WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #264
Enrollment Verification System
Member enrollment issues are the primary reason claims are denied. To reduce claim denials, providers should always verify a
member's enrollment before providing services, both to determine enrollment for the current date (since a member's enrollment
status may change) and to discover any limitations to the member's coverage. Providers may want to verify the member's
enrollment a second time before submitting a claim to find out whether the member's enrollment information has changed since the
appointment.
Providers can access Wisconsin's EVS (Enrollment Verification System) to receive the most current enrollment information
through the following methods:
• ForwardHealth Portal
• WiCall, Wisconsin's AVR (Automated Voice Response) system
• Commercial enrollment verification vendors
• 270/271 (270/271 Health Care Eligibility/Benefit Inquiry and Response) transactions
• Provider Services
Providers cannot charge a member, or authorized person acting on behalf of the member, for verifying their enrollment.
The EVS does not indicate other government programs that are secondary to Wisconsin Medicaid.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
c74edd20a3ddc384ebbf370fd43416005c5228591b98a6f8565e78a167d23287
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