Lakeland Care District
(920) 906-5100

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Lakeland Care District

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.)

Sample Billing Form

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

2010 Ancillary Services

Civil Rights Information:                           http://dhs.wisconsin.gov/civilrights/
Background Check Information: http://dhs.wisconsin.gov/caregiver/EmplContrs.htm

 

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