Children's Long-Term Support: How do providers get paid?
CLTS Claims are now being processed through the ForwardHealth Portal
For more information please contact the CLTS Operations Team at 844-942-5870 or cltsoperations@gainwelltechnologies.com Monday through Friday 8 a.m.-4:30 p.m.
Steps to get paid
Step 1
Before you deliver a service, make sure you have a prior authorization (PA) from the county waiver agency (CWA) of the county the participant lives in.
The PA will have the service, rate, and frequency that is approved for the child. Once you have a PA from the CWA, you may deliver the service.
Step 2
After delivering the authorized service to the Children's Long-Term Support (CLTS) Program participant, you will submit a claim for that service.
Claims processor update
You can begin submitting claims with Gainwell Technologies, the new CLTS claims processor, in the ForwardHealth Portal on April 28, 2025. Your claims will be processed on May 5, 2025.
For information about the new claims processor for the CLTS program visit the ForwardHealth CLTS Transition webpage.
The ForwardHealth Portal offers a few streamlined ways to submit claims.
- Direct data entry: you can enter a new claim right into the portal.
- Copy a claim: the portal allows you to copy information from a paid claim to a new claim. You can then make any needed edits before submitting your new claim.
- Create a claim from a prior authorization: you can create a claim using a PA. It will prepopulate information on the claim based on the PA.
You can submit claims for dates of services before the transition date. You have 365 days from when the service happened to submit a claim.
Step 3
Know how you’ll get paid. You can get paid in one of two ways:
- Electronic funds transfers (EFT), which is a direct deposit to a
bank account of your choosing - Paper check in the mail
If you want to get paid via EFT, you’ll have to sign up for EFT in the ForwardHealth Portal. EFT information from WPS does not carry over. Only a clerk from your organization who has been assigned the EFT role can sign up for EFT. Once you sign up for EFT, you cannot revert to receiving paper checks.
You can change your EFT information at any time. Signing up for EFT does not change your Remittance Advice.
Claims processor
The claims processor for the CLTS Program is Gainwell Technologies, LLC. (GWT), using the ForwardHealth Portal (the Portal).
Who do I contact with questions?
Enrolling as a provider
Contact the CLTS Provider Contact Center at 833-940-1576 or email dhscltsprovider@dhs.wisconsin.gov. They can:
- Answer questions about the enrollment process.
- Help you navigate the provider directory.
Getting authorizations to provide services
Contact the local county waiver agencies. They can:
- Help direct care workers get set up with a fiscal agent or other agency.
- Help you find more information about becoming a provider in a certain county.
Claims submission and payment
Contact the claims processor. They can answer questions about claims submission and payment:
Call: 844-942-5870
Email: cltsoperations@gainwelltechnologies.com
Monday through Friday: 8 a.m.–4:30 p.m.
Provider claims processing events and communications
ForwardHealth Portal Other Insurance Claims Training
July 30, 10–11 a.m.
Register for the webinar
Provider webinars
July 16 and 17, 2025
- Agenda: Converted PAs, date span billing, PA not found, modifiers and place of service (POS) codes, diagnosis pointer code, other Insurance attachments, not otherwise specified durable medical equipment (DME) code attachments, claim status, remittance advice
- Jul. 16, 2025, recording
- Jul. 17, 2025, recording
- Jul. 16 and 17 presentation (PDF)
April 16, 2025
- Agenda: Project timeline, implementation dates, finding your Medicaid ID, multiple dates of service, code crosswalk, place of service codes, payment and remittance advice schedules, outstanding checks and recovery
- Apr. 16, 2025 recording
- Apr. 16, 2025, presentation (PDF)
March 19, 2025
- Agenda: Project timeline, implementation dates, Submission Sandbox testing, Hypercare plan, PA batches, provider TPA transition, webpage: what’s new?, CLTS Operations Center support, training opportunities
- Mar. 19, 2025, recording
- Mar. 19, 2025, presentation (PDF)
December 17, 2024
