Description

Group Health Cooperative of South Central Wisconsin (GHC-SCW) is a non-profit, member-owned health plan providing high-quality health care services, including primary care and specialty care to over 75,000 members living in and around Dane County, Wisconsin.

When your health care and your health plan work together, the result is the superb care and impeccable service you've come to expect from GHC-SCW.

Your health care.
Your health plan.
Better Together.

What's New for 2021

GHC-SCW introduces GHC Care OnDemand - With this new telehealth platform, members can virtually access a doctor from their own home, office, or on-the-go, 24/7, 365. Board-certified doctors are available either by phone or secure video to help treat any non-emergency medical conditions. Visits are free for most members. (Note: Members with Medicare or HSA-Eligible plans have restrictions or limitations. Visit ghccareondemand.com to learn more.)

GHC-SCW has developed a new partnership with Southwest Health. GHC-SCW members can now choose a Primary Care Provider (PCP) from one of the two Southwest Health clinic locations. GHC-SCW members also have access to Emergency, Urgent Care and Specialty Care Services at Southwest Health Hospital in Platteville.

GHC-SCW has developed a new partnership with Memorial Hospital of Lafayette County (MHLC). GHC-SCW members can now choose a Primary Care Provider (PCP) from one of the three MHLC clinic locations. GHC-SCW members also have access to Emergency, Urgent Care and Specialty Care Services at Memorial Hospital of Lafayette County in Darlington.

GHC members will no longer need a referral to be seen at most routine UW Outpatient Specialist visits. This means no referrals for initial visits, no referral for subsequent visits and no need for the renewal of expiring 2020 referrals. 

If you are visiting one of the following UW Outpatient Specialist services it will still require a Referral/Prior Authorization:
Behavioral Health, Dermatology, Generations, Genetic Counseling, Multi-Disciplinary Clinics, Ophthalmology, Optometry, Orthopedics, Physical Therapy, Podiatry, Routine Lab/Radiology Services, (excluding STAT labs or testing on a clinic collected Specimen), Sports Medicine, Transformations

If you wish to see a specialist at a GHC-SCW clinic, you do not need a referral and may schedule an appointment directly with our specialty care departments.

Provider Directory

Go to ghcscw.com/health-insurance/government-employees and scroll down to the State Employees section. The current provider directories are available under Plan Information. To request a printed directory to be mailed to you, call Member Services at 1-800-605-4327.

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 areat that requires a prior authorization. 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 1-800-605-43274 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

Virtual Visits

We know you are busy. Now, when sickness finds you, you can get relief even quicker. You can get a diagnosis and prescription in just a few minutes at virtuwell, your 24/7, 365 online clinic. Visit ghcscw.com/virtuwell to learn more and get started.

Looking for a video visit?  Try GHC Care OnDemand.  With this new telehealth platform, members can virtually access a doctor from their own home, office, or on-the-go, 24/7, 365. Board-certified doctors are available either by phone or secure video to help treat any non-emergency medical conditions. Visits are free for most members. (Note: Members with Medicare or HSA-Eligible plans have restrictions or limitations. Visit ghccareondemand.com to learn more.)

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, Iowa County, Jefferson County, Juneau County, Sauk County

Limited Service Areas

Grant County, Lafayette County
Was this page helpful?