The Wisconsin Medical Treatment Statement — for listing charges from medical providers, or for medicine and supplies — is a form for documenting the financial transactions that occur between a patient and a medical provider. This form is required by the Wisconsin Department of Health Services (DHS) and must be completed by the medical provider before any reimbursement can be made. The form includes the patient's name, date of service, provider name, procedure codes, and charges for services rendered. It also includes a description of the services provided, the patient’s insurance coverage, and the amount due to the provider. There are two types of Wisconsin Medical Treatment Statements: The Professional Statement and the Institutional Statement. The Professional Statement is for professional services rendered by a physician or other medical provider, and includes charges for office visits, laboratory tests, imaging, and other services. The Institutional Statement is for services rendered by a hospital or other medical facility, and includes charges for hospital stays, surgical procedures, and other services.
Wisconsin Medical Treatment Statement -- For listing charges from medical providers, or for medicine and supplies.
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How to fill out Wisconsin Medical Treatment Statement -- For Listing Charges From Medical Providers, Or For Medicine And Supplies.?
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FAQ
Recent Wisconsin Court of Appeals' decision has determined that the WI copy fee statute does not allow providers to charge medical record copy fees when requested or received in electronic format.
Section 146.83 $1.08 per page for the first 25 pages. $0.80 per page for pages 26 to 50. $0.53 per page for pages 51 to 100. $0.31 cents per page for pages 101 and above.
EHRs improve the quality, accuracy, and timeliness of patient information at the point of care.
On average, a health record book can cost you around $25 to $40.
A Wisconsin living will, or ?Declaration to Physicians,? allows a person to instruct their physician to preferred treatment options if in a vegetative state. The treatment options include whether or not to use life-sustaining procedures such as feeding tubes and breathing support.
Electronic records: The charge for copies made from electronic records cannot exceed 50% of the per page charge for paper copies. This charge includes the cost of each CD-ROM, DVD, or other storage media.
(bm) Presumption. Billing statements or invoices that are patient health care records are presumed to state the reasonable value of the health care services provided and the health care services provided are presumed to be reasonable and necessary to the care of the patient.