POS Network
Welcome to the GHC-SCW Point-of-Sale (POS) Network!
Our POS plans give members access to In-Network GHC-SCW Providers and the flexibility to see Out-of-Network Providers according to their needs. We recommend this plan for members that want access to the GHC-SCW HMO Plan Network but prefer the freedom to see Providers outside of the GHC-SCW network.
Choose a Provider & Specialty Care
You can easily find a provider in the POS network by using the Find a Provider button on the upper right-hand corner of this page . The button below will also take you to the provider search, where you can view and choose from available providers.
If you need specialty care, you may visit any in-network Specialty Care Provider. To verify that the specialist is an in-network Specialty Care Provider, use the button below to search by name or location.
Virtual Care
Members with POS insurance have access to virtual care benefits, which are handy when you’re having unusual symptoms and need some peace of mind or just need a quick follow up with your provider to go over new medications you’ve been recently prescribed. Our virtual care options are a convenient and safe way to get the care you need at home or on the go.
• GHC NurseConnect
• Video Visit Using GHCMyChartSM
• Virtual Urgent Care powered by KeyCare
• Virtual Therapy powered by MDLIVE®
Emergency Care
In the event of a life-threatening emergency, visit one of the hospital emergency rooms participating in the POS Provider Network. If that is not possible, proceed immediately to the nearest hospital emergency room. In both situations, contact the GHC-SCW Care Management Department at (608) 257-5294 or toll-free at (800) 605-4327, and request Care Management within 48 hours of receiving emergency services or as soon thereafter as reasonably possible.
Prior Authorization
Prior Authorization is the process by which GHC-SCW provides prior written approval for coverage of specific benefits, treatments, Durable and Disposable Medical Equipment (DME), Prescription Drugs and supplies. The purpose of Prior Authorization is to determine and authorize the following:
• The specific type and extent of care, Durable and Disposable Medical Equipment, Prescription Drug or supply that is necessary
• The number of visits, or the period of time, during which care will be provided
• The Provider to whom the Member is being referred
• Whether the Member should receive coverage for the services from an out-of-network Provider because necessary services are not available from an in-network Provider
If Prior Authorization is not received prior to the date of service and/or receipt of supplies, your Provider should contact GHC-SCW’s Care Management Department for a determination of Medical Necessity. The Prior Authorization lists may differ depending on your health plan. Please contact Care Management at (608) 257-5294.
POS Frequently Asked Questions
Our POS plans give members access to In-Network GHC-SCW Providers and the flexibility to see Out-of-Network Providers according to their needs. We recommend this plan for members that want access to the GHC-SCW HMO Plan Network but prefer the freedom to see Providers outside of the GHC-SCW network.
An in-network provider has been contracted by GHC-SCW to provide Covered Health Services.
Examples include, but are not limited to:
- Orthopedists
- Cardiologists
- Pulmonologists
- Oncologists
- Gynecologists
Providers who are not contracted with GHC-SCW health insurance plan are considered out-of-network. If you choose to see an out-of-network Provider, you may be required to pay at the time of service and submit the claims to the network yourself.
Be sure to contact GHC-SCW before receiving care only if it is for a service that requires prior authorization.
Please note that if the provider does not participate in the Preferred Provider Network, your out-of-pocket costs may be greater.
When you use in-network providers, you may have fewer out-of-pocket costs. If you receive services from an out-of- network provider, your out-of-pocket costs will most likely be greater.
If the GHC-SCW POS Network includes a Copayment, you may be asked to pay this amount at the time of your visit.
If you choose an out-of-network provider, you may be required to pay in full at the time of service
When you visit an in-network provider, claims will be forwarded to the Preferred Provider Network. If you choose to see an out-of-network provider, you may be required to pay at the time of service and submit the claims to the Preferred Provider Network yourself.
Still have questions about what is covered under your POS insurance plan?
Call GHC-SCW Member Services at (608) 828-4853 or toll-free at (800) 605-4327.