Children's Long-Term Support Program: Claims Processing Transition

The Children’s Long-Term Support (CLTS) Program helps children with disabilities and their families through supports and services that help children grow and live their best lives in their homes and communities.

New Claims Processor in 2025

The Wisconsin Department of Health Services (DHS) has transitioned the state’s claims processing for CLTS Program prior authorizations (PAs) and claims from Wisconsin Physicians Service (WPS) to Gainwell Technologies using the ForwardHealth Portal (the Portal).

DHS created two temporary webpages to provide more information on ForwardHealth processes:

• Children's Long-Term Support: Third Party Administration Transition for Providers
• Children's Long-Term Support: Third Party Administration Transition for County Waiver Agencies

What changed?

CLTS providers and county waiver agencies (CWAs) may no longer use the WPS Portal. Instead, they must use the Portal to submit claims and view claims history or PAs. Here are some important notes about how the Portal works:

• CLTS providers can access claims and PA history on the Portal.
• ForwardHealth only accepts Health Insurance Portability and Accountability Act of 1996 (HIPAA)-standard claim submission methods. This means ForwardHealth does not allow spreadsheet submissions. Providers can use the Portal to:
  • Submit claims in a HIPAA-compliant electronic format.
  • Create a claim from a PA.
  • Copy and modify an existing paid claim instead of entering a new claim.

How can I learn more?

ForwardHealth hosted several webinars, forums, trainings, and system demonstrations about the transition. Providers and CWAs may view recordings and presentations on the DHS webpages listed above by scrolling to the Past Events drop-down menu.

Transition Timeline

Here is the full transition timeline:

• February 2025: Provider training
• February–July 2025: Provider testing
• April 2025: Provider refresher training
• April 28, 2025: Claims submission go live
• May 5, 2025: Claims processing go live

Testing

Existing CLTS providers received a welcome letter and a PIN letter in January 2025 containing a new Medicaid ID and PIN. In addition to using the Medicaid ID and PIN to log in to the Portal, CLTS providers may also use the submission sandbox through July 2025 to practice submitting claims to ForwardHealth for CLTS services.

Training Resources

Written and video presentations of the trainings are available:

• Children’s Long-Term Support Provider Claims Training, presentation and video
• Children’s Long Term Care Program Claims and PA Refresher Training for CWA’s video

Resources

• The ForwardHealth Catalog of Trainings and Educational Resources for Providers and Other Stakeholders webpage has trainings and resources to introduce providers to the Portal under the ForwardHealth Portal Basics/Navigation drop-down menu.
• The DHS Children's Long-Term Support (CLTS) Program: Information for Providers webpage has information about becoming a CLTS Program provider, payment rates, getting paid, and how to stay up to date about the CLTS Program.
• Refer to the FAQs About Children’s Long-Term Support Program: Third-Party Administration Transition (PDF) for answers to common CLTS provider questions. (Updated 04/28/2025)
• Learn about where to submit claims for CLTS Program services with the Children’s Long-Term Support Program and Electronic Data Interchange Guidance (PDF).