Wis. ForwardHealth Online Handbook, Hospice, Topic #217

Changes That Require ForwardHealth Notification

Providers are required to notify ForwardHealth of any changes to their demographic information, including the following, as they

occur:

• Address(es) — practice location and related information, mailing, PA (prior authorization), and/or financial

Note: Health care providers who are federally required to have an NPI (National Provider Identifier) are cautioned that

changes to their practice location address on file with ForwardHealth may alter their ZIP+4 code information that is

required on transactions.

• Business name

• Contact name

• Federal Tax ID number (IRS (Internal Revenue Service) number)

• Group affiliation

• Licensure

• NPI

• Ownership

• Professional certification

• Provider specialty

• Supervisor of nonbilling providers

• Taxonomy code

• Telephone number, including area code

Failure to notify ForwardHealth of changes may result in the following:

• Incorrect reimbursement

• Misdirected payment

• Claim denial

• Suspension of payments or cancellation of provider file if provider mail is returned to ForwardHealth for lack of a current

address

Entering new information on a claim form or PA request is not adequate notification of change.

Notifying ForwardHealth of Changes

Providers can notify ForwardHealth of changes using the demographic maintenance tool.

Providers Enrolled in Multiple Programs

If demographic information changes, providers enrolled in multiple programs (for example, Wisconsin Medicaid and WCDP

(Wisconsin Chronic Disease Program)) will need to change the demographic information for each program. By toggling between

accounts using the Switch Organization function of the Portal, providers who have a Portal account for each program can change

their information for each program using the demographic maintenance tool. The Account User Guide provides specific

information about switching organizations.

Providers Licensed or Certified by the Division of Quality Assurance

Providers licensed or certified by the DQA (Division of Quality Assurance) are required to notify the DQA of changes to physical

address, changes of ownership, and facility closures by emailing Lisa.Imhof@dhs.wisconsin.gov.