Documents & Forms 2011 - 2012

General Information

• View documents on the Wisconsin Department of Employee Trust Funds (ETF) website
• It's Your Choice Insurance Publications
• HealthSense Rewards™ Member Discount Program
• WPS Referral Authorization Request
• Independent Review Process

Preauthorization Forms

• Inpatient Pre-Certification Guidelines
• Outpatient Preauthorization Guidelines
• Medical Preauthorization Request Form

2011 Network Materials

Network Tip Sheets: Plan Year 2011

• SMP Network Tip Sheet - Plan Year 2011
• SMP Network Tip Sheet Wisconsin Public Employers(WPE) - Plan Year 2011
• Metro Choice Tip Sheet - Plan Year 2011
• Statewide/National Network Tip Sheet - 2011

Dental

• State of Wisconsin Metro Choice Network Dental Plan for Plan Year 2011

WPS Provider Directories: Plan Year 2011

• State Maintenance Plan (SMP) - 2011 Directory
• State Maintenance Plan (SMP) Minnesota - Featuring SelectCare Providers - 2011 Directory
  
• State PPO Directory Statewide - Eastern - 2011 Directory
  
• State PPO Directory Statewide - Western - 2011 Directory
• Metro Choice Provider - 2011 Directory
  

2012 Network Materials

Network Tip Sheets: Plan Year 2012

• SMP Network Tip Sheet - Plan Year 2012
• SMP Network Tip Sheet Wisconsin Public Employers(WPE) - Plan Year 2012
• Metro Choice Tip Sheet - Plan Year 2012
• Statewide/National Network Tip Sheet - 2012

Dental

• State of Wisconsin Metro Choice Network Dental Plan for Plan Year 2012

WPS Provider Directories: Plan Year 2012

• State Maintenance Plan (SMP) - 2012 Directory
• State Maintenance Plan (SMP) Minnesota - Featuring SelectCare Providers - 2012 Directory
  
• State PPO Directory Statewide - Eastern - 2012 Directory
  
• State PPO Directory Statewide - Western - 2012 Directory
• Metro Choice Provider - 2012 Directory