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Division of Health Care Access and Accountability (DHCAA)

Division Prefix / Old Publication  Number Assigned Publication Number Publication Title Publication Type Other Location Language
DHCAA P-00062 BadgerCare Plus Core Plan Insurance Coverage and Access Fact Sheet (PDF, 71 KB) PDF Program English
DHCAA P-00062S BadgerCare Plus Core Plan Insurance Coverage and Access Fact Sheet - Spanish (PDF, 49 KB) PDF None Spanish
DHCAA P-00079 ForwardHealth Enrollment and Benefits Handbook (PDF, 3.2 MB) PDF Program English
DHCAA P-00079S ForwardHealth Enrollment and Benefits Handbook - Spanish (PDF, 867 KB) PDF None Spanish
DHCAA P-00084 Milwaukee Enrollment Services (MilES) Contact Poster Paper FormsManager English
DHCAA P-00084A Milwaukee Enrollment Services (MilES) Contact Poster Tear Off Sheets Paper FormsManager English
DHCAA P-00084AH Milwaukee Enrollment Services (MilES) Contact Poster Tear Off Sheets - Hmong Paper FormsManager Hmong
DHCAA P-00084AS Milwaukee Enrollment Services (MilES) Contact Poster Tear Off Sheets - Spanish Paper FormsManager Spanish
DHCAA P-00084H Milwaukee Enrollment Services (MilES) Contact Poster - Hmong Paper FormsManager Hmong
DHCAA P-00084S Milwaukee Enrollment Services (MilES) Contact Poster - Spanish Paper FormsManager Spanish
DHCAA P-00085 BadgerCare Plus Core Plan Health Insurance Coverage and Exceptions (PDF, 73 KB) PDF None English
DHCAA P-00087 Milwaukee Enrollment Services (MilES) Key Contacts (PDF, 92 KB) PDF None English
DCHAA P-00087H Milwaukee Enrollment Services (MilES) Key Contacts - Hmong (PDF, 78 KB) PDF None Hmong
DCHAA P-00087S Milwaukee Enrollment Services (MilES) Key Contacts - Spanish (PDF, 81 KB) PDF None Spanish
DHCAA P-00102 FoodShare Wisconsin - Your FoodShare Rights Poster Paper Form Center English
DHCAA P-00102H FoodShare Wisconsin - Your FoodShare Rights Poster (Hmong) Paper Form Center Hmong
DHCAA P-00102S FoodShare Wisconsin - Your FoodShare Rights Poster (Spanish) Paper Form Center Spanish
DHCAA P-00126 BadgerCare Plus Core Plan - Health Care for Adults with No Dependent Children Waitlist (PDF, 107 KB) PDF None English
DHCAA P-00130 BadgerCare Plus Core Plain Waitlist - Frequently Asked Questions (PDF, 96 KB) PDF Program English
DHCAA P-00148 BadgerCare Plus Basic Plan Benefits and Enrollment Handbook (PDF, 379 KB) PDF None English
DCHAA P-00176 Family Planning Only Services for Males Fact Sheet (PDF, 73 KB) PDF Program English
DCHAA P-00176H Family Planning Only Services for Males Fact Sheet - Hmong (PDF, 74 KB) PDF None Hmong
DHCAA P-00176S Family Planning Only Services for Males Fact Sheet - Spanish (PDF, 78 KB) PDF None Spanish
DHCAA P-00218 BadgerCare Plus — Who Can Enroll (PDF, 110 KB) PDF None English
DHCAA P-00219 ACCESS - MyACCESS Account Brochure (PDF, 202 KB) PDF None English
DHCAA P-00219S ACCESS - MyACCESS Account Brochure - Spanish PDF None Spanish
DHCAA P-00234 ACCESS - MyACCESS Card (PDF, 9 KB) PDF Form Center English
DHCAA P-00247 BadgerCare Plus Basic Plan Frequently Asked Questions HTML None English
DHCAA P-00262 ForwardHealth Instructions Related to 820 Health Care Payroll Deducted and Other Group Premium Payment for Insurance Products (820) Based on ASC X12 Implementation Guide (PDF, 105 KB) PDF None English
DHCAA P-00263 ForwardHealth Instructions Related to 837 Health Care Claim: Dental (837D) Transactions Based on ASC X12 Implementation Guide (PDF, 302 KB) PDF None English
DHCAA P-00264 ForwardHealth Instructions Related to 834 Benefit Enrollment and Maintenance (834) Based on ASC X12 Implementation Guide (PDF, 247 KB) PDF None English
DHCAA P-00265 ForwardHealth Instructions Related to 837 Health Care Claim: Professional (837P) Transactions Based on ASC X12 Implementation Guide (PDF, 350 KB) PDF None English
