Credentialing in Wisconsin
Soft Home Global provides payer enrollment, revalidation and follow-up for Wisconsin practices and billing companies at $2,200 per seat per month. Full time, worked during Wisconsin business hours, inside your own system.
What is specific to Wisconsin
BadgerCare Plus enrols most members through contracted HMOs, and Wisconsin's commercial market is unusually fragmented, with several provider-sponsored regional plans rather than one carrier holding the bulk of the business.
Wisconsin’s Medicaid programme is BadgerCare Plus (Wisconsin Medicaid). Practices with a meaningful BadgerCare Plus (Wisconsin Medicaid) mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
What a credentialing seat does in Wisconsin
Applications, revalidations and payer follow-up, with every enrollment's status visible.
BadgerCare Plus (Wisconsin Medicaid) is not one enrollment but one per plan, and every one of them has a revalidation date that stops payment when it passes. That calendar is the work.
- Initial applications prepared and submitted
- Revalidations tracked ahead of the deadline
- CAQH kept current
- Payer follow-up until an effective date is issued
- Status of every enrollment visible to you
- Worked during Wisconsin business hours, not queued overnight
For the statute behind all of this — Wisconsin’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Wisconsin billing page.
BadgerCare Plus (Wisconsin Medicaid), in practice
BadgerCare Plus is delivered mainly through HMOs with county-limited service areas, with fee-for-service as the fallback; verbatim: "Most people who get BadgerCare Plus get it through HMOs (health maintenance organizations). These are insurance companies that offer services from select providers. ... If you do not choose an HMO by the due date, we pick one for you." Thirteen HMOs are currently listed: Anthem Blue Cross and Blue Shield, Chorus Community Health Plans, Dean Health Plan, Group Health Cooperative of Eau Claire, Group Health Cooperative of South Central Wisconsin, Independent Care Health Plan (iCare), MercyCare Insurance Company, MHS Health Wisconsin, Molina Health Care, Network Health Plan, Quartz, Security Health Plan Wisconsin, and UnitedHealthcare of Wisconsin — only Anthem, MHS Health Wisconsin and UnitedHealthcare cover all counties, so the correct plan depends on the member's county. Source
Working Wisconsin hours
Wisconsin runs on Central time, 11 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 8pm to 4am, and 7pm to 3am once the clocks go forward. Pakistan does not observe daylight saving, so the shift moves on this side rather than yours.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on Wisconsin hours and nobody else’s.
What it costs in Wisconsin
$2,200
Per seat, per month, in US dollars — $26,400 a year for one full-time person, forty hours a week, on Wisconsin hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Wisconsin run $1,500 to $2,500; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in Wisconsin
About a week from a signed agreement to a person working your queue, and that week of training on your workflow is not billed on top. The work happens in your own system under a login you issue, so there is nothing to migrate and nothing to install. The week, step by step, and what is signed before anyone has access.
Questions
Do you work with Wisconsin practices?
Yes. Wisconsin accounts are worked during Wisconsin office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Wisconsin?
BadgerCare Plus enrols most members through contracted HMOs, and Wisconsin's commercial market is unusually fragmented, with several provider-sponsored regional plans rather than one carrier holding the bulk of the business.
When does a Wisconsin payer have to pay a clean claim?
30 days after the insurer is furnished written notice of the loss and its amount (Wis. Stat. § 628.46(1)). This is a general insurance prompt-pay provision — the section does not set separate electronic vs. paper clean-claim deadlines; a parallel 30-day rule at § 628.46(2m) runs from receipt of the chiropractor's clinical documentation. A claim sitting past that is not merely late, it is late against a statute, and the follow-up call changes from "when might this be paid" to "this passed your statutory window on a specific date".
How much does credentialing cost in Wisconsin?
$2,200 per seat per month — $26,400 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our Wisconsin queue?
Wisconsin is on Central time, 11 hours behind Rawalpindi. The shift here runs 8pm to 4am so your seat is at a desk for your full working day, shifting to 7pm to 3am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle BadgerCare Plus (Wisconsin Medicaid) as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. BadgerCare Plus (Wisconsin Medicaid) has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
What is the minimum commitment, and how quickly can somebody start?
One seat for one month, cancellable on thirty days notice, and about a week from a signed agreement to a person working your queue. The week of training is not billed. The steps are at softhomeglobal.com/how-it-works.
Is our patient data safe offshore?
A Business Associate Agreement is signed before anyone has access, and the work happens in your own system under a login you issue, so every action is attributable to a person in your audit trail. The controls are listed at softhomeglobal.com/security.
Next step
One seat on your Wisconsin work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com