Effective 4/1/2024 – Inclusa is extending the timely filing deadline from 90 days to 120 days for clean claims.
11/07/2024: New Claims and Billing Resources have been added below:
- “Minimum Fee Schedule FAQs iCare-Inclusa”
- Purpose: To provide a list of provider “Frequently Asked Questions” (FAQs) related to the implementation of the Minimum Fee Schedule.
- “Minimum Fee Schedule for Home and Community-Based Service” DHS website link
- Purpose: To direct providers impacted by Minimum Fee Schedule to DHS resources.
- “Residential Claim Submission Tip Sheet”
- Purpose: To assist residential providers with Minimum Fee Schedule Claims and Billing changes.
- “MFS iCare Family Care Billing Guide”
- Purpose: To assist providers with Minimum Fee Schedule Claims and Billing changes for impacted Home and Community-Based Services.
Resources
- Authorization and Claims Support Contact Information for Providers
- Authorization Request Form for COBA/Medicare A or B Primary Product or Service
- Claim Appeal Submission Form
- Corrected Claim Form
- Corrected Claim Form Tip Sheet
- Corrected Claim Tips
- Electronic Visit Verification (EVV) Billing Facts
- Electronic Visit Verification (EVV) Billing Guide
- Electronic Visit Verification (EVV) Visit Key Rounding & Unit Calculations Reference
- Family Care Claim Explanation Codes
- Family Care Claim Form Outline
- Family Care/WPS General Claim Submission Requirements
- Home Health & Personal Care Claim Submission Coding
- WPS Electronic Funds Transfer (EFT)/Electronic Remittance Advice (ERA) Enrollment
- iCare Family Care MFS
- Inclusa Claim and Payment Question and Issue Contacts
- Inclusa Paper Claim Form
- Inclusa Paper Claim Form – Fillable
- Inclusa Provider Customer Support – Satisfaction Survey
- Inclusa Spreadsheet Submission Tips
- Minimum Fee Schedule FAQs iCare-Inclusa
- Minimum Fee Schedule iCare Family Care Billing Guide
- Minimum Fee Schedule for Home and Community-Based Services
- New Provider Outreach and Onboarding
- Preventing Duplicate Claims Denials & Payments
- Provider Appeal Rights Under Family Care
- Provider Nursing Home Authorization Information
- Provider Refund Request for WPS
- Rehab Agency Therapy Cover Sheet Form
- Residential Claim Form Example
- Residential Claim Submission Tip Sheet
- Respite Services Billing Tips for Residential Providers
- Residential Types of Bill
- Residential Transportation Claim Form Example
- Supported Employment Billing Process
- Therapy Cover Sheet Form (Microsoft Word Document)
- Therapy Cover Sheet Form (PDF)
- Timely Filing Update April 2024
- Transportation Paper Claim Training
- WPS Provider Portal Information
- WPS Provider Portal Login/Register
- WPS Spreadsheet Submitter Internet Agreement
- Z-Code Packages 2024
- Z-Code Packages 2023
Contact Information
Transportation Support Team
- Transportation (All)
Email: ACS-Transportation@inclusa.org
Phone: 1-888-544-9353, Option 4
Fax: 1-866-880-0551
DME/DMS/OTC Support Team
- Adaptive Aids
- Communication Aids
- Disposable Medical Supplies (DMS)
- Durable Medical Equipment (DME)
- Environmental Accessible Adaptations (Home Modifications)
- Over-the-Counter Medications (OTC)
- Vehicle Modifications
Email: ACS-DME-DMS-OTC@inclusa.org
Phone: 1-888-544-9353, Option 5
Fax: 1-866-880-0551
Residential/CSL/NH Support Team
- Community Supported Living (CSL)
- Nursing Homes
- Residential Care (AFHs, CBRFs & RCACs
- Respite Care
Email: ACS-Residential-CSL-NH@inclusa.org
Phone: 1-888-544-9353, Option 6
Fax: 1-866-880-0551
SHC/SDS/Home Health/Therapy Support Team
- Adult Day Care
- Alcohol and Other Drug Abuse Treatment
- Alternative Therapies
- Case Management – External
- Community Support Program (CSP)
- Consultative Clinical/Therapeutic Services for Caregiver
- Consumer Education and Training
- Counseling & Therapeutic Resources
- Daily Living Skills Training
- Day Habilitation Services
- Emergency Assistance to Obtain/Retain a Home
- Financial Management Service (Rep Payee)
- Home Delivered Meals
- Home Health Care
- Housing Counseling
- Mental Health Services
- Non-covered Family Care Services (Out of Benefit)
- Occupational, Physical, Speech Therapy
- Personal Care/Agency
- Personal Emergency Response Systems
- Pre-Vocational
- Self‐Directed Supports (SDS)
- Skilled Nursing Service – Independent/Private
- Support Broker
- Supported Employment
- Supportive Home Care
- Vocational Futures Planning & Support
Email: ACS-SHC-SDS-HomeHealth@inclusa.org
Phone: 1-888-544-9353, Option 7
Fax: 1-866-880-0551
Provider Claim Appeals
- Provider Claim Appeals
Email: providerclaimappeal@inclusa.org
Phone: 1-888-544-9353, Option 8
Fax: 1-866-880-0551
Provider Claim Audits
- Provider Audits
- Income Verification
- Provider Overpayments / Refunds
Email: audit@inclusa.org
Phone: 1-888-544-9353, Option 8
Fax: 1-866-880-0551
Insurance Claims Specialist
- Provider Medicare Denials
- Provider Medicare Authorization Requests
- Coordination of Benefits
- Other Insurance Coverages
Email: insuranceclaimsspecialist@inclusa.org
Fax: 1-866-880-0551
WPS Provider Customer Support
WPS / Family Care Contact Center
1-800-223-6016 (8:00 a.m. – 4:30 p.m., M-F)
- General claims support questions
- Claim and payment status
- WPS Inclusa Paper Claim Form
WPS EDI Help Desk
1-800-782-2680, Option 1
- Online registration issues, password resets, login assistance
- Missing files or other technical concerns
- Validating claim acceptance by EDI/EDI rejection message assistance
(rejected by EDI, not denied by WPS)
WPS EDI Marketing
1-800-782-2680, Option 2
- Assistance with enrollment for claims submission, electronic remittance, and direct deposit (EFT)
WPS Website
- Visit WPS/Inclusa Website
- Forms, instructions, and support related to options for claims and payments