Authorizations

Learn how authorizations are processed and find authorization forms and resources! You may access the Long Term Care Services Authorizations Portal from the box on the right.

IMPORTANT CHANGE EFFECTIVE FEBRUARY 1, 2020: For Care Wisconsin contracted providers, your authorization process will change for Family Care members. An authorization is required prior to rendering ALL services effective on or after February 1, 2020 for Family Care program members. 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. Training on this new process will be available by January 27, 2020. The Prior Authorization Reference Document linked here has been updated to reflect these changes and is effective February 1, 2020, while the version linked below is current until that date.
Please note: This excludes Partnership, Medicare Dual Advantage, and Medicaid SSI members. The authorization process for these programs will continue as usual until further notice.

Commonly referenced documents

  1. Prior Authorization Reference Document 
  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.

To submit a request for prior authorization, use the Care Wisconsin form appropriate to the service and fax it to (608) 210-4050.

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