New for 2010

When using your username and password to view your provider account you will see a helpful addition. 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.

The results and rationale will be displayed and can be downloaded as a PDF. This allows greater transparency of the code combinations being utilized at WPS.

Please contact us with any feedback and suggestions you have at 800-765-4977.

FAQ for WI Autism Spectrum Disorder Mandate:

Note: the following links will open a PDF document in a new window:

• Are you an Autism Qualified Provider?
  Please refer to the Ins 3.36, Wis Adm. Code – EmR0923
• Do you need to be Certified yet as an Autism Qualified Provider?
  Please download, fill out and return the WPS Professional Staff Update Notification form.
• Has the service level for your patient been determined? (Intensive vs. Non-intensive)
  Please download, fill out and return the Autism Spectrum Progress Report form.
• Do you need to know the approved providers/facilities by DHS?
  Review the document: DHS Approved Providers List
  Providers listed do not guarantee In-network status, please check your directory for preferred status.
• Do you need to review a sample claim form for billing: Testing & Screening; Intensive Services; Non-intensive Services?
  Review the sample claim forms:
  • Testing & Screening
  • Intensive Services
  • Non-intensive Services
• If you need further directions for completion of claim form HCFA CMS-1500, see these instructions.