Description

What’s New for 2019

Group Health Cooperative of South Central Wisconsin (GHC-SCW) has partnered with UnityPoint at Home for Durable Medical Equipment and Home Health Services. Some of these services may require a Prior Authorization (PA). For information regarding which services require a PA, members should contact GHC-SCW Member Services at (608) 828-4853.

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, Authorizations, Out-of-Network

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.

Emergency and Urgent Care

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

Major Health Systems

  • GHC-SCW Primary Care Clinics
  • UW Hospital
  • American Family Children's Hospital
  • Meriter Hospital
  • UW Medical Foundation

Full Service Areas

Columbia County, Dane County, Sauk County
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