Building the Healthcare Brain WISeR Portal.
Submit Medicare prior authorization requests for the CMS WISeR Innovation Model — New Jersey, MAC JL.
Operated by Genzeon Platforms in coordination with Novitas Solutions, the Medicare Administrative Contractor for Jurisdiction L. This page is the operational portal for healthcare providers and suppliers — submit a PA, find references, read provider FAQs.
The Provider Portal is the preferred channel — submissions transfer automatically into the coversheet template and reach a determination fastest. Use coversheets when submitting by fax or mail.
256 Eagleview Blvd, Suite 509
Exton, PA 19341
What is WISeR?
The Wasteful and Inappropriate Service Reduction (WISeR) Model is a six-year CMS Innovation Center program designed to reduce unnecessary or inappropriate services in Original Medicare (Part A & B) for selected items and services. It uses enhanced technologies — AI and machine learning — combined with human clinical review to streamline decisions and protect beneficiaries and taxpayers.
WISeR launches January 1, 2026 and runs through December 31, 2031 in six pilot states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.
In New Jersey, WISeR prior authorization and pre-payment medical review activities are administered through Novitas Solutions (MAC Jurisdiction L), with Genzeon Platforms providing the technology platform and operational support — specifically HIP One, the Reasoning Lobe of the Healthcare Brain.
Production proof, architecture, and the people behind the operation.
For health systems, analysts, and policy researchers evaluating Genzeon Platforms' role in the WISeR Innovation Model — the deeper context.
The first 90 days, on the record
12,609 PA cases. 100% three-day TAT. Sub-3-min decision latency. Zero auto-denials.
Healthcare Brain — Prior Authorization
Per-criterion citation chains, deterministic guardrails, clinician-in-the-loop architecture.
Bronze Stevie® · AI in Healthcare
Recognized in the 2026 American Business Awards for the WISeR work.
Genzeon Platforms leadership
The corporate and platforms leadership operating the WISeR deployment.
How the WISeR program works.
Built to make reviews more predictable and less burdensome, while aligning with existing Medicare rules.
Note: If a claim is submitted without required PA, it may enter pre-payment medical review. All appeal rights remain in place.
Three ways to submit a prior authorization.
The portal is the fastest, most accurate channel and the preferred submission method.
A WISeR model prior authorization request requires specific elements to be present on the submission. To avoid potential dismissals due to incomplete requests, submitters are highly encouraged to use the Genzeon Platforms or Novitas coversheet. See Section 3.2: General Prior Authorization Request Documentation in the CMS Provider/Supplier Operational Guide.
Services requiring prior authorization.
Per CMS Wasteful and Inappropriate Service Reduction Model, organized by category. All categories listed below apply to NJ (MAC JL) for performance years starting January 1, 2026.
Nerve Stimulation
- Electrical Nerve Stimulators
- Sacral Nerve Stimulation for Urinary Incontinence
- Phrenic Nerve Stimulator
- Vagus Nerve Stimulation
- Induced Lesions of Nerve Tracts
- Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea
Pain and Spine
- Epidural Steroid Injections for Pain Management
- Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)
- Cervical Fusion
Note: Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis was removed from this list just before model initiation.
Skin and Tissue Substitutes
- Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds
- Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities
Applicable to selected WISeR MAC jurisdictions and states with an active LCD in place during the WISeR PYs.
Other Services
- Incontinence Control Devices
- Diagnosis and Treatment of Impotence
For the complete and authoritative list of CPT/HCPCS codes within each category, see Appendix A of the CMS Provider/Supplier Operational Guide linked in References below.
Authoritative sources.
Primary documents from CMS and Genzeon Platforms. Bookmark the operational guide — it’s the canonical source for WISeR program rules.
Provider/Supplier Operational Guide
CMS WISeR Model Provider and Supplier Operational Guide, Version 2.0. The canonical operational rulebook.
Open PDF →
CMS Innovation — WISeR Model Details
Official CMS Innovation Center page on the Wasteful and Inappropriate Service Reduction Model.
Open page →
WISeR Fact Sheet
Overview, goals, participation, coverage and payment policies, beneficiary impact.
Open PDF →
CMS WISeR FAQs
Common questions on coverage policies, beneficiary protections, scope of services.
Open page →
Federal Register Notice (CMS-5056-N)
Official notice as recorded in the Federal Register.
Search Federal Register →
Genzeon Platforms User Guide for WISeR
Provider presentation covering Genzeon Platforms–Novitas operational coordination and portal use.
Open PDF →
Provider FAQs.
The questions providers and their staff ask most often. For the complete and continuously updated set, see the full FAQ at portal.hip.one.
Does WISeR change Medicare coverage?
No. WISeR uses existing Medicare coverage policies; it’s about how reviews happen, not what is covered.
