July 2, 2024
Process clarification for verifying eligibility in ForwardHealth
Situation:
As of July 1, 2024, all My Choice Wisconsin Medicaid SSI and BadgerCare Plus (BC+) members are now showing in ForwardHealth as having Molina Healthcare of Wisconsin, Inc. for their Medicaid HMO.
As a reminder, only Medicaid BC+ and SSI operations, benefit administration, and activities are changing to Molina at this time.
If a member is listed in ForwardHealth as having Family Care or Family Care Partnership under the Managed Care Enrollment, they are still participating through My Choice Wisconsin benefit programs.
Provider Action Needed:
- If you see a member listed in ForwardHealth with a Managed Care Organization as My Choice/MCW for Family Care/Family Care Partnership, submit Family Care/Family Care Partnership claims and authorizations to My Choice.
- Similarly, if you see that a member has Molina Medicaid for SSI/BC+ but also has My Choice for Medicare D-SNP, submit Medicare claims and authorization to My Choice.
Questions?
Please reach out to your provider relations representative or email us at:
- MHWIprovidernetworkmanagement@molinahealthcare.com(for BadgerCare Plus, Medicaid SSI, or existing Molina Medicare)
- Shfamccontracts@mychoicewi.org(for Family Care, Family Care Partnership, or existing My Choice Medicare)