Wis. ForwardHealth Online Handbook, Hospice, Topic #11677

Providers are able to upload attachments for most claims via the secure Provider area of the ForwardHealth Portal. This allows

providers to submit all components for claims electronically.

Providers are able to upload attachments via the Portal when a claim is suspended and an attachment was indicated but not yet

received. Providers are able to upload attachments for any suspended claim that was submitted electronically. Providers should

note that all attachments for a suspended claim must be submitted within the same business day.

Claim Types

Providers will be able to upload attachments to claims via the Portal for the following claim types:

• Professional

• Institutional

• Dental

The submission policy for compound and noncompound drug claims does not allow attachments.

Document Formats

Providers are able to upload documents in the following formats:

• JPEG (.jpg or .jpeg)

• PDF (.pdf)

• Rich Text Format (.rtf)

• Text File (.txt)

• OrthoCAD (.3dm) and 3Shape Ortho System (.dcm, .stl, and .ply) (for dental providers)

Make sure files are stored with the correct extension:

• JPEG files are stored with a ".jpg" or ".jpeg" extension.

• PDF files are stored with a ".pdf" extension.

• Rich text format files are stored with an ".rtf" extension.

• Text files are stored with a ".txt" extension.

• Dental OrthoCAD files are stored with a ".3dm" extension.

• Dental 3Shape Ortho System files are stored with ".dcm", ".stl", or ".ply" extensions.

Microsoft Word files (.doc) cannot be uploaded but can be saved and uploaded in Rich Text Format or Text File formats.

Uploading Claim Attachments

Claims Submitted by Direct Data Entry

When a provider submits a DDE (Direct Data Entry) claim and indicates an attachment will also be included, a feature button will

appear and link to the DDE claim screen where attachments can be uploaded.

Providers are still required to indicate on the DDE claim that the claim will include an attachment via the Attachments panel.

Claims will suspend for seven days before denying for not receiving the attachment.

Claims Submitted by Provider Electronic Software and 837 Health Care Claim Transactions

Providers submitting claims via 837 (837 Health Care Claim) transactions are required to indicate attachments via the PWK

segment. Providers submitting claims via PES (Provider Electronic Solutions) software will be required to indicate attachments via

the attachment control field. Once the claim has been submitted, providers will be able to search for the claim on the Portal and

upload the attachment via the Portal. Refer to the Implementation Guides for how to use the PWK segment in 837 transactions

and the PES Manual for how to use the attachment control field.

Claims will suspend for seven days before denying for not receiving the attachment.