Join the network or make changes to an existing contract

Thank you for your interest in participating with MHS Health Wisconsin. We are excited that you selected our provider network as your network of choice.If you are a non-contracted provider or are a current provider who wishes to add a line of business or service(s) to your existing contract, please use the appropriate form below. Lines of business that MHS Health offers include Medicaid and Medicare (Wellcare).
 

Want to a start contract with MHS Health? 

We appreciate your interest in MHS Health Wisconsin as a network of choice. If you are interested in joining as a network provider or provider group, please fill out the form below. One of our provider representatives will reach out to you shortly to discuss contracting options.

Please use this form if you would like to initiate a contract with MHS Health Wisconsin.
> Use this form to start a new contract 

Have a contract and need to add or change a provider? 

If you are an existing medical or behavioral health provider group that already has a contract with MHS Health Wisconsin and need to add a provider or practitioner, please use the form below to enroll a new provider to your group.

Please use the correct form below if you want to make a change to an existing contract.

> Use this form to add a medical provider to an existing contract (PDF)

> Use this form to add a behavioral health (BH) practitioner to an existing contract (PDF)

> Use this form to add a behavioral health (BH) facility or clinic to an existing contract (PDF) 
Note: If you have more than one location, please also fill out the additional locations form below and submit it with your application. Additional location(s) BH credentialing application (PDF)

Please send completed information to: 

Email: mhs-wipdm@mhswi.com

Mailing address: 
MHS Health Wisconsin
Attn: Provider Data Management
115 S. 84th Street, Suite 350
Milwaukee, WI 53214
 

Need to change your practice information? 

If you are an existing medical or behavioral health provider that already has a contract with MHS Health Wisconsin, it is important that you provide us with current information about your practice so we can:

• Accurately communicate your availability to members and other providers in directories
• Assure the timely processing of your claims

Medical Providers
> Use this form to make changes to your information (address, demographic, etc.) (PDF)

Behavioral Health Providers
> Use this form to make changes to your information (address, demographic, etc.)