Finding Prior Authorization Numbers

The Wisconsin Department of Health Services (DHS) has transitioned the state’s claims processor for the Children's Long-Term Support (CLTS) Program prior authorizations (PAs) and claims from Wisconsin Physicians Service (WPS) to Gainwell Technologies, using the ForwardHealth Portal.

Submitting claims

CLTS providers must use the Gainwell-assigned PA number when submitting claims in the portal. A claim cannot be made without this number. Each PA will have its own unique number. Using the WPS-assigned PA number will result in denied claims.

The portal offers the ability to find the Gainwell-assigned PA numbers to help CLTS providers submit their claims more easily.

PA Search-Bulk report

CLTS providers will use the “PA Search-Bulk” feature in the portal, found under Quick Links in the Providers tab, to find the Gainwell-assigned PA numbers for all converted PAs from WPS. The report will include previously assigned WPS authorization numbers.

To run the report, enter the date span and any other filtering information if needed, then hit “Export.”

Note: If there is a high volume of PA records, hitting “Search” may result in an error due to the volume of records on the report. Using the “Export” button immediately will prevent the error.

The report will provide important details, including:

Gainwell PA number County waiver agency PA number, if applicable Billing provider ID/Medicaid ID Member ID Participant name PA start and end dates Diagnosis codes

Service code Modifiers Units authorized, remaining, and used Dollars authorized, remaining, and used Internal Text: WPS authorization number

Step-by-step instructions on using the “PA Search-Bulk” feature are in the ForwardHealth Professional Claims User Guide.

Have questions or need help?

If you have questions or need help, please contact the CLTS Operations Team at cltsoperations@gainwelltechnologies.com or 844-942-5870