DHCAA P-00266 ForwardHealth Instructions Related to 837 Health Care Claim: Institutional (837I) Transactions Based on ASC X12 Implementation Guide (PDF, 432 KB) PDF None English
DHCAA P-00267 ForwardHealth Instructions Related to 270/271 Health Care Eligibility Benefit Inquiry and Response (270/271) Based on ASC X12 Implementation Guide (for Dates of Service on and after January 1, 2013) (PDF, 249 KB) PDF None English
DHCAA P-00268 ForwardHealth Instructions Related to 999 Acknowledgement for Health Care Insurance (999) Based on ASC X12 Implementation Guide (PDF, 145 KB) PDF None English
DHCAA P-00269 ForwardHealth Instructions Related to TA1 Interchange Acknowledgement (TA1) Based on ASC X12 Implementation Guide (PDF, 98 KB) PDF None English
DHCAA P-00270 ForwardHealth Instructions Related to 276/277 Health Care Claim Status (276/277) Transactions Based on ASC X12 Implementation Guide (for Dates of Service on and after January 1, 2013) (PDF, 135 KB) PDF None English
DHCAA P-00271 ForwardHealth Instructions Related to 835 Health Care Claim Payment/Advice (835) Based on ASC X12 Implementation Guide (PDF, 262 KB) PDF None English
DHCAA P-00272 ForwardHealth Payer Sheet: National Council for Prescription Drug Programs (NCPDP) Version D.0 (PDF, 1 MB) PDF None English
DHCAA P-00290 ForwardHealth Provider Handbook System None English
DHCAA P-00293 ForwardHealth Instructions Related to 278 Health Care Services Review - Request for Review and Response (278) Transactions Based on ASC X12 Implementation Guide (PDF, 341 KB) PDF None English
DHCAA P-00324 BadgerCare Plus Policy Changes Fact Sheet (PDF, 116 KB) PDF None English
DHCAA P-00358 Wisconsin Medicaid Electronic Health Record (EHR) Incentive Program (PDF, 242 KB) PDF None English
DHCAA P-00378 BadgerCare Plus Standard and Benchmark Plan Members in Southeastern Wisconsin - HMO Enrollment Changes (PDF, 53 KB) PDF None English
DHCAA P-00382 Medicaid and BadgerCare Plus Non-Emergency Medical Transportation (PDF, 94 KB) PDF None English
DHCAA P-00382A Medicaid and BadgerCare Plus NonEmergency Medical Transportation - How to request a ride (PDF, 153 KB) PDF None English
DHCAA P-00382B Medicaid and BadgerCare Plus - Meals and Overnight Stays (PDF, 96 KB) PDF None English
DHCAA P-00382C Medicaid and BadgerCare Plus NonEmergency Medical Transportation - Contacts (PDF, 143 KB) PDF None English
DHCAA P-00382D Medicaid and BadgerCare Plus NonEmergency Medical Transportation - Complaint Process (PDF, 116 KB) PDF None English
DHCAA P-00414 LogistiCare Fact Sheet (PDF, 80 KB) PDF None English
DHCAA P-00419 FoodShare Employment and Training Handbook HTML None English
DHCAA P-00439 Medicaid and BadgerCare Plus Member Q&A Non-Emergency Medical Transportation Provided by LogistiCare (PDF, 70 KB) PDF None English
DHCAA P-00469 Supplemental Security Income and Caretaker Supplement Statistics Talking Points, June 1, 2002 PDF None English
PHC-1007 P-01007 HealthCheck Brochure Paper Form Center English
PHC-1007 P-01007 HealthCheck Brochure (PDF, 18 KB) PDF Program English
PHC-1007H P-01007H HealthCheck Brochure - Hmong (PDF, 114 KB) PDF Program Hmong
PHC-1007S P-01007S HealthCheck Brochure - Spanish (PDF, 157 KB) PDF Program Spanish
PHC-1033 P-01033 HealthCheck Screening Recommendation for Pediatric Eye Problems (PDF, 10 KB) PDF None English
PHC-1041D P-01041D HealthCheck Logo Sheet - Locals (PDF, 123 KB) PDF None English
PHC-1042 P-01042 HealthCheck Periodicity Poster (PDF, 78 KB) PDF Form Center English
PHC-1042A P-01042A HealthCheck Dental Periodicity Table (PDF, 128 KB) PDF None English
PHC-1046 P-01046 PreNatal Care Coordination Brochure (PDF, 294 KB) Paper Form Center English
PHC-1046 P-01046 Pre-Natal Care Coordination Brochure (PDF, 294 KB) PDF Program English
PHC-1046H P-01046H Pre-Natal Care Coordination Brochure - Hmong (PDF, 79 KB) PDF Program Hmong
PHC-1046S P-01046S Pre-Natal Care Coordination Brochure - Spanish (PDF, 55 KB) PDF Program Spanish
