BadgerCare Plus Forms

New claims and customer service administration beginning on December 15, 2025. 

BadgerCare Plus forms that will streamline processes and support providers with tools to be efficient and effective.

Claims Forms

• Appeal/Claim Review Request Form
• Corrected Claim Submittal Guide
• Claims Recoup/Refund Request Form

Contracting/Credentialing

• Letter of Interest Form
• Provider Addition or Change Notification Form
• Provider Update/Change Form
  

Clinical Forms

• Case / Disease Management Referral Form
• Missed Appointment Notification Form
• Notification of Pregnancy Form

Authorization

• BadgerCare Plus Authorization List
• BadgerCare Plus Authorization Request Form

Patient Forms

• Appealing on behalf of member
• Ombudsman for grievances