- Agenda: Project timeline, implementation dates, payment and electronic funds transfer, date span clarifications and examples, International Classification of Diseases Tenth Edition (ICD-10) codes on Wisconsin Physicians Service (WPS) transfer prior authorizations, prior authorization number on claims, ForwardHealth Portal access, provider testing process and submission sandbox, training information
- Dec. 17, 2024 recording
October 31, 2024
- Agenda: Project timeline, provider survey, implementation dates, new payment and remittance advice schedules, Medicaid IDs, date span billing, direct data entry rejections, training information, what’s next
- Oct. 31, 2024, recording
- Oct. 31, 2024, presentation (PDF)
August 21 and August 28, 2024
- Agenda: Project timeline, third-party administrator (TPA) transition webpage, implementation dates, new overpayment recovery process, summary of design changes, what’s next
- August 21, 2024, recording
- August 28, 2024, recording
- Aug. 21 and 28, 2024, presentation (PDF)
Demonstration sessions
November 13, 2024: Overview of Portal Navigation and Claims Submission Options
- Agenda: Navigating the ForwardHealth Portal, portal resources, claim submission options, direct data entry, paper claim, 837 submission
- November 13, 2024, recording
- November 13, 2024 presentation (PDF)
August 13 and 15, 2024, How to Submit an 837 Demonstration
- Agenda: 837 claims, converting Excel files to 837 claims, uploading 837 files to the ForwardHealth Portal, finding help
- August 13, 2024, recording
- August 15, 2024, recording
July 24 and 25, 2024, Portal and Claims Submission Demonstration Sessions
- Agenda: Navigating the ForwardHealth portal, claim submissions options, where to find resources
- July 24, 2024, recording
- July 25, 2024, recording
- July 24 and 25, 2024, presentation (PDF)
Provider forums
May 16, 2024, CLTS TPA Transition Provider Forum
- Agenda: Updated project timeline, ForwardHealth portal, claims submission general updates, claims submission options, Medicaid IDs
- May 16, 2024, recording
- May 16, 2024, presentation (PDF)
January 11, 2024, CLTS Program TPA Transition Financial Management Services Provider Forum
- Agenda: CLTS TPA transition overview, forum objectives, claims submission functionality, viewing claims, viewing prior authorizations
- Jan. 11, 2024, recording
- Jan. 11, 2024, presentation (PDF)
January 9, 2024, CLTS Program TPA Transition Financial Management Services Provider Forum
- Agenda: CLTS TPA transition overview, forum objectives, claims submission functionality, viewing claims, viewing prior authorizations
- Jan. 9, 2024, recording
- Jan. 9, 2024, presentation (PDF)
January 4, 2024, CLTS Program TPA Transition Financial Management Services Provider Forum
- Agenda: CLTS TPA transition overview, forum objectives, claims submission functionality, viewing claims, viewing prior authorizations
- Jan. 4, 2024, recording
- Jan. 4, 2024, presentation (PDF)
November 30, 2023, CLTS Program TPA Transition
- Agenda: CLTS TPA transition overview, claims submission functionality, viewing claims history and prior authorizations
- Nov. 30, 2023, recording
- Nov. 30, 2024, presentation (PDF)
- Fact Sheet: Multiple Dates of Service on a Claim (Jul. 18, 2025)
- Children's Long-Term Support (CLTS) Claims Attachments and Updated Instructions (Jul. 11, 2025)
- Fact Sheet: Multiple Dates of Service on a Claim (Jul. 18, 2025)
- Children's Long-Term Support (CLTS) Claims Attachments and Instructions (Jun. 13, 2025)
- Updated Information on Prior Authorization Conversion and Next Steps (Jun. 6. 2025)
- Submitting Claims on Converted Prior Authorizations (Jun. 5, 2025)
- New and Updated Documents Available for the ForwardHealth Portal Transition (Jun. 4, 2025)
- ForwardHealth Claim Information (May 23, 2025)
- ForwardHealth Prior Authorization Conversion Process (May 7, 2025)
- ForwardHealth Portal Message Center (May 7, 2025)
- Resources to Support Submitting Claims Using 837s (May 5, 2025)
- Finding Prior Authorization Numbers (Apr. 30, 2025)
- Questions About the CLTS Program? Make Sure Your Email Gets to the Right Place (Apr. 29, 2025)
- Electronic Funds Payments (EFT) for TPA Transition (Apr. 25, 2025)
- Children’s Long-Term Support ForwardHealth Portal Welcome and PIN Letters (Jan. 30, 2025)