Prior Auth Required

01162 - Emergency for Non-U.S. Citizens (F- (02/09)) form for clients to take to the local county or tribal agency in their county of

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceEmergency for Non-U.S. Citizens (F- (02/09)) form for clients to take to the local county or tribal agency in their county of
Procedure / Service Description

Wisconsin Medicaid - A provider who gives emergency care to a non-U.S. citizen should refer him or her to the local county or tribal agency or ForwardHealth outstation site for a determination of BadgerCare Plus enrollment. Providers may complete the Certification of Emergency for Non-U.S. Citizens (F-01162 (02/09)) form for clients to take to the local county or tribal agency in their county of residence where the BadgerCare Plus enrollment decision is made.

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.