appointments and the office rules regarding missed appointments.

  • Contact the member by telephone or postcard prior to the appointment and remind the member of the time and place of the appointment and the importance of canceling scheduled appointments in advance.
  • Require members to verify their appointment by calling the dental office, using the following procedures:
    • Explain the policy carefully to members when they make appointments.
    • Send postcards to remind members of their appointments, of the office policy regarding confirming their appointments, and of the need to call immediately to confirm the upcoming appointment.
    • If members do not call by a given day before their appointment, give the appointment to another patient.
  • If the appointment is made through the HealthCheck screen or targeted case management programs, encourage staff from those programs to ensure that scheduled appointments are kept.
    • Call the local city/county health department for information about HealthCheck services in the area. Individual dentists may agree only to accept referrals from HealthCheck providers such as the local public health agencies and physicians. Some health departments have outreach staff who may be able to assist members in getting to their dental appointments
    • Contact programs and agencies, such as Head Start, sheltered workshops, or human service departments, to develop a referral system. Some of these agencies may assist members in finding transportation and keeping dental appointments.
    • Non-emergency medical transportation (NEMT) is available through the DHS NEMT manager. The NEMT manager arranges and pays for rides to covered services for members who have no other way to receive a ride. Non-emergency medical transportation can include rides using:
      • Public transportation, such as a city bus
      • Non-emergency ambulances
      • Specialized medical vehicles
      • Other types of vehicles, depending on a member’s medical and ride needs
      • Also, if a member uses their own vehicle for rides to and from your covered health care visits, they may be paid back for miles.
    • Schedule rides at least two business days before your visit. You can schedule a routine ride by calling the NEMT manager at 1-866-907-1493 (or TTY 1-800-855-2880), Monday through Friday, from 7:00 a.m. until 6:00 p.m. You may also schedule rides for urgent visits. A ride to an urgent visit will be provided in three hours or less.

Easy Options for Checking Claim Status or Member Eligibility Status:

Self Service Option

Register in our Provider Portal to obtain live Eligibility Status, ID Cards and Authorization information.  In addition, all claim processing information is available including the Explanation of Payment.  Please send your TIN and NPI to ProviderRelationsSpecialist@icarehealthplan.org so we can generate a PIN to assist with registration.

Electronic Option

270/271 Eligibility Status Check

Use the Eligibility and Benefit Inquiry (270) transaction to inquire about the health care eligibility and benefits associated with a subscriber or dependent. The Eligibility and Benefit Response (271) transaction is used to respond to a request inquiry about the health care eligibility and benefits associated with a subscriber or dependent.  You can obtain detailed benefit information including member ID number, date of coverage, copayment, year-to-date deductible amount, and commercial coordination of benefit (COB) information when applicable. Physicians and other health care professionals can perform eligibility (270/271) transactions in batch or real-time mode, based on your connectivity method.

276/277 Claim Status Check

Use the Claim Status Inquiry (276) transaction to inquire about the status of a claim after it has been sent to a payer, whether submitted on paper or electronically. The Claim Status Response (277) transaction is used to respond to a request inquiry about the status of a claim after it has been sent to a payer, whether submitted on paper or electronically. Once we return an acknowledgment that a claim has been accepted, it should be available for query as a claim status search. Physicians and other health care professionals can perform claim status (276/277) transactions in batch or real-time mode, based on your connectivity method.

How to Join the iCare network of contracted providers? Start here!

Join Our Network

iCare welcomes a variety of providers to join our Provider Network to assure the broadest choice of quality providers for iCare Members. As iCare continues to grow, so does our network of providers.

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iCare Quality Programs measure quality of care for continual improvement.

Quality Programs at iCare

iCare strives to improve health outcomes for our members. That’s why we work in conjunction with numerous industry, state and federal programs to measure our results.

Quality Programs

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Provider Reference Manuals

These manuals are a provider’s primary resources to efficiently conduct transactions related to iCare members.

Medicare & Medicaid Manual

FCP Manual 

Contacting iCare

Whether you are already an iCare provider or looking to become one, we make it easy for you to communicate with the people you need to connect with.

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Find a Provider

Quickly review your listing – or the listings of other physicians, facilities, pharmacies or other contracted providers – using iCare’s Find A Provider tool.

Find a Provider

Demographics/Affiliation

If you need to update demographics or add/remove providers,  please use the applicable form:

Name, Tax ID, Physical or Billing Address Changes:


Demographic Change -  Fillable PDF Form

Demographic Change  - Web Form

Adding or removing providers associated with a contracted provider group:

Affiliation Change - Fillable PDF Form 

Affiliation Change  - Web Form

 

Provider Documents

All documentation that providers need to do business with iCare is in one convenient location. Handy filters help you locate forms, applications, policies or whatever you need.

View Provider Documents

Recent News & Documents

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Recent News

Provider Bulletin Issue 01 2024

Website, Claim and Enrollment Status Check, annual MOC Review

Leaving iCareHealthPlan.org

By clicking this link, you may be leaving the iCareHealthPlan.org website. Independent Care Health Plan (iCare) only provides these links and pointers for your information and convenience. When you select a link to an outside website, you are leaving the www.iCareHealthPlan.org website.

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