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Claims that do not contain the required elements will be rejected and the provider will be required to resubmit after making the necessary corrections. Elements of a clean claim are as follows:
If the service provided is a Medicaid service, the clean claim must also be submitted in a format and coding system acceptable to Wisconsin’s Medicaid program.
Administration Office28526 US Hwy 14Lone Rock, WI 53556P: 608-647-4729 F: 608-647-4754