PHC-1122 P-01122 Medicaid and BadgerCare Plus Private Duty Nursing Guide (PDF, 25 KB) PDF None English
PHC-1122H P-01122H Medicaid and BadgerCare Plus Private Duty Nursing Guide - Hmong (PDF, 29 KB) PDF None Hmong
PHC-1122S P-01122S Medicaid and BadgerCare Plus Private Duty Nursing Guide - Spanish (PDF, 59 KB) PDF None Spanish
PHC-1147 P-01147 Wisconsin Chronic Disease Program Member Handbook (PDF, 119 KB) PDF None English
PHC-1147A P-01147A Wisconsin Chronic Renal Disease Program Brochure (PDF, 29 KB) PDF None English
PHC-1147B P-01147B Wisconsin Chronic Disease Program Policies Coverage of Enteral Nutritional Products (PDF, 18 KB) PDF None English
PHC-1148 P-01148 School Based Services Fact Sheet (PDF, 1.5 MB) PDF None English
PHC-1190 P-01190 Wisconsin Chronic Disease Program Income Deductible (PDF, 26 KB) PDF None English
PHC-1191 P-01191 Wisconsin Hemophilia Home Care Program Liability Chart (PDF, 22 KB) PDF None English
PHC-1192 P-01192 Wisconsin Adult Cystic Fibrosis Program Liability Chart (PDF, 22 KB) PDF None English
PHC-1193 P-01193 Wisconsin Chronic Renal Disease Program Liability Chart (PDF, 25 KB) PDF None English
PHC 10022 P-10022 Medicaid - Tuberculosis (TB) Related Services Plan Fact Sheet (PDF, 80 KB) PDF Program English
PHC 10022H P-10022H Medicaid - Tuberculosis (TB) Related Services Plan Fact Sheet - Hmong (PDF, 197 KB) PDF Program Hmong
PHC 10022S P-10022S Medicaid - Tuberculosis (TB) Related Services Plan Fact Sheet - Spanish (PDF, 110 KB) PDF Program Spanish
PHC 10026 P-10026 BadgerCare Plus Prenatal Services (PDF, 46 KB) PDF None English
PHC 10026H P-10026H BadgerCare Plus Prenatal Services - Hmong (PDF, 48 KB) PDF None Hmong
PHC 10026S P-10026S BadgerCare Plus Prenatal Services - Spanish (PDF, 222 KB) PDF None Spanish
PHC 10030 P-10030 Medicaid Eligibility Handbook HTML None English
PHC 10048 P-10048 Medicaid - Applying for Medicaid Disability Fact Sheet (PDF, 64 KB) PDF Program English
DHCAA P-10048S Medicaid - Applying for Medicaid Disability Fact Sheet - Spanish (PDF, 68 KB) PDF None Spanish
PHC 10049 P-10049 Medicaid - Enrollment Renewal Fact Sheet (PDF, 61 KB) PDF Program English
DHCAA P-10049H Medicaid - Enrollment Renewal Fact Sheet - Hmong (PDF, 68 KB) PDF None Hmong
DHCAA P-10049S Medicaid - Enrollment Renewal Fact Sheet - Spanish (PDF, 9 KB) PDF None Spanish
PHC 10052 P-10052 Medicaid / BadgerCare Plus Deductible Plans Fact Sheet (115 KB) PDF Program English
PHC 10052S P-10052S Medicaid / BadgerCare Plus Deductible Plans Fact Sheet - Spanish (PDF, 96 KB) PDF Program Spanish
PHC 10053 P-10053 Health Care for Migrant Workers (PDF, 182 KB) PDF Program English
PHC 10053H P-10053H Health Care for Migrant Workers - Hmong (PDF, 185 KB) PDF None Hmong
PHC 10053S P-10053S Health Care for Migrant Workers - Spanish (PDF, 193 KB) PDF Program Spanish
PHC 10055 P-10055 Medicaid - Alien Eligibility Fact Sheet (PDF, 23 KB) PDF Program English
PHC 10055H P-10055H Medicaid - Alien Eligibility Fact Sheet - Hmong (PDF, 20 KB) PDF Program Hmong
PHC 10055R P-10055R Medicaid - Alien Eligibility Fact Sheet - Russian (PDF, 79 KB) PDF None Russian
PHC 10058 P-10058 Medicaid - Elderly, Blind or Disabled Divestment Fact Sheet (PDF, 86 KB) PDF Program English
DHCAA P-10058H Medicaid - Elderly, Blind or Disabled Divestment Fact Sheet - Hmong (PDF, 70 KB) PDF None Hmong
DHCAA P-10058S Medicaid - Elderly, Blind or Disabled Divestment Fact Sheet - Spanish (PDF, 116 KB) PDF None Spanish
PHC 10059 P-10059 Medicaid - Community Waivers Plan Fact Sheet (PDF, 54 KB) PDF Program English
PHC 10059S P-10059S Medicaid - Community Waivers Plan Fact Sheet - Spanish (PDF, 53 KB) PDF Program Spanish
PHC 10061 P-10061 Medicaid - Patient Liability Fact Sheet (PDF, 35 KB) PDF Program English
PHC 10061S P-10061S Medicaid - Patient Liability Fact Sheet - Spanish (PDF, 42 KB) PDF Program Spanish
