WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #660
Purpose of Provider-Based Billing
The purpose of provider-based billing is to reduce costs by ensuring that providers receive maximum reimbursement from other
health insurance sources that are primary to BadgerCare Plus or Wisconsin Medicaid. For example, a provider-based billing claim
is created when BadgerCare Plus or Wisconsin Medicaid pays a claim and later discovers that other coverage exists or was made
retroactive. Since BadgerCare Plus and Wisconsin Medicaid benefits are secondary to those provided by most other health
insurance sources, providers are required to seek reimbursement from the primary payer, as stated in Wis. Admin. Code § DHS
106.03(7).
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
bb9e9f8415855ab3fcd62b7b18fa9d11f904737e5fe4d4d719171b276cbb6acb
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