Provider Q&A2017-08-29T17:37:20-06:00
Read answers to common questions asked by our providers

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.

What do we call the new company?2020-01-23T09:46:31-06:00

We are temporarily calling the new organization My Choice Family Care – Care Wisconsin until we roll out our new brand name and logo.

We are beginning the process of developing our new brand strategy and will reveal our new name and design in the middle of 2020.

Why are the two companies merging?2020-01-23T09:47:37-06:00

The two companies are merging to provide a comprehensive array of services and network of integrated care for our members.

Which 800 number should I use to contact My Choice Family Care – Care Wisconsin?2020-01-23T09:53:16-06:00

My Choice Family Care
Toll Free: 1-877-489-3814

Care Wisconsin
Toll Free: 1-800-963-0035

What is changing effective January 1, 2020 with the merger?2020-01-23T09:55:15-06:00

At this time, providers should continue to operate as status quo until February 1, 2020. Our priority is to merge all Family Care member and Family Care program provider information into the MIDAS system by February 1, 2020, which will change how providers work with the new organization. This excludes Partnership, Dual Advantage and SSI members; the operations for these programs will remain status quo until further notice.

What is changing for Family Care program providers effective February 1, 2020?2020-01-23T09:57:25-06:00

For Care Wisconsin contracted providers your authorization process will change for Family Care program members. For Family Care program members an authorization is required prior to rendering ALL services effective on/after February 1, 2020. Care Teams will enter all authorizations and providers will be able to see and/or print the authorization from the MIDAS portal for these members.

On the bottom of each authorization indicates the MCO the member is enrolled in.

If you serve both My Choice and Care Wisconsin Family Care members you will need two separate logins. My Choice Family Care – Care Wisconsin Provider Contracting Staff will be reaching out to you soon to provide login information to MIDAS. Stay tuned for upcoming communications regarding MIDAS login information. Training will be available for providers by February 1, 2020.

Please note: this excludes Partnership, Dual Advantage and SSI members, the operations for these programs will remain status quo until further notice.

Who can help me with claims-related questions?2020-01-22T11:50:10-06:00

Please contact the appropriate TPA with claims questions. For Family Care members with My Choice Family Care, please contact WPS at 800-223-6016. For Family Care members with Care Wisconsin, please contact 855-878-6699.

Provider Forums will be held in February and March to share additional information regarding the merger, changes providers are experiencing with the merger, who providers can contact for questions, claims, authorizations and any additional information we may have about what’s next (re-contracting, etc).

Times and dates will be added to our websites and emailed out to currently contracted providers.

For Family Care if you are serving a member from My Choice Family Care claims should be submitted through WPS. If you are serving a member from Care Wisconsin, you must first review MIDAS for your authorization then claims should be submitted through your normal Care Wisconsin process to the TPA (TriZetto) with the included authorization number in MIDAS on the claim. If you are a provider serving a member for Partnership, Dual Advantage or SSI, claims should continue to go through the normal Care Wisconsin process to the TPA (TriZetto).

Additionally, the Provider Manual may be able to answer common questions for claims.

How do I reset my login or password?2020-01-22T11:53:53-06:00

Please contact your Contracting Representative, or the following phone numbers and staff will be happy to assist you in resetting your password:

You can also email your password reset request to:

What if I already have a MIDAS login because I’m already contracted with My Choice Family Care?2020-01-23T10:03:28-06:00

If you have a MIDAS login because you are currently contracted with My Choice Family Care, you will need to obtain a second login to gain access to authorizations for any Care Wisconsin Family Care program members. My Choice Family Care – Care Wisconsin Provider Contracting Staff will be reaching out to you soon to provide login information to MIDAS. Stay tuned for upcoming communications regarding MIDAS login information.

I have a contract with both My Choice Family Care and Care Wisconsin for the Family Care program, which contract should I follow?2020-01-23T10:04:01-06:00

If a Family Care program member is an original enrollee to My Choice Family Care, the My Choice Family Care contract will apply. If the Family Care program member is an original enrollee of Care Wisconsin, the Care Wisconsin contract will apply. These contracts will remain in place and effective until we are able to re-contract with providers at a future date.

If you would like to become a My Choice Family Care – Care Wisconsin Provider2020-01-22T12:00:16-06:00

On January 1, 2020, My Choice Family Care and Care Wisconsin merged and are now one company, My Choice Family Care – Care Wisconsin. While we work through the process of integrating our operations, we are temporarily pausing on new Long-Term Care contracts, including adding of new locations, rate reviews and new AFH certifications. We plan to resume contracting in mid-February 2020. Thank you for your patience as we work through this exciting time.

I am contracted with Care Wisconsin for the Partnership, Medicare Dual Advantage and/or SSI programs, are there any changes for these programs?2020-01-23T10:18:22-06:00

If you are contracted with Care Wisconsin for other programs there are no changes you need to be aware of at this time. These contracts will remain in place and effective until we are able to re-contract with providers under the new organization.

I am interested in becoming a network service provider; what services does My Choice Family Care provide?2020-01-22T12:03:01-06:00

On January 1, 2020, My Choice Family Care and Care Wisconsin merged and are now one company My Choice Family Care – Care Wisconsin. While we work through the process of integrating our operations, we are temporarily pausing on new Long-Term Care contracts, including adding of new locations, rate reviews and new AFH certifications. We plan to resume contracting in mid-February 2020. Thank you for your patience as we work through this exciting time.

My Choice Family Care – Care Wisconsin offers all services as indicated on the chart located at the following link including Family Care, Partnership, Badger Care, Medicare Dual Advantage and SSI: https://www.dhs.wisconsin.gov/familycare/benpackage.htm

Why does our name have to be on the certificate of insurance?2020-01-22T12:47:02-06:00

The additional insured endorsement extends your liability coverage to the MCO to address any additional liability exposure you potentially create for us in the course of providing services.

Why are your rates different from other MCOs?2017-09-25T10:24:31-06:00

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?2020-01-22T12:49:16-06:00

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

On January 1, 2020, My Choice Family Care and Care Wisconsin merged and are now one company, My Choice Family Care – Care Wisconsin. While we work through the process of integrating our operations, we are temporarily pausing on new Long-Term Care contracts, including adding of new locations, rate reviews and new AFH certifications. We plan to resume contracting in mid-February 2020. Thank you for your patience as we work through this exciting time.

It seems to take longer for approval/authorization for durable medical equipment (DME) products. Why is that?2020-01-22T12:53:28-06:00

My Choice Family Care – Care Wisconsin 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?2018-07-30T10:48:56-06:00

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

How are placement decisions made?2017-09-25T10:24:56-06:00

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?2020-01-22T13:11:20-06:00

Provider Forums will be held in February and March to share additional information regarding the merger, changes providers are experiencing with the merger, who providers can contact for questions, claims, authorizations and any additional information we may have about what’s next (re-contracting, etc).

Times and dates will be added to our websites and emailed out to currently contracted providers.

What are the steps that need to be taken to certify my one- or two-bedroom adult family home (AFH)?2020-01-22T13:09:35-06:00

Providers interested in certification through My Choice Family Care – Care Wisconsin should reach out to the Contracts and Provider Relations 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. We will accept previous certifications from another MCO.

On January 1, 2020, My Choice Family Care and Care Wisconsin merged and are now one company, My Choice Family Care – Care Wisconsin. While we work through the process of integrating our operations, we are temporarily pausing on new Long-Term Care contracts, including adding of new locations, rate reviews and new AFH certifications. We plan to resume contracting in mid-February 2020. Thank you for your patience as we work through this exciting time.

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