PHC 10062 P-10062 Medicaid - Medicare Premium Assistance Plans Fact Sheet (PDF, 199 KB) PDF Program English
DHCAA P-10062S Medicaid - Medicare Premium Assistance Plans Fact Sheet - Spanish (PDF, 209 KB) PDF None Spanish
PHC 10063 P-10063 Medicaid - Spousal Impoverishment Protection Fact Sheet (PDF, 64 KB) PDF Program English
PHC 10064 P-10064 BadgerCare Plus and Medicaid Plans - Medical Support Liability Fact Sheet (PDF, 21 KB) PDF Program English
DHCAA P-10064S BadgerCare Plus and Medicaid Plans - Medical Support Liability Fact Sheet - Spanish (PDF, 120 KB) PDF Program Spanish
PHC 10065 P-10065 Medicaid - Wisconsin Well Woman Medicaid Fact Sheet (PDF, 58 KB) PDF Program English
PHC 10065H P-10065H Medicaid - Wisconsin Well Woman Medicaid Fact Sheet - Hmong (PDF, 58 KB) PDF Program Hmong
PHC 10065R P-10065R Medicaid - Wisconsin Well Woman Medicaid Fact Sheet - Russian (PDF, 92 KB) PDF Program Russian
PHC 10065S P-10065S Medicaid - Wisconsin Well Woman Medicaid Fact Sheet - Spanish (PDF, 80 KB) PDF Program Spanish
PHC 10068 P-10068 BadgerCare Plus Family Planning Only Services - Female Fact Sheet (PDF, 205 KB) PDF Program English
PHC 10068H P-10068H BadgerCare Plus Family Planning Only Services - Female Fact Sheet - Hmong (PDF, 189 KB) PDF None Hmong
PHC 10068S P-10068S BadgerCare Plus Family Planning Only Services - Female Fact Sheet - Spanish (PDF, 183 KB) PDF None Spanish
PHC 10071 P-10071 Medicaid Purchase Plan Fact Sheet (PDF, 11 KB) PDF Program English
PHC 10071H P-10071H Medicaid Purchase Plan Fact Sheet - Hmong (PDF, 30 KB) PDF Program Hmong
PHC 10071S P-10071S Medicaid Purchase Plan Fact Sheet - Spanish (PDF, 77 KB) PDF Program Spanish
PHC 10072 P-10072 Medicaid and BadgerCare Plus Emergency Services (PDF, 58 KB) PDF Program English
PHC 10072H P-10072H Medicaid and BadgerCare Plus Emergency Services - Hmong (PDF, 55 KB) PDF Program Hmong
PHC 10072S P-10072S Medicaid and BadgerCare Plus Emergency Services - Spanish (PDF, 52 KB) PDF Program Spanish
PHC 10074 P-10074 SeniorCare and Medicare Part D Fact Sheet (PDF, 96 KB) PDF Program English
PHC 10077 P-10077 SeniorCare Prescription Drugs for Wisconsin Seniors Brochure (PDF, 298 KB) PDF None English
PHC 10078 P-10078 SeniorCare Prescription Drugs for Wisconsin Seniors Fact Sheet (PDF, 17 KB) Paper Form Center English
DHCAA P-10078 SeniorCare Prescription Drugs for Wisconsin Seniors Fact Sheet (PDF, 17 KB) PDF Program English
PHC 10078H P-10078H SeniorCare Prescription Drugs for Wisconsin Seniors Fact Sheet - Hmong (PDF, 77 KB) PDF None Hmong
PHC 10078S P-10078S SeniorCare Prescription Drugs for Wisconsin Seniors Fact Sheet - Spanish (PDF, 130 KB) PDF None Spanish
PHC 10079 P-10079 SeniorCare Prescription Drugs for Wisconsin Seniors Member Handbook (PDF, 481 KB) PDF None English
PHC 10083 P-10083 SeniorCare Prescription Drugs for Wisconsin Seniors Frequently Asked Questions Fact Sheet (PDF, 255 KB) PDF Program English
PHC 10084 P-10084 SeniorCare Prescription Drugs for Wisconsin Seniors Covered Drugs Fact Sheet (PDF, 105 KB) PDF None English
PHC 10085 P-10085 SeniorCare Annual Renewal Fact Sheet (PDF, 15 KB) PDF Program English
PHC 10085H P-10085H SeniorCare Annual Renewal Fact Sheet - Hmong (PDF, 61 KB) PDF Program Hmong
PHC 10085S P-10085S SeniorCare Annual Renewal Fact Sheet - Spanish (PDF, 69 KB) PDF Program Spanish
PHC 10086 P-10086 SeniorCare Spenddown and Deductible Fact Sheet (PDF, 148 KB) PDF Program English
PHC 10087 P-10087 SeniorCare Income Fact Sheet (PDF, 16 KB) PDF Program English
PHC 10095 P-10095 BadgerCare Plus Health Insurance Premium Payment (HIPP) Plan Fact Sheet (PDF, 122 KB) PDF Program English
PHC 10096 P-10096 Wisconsin Legal Services Programs Fact Sheet (PDF, 80 KB) PDF None English
PHC 10097 P-10097 Wisconsin Funeral and Cemetery Aids Program Manual HTML None English
PHC 10163 P-10163 Health Care Coverage for You or Someone You Know PDF None English