How do I contact someone with additional questions?
If you need any assistance, please email [email protected] or visit the portal page at portal.hip.one.
Is participation optional for providers?
WISeR is a voluntary model for vendors and MAC operations, but prior authorization is required for included services furnished in pilot states.
How do providers submit prior authorization requests for WISeR model services?
Providers submit prior authorization requests to Genzeon Platforms or Novitas. The PA request can be submitted via Genzeon Platforms' portal, Novitasphere, by fax at (484) 200-2155, or by mail to Genzeon Corporation, 256 Eagleview Blvd, Suite 509, Exton, PA 19341. Coversheets can be accessed via Genzeon Platforms' or Novitas' websites.
When using the participant’s portal or Novitasphere to request prior authorization for a WISeR service, will completing all the screens transfer the information to the coversheet?
Yes. When submitting prior authorization through the portals, the information will automatically transfer to the coversheet.
Which coversheet is used when sending a WISeR model prior authorization request via fax or mail?
Prior authorization requests submitted directly to Genzeon Platforms are sent using Genzeon Platforms' designated coversheet and faxed to (484) 200-2155 or mailed to Genzeon Corporation, 256 Eagleview Blvd, Suite 509, Exton, PA 19341. Prior authorization requests submitted to Novitas using the Novitas WISeR model coversheet, whether by fax, mail, or Novitasphere, will be forwarded to Genzeon Platforms.
Can providers submit a WISeR model prior authorization request using their own coversheet?
A WISeR model prior authorization request requires specific elements to be present on the submission. To avoid potential dismissals due to an incomplete prior authorization request, submitters are highly encouraged to use the Genzeon Platforms or Novitas coversheet. Providers can refer to the Wasteful and Inappropriate Service Reduction (WISeR) Model Provider and Supplier Operational Guide, Section 3.2: General Prior Authorization Request Documentation.
Can a third party submit a prior authorization request on behalf of a provider, or does it have to be submitted by the provider directly?
Yes, a third party can submit a prior authorization request on behalf of the provider or facility, provided the third party has access to the necessary information to submit a complete request.
If a provider requests a prior authorization, will the ambulatory surgical center (ASC) need to request prior authorization as well for the same procedure, or can the ASC use the UTN obtained by the provider’s office?
CMS allows a physician or practitioner to submit a prior authorization request on behalf of a facility. Physicians and practitioners who submit the prior authorization request on behalf of a facility should include their contact information on the prior authorization request cover sheet, in addition to the facility’s contact information. If the physician or practitioner is not the requester and would like to obtain a copy of the decision notification, they should contact the facility.
Can multiple CPT codes be submitted on one prior authorization request?
All procedure codes within the same category that require prior authorization for the same beneficiary must be filed on a single claim and listed on the coversheet for review. The categories and codes are available in Appendix A of the Wasteful and Inappropriate Service Reduction (WISeR) Model Provider and Supplier Operational Guide.
When submitting a new prior authorization request, should we submit the number of units we expect the patient to receive or indicate how many units of the product we will use?
Yes, the prior authorization request must list the number of units that are needed for the specific CPT code. Units are determined based on the HCPCS or CPT code descriptor for the service. Refer to Appendix A of the Wasteful and Inappropriate Service Reduction (WISeR) Model Provider and Supplier Operational Guide for specific code descriptors.
If a procedure code is affirmed and the service changes after the procedure begins, how do we handle updating the service for authorization?
Once the procedure has started and needs to be changed to a different CPT code, you would verify that the new CPT code requires prior authorization, as outlined in Appendix A of the Wasteful and Inappropriate Service Reduction (WISeR) Model Provider and Supplier Operational Guide. Due to the timing of this discovery, prior authorization cannot be requested before the procedure. If the CPT code requires prior authorization, the claim will be filed with no UTN and will be stopped for prepayment review. An ADR letter will be sent requesting documentation for the service performed.
Where can I find additional FAQs?
A full list of FAQs is maintained on the WISeR portal page under Blogs: portal.hip.one/blog/faq-wiser-model.
Linking to this page from your provider bulletin or intranet?
Use the canonical URL below. We maintain this page as the authoritative provider portal for the CMS WISeR Innovation Model in New Jersey. Bookmark it, link it from your operational documents, and share it with the providers who need it.
https://genzeon.one/wiser-portal
A neutral 50-word paragraph for provider bulletins, intranets, or operational documents. Copy and paste — no attribution required.
Submitting a PA? You’re in the right place. Evaluating the deployment? See the overview.
This page is the operational portal. For the WISeR deployment story — how Genzeon Platforms operates the model in New Jersey alongside Novitas Solutions, Q1 2026 production results, and the architecture behind it — see the WISeR overview.