Medical Billing Built for Wisconsin Healthcare Providers
Wisconsin is one of the states that never formally adopted the ACA's standard Medicaid expansion to 138% of the federal poverty level. Instead, it covers childless adults only up to 100% FPL through BadgerCare Plus under a Section 1115 waiver extended through 2029 — a partial-expansion approach that doesn't qualify for the ACA's enhanced federal match, though unlike some non-expansion states it avoids leaving a coverage gap, since marketplace subsidies begin right at 100% FPL. That distinction changes how adult eligibility gets verified in Wisconsin compared to standard expansion states. On the commercial side, Anthem Blue Cross Blue Shield of Wisconsin is the state's largest commercial insurer, while Quartz Health Benefit Plans — built around the UW Health network — dominates the Madison and south-central Wisconsin market, and Network Health has a strong presence in the Fox Valley and northeast.
Whether you're in Milwaukee, Madison, Green Bay or anywhere else in Wisconsin — ZenoMedix RCM provides the same certified billing expertise with deep knowledge of local payer rules and Wisconsin Medicaid requirements.
Major Payers We Work With in Wisconsin
Wisconsin Medicaid
BadgerCare Plus — Wisconsin's Medicaid/CHIP program. Wisconsin has not adopted the ACA's standard Medicaid expansion; instead, a Section 1115 waiver covers childless adults only up to 100% FPL, without the ACA's enhanced federal match.
HIPAA Compliance
Full HIPAA compliance for all WI providers. We stay current with all Wisconsin billing regulations. View HIPAA Statement →
Every City in Wisconsin — We're Your Billing Team
Remote billing means you get the same expert service whether you're in a major metro or a smaller community across Wisconsin.
75+ Specialties Served Across Wisconsin
Each specialty has a dedicated billing team trained on its CPT codes, modifiers, and payer-specific requirements in Wisconsin.
Everything Your Practice Needs — Nothing You Don't
Wisconsin Billing FAQ
Yes. Wisconsin covers childless adults only up to 100% FPL through BadgerCare Plus under a Section 1115 waiver, not the ACA's standard 138% FPL expansion, so we verify eligibility against that specific threshold rather than assuming standard expansion-state rules apply.
Yes. Anthem Blue Cross Blue Shield of Wisconsin is the state's largest commercial insurer, and our Wisconsin coding team bills it regularly alongside Quartz, UnitedHealthcare, Network Health, and Dean Health Plan, tracking each payer's documentation and modifier requirements.
Yes. Quartz Health Benefit Plans, built around the UW Health network, dominates the Madison and south-central Wisconsin market, and it's one of the payers our Wisconsin billing team works with regularly.
Most Wisconsin practices are fully onboarded and submitting live claims within 48 hours of signing. We're month-to-month — no long-term contract — and we work your existing claims backlog into the transition so nothing falls through.
We serve Wisconsin practices statewide, from Milwaukee, Madison, Green Bay, Kenosha, and everywhere in between — not just the biggest metro area.