Updated Payment Policy - Effective June 1, 2024
Date: 05/01/24
MHS Health Wisconsin continually adds new or provides updates to clinical and payment policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members.
The following payment policy is effective June 1, 2024.
Policy | Policy | Policy | Business Line(s) |
CP.PP.053 | Leveling of Emergency Room Services | The health plan has adopted a program integrity strategy that will provide appropriate levels of reimbursement for services indicating lower levels of complexity or severity rendered in the emergency room.
| Medicaid; Medicare |
View all Clinical and Payment Policies.
Thank you for being a valued partner in caring for the health and well-being of our members. If you have any questions about the policies listed above or any our Clinical & Payment Policies, please contact your Provider Relations representative or call the Provider Inquiry Line at 1-800-222-9831. If you are unsure who your representative is, please email us at WI_Provider_Relations@mhswi.com.