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​Provider Resource Manual 

We developed the Group Health Cooperative of South Central Wisconsin (GHC-SCW) Provider Resource Manual to serve as a reference for our participating Practitioners and Providers. The purpose of the manual is to inform you about GHC-SCW, our policies and procedures and our Quality Improvement program and initiatives. The manual is a quick reference where you can find answers to frequently asked questions.

Download the GHC-SCW Provider Resource Manual

Provider Documents

The following documents are made available for all plan providers and practitioners as a reference of key GHC-SCW programs and/or policies and procedures to provide additional information about the services and/or processes of the health plan. ​

• App​eal or Grievance Process 
  
• Credentialing and Re-Credentialing Policy
  
• Guidelines for BadgerCare Plus Claim​ Appeals
  
• Member Rights and Responsibilities Policy
  
• Peer Review Policy
• Pharmaceutical Management Program Policy
  
• Population Health Management 
  
• Prior Authorization Guidelines
  
• Utilization Management Program
  
• Provider Orienta​tion Manual
  

BadgerCare Plus/WI Medicaid Provider Documents

Guidelines for BadgerCare Plus Claim​ Appeals

• Medicaid Member Grievances and Appeals Guide
• Medicaid Ombudsman Resource Info

Alternate Format

If you would like a printed copy of the GHC-SCW Provider Resource Manual, please contact your provider coordinator or
email GHC-SCW Member Services.
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