Lakeland Care District
(920) 906-5100
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Provider Network Team
District-wide
Megan A Acheson
Employment Services Coordinator
N6654 Rolling Meadows Drive
Fond du Lac, WI 54937
920.906.5181 phone
920.906.5103 fax
megan.acheson@lakelandcaredistrict.org
Marty Watkins
Provider Network Developer
N6654 Rolling Meadows Drive
Fond du Lac WI 54937
920.906.5173 phone
920.906.5103 fax
marty.watkins@lakelandcaredistrict.org
Sherry Schwandt
AFH/Respite Coordinator
N6654 Rolling Meadows Drive
Fond du Lac, WI 54937
920.906.5174 phone
920.906.5103 fax
sherry.schwandt@lakelandcaredistrict.org
Kathryn Stark
AFH/Respite Coordinator
N6654 Rolling Meadows Drive
Fond du Lac WI 54937
920.906.5148 phone
920.906.5103 fax
Kathryn.stark@lakelandcaredistrict.org
Jill Krzanowski, BSW, MS-OLQ
Provider Network Director
N6654 Rolling Meadows Drive
Fond du Lac, WI 54937
920.906.5127 phone
920.251.3581 cell
920.906.5103 fax
jill.krzanowski@lakelandcaredistrict.org
Central Office
N6654 Rolling Meadows Drive
Fond du Lac, WI 54937
Tricia Bonlander
Provider Network Specialist
920.906.5171 phone
920.906.5103 fax
tricia.bonlander@lakelandcaredistrict.org
West Office
500 City Center
Oshkosh, WI 54901
Greg Schlichting
Provider Network Specialist (for all Residential/Supported
Apartments/Nursing Home providers)
920.906.5193 phone
920.906.5103 fax
greg.schlichting@lakelandcaredistrict.org
Lorie Ruck
Provider Network Specialist (for all NON-residential providers)
920.456.3217 phone |
920.456.3201 fax
Lorie.ruck@lakelandcaredistrict.org
East Office
3415 Custer Street
Manitowoc, WI 54220
Molly Burke
Provider Network Specialist
920.652.2181 phone
920.652.2441 fax
Molly.burke@lakelandcaredistrict.org
District-wide Authorizations, Member Billing, Claims & Appeal
Inquiries
Lori Konkel
920.906.5852 phone
lori.konkel@lakelandcaredistrict.org
Applications
Respite Care
Supportive
Home Care
Home Health
Relocation
Services
DMS/DME/Adaptive
Aids
Home
Delivered Meals
Residential
Services
Nursing Home
Therapy/Counseling
Supported
Employment
Financial
Management
AODA
Addenda
Adult
Day Care Addendum
Daily Living Skills Training Addendum
Personal Electronic Monitoring and Response Addendum
Responder Job Description Addendum
Prevocational Services Addendum
Residential Addendum
Residential Respite Addendum
Supportive Home Care Addendum
Transportation Addendum
Materials
Sample Debarment
Policy
Sample
Debarment Attestation Letter
Sample
Individual Service Invoice
Sample Letter of
Authorization
Sample Letter of Authorization - package category
Elements of a Clean Claim
Claim Appeal
Process
Civil Rights Compliance Plan Letter of Assurance (For Providers having less than 25 employees or receiving less than $25,000 from this contract.)
Residential Provider Face Sheet
Provider Background Checklist
Residential Computation Worksheet
Residential Salary Allocation Worksheet
Residential Weekly Staff Schedule
Residential Facility Rate - Instructions
Residential Member-Staff Scheduling Form
Civil Rights Information:
http://dhs.wisconsin.gov/civilrights/