5 Payments

Note: Payments will not be approved or issued if the good or services have not yet been provided.

5.1 Denying or Reducing Payments

WFCAP payments can be denied or reduced for reasons including, but not limited to, the following:

The application for payment was not submitted on the proper form.
The decedent does not qualify for WFCAP benefits.
The decedent information is incomplete.
The application was received more than one year after the date of death.
The date of service is a future date.
The service provider’s information is incomplete.
The application was submitted by an entity other than a funeral home, cemetery, or crematory.
Payment for funeral expenses was requested, but the Statement of Funeral Goods and Services Selected was not submitted.
The Statement of Funeral Goods and Services Selected indicates cash advances, but adequate verification was not submitted.
Payment for cemetery/crematory expenses was requested, but an itemized statement from the provider of these goods and services was not submitted.
Total funeral expenses are unclear.
Total cemetery/crematory expenses are unclear.
Total funeral expenses exceed the cap of $4,500 and no special circumstances are indicated.
Total cemetery/crematory expenses exceed the cap of $3,500 and no special circumstances are indicated.
Special circumstances were requested; however, upon review, the special circumstances were not approved.
Payment for funeral expenses was requested; however, the funeral home service provider and/or the executor/family representative has not signed and dated the form.
Payment for cemetery/crematory expenses was requested; however, the cemetery/crematory service provider and/or the executor/family representative has not signed and dated the form.
There is a life insurance policy insuring the decedent’s life; however, adequate verifying documentation was not submitted.
The life insurance declaration section of the application was not signed and dated by both the service provider and the executor or family representative.
There is a life insurance policy insuring the decedent’s life; therefore, payment has been reduced by one dollar for every dollar by which the face value of the policy exceeds $3,000.
The Statement of Funeral Goods and Services Selected and/or itemized statement indicate that the total expenses on the application includes fees for services rendered by a coroner or medical examiner, fees assessed for the signing of a death certificate by a coroner or medical examiner, and/or fees assessed by a county related to transportation services.

If the reason for denial is for incomplete or insufficient information, or lack of verification documentation, service providers will be sent a Wisconsin Funeral and Cemetery Aids Program verification checklist. This notice will identify any missing items on the application and give the service provider 15 calendar days to submit the requested items. If the requested items are not received by WFCAP by the stated due date, the application will be denied.

5.2 Discretion in Approving Payments

Prior authorization is not required (such as approval prior to the funeral) as a condition of payment or that the services of a particular funeral home or cemetery association be used.

There is no requirement that a funeral home or cemetery/crematory bill for expenses at a wholesale amount, including those for outer burial containers. The funeral home or cemetery/crematory may bill wholesale or retail expenses. Regardless of the choice, the total expense caps will apply subject to the policies documented here.

5.3 Required Forms for Payments

In order to receive WFCAP payments, the following forms must be on file with the DHS Department of Health Services Division of Enterprise Services for each funeral home, cemetery, or crematory:

Form W-9, Request for Taxpayer Identification Number and Certification
DOA-6457: STAR Vendor Information Form (to obtain a supplier identification number).
DOA-6456: STAR Authorization for Electronic Deposits [to enroll in electronic fund transfers (ACH) for a direct deposit payment for approved claims]. A voided check, deposit ticket, or bank letter must be attached to this form. A direct deposit payment notification includes an email confirmation identifying each decedent’s name, date of death, and amount deposited for record reconciliation by the service provider.

The above forms should be completed and emailed to DHSDLDESBFSVendorVAL@dhs.wi.gov, or faxed to 608-266-8317. If service providers have questions about form W-9, DOA-6457, or DOA-6456, they should contact the Division of Enterprise Services, Bureau of Fiscal Services, by email at DHSDLDESBFSVendorVAL@dhs.wi.gov.

This page last updated in Release Number: 17-01

Release Date: 03/01/2017

Effective Date: 03/01/2017