Wis. ForwardHealth Online Handbook, Hospice, Topic #104

A provider may collect payment from a member for noncovered services if certain conditions are met.

Providers may not collect payment from a member (or authorized person acting on behalf of the member) for certain noncovered

services or activities provided in connection with covered services, including:

• Charges for missed appointments

• Charges for phone calls

• Charges for time involved in completing necessary forms, claims, or reports

• Translation services

Missed Appointments

Federal CMS (Centers for Medicare and Medicaid Services) does not allow state Medicaid programs to permit providers to

collect payment from a member, or authorized person acting on behalf of the member, for a missed appointment.

Avoiding Missed Appointments

ForwardHealth offers the following suggestions to help avoid missed appointments:

• Remind members of upcoming appointments (by phone or postcard) before scheduled appointments.

• If a member needs help getting transportation to a medical appointment, encourage the member to call the NEMT (non-emergency medical transportation) manager contracted with Wisconsin DHS (Department of Health Services). Most

Medicaid and BadgerCare Plus members can receive NEMT services through the NEMT manager if they have no other

way to receive a ride. Refer to the NEMT service area for more information.

• If the appointment is made through the HealthCheck screening or targeted case management programs, encourage the staff

from those programs to ensure that the scheduled appointments are kept.

Translation and Interpretive Services

Translation services, which refer to translation of the written word, are considered part of the provider's overhead cost and are

not separately reimbursable. Providers may not collect payment from a member (or authorized person acting on behalf of the

member) for translation services.

Interpretive services, which refer to interpretation of the spoken word or sign language, are a covered service. More information

on interpretive services can be found in the Interpretive Services topic.

Providers should call the Affirmative Action and Civil Rights Compliance Officer at 608-266-9372 for information about when

translation services are required by federal law. Providers may also write to the following address:

AA/CRC Office

201 E Washington Ave Room B300

PO Box 7850

Madison WI 53707-7850