Policies & ProceduresThe following policies, procedures and guidelines may be relevant to providers. For more information, please call Provider Services at 1-800-963-0035, Monday-Friday, 8 a.m. to 4:30 p.m., CT.
Clinical Practice Guidelines
Care Wisconsin has adopted the use of published texts for its Clinical Practice Guidelines—standards for managing specific diseases or syndromes that are evidence-based. The strongest available information on the efficacy of treatment is used to develop standards of care that result in the highest quality of care.
These references are posted for your convenience: - Reuben D. B., Heer K. A., Pacala J. T., et al. (2006). 2007-2008 Geriatrics At Your Fingertips, 9th Edition. American Geriatrics Society, New York, New York. (Also available online at www.geriatricsatyourfingertips.org
- Beizer J. L., et al. (2005). Lexi-Comp's Geriatric Dosage Handbook, 11th Edition. Lexi-Comp, Hudson, Ohio.
- Guide to Clinical Preventive Services, 2007—Recommendations by the U.S. Preventive Services Task Force of the U.S. Department of Health and Human Services.
Partnership Model of Care
The primary care physician (PCP) provides overall coordination of care for Care Wisconsin members, and works collaboratively with Care Wisconsin care teams and other health care professionals to ensure quality of care and the appropriate utilization of services. The PCP provides care within his or her area of expertise and refers to specialist providers for other services as necessary. Nondiscrimination Statement
Care Wisconsin Health Plan will not discriminate in selection of providers in terms of participation, reimbursement, or indemnification, against any health care professional acting within the scope of his or her certification or license under state law, solely on the basis of the license or certification. Care Wisconsin Health Plan will not discriminate against particular providers who serve high-risk populations or specialize in conditions that require costly treatment. Recipient of Federal Funds Policy
Network provider acknowledges that payments received under Care Wisconsin Health Plan to members are, in whole or part, from federal funds. Therefore, network providers and their subcontractors are subject to certain laws that are applicable to individuals and entities receiving federal funds. These laws include but are not limited to Title VI of the Civil Rights Act of 1964, the Age Discrimination Act of 1975, the Rehabilitation Act of 1973, and the Americans With Disabilities Act. Make a Referral | Request Information
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