NEW FOR PROVIDERS:  “Fillable” invoice templates that you can now complete by typing your information right on the form. 

•  Residential Invoice Template - Effective August 1, 2010 and  Instructions 
  
  Please use this Residential Invoice Template for July 2010 dates of service and after.
           
•  Residential Invoice Template - Discontinue July 31, 2010 and  Instructions   
  
  Please stop use of this Residential Invoice Template after the June 2010 dates of service.

•  Non-Residential Invoice Template

After filling out the invoice, please print copies and then mail the completed invoice to our third party administrator: 

    
TriZetto - Care Wisconsin
P.O. Box 853924
Richardson, TX  75085-3924

You will need Adobe Acrobat Reader to view and use the template invoice forms.  To download a free copy of Adobe Acrobat Reader, click here. 

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