Security Health Plan - Valley

1-844-813-7286 or 715-221-9199
www.securityhealth.org/statevalley

What’s New for 2018

Security Health Plan - Valley service area featuring ThedaCare and Bellin Health Partners (Bellin Health System, Dickinson County Healthcare System, Holy Family Memorial and others providers) has extended into Marinette County.

Provider Directory

Visit www.securityhealth.org/valleylist to access a provider directory. To request a printed directory be mailed to you, call customer service at 1-844-813-7286.

Referrals, Prior Authorizations, Out-of-Network Care

Security Health Plan requires a referral for certain services. Security Health Plan also requires a referral and approval for services received from a non-network provider. Services from a non-network provider without prior authorization are not reimbursed.

A number of services require prior authorization. That is, you and your provider must contact us before the service is delivered. 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, contact 1-844-813-7286 prior to the appointment, or visit www.securityhealth.org/priorauthorization for a complete listing of services that require prior authorization.

The following services require you to participate in shared decision-making:

• Hysterectomy with fibroid diagnosis - surgery
• Chronic hip pain - osteoarthritis - specialty consult
• Chronic knee pain - osteoarthritis or meniscal degeneration - specialty consult
• Low back pain - orthopedic or neurosurgery consult
• Carpal Tunnel - median neuropathy - specialty consult

Shared decision-making provides you with information about the surgery you’re considering, including the risks and benefits, as well as alternatives to surgery.

Service Area

Brown, Kewaunee, Oconto, Outagamie, Waupaca, Waushara and Winnebago counties.
Limited provider availability in: Green Lake, Marinette, Marquette and Shawano 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 the 24-hour Nurse Line at 1-800-549-3174 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 Security Health Plan.

Mental, Behavioral Health and Substance Abuse Services

You may see any provider in the network for mental/behavioral health care. You do not need a referral or authorization.

24-Hour Nurse Line

Care My Way®. When a visit to your doctor’s office is inconvenient, you can call our 24-hour Nurse Line at 1-800-549-3174 and talk with a Care My Way nurse practitioner about many common health concerns such as flu, pinkeye or urinary tract infections. Depending on your condition, a prescription can even be called into the pharmacy of your choice.