Forms and Resources

 

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An Important message to Providers: We are proud to announce our partnership with CAQH, the electronic solution and industry standard for credentialing and recredentialing.

General Info

Get Help Service Area Maps Provider Updates Provider Portal Access Authorization Network Application

Provider Manuals

Cooperative Commercial Manual Cooperative BadgerCare Plus and Medicaid SSI Manual

Network Maintenance

Facility Change Form Credentialing Guidelines

Claims Resources

QuickClaim User Manual Access QuickClaim


Claims Forms

ACH Credits Enrollment Available Electronic Data Partners Claims Status Inquiry 276-277
 
Electronic Claims Submission 837 Electronic Transfer Remittance 835 Eligibility Benefit Inquiry 270-271
Medical Claim Notes Provider Appeal
 

Prior Authorization Resources

Prior Authorization Guidelines


Prior Authorization Forms

Cardiac/Pulmonary Rehab DME PT/OT/ST Intensive Outpatient Treatment
Home Health   Inpatient Admission  Out of Network  Day Treatment/Partial Hospitalization
Service/Procedure Surgical Consult for Low Back Pain Behavioral Health Inpatient Admission Neuro/Psychological Testing