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Wisconsin Department of Health and Family Services Obsolete Medicaid Eligibility Handbook For the current MEH, see http://www.emhandbooks.wi.gov/meh-ebd/ For the current BC Plus Handbook, see http://www.emhandbooks.wi.gov/bcplus/ |
EDS initiates the Good Faith claim process by sending you a Good Faith form ( HCF 10111 ) that they have partially completed, and one or two letters, depending on what documentation of eligibility the provider included with their claim. Complete the ( HCF 10111 ) form if this is a new client (cert. 1) or return a new HCF 10110 ( formerly DES 3070 ) for amended certifications (cert. 3). Send completed ( HCF 10111 ) forms to:
EDS
Good Faith Unit
P.O. Box 6215
Madison, WI 53784
Send completed 3070 forms to:
Mail: EDS
P.O. Box 7636
Madison, WI 53707
E-mail: veds@wisconsin.gov
Fax: (608) 221-8815
This page last updated in Release Number : 02-03
Release Date : 01/01/02
Effective Date : 07/01/02
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