WPTA Payer Specialist Provides ForwardHealth Updates

Posted on November 13, 2014

WI Medicaid held several trainings around the state to educate members on the use of the Forward Health Portal.

Key Messages:

Provider Enrollment & Validation:

Be sure to keep your mailing address current with Medicaid so that you receive ALL notices for revalidation of your Medicaid Enrollment or you may have to reapply!

Go to:

Provider Revalidation must be completed every 3 years due to the Affordable Care Act.

Go to:

Group Provider Validation:

If you are part of an agency NPI- someone can go on through the agency NPI & validate providers in the group!

Medicaid Plans Eliminated: (March 31, 2014)

BadgerCare Plus Benchmark

BadgerCare Plus Core

BadgerCare Plus Basic


Current Medicaid Plan: ( April 1, 2014)

BadgerCare Plus is NOW one benefit Plan


Member Enrollment Verification:

Verify eligibility of Medicaid Enrollees before providing service!  See:

Re-Verify eligibility AGAIN after the 20th of each month when re-enrollment is addressed.

Many Medicaid enrollees are switching from Fee-for-service to HMO & from one HMO to another!

Retroactive PAs are possible if an enrollee was enrolled during a PA period.  However, if you are NOT a provider of the HMO in question- you may NOT be able to bill.

Using the Forward Health Provider Portal:

Portal Prior Authorizations are Highly Recommended!!! If you wish to be trained on the Portal- Contact your Provider Relation Field Representative!  See:

The Portal User Guides can be very helpful as references. See:

Provider Prior Authorization Questions:

We HIGHLY encourage Providers should actively call the Consultants with questions, concerns: CALL 800-947-9627 and ask to be put into the specific OT/PT/SLP consultant’s voice mail box with your best days/hours/phone numbers to return your call!


Provider Prior Authorization concerns, suggestions, concerns can be documented and sent via

We HIGHLY encourage providers to submit this form to DHS and a copy to WPTA.  The Department MUST respond to your inquiry- please forward their response to WPTA as well.


Prior Authorization Amendments:

Amending a Currently Approved PA for 30 days ONLY if you plan to DC at the end of PA:

·        Frequency of Rx

·        Change rendering provider when the billing provider change

·        Grant/Expire Dates

·        Co-treat

·        Specific Rx Codes/Procedures


Must have a WI Medicaid Enrolled MD on Claims in order to be covered!  Can be a Prescribing, Referring or Ordering Provider (PRO- Providers) that do NOT take Medicaid themselves.

See the attached Medicaid Update: 2-013-34: New Requirements for Prescribing/Referring/ Ordering Providers Due to the Affordable Care Act at

If you are having problems with Medicaid HMOs- call the Medicaid Ombudsmen at 800-760-0001






WPTA Member Elected to Student Assembly Board of Directors!

Posted on November 12, 2014

Newly elected members of the Student Assembly Board of Directors - WPTA congratulates Rob Hofschulte!

President: Fred Gilbert, University of Alabama-Birmingham
Vice President: Rob Hofschulte, Marquette University
Secretary: Aimee Winston, Boston University
Director of Communications: Brooke McIntosh, University of St. Augustine-Florida
Director of Membership: Lang Ho, University of Minnesota
Student Physical Therapist Delegate: Dhara Shah, University of Alabama-Birmingham
Student Physical Therapist's Assistant Delegate: Jarrod Evans, Madisonville Community College

Nominating Committee Chair: Kait Bianco (Chair Elect from 2013-2014), University of Pittsburgh
Nominating Committee Chair Elect: Scott McAfee, University of Southern California
Nominating Committee Member: Jillian Carney, St. Catherine University



October PT Connections Member Newsletter Now Available!

