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Provider Manual

Order of benefit determination

Last Updated on August 28, 2018

Most insurance plans or other payers, including group and direct pay plans or BadgerCare, should pay as primary to Family Health Center. For example:

  • Wisconsin Medicaid Family Planning –if the diagnosis on the claim is related to family planning, Wisconsin Medicaid would pay as primary for the family planning services.
  • Chronic Renal Disease Program (CRD) – if the diagnosis on the claim is related to renal services, the state funded CRD program would pay as primary for the renal services.

Exceptions:

  • Indian Health Services (IHS) – if the member receives their medical services off the reservation, Family Health Center should pay as primary to an IHS plan.