Wisconsin Prior Authorization Requirements

A guide to prior authorization rules, turnaround times, and laws for medical practices operating in Wisconsin (WI).

PA Turnaround Times

Standard Requests

14 calendar days

Urgent / Expedited

72 hours

Key Regulations

  • Standard PA turnaround of 14 calendar days
  • Urgent requests within 72 hours

Wisconsin Medicaid PA

Wisconsin Medicaid (BadgerCare Plus) uses managed care. PA administered by MCOs.

Top Payers in Wisconsin

Anthem Blue Cross Blue ShieldQuartzUnitedHealthcareDean Health PlanGroup Health Cooperative

State Regulatory Body: Wisconsin Office of the Commissioner of Insurance

File PA complaints or appeals through your state insurance department.

Automate PA in Wisconsin

Greenlight knows every payer's PA requirements in Wisconsin and checks them automatically before every appointment -- so your staff does not have to.

See a Demo