Posted on October 09, 2014

Please download and read the WPTA Member Newsletter for October:

PT Connections



APTA Launches Integrity in Practice Website

Posted on September 22, 2014

A new website launched by APTA will support the profession’s effort to eliminate fraud, abuse, and waste in the health care system. The APTA Center for Integrity in Practice website ( houses information on how PTs, PTAs, and students can continue to uphold the profession's high standards. Resources include information and supporting evidence on the recently released Choosing Wisely® list of "5 Things Physical Therapists and Patients Should Question;” a primer on preventing fraud, abuse, and waste; a free course on compliance; and other information on regulation and payment systems, evidence-based practice, ethics, professionalism, and fraud prevention. The site is part of the association's Integrity in Practice Campaign, a broad initiative that seeks to position physical therapy as a leader in responsible patient-centered care. Plans are for the website to continue expanding its offerings, and APTA is seeking partners to share resources, work together on advocacy, and possibly develop joint educational offerings to bring the message of practice integrity to the widest possible audience.



Choosing Wisely: APTA Releases List of Procedures That PTs and Patients Should Question

Posted on September 17, 2014

Choosing Wisely: APTA Releases List of Procedures That PTs and Patients Should Question

Passive physical agents that aren’t part of an active treatment plan, under-dosed strength training for older adults, and the use of whirlpools for wound management are among the "5 Things That Physical Therapists and Patients Should Question," according to a list recently announced by APTA. The list, developed through member suggestions and refined by an expert panel, is now part of a national campaign that encourages patients and health care providers to talk about whether a given procedure is really necessary based on the patient's individual circumstances.


The list announced is part of APTA's partnership with the Choosing Wisely® campaign from the American Board of Internal Medicine (ABIM) Foundation. The initiative aims to help consumers make informed health care choices by providing lists of procedures that tend to be done frequently, yet whose usefulness is called into question by evidence. APTA is the first nonphysician group to release a list, joining more than 50 medical specialty societies. See for more details.



June Documentation Webinar Recording now available for sale!

Posted on September 05, 2014


Best Practice in Documentation Webinar Series: Evaluations

**Course meets the WI Ethics and Jurisprudence Requirement - 1 Contact Hour**

 WPTA Member $50 | Non-member $125

Watch Instantly!





Positions Statements Related to Physical Therapy Issued by the Physical Therapy Examining Board

Posted on June 17, 2014

Positions Statements Related to Physical Therapy Issued by the Physical Therapy Examining Board

Please Download Here



NEW! Ethics and Jurisprudence Online Course Available

Posted on June 08, 2014

As of January 1, 2014 (insert correct date) the state of Wisconsin requires that all physical therapists applying for license renewal complete a total of four hours of ethics and jurisprudence education. To help therapists comply, the WPTA is offering this course through the interactive platform of EDUCATA. WPTA members receive a 10% discount, see details at the link below.

Online Ethics & Jurisprudence Course Details



Do You Have 100% APTA/WPTA Membership at Your Facility?!

Posted on November 21, 2013

Facility Challenge
Help recognize facilities for their commitment to APTA membership. Facilities that attain 100% APTA membership of PTs and PTAs should submit a Facility Challenge application. Annual renewal is required. Qualifying facilities receive a certificate, are featured on, and included on banner displays at Combined Sections Meeting and NEXT Conference and Exposition.



Help Needed at St. Clare Health Mission

Posted on November 11, 2013

The WCD is looking for volunteers to help out at the St.Clare Health Mission located at 916 Ferry Street in La Crosse. The Mission is open Tuesday, Wednesday and Thursday evenings from 5pm to 9pm. Please contact Mary Kerrigan at for more details. Thanks,



NE District Guidelines for Sponsorship

Posted on April 05, 2011






Request Form for Sponsorship for Youth Sports/Adult League Teams

Please contact District Chair, Jonathon Weiss, by email with the following information:

1.       Name of individual requesting sponsorship and APTA number:
2.       Sport :__________________________________________________
3.       Type of League: Adult/Children ____________________________________________________

4.       Sponsorship amount being requested (Max limit of $250):      ___________________________                                                                                   

(please list breakdown of league fees and t-shirt fees)

·         T-shirts with a minimum of 1.5” lettering spelling out Wisconsin Physical Therapy Association    (either front or back)
·         We request a digital photo of the team in t-shirts.
·         This will be on a first come, first serve basis.
 Thank you,
Download NE District Guidelines for Sponsorship

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