PHC 10163H P-10163H Health Care Coverage for You or Someone You Know - Hmong PDF None Hmong
PHC 10163S P-10163S Health Care Coverage for You or Someone You Know - Spanish PDF None English
PHC-10164 P-10164 Health Care for Wisconsin Immigrants (PDF, 41 KB) PDF None English
PHC-10164H P-10164H Health Care for Wisconsin Immigrants - Hmong (PDF, 49 KB) PDF None Hmong
PHC-10164S P-10164S Health Care for Wisconsin Immigrants - Spanish (PDF, 40 KB) PDF None Spanish
PHC 10165 P-10165 BadgerCare Plus Pocket Guide Paper Form Center English
PHC 10166 P-10166 BadgerCare Plus Poster (Picture of Three Children on a Tire) Paper Form Center English
PHC 10166A P-10166A BadgerCare Plus Poster Tear Off Sheets Paper Form Center English
PHC 10166AS P-10166AS BadgerCare Plus Poster Tear Off Sheets - Spanish Paper Form Center Spanish
PHC 10166S P-10166S BadgerCare Plus Poster (Picture of Three Children on a Tire) - Spanish Paper Form Center Spanish
PHC 10168 P-10168 BadgerCare Plus Temporary Health Insurance for Children Fact Sheet (PDF, 178 KB) PDF None English
PHC 10168H P-10168H BadgerCare Plus Temporary Health Insurance for Children Fact Sheet - Hmong (PDF, 178 KB) PDF None Hmong
PHC 10168S P-10168S BadgerCare Plus Temporary Health Insurance for Children Fact Sheet - Spanish (PDF, 165 KB) PDF None Spanish
PHC 10169 P-10169 BadgerCare Plus Temporary Health Insurance for Pregnant Women Fact Sheet (PDF, 196 KB) PDF None English
PHC 10169H P-10169H BadgerCare Plus Temporary Health Insurance for Pregnant Women Fact Sheet - Hmong (PDF, 188 KB) PDF None Hmong
PHC 10169S P-10169S BadgerCare Plus Temporary Health Insurance for Pregnant Women Fact Sheet - Spanish (PDF, 156 KB) PDF None Spanish
PHC 10170 P-10170 BadgerCare Plus Health Care for Children and Families Brochure (PDF, 468 KB) PDF None English
PHC 10170H P-10170H BadgerCare Plus Health Care for Children and Families Brochure - Hmong (PDF, 952 KB) PDF None Hmong
PHC 10170S P-10170S BadgerCare Plus Health Care for Children and Families Brochure - Spanish (PDF, 429 KB) PDF None Spanish
PHC 10171 P-10171 BadgerCare Plus Eligibility Handbook PDF None English
PHC 10173 P-10173 BadgerCare Plus General Fact Sheet (PDF, 236 KB) PDF None English
PHC 10173H P-10173H BadgerCare Plus General Fact Sheet - Hmong (PDF, 408 KB) PDF None Hmong
PHC 10173S P-10173S BadgerCare Plus General Fact Sheet - Spanish (PDF, 258 KB) PDF None Spanish
PHC 10175 P-10175 BadgerCare Plus Poster (Picture of a Girl and a Picture of a Nurse) Paper Form Center English
PHC 10176 P-10176 BadgerCare Plus Change Report Card for Young Adults Exiting Out-of-Home Care (PDF, 40 KB) PDF None English
PHC 10177 P-10177 BadgerCare Plus Employer-Sponsored Health Insurance Fact Sheet (PDF, 130 KB) PDF None English
DHCAA P-10177H BadgerCare Plus Employer-Sponsored Health Insurance Fact Sheet - Hmong PDF None English
DHCAA P-10177S BadgerCare Plus Employer-Sponsored Health Insurance Fact Sheet - Spanish PDF None Spanish
PHC 10179 P-10179 BadgerCare Plus Health Insurance for Families and All Children Fact Sheet (PDF, 186 KB) PDF None English
PHC 10179H P-10179H BadgerCare Plus Health Insurance for Families and All Children Fact Sheet - Hmong (PDF, 248 KB) PDF None Hmong
PHC 10179S P-10179S BadgerCare Plus Health Insurance for Families and All Children Fact Sheet - Spanish (PDF, 202 KB) PDF None Spanish
DHCAA P-10180 BadgerCare Plus Immigrants and BadgerCare Plus Fact Sheet (PDF, 44 KB) PDF None English
DHCAA P-10181 BadgerCare Plus Benchmark Plan Health Coverage Tax Credit (HCTC) Wisconsin's State Qualified Health Plan (PDF, 123 KB) PDF None English
DHCAA P-10194 BadgerCare Plus Core Plan Health Care for Adults with No Dependent Children - Covered Services (PDF, 150 KB) PDF None English
DHCAA P-10194S BadgerCare Plus Core Plan Health Care for Adults with No Dependent Children - Covered Services - Spanish (PDF, 99 KB) PDF None Spanish
