Wraparound Milwaukee Provider Network

Wraparound Milwaukee has a broad benefit plan of over 80 different mental health, social and supportive services. To deliver those services in the most flexible and cost effective manner, Wraparound Milwaukee has developed a network of community agencies and individual providers to deliver services based on a comprehensive fee-for-service approach. No formal contracting with Providers is used. Wraparound Milwaukee develops service descriptions, standards for all services, and the unit rate. Community agencies are invited apply to provide one or more of the 80 core services based on service needs which are reevaluated throughout the course of the year. Wraparound Milwaukee then credentials providers who seek to to become a Network Provider as an agency or individually.

There are currently over 205 agency and individual providers (i.e., independent psychiatrists, psychologists, therapists) involved in the provider network. Certain high cost and restrictive services such as residential treatment, psychiatric hospitalization and day treatment require prior authorization. For most services, authorization to a provider to provide services is simply based on a care coordinator entering the requested services, units needed, and name of provider into the automated information system called Synthesis. Vendors are immediately notified on-line of units of service approved for the upcoming month. Providers invoice on-line for services provided and the IT system matches actual services provided against the Service Authorization Request (SAR). The Synthesis system links with another county IT system to cut checks and enter payments on a general ledger.

Because these are multiple service providers in the Network for almost every service, families have a great deal of choice related to who they desire to have provide service to their child and family. Oversight of the network related to Quality Assurance is provided by the Wraparound Milwaukee program directly as well as through the County's Centralized Quality Assurance office.