An ombudsperson sitting at a desk with a member going over information.

 

If you have questions, concerns or a potential dispute regarding your benefits, start by contacting our benefits specialists.

Our knowledgeable benefits specialists can assist you with most benefits-related matters. If you have a benefits dispute, our Ombudsperson Services can assist you.

An ombudsperson acts as a neutral party while helping with your benefit concerns. The goal is to offer a fair resolution for all parties while sticking to program policies, contracts and the law.

 

An ETF Ombudsperson Can Help

  • When a prior authorization request has been denied.
  • When claims have not been processed correctly.
  • When you have been told you have no insurance coverage.
  • If you want to file a grievance or an independent review.
  • If you receive a bill for services that were covered in the past.

An ETF Ombudsperson Cannot

  • Guarantee a favorable outcome.
  • Change any plan’s policy.
  • Authorize claims payment.
  • Make medical determinations.
  • Make ETF policy or management decisions.

Contact ETF’s Ombudsperson Services

Phone:  1-877-533-5020 ext. 17947

Email:  ombudsperson@etf.wi.gov

 

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