Provider Q&A 2017-08-29T17:37:20+00:00

My Choice Family Care Providers Make a Difference

My Choice Family Care contracts with thousands of local, compassionate, community-based care and service providers. Each one brings something special and of value to our network of supports for seniors, adults with disabilities, and the family and friends who care for them. We can’t achieve our mission without them, so we encourage collaboration. Just as they support members, we support them and give them the opportunities, information, training, and tools they need to succeed.

If you would like to become a My Choice provider, 2017-09-25T10:18:00+00:00

start by applying online.

If you would like to learn more about becoming a provider, 2017-09-25T10:19:24+00:00

keep reading for answers to some of the most common questions from providers. For more information, please email a contracts representative or call 877-489-3814.

I am interested in becoming a network service provider; what services does My Choice Family Care provide? 2017-09-25T10:23:46+00:00

We have a robust network of providers offering community-based, long-term care services to ensure optimal choice for members in all of the communities we serve.

My Choice Family Care offers all services included in the Home & Community Based Waiver program.

If I want to become a network service provider, are there certain requirements that I must meet? 2017-09-25T10:23:53+00:00

The requirements are listed in the My Choice Family Care Provider Contract, and explained during the credentialing and contracting process. You can also review the Provider Handbook, but initial requirements are as follows:

  • Must be in business for one year and able to show financial stability
  • Be licensed, certified, and Medicare and/or Medicaid certified, as applicable
  • Have internet access
  • Not be federally excluded by the Office of Inspector General (OIG)
  • Supply a criminal and/or caregiver background check for owners and principals
If I want to request a provider application to become part of your network, what is the process? 2017-09-25T10:24:00+00:00

My Choice Family Care’s contracting team continuously monitors the Provider Network to ensure there is sufficient capacity to meet our Members’ needs. Please refer to the “Becoming a Service Provider” section of this website for the openings in our network service areas.

Who can help me with claims-related questions? 2017-09-25T10:24:07+00:00

My Choice Family Care has a provider claims technician to assist you with all billing and claims questions. Call 414-287-7424 for help with claims submission and payment.

How do I reset my login or password? 2017-09-25T10:24:16+00:00

Please contact our Contracting Department at either 414-287-7657 or 414-287-7498, and they would be happy to assist you in resetting your password.

Why does our name have to be on the certificate of insurance? 2017-09-25T10:24:24+00:00

This is a credentialing requirement, so if an accident occurs, both the insured provider and the managed care organization are covered for any potential liability that ensues.

Why are your rates different from other MCOs? 2017-09-25T10:24:31+00:00

Rates are negotiated between each individual provider and our managed care organization. Because the MCO receives varied capitation rates between counties served, not all rates will be the same.

How long does it take to execute a contract? 2017-09-25T10:24:39+00:00

There are many factors that go into the contracting process. The credentialing and rate negotiation process varies depending on the provider type, size, and number of employees. Generally, the process for contracting takes from 30 to 60 days, depending on the provider size, number of residential locations, and other factors.

It seems to take longer for approval/authorization for durable medical equipment (DME) products. Why is that? 2017-09-25T10:24:45+00:00

The MCO needs to determine whether Medicare is the primary insurer. There are extensive documentation and requirements that must be met in order to satisfy Medicare approval prior to the receipt of DME products. Because Family Care is a secondary pay source, the primary payor must be established first.

How do I receive placement referrals? 2017-09-25T10:24:51+00:00

Providers need to submit open bed information to the residential placement team. You can email them at famcplacementteam@mychoicefamilycare.org.

How are placement decisions made? 2017-09-25T10:24:56+00:00

When a member needs placement, our residential team works closely with his or her interdisciplinary team to ensure viable placement options are offered for consideration. There are several factors that go in to placement decisions, including the member’s ability to afford the room and board at the in-network residential facility of their choice, the provider’s ability to meet the individual member’s needs, and the proximity of placement. Placement is a collaborative process between the member, care team and guardian, as applicable.

Does the MCO offer free or low-cost training to become a provider? 2017-09-25T10:25:04+00:00

Yes! My Choice Family Care offers and promotes a wide range of free or low-cost training options to provider agencies and their employees throughout the year. Notifications about training options are sent via email to providers within our network, and include a description of the training, registration guidelines, and other relevant information.

What are the steps that need to be taken to certify my one- or two-bedroom adult family home (AFH)? 2017-09-25T10:25:12+00:00

Providers interested in certification through My Choice Family Care should reach out to the Contracting Department to determine whether and which types (populations, accessibility, location, etc.) of AFHs the MCO is currently accepting applications for. If applications are being accepted, the first step is to complete and submit a provider application. After an initial screening, the provider will be referred to an AFH Certifier to arrange for certification application and site visit. Certification guidelines can also be viewed on the Wisconsin DHS website.

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