​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

Are you an employer group looking to go electronic? Please review our Enrollment Method O​ptions PDF and then discuss options with your sales representative.  

837 Claims Provider Setup Request
835 ERA Provider Setup Request  
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