Welcome Providers
This area of the HIRSP website is designed to assist providers with general information regarding HIRSP. If you are a member looking for a provider, please visit our provider and network page.
Effective November 1, 2010, the Health Insurance Risk Sharing Pool (HIRSP), will begin offsetting provider payments for unpaid refund requests. Providers will continue to be sent an initial request letter asking for payment to be made within 30 days. If there is no response, the next available HIRSP payment made to the provider will be ‘offset’. This includes both paper check and electronic payments.
The PRA – Provider Remittance Advice or ERN - Electronic Remittance Notice will contain information related to the customer for which the offset is being taken.
iEXCHANGE Overview
iEXCHANGE is a program offered by WPS Health Insurance that allows your clinical staff to submit prior approval requests for inpatient and outpatient services electronically to WPS using the Internet.
View the iExchange overview at
our Benefit Administrator's Website
(WPS Health Insurance)
Resources
-
HIRSP Federal Provider Rates
(The following page is located at the Forward Health Portal website.)
Visit Fee Schedules at Forward Health
- HIRSP Provider Rates (Note: you will need to use a program that will read Microsoft Excel documents to view these documents).
- Medical Policies
MedTrak Pharmacy Services
For formulary and pharmacy benefit information please visit the HIRSP Pharmacy Benefit Administrator's site:
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