Forms and Resources

 

...
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

Provider Manuals

Cooperative Commercial Manual Cooperative BadgerCare Plus and Medicaid SSI Manual

Network Maintenance

Facility Change Form Credentialing Guidelines

Behavioral Health Forms

Behavioral Health Inpatient Admission Intensive Outpatient Treatment
Day Treatment/Partial Hospitalization Neuro/Psychological Testing

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

High End Imaging CPT Codes
High End Imaging FAQs
Prior Authorization Guidelines

Prior Authorization Forms

Cardiac Pulmonary Rehab DME Request PT/OT Rehab
Home Health Request  Admission Authorization Request Out of Network Referral Event
Service Event Request Speech Therapy Request Surgical Consult for Low Back Pain