Wisconsin Provider Enrollment - Frequently Asked Questions
Who needs to enroll in Wisconsin Medicaid?
Any provider who would like to receive Medicaid reimbursement for services rendered to Medicaid recipients. This includes rendering and billing providers, groups, and facilities.
How do I enroll?
Via the online Forward Health enrollment wizard: ENROLL NOW
What information do I need?
- Name, date of birth, Social Security Number, and home address of each person with ownership or control interest in the provider.
- Name, Federal Employer Identification Number, and applicable addresses for each entity with ownership or control interest in the provider
- Internal Revenue Service (IRS) document showing the provider's name and tax identification number
- Professional or facility license number, as appropriate.
- National Provider Identifier (NPI) from the National Plan and Provider Enumeration System (NPPES), as appropriate.
- Documentation of any adverse actions involving:
- Criminal History,
- Disciplinary action against any license,
- Denial, termination, exclusion, suspended payments, or unpaid fines from Medicare or Medicaid in this or any state.
- Required elements:
- Copy of Professional License
- Copy of NPI Registration Form
- Proof of TAX ID.
How long does it take to hear back from enrollment?
Up to 60 days. To track the status of your enrollment, you may go to Forward Health's Enrollment Tracking page and enter your Application Tracking Number (ATN).
Who should I contact with further questions?
You may call Wisconsin Medicaid Provider Enrollment Unit at 1-800-362-3002.
For questions concerning why Envolve requires providers to take this action, please contact Envolve Customer Service at 1-844-464-5635.