Provider Resources

Revised Practitioner and Facilities Forms

We have recently revised the forms to be used when notifying WPS of practitioner or facility updates. Several forms have been removed and consolidated into two easy fillable PDF documents. These forms can be accessed on our website at WPS Provider Forms, under the section entitled Update Provider Demographics.

The Practitioner Data Sheet can be used to add, terminate, and update a practitioner. In addition, this document can be used if your practice should change locations. The Facility Data Sheet is used for notifications related to adding, terming or updating a facility, such as a skilled nursing facility or ambulatory surgery center. Please note, both documents are sent to Arise Health Plan, a wholly owned subsidiary of WPS based in DePere.

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