DHCAA P-10195 BadgerCare Plus Core Plan Health Care for Adults with No Dependent Children (PDF, 115 KB) PDF Program English
PHC 11065 P-11065 Guide to Obtaining Augmentative Communication Devices and Accessories Through Wisconsin Medicaid (PDF, 35 KB) PDF Program English
PHC 12002 P-12002 BadgerCare Plus or Medicaid SSI HMO Ombuds Brochure (PDF, 84 KB) PDF None English
PHC 12002H P-12002H BadgerCare Plus or Medicaid SSI HMO Ombuds Brochure - Hmong (PDF, 84 KB) PDF None Hmong
PHC 12002R P-12002R BadgerCare Plus or Medicaid SSI HMO Ombuds Brochure - Russian (PDF, 160 KB) PDF None Russian
PHC 12002S P-12002S BadgerCare Plus or Medicaid SSI HMO Ombuds Brochure - Spanish (PDF, 84 KB) PDF None Spanish
PHC 12020 P-12020 BadgerCare Plus HMO Program Guide Standard Plan and Benchmark Plan (PDF, 98 KB) PDF None English
PHC 12020A P-12020A BadgerCare Plus HMO Choice Booklet - Standard Plan and Benchmark Plan (PDF, 348 KB) PDF None English
PHC 12020AH P-12020AH BadgerCare Plus HMO Choice Booklet - Standard Plan and Benchmark Plan - Hmong (PDF, 327 KB) PDF None Hmong
PHC 12020AR P-12020AR BadgerCare Plus HMO Choice Booklet - Standard Plan and Benchmark Plan - Russian (PDF, 555 KB) PDF None Russian
PHC 12020AS P-12020AS BadgerCare Plus HMO Choice Booklet - Standard Plan and Benchmark Plan - Spanish (PDF, 341 KB) PDF None Spanish
DHCAA P-12020B BadgerCare Plus HMO Program Guide - Core Plan for Health Care for Adults with No Dependent Children (PDF, 315 KB) PDF None English
DHCAA P-12020BH BadgerCare Plus HMO Program Guide Health Care Core Plan for adults with no dependent children - Hmong (PDF, 318 KB) PDF None Hmong
DHCAA P-12020BR BadgerCare Plus HMO Program Guide Health Care Core Plan for adults with no dependent children - Russian (PDF, 459 KB) PDF None Russian
DHCAA P-12020BS BadgerCare Plus HMO Program Guide Health Care Core Plan for adults with no dependent children - Spanish (PDF, 318 KB) PDF None Spanish
PHC 12020H P-12020H BadgerCare Plus HMO Program Guide - Standard Plan and Benchmark Plan - Hmong (PDF, 102 KB) PDF None Hmong
PHC 12020R P-12020R BadgerCare Plus HMO Program Guide - Standard Plan and Benchmark Plan - Russian (PDF, 269 KB) PDF None Russian
PHC 12020S P-12020S BadgerCare Plus HMO Program Guide - Standard Plan and Benchmark Plan - Spanish (PDF, 113 KB) PDF None Spanish
PHC 12770 P-12770 Medicaid SSI HMO Program Guide (PDF, 114 KB) PDF None English
PHC 12770A P-12770A Medicaid SSI HMO Choice Booklet (PDF, 169 KB) PDF None English
PHC 12770AH P-12770AH Medicaid SSI HMO Choice Booklet - Hmong (PDF, 180 KB) PDF None Hmong
PHC 12770AR P-12770AR Medicaid SSI HMO Choice Booklet - Russian (PDF, 324 KB) PDF None Russian
PHC 12770AS P-12770AS Medicaid SSI HMO Choice Booklet - Spanish (PDF, 124 KB) PDF None Spanish
PHC 12770H P-12770H Medicaid SSI HMO Program Guide - Hmong (PDF, 148 KB) PDF None Hmong
PHC 12770R P-12770R Medicaid SSI HMO Program Guide - Russian (PDF, 299 KB) PDF None Russian
PHC 12770S P-12770S Medicaid SSI HMO Program Guide - Spanish (PSF, 146 KB) PDF None Spanish
PHC 13009 P-13009 Estate Recovery Transfer by Affidavit (PDF, 26 KB) PDF None English
DCHAA P-13032 Medicaid Estate Recovery Program Paper Form Center English
PHC 13032 P-13032 Medicaid Estate Recovery Program (PDF, 174 KB) PDF Program English
DHCAA P-13032P Medicaid Estate Recovery Program - Polish (PDF, 294 KB) PDF None English
PHC 13032S P-13032S Medicaid Estate Recovery Program - Spanish (PDF, 109 KB) PDF Program English
PHC 13040 P-13040 HIPAA Medicaid and BadgerCare Plus Notice of Privacy Practices (PDF, 113 KB) PDF None English
PHC 13040H P-13040H HIPAA Medicaid and BadgerCare Plus Notice of Privacy Practices - Hmong (PDF, 114 KB) PDF None Hmong
PHC 13040L P-13040L HIPAA Medicaid and BadgerCare Notice of Privacy Practices - Laotian (PDF, 213 KB) PDF None Laotian
