View the Wisconsin Medicaid Provider Profile
The Medicaid Provider Profile page shows the Medicaid services provided by your facility, along with the values and effective dates of Medicaid reimbursement calculations.
- To access the Medicaid Provider Profile page, select Go To > Government Payor Research > Medicaid > Provider Profile. The Medicaid Provider Profile page opens.
- In the Select State or Payer drop down list, select WI.
- Select Go.
- Enter the ten-digit National Provider Identification (NPI) number for the provider you want to review in the NPI or Provider Number field.
- Enter a date in the Effective Date field if you want to view provider profile information for an effective date other than today.
- Click Display Profile. The Medicaid Provider Profile information displays.
Note: To clear the results and return to original Medicaid Provider Profile page, click Reset.
- Review your Medicaid Provider Profile information.
Note: The data that displays on the provider profile varies from state to state.
The following table describes each of the fields on the Medicaid Provider Profile page for Wisconsin Medicaid.
|
Field |
Description |
|
State or Payer |
State or payer for the selected provider number |
|
NPI or Provider Number |
Provider’s tax ID number or ten-digit National Provider Identification (NPI) number required on all claims |
|
Effective Date |
Date on which the selected profile went into effect |
|
Begin Date |
Rates effective date. |
|
End Date |
Rates end date. |
|
Grouper Type |
The type of grouper used for this profile. |
|
Grouper Version |
The DRG grouper version used for this profile. |
|
Payer Exception |
Identifies the payer exception. |
|
Base Rate |
State determined, Facility specific Base Rate used for standard EAPG Payment. |
|
Access Payment |
Facility specific access payment applied to claim. |
|
User Defined Adjustment Factor |
Facility specific adjustment factor for payments. |
|
P4P Adjustment |
Indicates the P4P adjustment. |
|
Hospital Type |
Identifies the hospital type. |