Caring Starts with Finding the Information You Need
My Choice Wisconsin providers can find important information about programs, authorizations, billing and reimbursements, and so much more. You can use the category filter to access specific types of documents or you can search the full library.
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Resource Downloads for Providers
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Adult Family Home (AFH) Application Form – Re-Certification Form
October 23, 2020 | pdf (164.03 KB) |
Authorization Portal User Guide
September 23, 2019 | pdf (882.45 KB) | Authorizations, Provider Manuals & Policies
Care Team Resources for Member Education and Empowerment
January 11, 2021 | pdf (147.37 KB) | Provider Manuals & Policies
Chiropractic Prior Authorization Request Form
October 23, 2020 | pdf (279.03 KB) | Authorization Request Form, Authorizations
Cognizant (Trizetto) Electronic Funds Transfer (EFT) Form
September 16, 2020 | pdf (128.45 KB) | Claims Information
Dental Procedures Prior Authorization List
October 30, 2020 | pdf (8.88 KB) | Authorizations, Provider Manuals & Policies
Dental Supplement Prior Authorization Request Form
October 23, 2020 | pdf (374.10 KB) | Authorization Request Form, Authorizations
Disposable Medical Supplies (DMS) Exception List
November 3, 2020 | pdf (452.74 KB) | Authorizations
Durable Medical Equipment and Supplies (DME/DMS) Prior Authorization Request Form
October 23, 2020 | pdf (239.35 KB) | Authorization Request Form, Authorizations
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