WPS Health Insurance

Welcome Providers!

Wisconsin providers overlooking a daughter with her expectant mother

Provider Registration Update

Beginning Thursday, April 10, when you log into your online provider account, you’ll be able to see ALL claims status for any of the claims billed with your tax ID. You will NOT need multiple logins for specific locations to access this information anymore.

However, you will still need separate logins for different tax IDs.

What you need to do: Pick and use one of your current logins for your tax ID. Discontinue use of all other logins. It’s that easy! Any unused provider account logins will expire after 180 days.

News

New - HCFA 1500 Claim Form Update

Check out your Provider Remittance Advices (PRAs) online!

Now you can view your Provider Remittance Advices (PRAs) online using Emdeon Payment Manager or Emdeon Vision for Claim Management. Simply select WPS Health Insurance (ID SX022) from the Payer list and access the exact PRA images you receive in the mail – now all in one place and available 24 hours a day!

Need to register? Simply visit: http://www.emdeon.com/emdeonvisioneducationcenter/contact.php to register for Emdeon Vision - it’s FREE! Or call 877.EMDEON.6 (877-363-3666) to get set up!

Already registered to view Provider Remittance Advices online? Login here.

Provider Registration and Log In News

We recently enhanced our provider portal.  To take advantage of the improved features, you will need to re-register.  If you have already received an email from Register@wpsic.com please have your site administrator reply to that email with their first and last name, email address, the tax id number and corresponding name of the practice you represent, and the physical addresses of all of your locations.  If you have not received a request from us, please email us at Register@wpsic.com and provide the same information.

Our goal is to respond to your inquiry in 2 business days. In the interim, please use our Interactive Voice Recognition system at (800) 765-4977 to answer inquiries related to benefits, eligibility and claim status.

If you have already received an invitation from us to complete your registration and have questions, please contact WPS EDI at (800) 782-2680.  We appreciate your patience.

Please note HIRSP and Family Care member information is not currently available on the portal.

HSM reminder for chiropractic and rehabilitative therapy providers

WPS recently announced that we have teamed up with HSM, Inc. to manage and streamline utilization management (UM) reviews effective April 1, 2014. With this relationship, some chiropractic and all rehabilitative therapy (PT/OT/ST) services will be subject to HSM oversight, which will help ensure that services are delivered at the appropriate time and level of care.

The WPS iExchange login page provides a convenient link to the HSM portal to submit requests for rehabilitative therapy services. If you already have an account with HSM, you can use the same account to request services for WPS members. If you do not have an existing account, please contact HSM Provider Services at 1-800-432-3640, option 3, for assistance.

Effective July 1, 2014, all chiropractic services will be managed by HSM. This will include credentialing, UM, provider contracting, and network management.

If you have questions concerning the transition, please contact:

  • ChiroCare:  Hans Hildebrand, 414-476-4733, extension 404
  • HSM:          Traci Wills, 651-287-4722
  • WPS:          See the WPS Provider Manual for your provider relations contact

Thank you for serving as a WPS preferred provider. We value your participation and look forward to working with HSM and you in the future.

Get Answers Faster! Check out the Enhanced Voice Recognition (IVR) Service!

Did you know you have access to our newly enhanced Interactive Voice Recognition (IVR) system? Our automated call service quickly and efficiently delivers answers for most types of information requests, including benefit, eligibility, and claim status inquiries. If you require further assistance during standard business hours, a member services representative is standing by to provide additional support. We hope you’ll enjoy the convenience of this service and try it out today!
Call (800) 765-4977

Demonstration of new features for Providers


Our paper claims submission address has changed.

If you previously submitted claims to PO Box 8190, please use the address below (effective August 5, 2013):
Wisconsin Physicians Service
PO Box 981641
El Paso, TX 79998-1641

All correspondence should continue to be sent to:
Wisconsin Physicians Service
PO Box 8190
Madison, WI 53708-8190

Please refer to the member’s ID card for other appropriate addresses.

CPT Behavioral Health Code Changes

Effective January 1, 2013, the Psychiatry section of the CPT manual published by the American Medical Association (AMA) was revised. A number of frequently used behavioral health codes were deleted. New codes were added and must be used for billing and documentation for all carriers.
Find out more!

Online Code Combination Simulation Tool

We now provide an on-line tool for you to simulate code combinations with the ability to view and edit results and rationales. You will be able to enter procedure codes, modifiers, diagnosis codes, date of service, patient gender, date of birth and place of service parameters, in order to review results specific to the procedure codes being queried.
Find out more!

FAQ for WI Autism Spectrum Disorder Mandate:

Hot Topics

Do You Have Your National Provider Identifier (NPI)?

  • If you have not shared your NPI with WPS email the following information:
    Name, NPI Number, Tax ID, License Number, and Contact Information to
    edinpi@wpsic.com
  • If you have questions, please contact EDI toll-free at 1-800-782-2680 (option 2), or visit the EDI portion of the WPS website.

How to Become a WPS Preferred Provider

How to Register