Medical billing services in Wisconsin
Billing, coding, credentialing and A/R follow-up for providers in Wisconsin.
Billing in Wisconsin: what is different
BadgerCare Plus HMOs serve most Medicaid members.
Key payers and contractors in Wisconsin
- Medicare Part A/B
- National Government Services, Jurisdiction J6Portal: NGSConnex
- Medicare DME
- CGS, DME MAC Jurisdiction BDME supplier claims only · Portal: myCGS
- Medicaid
- Wisconsin Medicaid (BadgerCare Plus)Portal: ForwardHealth Portal
- Blue Cross Blue Shield
- Anthem Blue Cross and Blue Shield
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with Wisconsin providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with National Government Services through NGSConnex
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in Wisconsin: common questions
Do you bill Wisconsin Medicaid and its managed care plans?
Yes. We bill Wisconsin Medicaid fee-for-service claims and each Medicaid managed care plan, after confirming the patient’s assigned plan for the date of service.
Who processes Medicare claims in Wisconsin?
Medicare Part A and B claims in Wisconsin are processed by National Government Services (Jurisdiction J6), and we submit and track them through NGSConnex. DME supplier claims go to a different contractor, CGS (DME MAC Jurisdiction B), through myCGS.
Can you credential new providers in Wisconsin?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Wisconsin.
Get a free billing audit for your Wisconsin practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.