/depts/,/depts/uwmf/,/depts/uwmf/patient-resources/,/depts/uwmf/patient-resources/social-guide/,/depts/uwmf/patient-resources/social-guide/manual/,/depts/uwmf/patient-resources/social-guide/manual/financial/,/depts/uwmf/patient-resources/social-guide/manual/financial/title-19/,/depts/uwmf/patient-resources/social-guide/manual/financial/title-19/wisconsin/,/depts/uwmf/patient-resources/social-guide/manual/financial/title-19/wisconsin/elderly-blind-disabled/,

/depts/uwmf/patient-resources/social-guide/manual/financial/title-19/wisconsin/elderly-blind-disabled/

20150123

page

100

UWHC,

Patient Services,

UW Medical Foundation,Patient Resources,Social Work Services Quick Guide,Social Work Manual,Financial,Medicaid a.k.a. Medical Assistance a.k.a. Title 19,Wisconsin

Elderly, Blind, Disabled

Elderly, Blind, Disabled - UW Medical Foundation, Patient Resources, Social Work Services Quick Guide, Social Work Manual, Financial, Medicaid a.k.a. Medical Assistance a.k.a. Title 19, Wisconsin

Focus

MADA

Forms

Wisconsin Medical Assistance for Elderly, Blind and Disabled (10101, Financial Portion)

  • This needs to be sent either at the same time as or before the next form as this form is needed to open a new case

Medicaid-Disability Application (10112, Medical Portion)

Authorization for Verbal Communication - 1280490V (for phone calls)

  • Note: All releases should be sent to HIM for scanning via MC# 2427 for scanning into the Media Tab in Health Link.

Authorization for Disclosure to DDB (have patient sign 3 original copies)

Verification

Proof of Identify, Income and Assets

As needed

Cover Letter

Presumptive Forms

Registration Form (secures the date of application)

Elderly, Blind or Disabled

Forms

Wisconsin Medical Assistance for Elderly, Blind and Disabled (Financial Portion)

  • This needs to be sent either at the same time as or before the next form as this form is needed to open a new case

Authorization for Verbal Communication - 1280490V (for phone calls)

  • Note: All releases should be sent to HIM for scanning via MC# 2427 for scanning into the Media Tab in Health Link.

Verification

Proof of Identify, Income and Assets

As needed

Cover Letter

Registration Form (secures the date of application)

Authorization of Representative