Payer Question Form

Association members are invited to submit their questions for Wisconsin Payers.  PLEASE: NO PHI or other Patient Identifiers

Timeline & Due Dates:

The committee will meet bi-monthly starting in January 2026.
 

Please submit a separate form for each question!

Questions about the event?  Email Association Executive Director:  Jean Thomas, CMPE | director@healthcareleaderswi.org

Question Submitted By
Your Name: *
Your Organization: *
Your Title: *
Best number to reach you in the event that clarification is needed: *
Your Email: *
Question Details
Question for: *
Third Party Payer
Medicaid
Medicare
Medicare Advantage
Other (Describe in next question)
Explain Other:
Question relates to: *
Facility
Professional
BOTH Facility AND Professional
Procedure code in question (if there is more than one, please submit a separate form):
Scenario that code is used in:
Provider types:
Additional Information:
Question:
Is your question prompted by:
New Service
General Policy/Coverage Research/Policy Rationale
Denials (If Denials please provide detail in next question)
If you answered 'Denials' in the previous question, please provide the denial code(s) being used:


Thank you for submitting your questions for the Wisconsin Payers/Revenue Cycle Committee

Have questions?  Email HLA Wisconsin Association Executive Director:  Jean Thomas, CMPE | director@healthcareleaderswi.org