WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #1640
Availability of Records to Authorized Personnel
Wisconsin DHS (Department of Health Services) has the right to inspect, review, audit, and reproduce provider records pursuant
to Wis. Admin. Code § DHS 106.02(9)(e). DHS periodically requests provider records for compliance audits to match
information against ForwardHealth's information on paid claims, PA (prior authorization) requests, and enrollment. These records
include, but are not limited to, medical/clinical and financial documents. Providers are obligated to ensure that the records are
released to an authorized DHS staff member(s).
If Wisconsin Medicaid requires a provider to submit hard copies of records instead of scanning or accepting electronic records
during a compliance audit, DHS reimburses providers $0.06 per page. A letter of request for records from DHS will be sent to a
provider when records are required, with instructions on how to submit records electronically or if physical records are required.
Reimbursement is not made for other reproduction costs included in the provider agreement between DHS and a provider, such
as reproduction costs for submitting PA requests and claims.
Also, state-contracted MCOs (managed care organizations), including HMOs and SSI HMOs, are not reimbursed for the
reproduction costs covered in their contract with DHS.
The reproduction of records requested by the PRO (Peer Review Organization) under contract with DHS is reimbursed at a rate
established by the PRO.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
c612df68d89ee17ee5689872e0c6cbcb0f12bc879cee4d8a8764221441b555c5
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.