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DEPARTMENT OF HEALTH SERVICES
Division of Medicaid Services
F12022A (02/2020)STATE OF WISCONSIN
Wis. Stat. 49.45WISCONSIN MEDICAID AND BADGER CARE MISMANAGED CARE PROGRAM PROVIDER APPEAL INSTRUCTIONS
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What is clarifications to managed care?
Clarifications to managed care are additional information or explanations provided to managed care organizations to address any discrepancies or provide further details.
Who is required to file clarifications to managed care?
Healthcare providers, facilities, or organizations that have submitted claims to managed care organizations may be required to file clarifications.
How to fill out clarifications to managed care?
Clarifications can be filled out using the required forms provided by the managed care organization, and should include detailed explanations or supporting documentation.
What is the purpose of clarifications to managed care?
The purpose of clarifications to managed care is to ensure accurate and complete information is provided to managed care organizations, which can help prevent claim denials or delays in payment.
What information must be reported on clarifications to managed care?
Clarifications may include information such as additional diagnosis codes, treatment details, or any other relevant information that can help clarify the original claim.
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