WPQC Providers & Patients

Physician Referral to WPQC

Physicians are encouraged to refer any patient that they feel would benefit from MTM services, even if they do not meet the standard eligibility criteria. Patients are eligible for WPQC services at no cost if they have prescription insurance coverage from participating payers. Patients also have access to WPQC pharmacies as there is a WPQC pharmacy located in almost every Wisconsin county. The Prescriber Referral form can be found here.

Process for Physician WPQC Referral

1. Determine if the patient’s prescription insurance participates in WPQC. The current payers that participate in WPQC are:
   1. Wisconsin Forward Health (Medicaid and SeniorCare)
   2. United Way of Dane County
2. Assess if patient would benefit from WPQC MTM services. Patients with the following conditions or circumstances are likely to benefit from a comprehensive medication review and assessment (CMR/A).
   1. Multiple medications to treat or prevent chronic conditions
   2. Receives prescriptions from multiple providers
   3. Recent discharge from the hospital or long-term care setting
   4. Low health literacy
3. Call in verbal order or fax an order to a WPQC-accredited pharmacy,  requesting the patient receive CMR/A. The CMR/A can be conducted at any time, whether prior to or following regularly-scheduled physician visits.