​Self-Help Forms

Please access all our avalible 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

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