Physicians are reminded that Wisconsin’s 2013-2015 biennial budget sunsets the Health Insurance Risk-Sharing Plan (HIRSP) on December 31, and all claims with dates of service on or before that date must be filed by March 31, 2014. In addition, Medicaid-certified providers may not balance-bill HIRSP members for any claims denied because they were submitted after the deadline.
All corrected claims and submissions also must be received by March 31, 2014, to be considered for payment. Supporting documentation related to a pre-existing condition review must be received by June 30, 2014, to have the associated claims considered for payment.
Overpayments and refunds owed to HIRSP must be paid and can be returned at any time.
HIRSP currently offers health insurance to roughly 22,000 Wisconsin residents who either are unable to find adequate health insurance coverage in the private market due to their medical conditions or who have lost their employer-sponsored group health insurance. Participants must transition to the Health Insurance Marketplace (also known as health insurance exchanges) by January 1, 2014.
Questions may be directed to Chris Rasch in the Wisconsin Medical Society’s Government Relations Department or HIRSP customer service at 800.828.4777.
Back to October 17, 2013 Medigram