Network Health Southeast

1-800-826-0940
networkhealth.com

What’s New for 2017

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 SE 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

Milwaukee, Ozaukee, Racine, Washington and Waukesha 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