Check Recipient Eligibility
Verify a recipient’s eligibility before providing services. Resources available
to providers by telephone to check eligibility:
Provider Services toll-free at 1-800-947-9627
Monday, Wednesday, Friday 8:30 a.m. to 4:30 p.m.
Tuesday 9:30 a.m. to 4:30 p.m.
Automated Voice Response System toll-free at 1-800-947-3544
Available 24 hours a day, 7 days a week
Filing Claims
Providers should file CMS 1500, UB92 and CMS 1450 medical and mental
health claim forms to the following address:
UCare
Attn: Health Tradition Claims
P.O. Box 70
Minneapolis, MN 55440-0070
Health Services Management (HSM) is Health Tradition’s chiropractic
benefit manager. Chiropractic providers should file CMS 1500 claim forms to the
following address:
Health Tradition BadgerCare Plus Claims
c/o Health Services Management
7805 Hudson Road, Suite 190
Woodbury, MN 55125
Customer Service Phone: 651-287-4701
Customer Service Fax: 651-501-9644
Coordination of Benefits
BadgerCare Plus is generally the payer of last resort. File CMS 1500 and CMS 1450
claim forms to the primary insurance first. After other insurance responds, file
claim along with other insurance Explanation of Benefits (EOB) form to Health Tradition.
Claims will be denied if the other insurance EOB is not attached.
Explanation of Payment
UCare Minnesota will mail providers a weekly Explanation of Payment (EOP) form along
with their payment on behalf of Health Tradition. Refer to the sample EOP
.
Claim Status
Providers can contact the Health Tradition BadgerCare Plus Provider Advocate to
check claim status, reason for claim denial or when filing an oral complaint.
Provider Advocate Phone: 608-783-9507
Provider Advocate Fax: 608-781-9653
Mailing Address: PO Box 188, La Crosse, WI 54602-0188
Wisconsin BadgerCare Plus Maximum Allowable Fee Schedule
To obtain current Wisconsin BadgerCare Plus fee schedule information refer to the
DHFS Web Site at https://www.forwardhealth.wi.gov/WIPortal/Max%20Fee%20Home/Max%20Fee%20Download/tabid/80/Default.aspx.
Wisconsin BadgerCare Plus Provider Updates
To obtain Wisconsin BadgerCare Plus provider updates refer to the DHFS Web Site
at https://www.forwardhealth.wi.gov/WIPortal/Tab/42/icscontent/provider/updates/year/publist2011.htm.spage.
Transportation for BadgerCare HMO Enrollees
Effective July 1, 2011, the Wisconsin Department of Health Services will implement a new transportation management system that will
coordinate non-emergency medical transportation (NEMT) services statewide.
In an effort to reduce costs for Wisconsin Medicaid, DHS has contracted with LogistiCare Solutions to provide NEMT for Medicaid and BadgerCare Plus Members.
Non-emergency medical transportation is defined as transportation provided by a specialized medical vehicle (SMV) or common carrier (private car) to a
Medicaid covered service.
Claim submission and reimbursement for emergency transportation by ambulance is not changing.
For additional information regarding this change and for the full ForwardHealth Provider update, please click on the link below.
New Transportation System for BadgerCare Plus Members