Forms and Resources

 

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An Important message to Providers: We are proud to announce our partnership with Echo, the electronic payment and EOP solution.

General Info

Get Help Service Area Maps Provider Updates Network Application Ombudsmen Information Commercial Member Rights & Responsibilities Policy & Procedure
 BCP/SSI Member Rights & Responsibilities Policy & Procedure Cooperative Advantage Model of Care Training

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
ECHO Provider Enrollment Guide ECHO Provider FAQ
ECHO Provider Communication Letter ECHO Provider Communication Summary


Claims Forms

Available Electronic Data Partners Claims Status Inquiry 276-277 Waiver of Liability
Electronic Claims Submission 837 Eligibility Benefit Inquiry 270-271 
Provider Appeal Medical Claim Notes
 

Prior Authorization Resources

Prior Authorization Guidelines Pharmacy Prior Authorization


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 Behavioral Health Inpatient Admission Neuro/Psychological Testing