​Self-Help Forms

Please access all our available​ self-help forms below.

EpicLink

GHCEpicLink Partner Agreement
GHCEpicLink Site Coordinator Agreement
GHCEpicLink Handbook

Claims and Enrollment Setup

GHC-SCW EDI Form
834 Setup Form 
834 Companion Guide, Version 5010
EFT Authorization Form

Enrollment Method O​ptions​

Medical Management

Prior Authorization Request Form
Initial Notification of Outpatient Behavioral Health Services Form   
Request for Ongoing Authorization of External Behavioral Health Services Form
Transition of Care Form

Medical Management - Sauk County Only​

Initial Notification of Outpatient Behavioral Health Service Form
Request for Authorization of External Behavioral Health Service Form

Pharmacy

Medication Prior Authorization Form

Provider Information

GHC-SCW Provider Resource Manual
Reference Guide to Key Network Contact Information​