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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2016 State of Wisconsin Group Health Insurance Program
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Wisconsin Department Of Employee Trust Funds

It's Your Choice 2016


State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)

Group Health Cooperative of South Central Wisconsin

608-828-4853 or 1-800-605-4327, ext. 4504
ghcscw.com

What’s New for 2016

GHC-SCW members will have access to the new UW Health at The American Center located on Madison’s east side. The GHC-SCW service area will no longer include Marquette County.

Provider Directory

Go to ghcscw.com, click on “Find a Provider,” select “Primary Care” and click on the “State and WPEG Employee Provider Directory” on the right hand navigation bar. To request a printed directory be mailed to you, call Member Services at 1-800-605-4327, ext. 4504.

Referrals, Prior Authorizations, Out-of-Network Care

Your primary care provider will submit a referral request to GHC-SCW Care Management Department when you need to receive services outside of a GHC-SCW clinic or through a specialty care area. Certain procedures or tests also require a prior authorization for medical necessity review. You will receive a letter from GHC-SCW, as well as notification in your GHCMyChartSM account, letting you know if the referral/prior authorization has been approved.

Service Area

Columbia, Dane and Sauk counties.

Emergency and Urgent Care Outside Service Area

If you require emergency or urgent care when outside of the network, seek care at the nearest medical facility. Contact GHC-SCW Member Service at (800) 605-4327, ext. 4504 if assistance is needed to determine the appropriate level of care. Follow-up care must be received from an in-network provider unless otherwise approved by GHC-SCW.

Mental, Behavioral Health and Substance Abuse

When you need mental health services, contact GHC-SCW mental health triage at 608-441-3290. Please refer to the GHC-SCW Provider Directory. A referral is not required for services provided in a GHC-SCW clinic. A referral is needed for transitional, outpatient and/or inpatient care.

24-Hour Nurseline

GHCNurseConnect: 608-661-7350 or 1-855-661-7350

Disclaimer:
Every effort has been made to ensure that this information is accurate, but may be subject to change. Please note revision dates located at the bottom of each page. In the event of conflicting information, federal law, state statute, state health contracts and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed.

This page was last modified on: 9/11/2015 7:53:05 PM