PHC 13040R P-13040R HIPAA Medicaid and BadgerCare Plus Notice of Privacy Practices - Russian (PDF, 184, KB) PDF None Russian
PHC 13040S P-13040S HIPAA Medicaid and BadgerCare Plus Notice of Privacy Practices - Spanish (PDF, 112 KB) PDF None Spanish
PHC 13041 P-13041 HIPAA SeniorCare Notice of Privacy Practices (PDF, 116 KB) PDF None English
PHC 13041H P-13041H HIPAA SeniorCare Notice of Privacy Practices - Hmong (PDF, 122 KB) PDF None Hmong
PHC 13041L P-13041L HIPAA SeniorCare Notice of Privacy Practices - Laotian (PDF, 213 KB) PDF None Laotian
PHC 13041R P-13041R HIPAA SeniorCare Notice of Privacy Practices - Russian (PDF, 190 KB) PDF None Russian
PHC 13041S P-13041S HIPAA SeniorCare Notice of Privacy Practices - Spanish (PDF, 120 KB) PDF None Spanish
PHC 13045 P-13045 ForwardHealth InterChange Companion Document to HIPAA Implementation Guide - (PDF, 125 KB) X12 270/271 Eligibility, Coverage or Benefit Inquiry and Response (PDF, 125 KB) PDF None English
PHC 13048 P-13048 ForwardHealth InterChange Companion Document to HIPAA Implementation Guide - X12 834 Benefit Enrollment Maintenance (PDF, 112 KB) PDF None English
PHC 13049 P-13049 ForwardHealth InterChange Companion Document to HIPAA Implementation Guide - X12 835 Health Care Claim Payment / Advice (PDF, 67 KB) PDF None English
PHC 13050 P-13050 ForwardHealth interChange HIPAA Companion Document to HIPAA Implementation Guide: X12 997 Functional Acknowledgement (PDF, 130 KB) PDF None English
PHC 13051 P-13051 ForwardHealth interChange HIPAA Companion Document to HIPAA Implementation Guide: X12 TA1 Interchange Acknowledgement (PDF, 120 KB) PDF None English
PHC 13052 P-13052 ForwardHealth Companion Document to HIPAA Implementation Guide: NCPDP V5.1 (PDF, 239 KB) PDF None English
PHC 13054 P-13054 ForwardHealth InterChange Companion Document to HIPAA Implementation Guide: X12 276/277 Health Care Claims Status Request and Response(PDF, 132 KB) PDF None English
PHC 13067 P-13067 ForwardHealth interChange Companion Document to HIPAA Implementation Guide: 837 Health Care Claim - Institutional (PDF, 177 KB) PDF None English
PHC 13068 P-13068 ForwardHealth interChange Companion Document to HIPAA Implementation Guide: 837 Health Care Claim Professional (PDF, 174 KB) 837 Health Care Claim Professional (PDF, 174 KB) PDF None English
PHC 13069 P-13069 ForwardHealth interChange Companion Document to HIPAA Implementation Guide: (PDF, 137 KB) 837 Health Care Claim - Dental (PDF, 137 KB) PDF None English
PHC 13075 P-13075 ForwardHealth InterChange Companion Document to HIPAA Implementation Guide - X12 820 Payroll Deducted and Other Group Premium Payment for Insurance Products (PDF, 64 KB) PDF None English
DHCAA P-13091 HIPAA Wisconsin Chronic Disease Program Notice of Privacy Practices (PDF, 116 KB) PDF None English
PHC 13482 P-13482 ForwardHealth Provider Electronic Solutions Trading Partner Testing Packet PDF None English
PHC 13483 P-13483 ForwardHealth Trading Partners Testing Packet PDF None English
PHC 13484 P-13484 ForwardHealth Managed Care Trading Partner Testing Packet (PDF, 98 KB) PDF None English
DHCAA P-13606 HIPAA Wisconsin Well Woman Program Notice of Privacy Practices (PDF, 113 KB) PDF None English
DHCAA P-13606S HIPAA Wisconsin Well Woman Program Notice of Privacy Practices - Spanish (PDF, 115 KB) PDF None Spanish
PHC 16000 P-16000 FoodShare Wisconsin - FoodShare Quality Assurance Review Fact Sheet (PDF, 59 KB) PDF None English
PHC 16000H P-16000H FoodShare Wisconsin - FoodShare Quality Assurance Review Fact Sheet - Hmong (PDF, 46 KB) PDF None Hmong
PHC 16000S P-16000S FoodShare Wisconsin - FoodShare Quality Assurance Review Fact Sheet - Spanish (PDF, 45 KB) PDF None Spanish
PHC 16001 P-16001 FoodShare Wisconsin - FoodShare Income Maintenance Handbook HTML None English
PHC 16013 P-16013 FoodShare Wisconsin - FoodShare (SNAP) for Seniors and People with Disabilities Fact Sheet (PDF, 65 KB) PDF None English
