Process improvement for behavioral health

Become a Certified Medicaid Provider


Some providers do not have a process in place to bill for Medicaid.


Become a certified Medicaid provider in order to get reimbursed for clients who qualify for Medicaid.

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Milwaukee County providers became certified Medicaid providers by inviting a state Medicaid expert to educate them and help navigate them through the approval process via face-to-face, online, and phone meetings.

Guest House of Milwaukee Counseling Clinics in Milwaukee, Wisconsin became a Medicaid certified clinic by completing the following steps: (1) Completing the application process, which involved getting a National Provider Identifier (NPI) number, certifying individual staff members for Medicaid billing numbers, and setting up the ForwardHealth Portal, the interface for the Wisconsin Medicaid Management Information System, (2) Creating financial procedures, including a policy and procedure manual, a sliding fee scale, and prior authorization form, (3) Ensuring HIPPA compliance, by using encrypted files and developing an e-mail confidentiality statement, and (4) creating an intake process that involved intake procedures specific to Medicaid clients, and completing a BioPsychoSocial form.

Lessons Learned

  • Invite a state Medicaid expert to educate providers and help navigate them through the approval process.

Tracking Measures

Cycle Measure Data Collection Form
$ of revenue from third-party payers (in particular Medicaid) Revenue by Payer Worksheet


Related Information