Group Health Cooperative of South Central Wisconsin

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

What’s New for 2018

Group Health Cooperative of South Central Wisconsin (GHC-SCW) and UnityPoint Health – Meriter recently partnered to provide insurance coverage for GHC-SCW members’ mother-baby services, including labor and delivery and in-patient newborn care, at UnityPoint Health – Meriter beginning January 1, 2018. These services have historically been provided by St. Mary’s Hospital.

GHC-SCW members who are currently pregnant and expecting to give birth prior to January 1, 2018 should still deliver at St. Mary’s Hospital.

GHC-SCW members will gain access to the full range of services provided through Meriter and UW Health’s shared Mother-Baby Care program, which includes the Center for Perinatal Care for high-risk pregnancies, Birthing Center, a Level III and a Level IV NICU, and a full team of specialists for both mother and baby.  Members will also have added birth options, like midwife deliveries and the region’s only Baby-Friendly™ birth facility to support breastfeeding.

Provider Directory

Go to ghcscw.com, click on the Health Insurance drop down menu at the top of the page, select Government Employees and scroll down to the State Employees section. The Provider Directory is available under the 2018 Plan Information. 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 Services

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