Your browser does not support JavaScript!
calculators
Member Education
forms and publications
news
about etf
frequently asked questions
contact etf
site map
related links
home
top of page
Wisconsin Department of Employee Trust Funds header image It's Your Choice 2017 State of Wisconsin Group Health Insurance Program
members retirees employers governing boards careers at etf
skip to end of menu
2017 It's Your Choice - State of Wisconsin Group Health Insurance for Employees and Retirees

Wisconsin Department Of Employee Trust FundsIt's Your Choice 2017


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

Network Health Northeast

1-800-826-0940
networkhealth.com

What’s New for 2017

ThedaCare will no longer be participating in our provider network effective January 1, 2017. For anyone who might need help finding a new in-network provider, our customer service team and Network Health’s Nurse Line are available to help. You can also find more information and answers to common questions at networkhealth.com/ThedaCare-Toolkit.

Network Health will be offering e-visits beginning in 2017. An e-visit provides an alternative to the traditional office visit. A phone or online video visit with a provider will be a convenient option for members seeking care for non-urgent medical issues.

Network Health is also implementing a proven health management solution, Medecision’s AerialTM, to assist us in quickly identifying members with chronic or complex conditions who would benefit from help managing their medical needs. The new technology means we can better identify members in need and connect with them more efficiently.

Network Health members will continue to have access to more than 1,745 primary care doctors and 10,255 specialists at more than 40 hospitals in Wisconsin.

Provider Directory

Go to networkhealth.com to access a provider directory. Choose "State of Wisconsin NE employees 2017" as your plan, enter your location and search for a provider. Or, click on Printable Directory on the right. To request a printed directory be mailed to you, call 1-800-826-0940.

Referrals, Prior Authorizations, Out-of-Network Care

Referrals are not needed when receiving care from in-network providers. Prior authorization (or prior approval) is required for certain services, procedures and for out-of-network providers before you receive care. You will receive written notification of the approval or denial for the prior authorization. If you are unsure if a service, test or procedure requires prior authorization or a referral, call 1-800-826-0940 prior to the appointment.

Service Area

Brown, Calumet, Dodge, Door, Fond du Lac, Manitowoc, Oconto, Outagamie, Sheboygan and Winnebago counties.
Limited provider availability in: Green Lake, Kewaunee, Marinette, Portage, Shawano, Waupaca and Waushara 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 Network Health at 1-800-826-0940 or your primary care physician 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 Network Health.

Mental, Behavioral Health and Substance Abuse

Prior authorization (or prior approval) is required for autism treatment and any inpatient service for mental health, behavioral health or substance abuse services. Contact 1-800-555-3616 for assistance. After hours, please call your provider.

24-Hour Nurseline

Network Health's Nurse Line: 1-888-879-8960

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: 9/7/2016 11:23:35 AM