Authorizations

IMPORTANT INFORMATION on temporary prior authorization changes during the COVID-19 health emergency for My Choice Family Care-Care Wisconsin Health Plans including Medicaid SSI, Medicare Dual Advantage, and Partnership

To submit a request for prior authorization for Partnership, Medicare Dual Advantage, and Medicaid SSI members, use the Care Wisconsin form appropriate to the service and fax it to (608) 210-4050.
For Family Care members, contact the member’s Care Manager directly for authorization.

As of February 1, 2020, an authorization is required prior to rendering ALL services for Family Care program. Care teams will enter all authorizations and providers will be able to see and/or print the authorization from the MIDAS portal for these members. This excludes Partnership, Medicare Dual Advantage, and Medicaid SSI members. Please see the Prior Authorization Reference Document for authorization requirements for these programs.

Commonly referenced documents

  1. Prior Authorization Reference Document *see Temporary Prior Authorization Changes during COVID-19 Health Emergency notice
  2. Outpatient Procedure Prior Authorization Exception List
  3. DME/DMS Prior Authorization Request Form

For more Prior Authorization request forms, please see the below library. Other important information about programs, billing and reimbursements, and much more search our Provider Resource Library. Search the full library or use the “Document Types” filter to limit to category-specific documents.

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