Wis. ForwardHealth Online Handbook, Hospice, Topic #459

Companion guides and the NCPDP (National Council for Prescription Drug Programs) version D.0 payer sheet are available for

download on the ForwardHealth Portal.

Purpose of Companion Guides

ForwardHealth companion guides and payer sheet provide trading partners with useful technical information on ForwardHealth's

standards for nationally recognized electronic transactions.

The information in companion guides and payer sheet applies to BadgerCare Plus, Medicaid, SeniorCare, HDAP (Wisconsin

HIV Drug Assistance Program), WCDP (Wisconsin Chronic Disease Program), and WWWP (Wisconsin Well Woman

Program). Companion guides and payer sheet are intended for information technology and systems staff who code billing systems

or software.

The companion guides and payer sheet complement the federal HIPAA (Health Insurance Portability and Accountability Act of

1996) implementation guides and highlight information that trading partners need to successfully exchange electronic transactions

with ForwardHealth, including general topics such as the following:

• Methods of exchanging electronic information (for example, exchange interfaces, transaction administration, and data

preparation)

• Instructions for constructing the technical component of submitting or receiving electronic transactions (for example, claims,

RA (Remittance Advice), and enrollment inquiries)

Companion guides and payer sheet do not include program requirements, but help those who create the electronic formats for

electronic data exchange.

Companion guides and payer sheet cover the following specific subjects:

• Getting started (for example, identification information, testing, and exchange preparation)

• Transaction administration (for example, tracking claims submissions, contacting the EDI (Electronic Data Interchange)

Helpdesk)

• Transaction formats

Revisions to Companion Guides and Payer Sheet

Companion guides and payer sheet may be updated as a result of changes to federal requirements. When this occurs,

ForwardHealth will do the following:

• Post the revised companion guides and payer sheet on the ForwardHealth Portal.

• Post a message on the banner page of the RA.

• Send an email to trading partners.

Trading partners are encouraged to periodically check for revised companion guides and payer sheet on the Portal. If trading

partners do not follow the revisions identified in the companion guides or payer sheet, transactions may not process successfully

(for example, claims may deny or process incorrectly).

A change summary located at the end of the revised companion guide lists the changes that have been made. The date on the

companion guide reflects the date the revised companion guide was posted to the Portal. In addition, the version number located

in the footer of the first page is changed with each revision.

Revisions to the payer sheet are listed in Appendix A. The date on the payer sheet reflects the date the revised payer sheet was

posted to the Portal.