Care Wisconsin Health Plan
For prior authorization or assistance with provider contracts, benefits coverage or claims, call (608) 245-3053 or 1-800-963-0035. Mail correspondence to: Care Wisconsin Health Plan, 2802 International Lane, Madison, WI 53704. Medical Claims Processing
Contact TMG Health, Inc. at (866) 412-9898 or mail claims to: CWHP, P.O. Box 600, Dunmore, PA 18512.
Pharmacy Claims Processing
Contact PharmaStar at (715) 552-4320 or (888) 298-7770.
Clinical Practice Guidelines
Care Wisconsin has adopted the use of published texts for its Clinical Practice Guidelines—standards for managing specific diseases or syndromes that are evidence-based. The strongest available information on the efficacy of treatment is used to develop standards of care that result in the highest quality of care.
These references are posted for your convenience: - Reuben D. B., Heer K. A., Pacala J. T., et al. (2006). 2007-2008 Geriatrics At Your Fingertips, 9th Edition. American Geriatrics Society, New York, New York. (Also available online at www.geriatricsatyourfingertips.org)
- Beizer J. L., et al. (2005). Lexi-Comp's Geriatric Dosage Handbook, 11th Edition. Lexi-Comp, Hudson, Ohio.
 Provider Manual
This resource tool assists providers in the care and treatment of program members. It includes policies, procedures and guidelines required by the Centers for Medicare & Medicaid Services and Care Wisconsin Health Plan. (Note: Care Wisconsin Health Plan was formerly called Elder Care Health Plan.)
2008 Formulary
For information on our Prescription Drug Grievance, Appeal and Coverage Determination Processes, click here.
Member Materials
To view and download member materials, including the Provider Directory, Summary of Benefits and Evidence of Coverage, go to: Make a Referral | Provider Network
Back to Top
|
