State of Wisconsin Department of Health Services

Release 24-03 November 15, 2024

12.1 Introduction

12.1.1 What is Express Enrollment?

The following terms are used in reference to the Express Enrollment process:

• Express Enrollment: The process of making a presumptive eligibility determination to temporarily enroll a person in BadgerCare Plus or Family Planning Only Services.
• Presumptive eligibility: The determination of whether or not an applicant is eligible to temporarily enroll in BadgerCare Plus or Family Planning Only Services.
• Temporary enrollment: Short-term eligibility for BadgerCare Plus or Family Planning Only Services

Determinations made through the Express Enrollment application process are based solely on preliminary household and financial information provided by the applicant. This process allows an applicant to receive immediate health care coverage for a short period of time until an application for ongoing coverage is completed and processed.

12.1.2 What is ACCESS for Partners and Providers?

APPACCESS For Partners and Providers is the web-based Express Enrollment application tool in ACCESS for providers, partners, and qualified hospitals to make presumptive eligibility determinations for the temporary enrollment of certain populations for BadgerCare Plus or Family Planning Only Services coverage.

12.1.3 Who can provide Express Enrollment?

Express Enrollment applications are completed by providers, partners, and qualified hospitals approved by ForwardHealth to make presumptive eligibility determinations. The applicant must be physically present in order to review and electronically sign the application. Telephonic signatures are not allowed for Express Enrollment.

The following is a summary of who can make presumptive eligibility determinations through the Express Enrollment process, which varies based on program and/or the population the applicant falls into:

• BadgerCare Plus:
  • Children: Community organizations, Medicaid-enrolled providers, and staff of qualified hospitals who have been approved by ForwardHealth to make presumptive eligibility determinations and who have received Express Enrollment training
  • Pregnant women: Medicaid-enrolled providers and staff of qualified hospitals who have been approved by ForwardHealth to make presumptive eligibility determinations and who have received Express Enrollment training
  • Adults: Only staff of qualified hospitals who have been approved by ForwardHealth to make presumptive eligibility determinations and who have received Express Enrollment training

• Family Planning Only Services: Medicaid-enrolled providers and qualified hospitals who have been approved by ForwardHealth to make presumptive eligibility determinations and who have received Express Enrollment training

12.1.4 Partner and Provider Accounts

Wisconsin User IDs used to login as a Community Partner or a Provider/Hospital user should not be used to apply for ongoing benefits or view benefit information online through ACCESS. Separate User IDs are required for using ACCESS as a Community Partner or Provider/Hospital user and for managing personal benefit information.

• If you are helping a person who either wants to apply for benefits or view their benefit information, and are logged into ACCESS with a Community Partner or Provider/Hospital User ID, you must log out of your Community Partner or Provider/Hospital account. The person you are helping will then need to create and login to ACCESS with their own User ID.
• If you want to apply for benefits for yourself or view your benefit information, and are logged into ACCESS with a Community Partner or Provider/Hospital User ID, you must log out of your Community Partner or Provider/Hospital account. You will then need to create and log in to ACCESS with your own User ID.
• If you are logged into ACCESS using a personal Wisconsin User ID used to apply for benefits or view benefit information, and you would like to use ACCESS as a Community Partner or Provider/Hospital user to submit Express Enrollment applications, you must log out of your personal account. You will then need to login with your Community Partner or Provider/Hospital User ID.

This page last updated in Release Number: 19-02
Release Date: 06/24/2019
Effective Date: 06/24/2019

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Notice: The content within this guide is the responsibility of the State of Wisconsin's Department of Health Services (DHS) and the Department of Workforce Development (DWD).

Publication Number: P-16101