WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #512
Electronic
837 Transaction
Even if the original claim was submitted on paper, providers may submit electronic adjustment requests using an 837 (837 Health
Care Claim) transaction.
Provider Electronic Solutions Software
The Wisconsin DHS (Department of Health Services) offers electronic billing software at no cost to providers. The PES (Provider
Electronic Solutions) software allows providers to submit electronic adjustment requests using an 837 transaction. To obtain PES
software, providers may download it from the ForwardHealth Portal. For assistance installing and using PES software, providers
may call the EDI (Electronic Data Interchange) Helpdesk.
Portal Claim Adjustments
Providers can submit claim adjustments via the Portal. Providers may use the search function to find the specific claim to adjust.
Once the claim is found, the provider can alter it to reflect the desired change and resubmit it to ForwardHealth. Any claim
ForwardHealth has paid within 365 days of the DOS (date of service) can be adjusted and resubmitted on the Portal, regardless
of how the claim was originally submitted.
Claim adjustments with DOS beyond the 365-day submission deadline should not be submitted electronically. Providers who
attempt to submit a claim adjustment electronically for DOS beyond 365 days will have the entire amount of the claim recouped.
Requests for adjustments to claims with DOS beyond the 365-day submission deadline may be submitted using the timely filing
process (a paper process) if the claim adjustment meets one of the exceptions to the claim submission deadline.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
2caedf4f75796bd8041db2bf60af21e2940de09f5c48a9b1779fc4f9bcec42ee
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