About Wisconsin Physicians Service (WPS) Medicare
Understanding the complexities of the new Medicare Administrative Contractor (MAC) environment can be challenging. WPS Medicare created this resource to help you better understand who we are, the MAC implementation, and how to find the information you need more quickly.
Who We Are
Wisconsin Physicians Service (WPS) began processing claims for Medicare Part B Fee-For-Service (FFS) customers when the Medicare program began in 1966. Over the years, we became the Part B carrier for Wisconsin, Illinois, Michigan, and Minnesota.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) announced that Medicare contractors would begin to process claims for both Part A and Part B services. To ensure WPS would continue to provide you with high quality service, we acquired Mutual of Omaha's Medicare Division in November 2007. This partnership resulted in a combined 80 years of experience with processing Medicare Part A and Part B claims. WPS was awarded its first MAC (Jurisdiction 5) by the Centers for Medicare & Medicaid Services (CMS) in September 2007.
Since the transition to the MAC environment is not anticipated to be completed until 2009, today WPS Medicare serves a variety of Medicare customers, including:
- MAC Part A Providers in Jurisdiction 5 (Iowa, Kansas, Missouri, and Nebraska)
- MAC Part B Providers in Jurisdiction 5 (Iowa, Kansas, Missouri, and Nebraska)
- Legacy Part A Providers (Providers formerly served by Mutual of Omaha Medicare)
- Legacy Part B Providers (Wisconsin, Illinois, Michigan, and Minnesota)
Medicare Administrative Contracts (MAC)
To ensure the security of health care for beneficiaries, congress passed MMA in 2003. MMA mandated the implementation of MACs, to replace FFS Medicare (also known as "Original Medicare" or "Traditional Medicare").
Under MMA, CMS is replacing its current FFS claims payment contractors – Part A Fiscal Intermediaries and Part B Carriers - with new contract entities called MACs. CMS plans to award 15 A/B MAC contracts through three procurement cycles. The anticipated completion date for the transition to the MAC environment is September 2009.
For more information about CMS, MMA, and MACs, go to:
http://www.cms.hhs.gov/MedicareContractingReform/
Where Do I Go?
WPS understands it may be difficult during this time of transition to determine where you should go to find information, so we created this page to help you find what you are looking for more easily. Since WPS Medicare has multiple Medicare customers and contracts, information provided for each customer may differ, so it is important that you select the appropriate choice listed below.
Providers, Suppliers, and Billers
Are you a Medicare Part A or Medicare Part B provider, supplier, or biller? If so, please select one of the following options.
Part A
You provide inpatient care in hospitals, including critical access hospitals and skilled nursing facilities (not custodial or long-term care), hospice care, and some home health care.
- Part A MAC Providers Serving Iowa, Kansas, Missouri, and Nebraska
- BCBS of Kansas
- BCBS of Nebraska
- BCBS of Mississippi
- Cahaba
This Website is for Part A providers serving beneficiaries in Iowa, Kansas, Missouri, and Nebraska whose claims and other related work have transitioned to WPS Medicare as the result of the MAC change. WPS Medicare is providing your claims processing and other Medicare Part A services under a MAC. Your former Medicare FFS provider was one of the following:
You are now a provider located in Jurisdiction 5. Click here for information on when WPS Medicare became/will become your MAC. Click here to go to the WPS Medicare Part A MAC Website.
- Part A Legacy Providers, Formerly with Mutual of Omaha Medicare
This Website is for Part A providers located throughout the United States and the Virgin Islands formerly served by Mutual of Omaha Medicare whose claims and other related work have not yet transitioned to the new MAC environment. All providers formerly served by Mutual of Omaha Medicare have not yet transitioned to the new MAC environment, and as "legacy" providers, your claims and other Medicare Part A services are being provided by WPS Medicare under a Medicare FFS contract, not a MAC contract. We anticipate your transition to the MAC environment in late 2009. Please note, Mutual of Omaha Medicare processed your claims, cost reports, and inquiries until November 2007, when WPS Medicare assumed responsibility for administering this Medicare FFS Contract. Click here to go to the WPS Medicare Part A Legacy Website.
Part B
You provide doctors' services and outpatient care, as well as some other medical services that Part A does not cover, such as some of the services of physical and occupational therapists, and some home health care.
- Part B MAC Providers Serving Iowa, Kansas, Missouri, and Nebraska
- BCBS of Kansas
- Noridian Mutual Insurance Company
- Pinnacle
This Website is for Part B providers serving beneficiaries in Iowa, Kansas, Missouri, and Nebraska whose claims and other related work have transitioned to WPS Medicare as the result of the MAC change. WPS Medicare is providing your claims processing and other Medicare Part B services under a MAC. Your former Medicare FFS provider was one of the following:
You are now a provider located in Jurisdiction 5. Click here for information on when WPS Medicare became/will become your MAC. Click here to go to the WPS Medicare Part B MAC Website.
- Part B Legacy Providers Serving Illinois, Michigan, Minnesota and Wisconsin
This Website is for Part B providers located in Wisconsin, Illinois, Michigan, and Minnesota whose claims and other related work have not yet transitioned to the new MAC environment. As "legacy" providers, WPS Medicare is providing your claims processing and other Medicare Part B services under a Medicare FFS contract, not a MAC contract. We anticipate your transition to the MAC environment in September 2008. Click here to go to the WPS Medicare Part B Legacy Website.
