At Network Health, we understand the importance of quality health care and believe it should be convenient.
What’s New for 2020
Enhancements include the following.
- A simplified design—you can choose a plan and enter keywords in the "Help Me Find" field.
- An Advanced Search section provides filters to refine search results.
- The doctor and facility search are combined.
- A map displays search results, so you can see where providers are located.
- You can view a printable map of your results.
- Mobile responsiveness has been enhanced, so the page is easier to navigate on a mobile device.
Orthopaedic Associates of Wisconsin
Orthopaedic Associates of Wisconsin has joined the Network Health provider network. Now, Network Health members have access to a fully covered, highly-rated orthopaedic facility in Waukesha county.
Go to networkhealth.com/find-a-doctor to access an easy-to use provider and facility search. Choose State of Wisconsin employees/members as your plan. Or, view a PDF of the Provider Directory. To request a printed directory be mailed to you, call 1-844-625-2208.
Referrals, Authorizations, Out-of-Network
As a state of Wisconsin member of Network Health, you can see most in-network doctors without a referral. Orthopedic and neurology specialists require a referral for lower back pain. Prior authorization (or prior approval) is required for certain services, procedures and for out-of-network providers before you receive care. A list of services that require prior authorization is available here or through your member portal account under My Materials. If you submit a prior authorization, you will receive written notification of the approval or denial. To determine if a service, test or procedure requires prior authorization or a referral, call 1-844-625-2208 prior to your appointment.
Emergency and Urgent Care
If you require emergency or urgent care when outside the Network Health service area, seek care at the nearest medical facility. Contact your primary care physician if you need help determining 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
We require prior authorization for all inpatient services for mental health, behavioral health or substance abuse services. For assistance, please contact Network Health’s Care Management Behavioral Health Department at 1-800-555-3616. After hours, call your personal doctor.
If you have health care questions during normal business hours, you can contact your personal doctor's office. Health care questions that arise outside normal business hours can be directed to one of our provider nurse lines that can be found on the Getting Care Quickly page of our website.
We gathered and incorporated customer feedback to deliver a redesigned member portal. This portal is easy to navigate and you’ll find tools, tips and important information to help get the most out of your benefits. The portal is also mobile responsive so you can access your important health insurance plan information 24/7 from any device.
When you sign in, you’ll see a customized dashboard specific to you and your plan. From this dashboard, you can view benefit information, view out-of-pocket expenses, reorder an ID card, access plan materials and more. You can also select communication preferences, so you can choose to receive your Explanation of Benefits (EOB) statements by email instead of mail.
Once you are logged in, you’ll find all this and more.
- Benefits and coverage overview
- Out-of-pocket expenses tracker
- Claims detail and status
- Authorization information and status
- Mobile access to view or order an ID card
- Plan-related materials and forms
- Secure messaging with our customer service team
- Wellness programs and tools
- Find a Doctor search
Dedicated Customer Service Line
You'll continue to have a dedicated customer service line. By calling 1-844-625-2208 or 920-720-1811, you'll be connected with Network Health representatives who are specially trained to answer State of Wisconsin and Wisconsin Public Employer Group Health Insurance Program questions. Representatives can be reached Monday, Wednesday - Friday from 8:00 a.m. to 5:00 p.m. and Tuesday from 8:00 a.m. to 4:00 p.m.
Major Health Systems
- Froedtert & the Medical College of Wisconsin Health System
- Children’s Hospital of Wisconsin
- Ascension Wisconsin
- Prevea Health
- Bellin Health