Wis. ForwardHealth Online Handbook, Hospice, Topic #466

WiCall, ForwardHealth's AVR (Automated Voice Response) system, gathers inquiry information from callers through voice

prompts and accesses ForwardHealth interChange to retrieve and "speak" back the following ForwardHealth information:

• Claim status

• Enrollment verification

• PA (prior authorization) status

• Provider CheckWrite information

Note: ForwardHealth releases CheckWrite information to WiCall no sooner than on the first state business day following the

financial cycle.

Providers are prompted to enter NPI (National Provider Identifier) or provider ID and in some cases, NPI-related data, to

retrieve query information.

In all inquiry scenarios, WiCall offers the following options after information is retrieved and reported back to the caller:

Letter Key

Combination Letter Key

Combination

A *21 N *62

B *22 O *63

C *23 P *71

D *31 Q *11

E *32 R *72

F *33 S *73

G *41 T *81

H *42 U *82

I *43 V *83

J *51 W *91

K *52 X *92

L *53 Y *93

M *61 Z *12

• Repeat the information.

• Make another inquiry of the same type.

• Return to the main menu.

• Repeat the options.

Claim Status

Providers may check the status of a specific claim by selecting the applicable financial payer program, (for example, Wisconsin

Medicaid, WCDP (Wisconsin Chronic Disease Program), or WWWP (Wisconsin Well Woman Program)) and entering their

provider ID, member identification number, DOS (date of service), and the amount billed.

Note: Claim information for BadgerCare Plus and SeniorCare is available by selecting the Medicaid option.

Enrollment Verification

Providers may request enrollment status for any date of eligibility the member has on file by entering their provider ID and the

member ID. If the member ID is unknown, providers may enter the member's date of birth and SSN (Social Security number).

Additionally, the provider is prompted to enter the From DOS and the To DOS for the inquiry. The From DOS is the earliest

date the provider requires enrollment information and the To DOS must be within 365 days of the "From" DOS.

Each time a provider verifies member enrollment, the enrollment verification is saved and assigned a transaction number as

transaction confirmation. Providers should note the transaction number for their records.

PA Status

Except in certain instances, providers may obtain the status of PA requests for Medicaid and WCDP via WiCall by entering their

provider ID and the applicable PA number. If the provider does not know the PA number, there is an option to bypass entering

the PA number and the caller will be prompted to enter other PA information such as member ID and type of service (for

example, NDC (National Drug Code), procedure code, revenue code, or ICD (International Classification of Diseases)

procedure code). When a match is found, WiCall reports back the PA status information, including the PA number for future

reference, and the applicable program.

Information on past PAs is retained indefinitely. Paper PAs require a maximum of 20 working days from receipt to be processed

and incorporated into WiCall's PA status information.

Note: PA information for BadgerCare Plus and SeniorCare is available by selecting the Medicaid option.