For Providers

Select your county for more information:

Joining Care Wisconsin's Provider Network

If you are interested in becoming a Care Wisconsin network provider, please complete one of the application forms below.

PDF document General Provider Application: (368 KB) Complete this application if you provide long-term care services. (examples include: Residential Facilities, Adult Day Care Services, Lawn Care Services, Transportation, Supportive Home Care, Prevocational Services)

PDF document Healthcare Provider Application: (502 KB) Complete this application if you provide Medical or Health services. (examples include: Mental Health, Physician, Hospital, SNF, Home Health Care, DME, Physical/Occupational Therapy, ASC)

Please return your completed application to our Provider Services Department by email.  This email address is being protected from spambots. You need JavaScript enabled to view it. 

You may also fax to: 608-245-3844 – Attn: Contracting Specialists