Wis. ForwardHealth Online Handbook, Hospice, Topic #17097

Licensed providers are required to keep all licensure information, including license number, grant and expiration dates, and

physical location as applicable (for example, hospital providers), current with ForwardHealth.

If providers do not keep their licensure information, including their license number, current with ForwardHealth, any of the

following may occur:

• Providers' enrollment may be deactivated. As a result, providers would not be able to submit claims or PA (prior

authorization) requests or be able to function as prescribing/referring/ordering providers, if applicable, until they update their

licensure information.

• Providers may experience a lapse in enrollment. If a lapse occurs, providers may need to re-enroll, which may result in

another application fee being assessed.

Providers may change the grant and expiration dates for their current license(s) and enter information for a new license(s), such as

the license number, licensing state, and grant and expiration dates, using the demographic maintenance tool. After entering

information for their new license(s), some providers (for example, out-of-state providers) will also be required to upload a copy of

their license using the demographic maintenance tool. Provided licensure information must correspond with the information on file

with the applicable licensing authority.

In some cases, ForwardHealth will need to verify licensure information with the applicable licensing authority, which may take up

to 10 business days after submission. Providers updating their license information should plan accordingly so that they do not

experience any of the indicated interruptions in enrollment. If provided licensure information (for example, grant and expiration

dates) does not correspond with the licensing authority's information, the licensing authority's information will be retained and will

display in the demographic maintenance tool once verified by ForwardHealth.