DHCAA P-16013S FoodShare Wisconsin - FoodShare for Senior Citizens and People with Disabilities Fact Sheet - Spanish (PDF, 200 KB) PDF None Spanish
PHC 16062 P-16062 FoodShare Wisconsin - FoodShare Makes Wisconsin Healthier Fact Sheet (PDF, 93 KB) PDF None English
PHC 16062H P-16062H FoodShare Wisconsin - FoodShare Makes Wisconsin Healthier Fact Sheet - Hmong (PDF, 153 KB) PDF None Hmong
PHC 16062S P-16062S FoodShare Wisconsin - FoodShare Makes Wisconsin Healthier Fact Sheet - Spanish (PDF, 155 KB) PDF None Spanish
PHC 16063 P-16063 FoodShare Wisconsin - FoodShare Makes Wisconsin Healthier Brochure (PDF, 65 KB) PDF Form Center English
PHC 16063S P-16063S FoodShare Wisconsin - FoodShare Makes Wisconsin Healthier Brochure - Spanish (PDF, 302 KB) PDF Form Center Spanish
PHC 16074 P-16074 FoodShare Wisconsin - Transitional FoodShare Benefits Fact Sheet (PDF, 113 KB) PDF None English
DHCAA P-16074S FoodShare Wisconsin - Transitional FoodShare Benefits Fact Sheet - Spanish (PDF, 134 KB) PDF None Spanish
PHC 16075 P-16075 FoodShare Wisconsin - QUEST Card Mailer / Wallet Card Only (PDF, 62 KB) PDF None English
PHC 16075H P-16075H FoodShare Wisconsin - QUEST Card Mailer / Wallet Card Only - Hmong (PDF, 86 KB) PDF None Hmong
PHC 16075R P-16075R FoodShare Wisconsin - QUEST Card Mailer / Wallet Card Only - Russian (PDF, 85 KB) PDF None Russian
PHC 16075S P-16075S FoodShare Wisconsin - QUEST Card Mailer / Wallet Card Only - Spanish (PDF, 90 KB) PDF None Spanish
PHC 16077 P-16077 ACCESS Business Card (PDF, 41 KB) PDF None English
PHC 16077S P-16077S ACCESS Business Card - Spanish (PDF, 45 KB) PDF None Spanish
PHC 16078 P-16078 FoodShare Wisconsin - FoodShare and / or Child Care Six Month Report Form Fact Sheet (PDF, 93 KB) PDF None English
PHC 16078S P-16078S FoodShare Wisconsin - FoodShare and / or Child Care Six Month Report Form Fact Sheet - Spanish (PDF, 84 KB) PDF None Spanish
PHC 16084 P-16084 ACCESS Poster (PDF, 445 KB) PDF Form Center English
PHC 16084A P-16084A ACCESS Poster Tear Off Sheet (PDF, 137 KB) PDF Form Center English
PHC 16084AS P-16084AS ACCESS Poster Tear Off Sheet - Spanish (P-DF, 35 KB) PDF Form Center Spanish
PHC 16084S P-16084S ACCESS Poster - Spanish (PDF, 448 KB) PDF Form Center Spanish
PHC 16088 P-16088 FoodShare Wisconsin - Your Wisconsin Quest Card Fact Sheet (PDF, 115 KB) PDF None English
PHC 16088A P-16088A FoodShare Wisconsin - Your Wisconsin Quest Card Frequently Asked Questions HTML None English
DHCAA P-16089 FoodShare Wisconsin and the SHARE Wisconsin Program PDF None English
PHC 16091 P-16091 Guide to Applying for Wisconsin Health, Nutrition and Other Programs (PDF, 212 KB) PDF Form Center English
PHC 16091H P-16091H Guide to Applying for Wisconsin's Health and Nutrition Programs - Hmong (PDF, 248 KB) PDF None Hmong
PHC 16091S P-16091S Guide to Applying for Wisconsin's Health and Nutrition Programs - Spanish (PDF, 279 KB) PDF None Spanish
PHC 16092 P-16092 FoodShare Wisconsin - FoodShare Employment and Training (FSET) (PDF, 89 KB) PDF None English
PHC 16100 P-16100 Income Maintenance Manual HTML None English
PHC 16101 P-16101 ACCESS Handbook HTML None English
PHC 16102 P-16102 Electronic Case File (ECF) Handbook HTML None English
PHC 16103 P-16103 Process Help Book HTML None English
PHC 16108 P-16108 Key Contacts (PDF, 33 KB) PDF None English
DHCAA P-16108S Key Contacts - Spanish (PDF, 149 KB) PDF None English
PHC-9004 P-19004 And Justice for All Poster Paper Form Center English
PDE 0679 P-20679 SSI Exceptional Expense SSI-E Handbook HTML None English
PDE 3043 P-23043 SSI in Wisconsin 2013 Fact Sheet (PDF, 75 KB) PDF None English
PDE 3110 P-23110 Caretaker Supplement-information (PDF, 7 KB) PDF None English
PDE 3128 P-23128 SSI-E Information HTML None English
PDE 3129 P-23129 SSI Administration Handbook HTML None English
PDE 3131 P-23131 SSI Caretaker Supplement Handbook HTML None English