Provider and network directory
HMo
2 0
1 3
table of contents
about tHis directory
This directory is accurate at the time of printing. Visit ghcscw.com to review availability of Provider panels. To verify the availability of a Primary Care Provider before completing your enrollment form, please call GHC–SCW Member Services.
Learn more about being a GHC–SCW member by reviewing your Membership Information booklet that you received as part of your enrollment materials.
For complete details regarding what is covered under your GHC–SCW Plan, please refer to your Benefits Summary, Member Certificate and Plan Amendments, contact your employer, or call the GHC–SCW Member Services Department.
interPreter services
Interpreter Services are provided at no charge to you. GHC–SCW does not discriminate on the basis of disability in the provision of programs, services or activities. If you need this printed material interpreted, in an alternative format,
or need assistance in using any of our services, please contact GHC–SCW Member Services.
ESPAÑOL
Si necesita ayuda para traducir o entender este texto, por favor llame al telefono (608) 828–4853 o (800) 605–4327, extensión 4504.
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Federal Employees: It is important to know that when you enroll in this Plan, services are provided through the Plan’s Provider Network as described in the Plan’s Federal brochure RI 73–061, but the continued participation of any one doctor, hospital or other Provider cannot be guaranteed.
MyChart® is a registered trademark of Epic Systems Corporation. GHCMyChartSM is a service mark of Group Health Cooperative of South Central Wisconsin (GHC–SCW).
table of contents
about your care ...4–9
Networks ...4–5 Urgent Care & Emergency Care ...6–7
GHC–SCW Pharmacy ...8
PriMary care section ...10–22
Choosing the Right Provider ...11GHC–SCW Primary Care Network ...12–17 GHC–SCW Primary Care Clinics ... 12–13 GHC–SCW Primary Care Providers ... 14–17 Capitol Clinic ... 14
Capitol Clinic Urgent Care ... 15
DeForest Clinic ... 15
East Clinic ... 16
Hatchery Hill Clinic ... 16–17 Sauk Trails Clinic ... 17
UW Health–Family Medicine Network ...18
UW Health–Cottage Grove Network ...19
UW Health–Stoughton Network ...20
Access Community Health Centers Network ...21
Access–Wingra Family Medical Center Network ...22
sPecialty care section ...23–49
GHC–SCW Specialty Care Locations ...24GHC–SCW Specialty Providers ...25–28 Chiropractic Providers ... 25
Clinical Health Educators ... 25
Dermatology Providers ... 25
Domestic Violence Intervention Program ... 27
Eye Care Providers ... 27
Mental Health Providers ... 26–27 Occupational Therapy Providers ... 27
Physical Therapy Providers ... 28
Podiatry Providers ... 28
GHC–SCW Complementary Medicine ...29–32 Complementary Medicine Services & Classes ... 30
Complementary Medicine Providers ... 31–32 Seeing a Specialist Outside of GHC–SCW ...33
Specialty Care Network Grid–All Networks ...34–49 GHCMyChartSM ...50–51 Wellness Reimbursement ...52 Glossary ...53–54
GHc–scw
MeMber services
PHONE:
(608) 828–4853
(800) 605–4327, ext 4504 TDD (608) 828–4815
HOURS:Monday – Friday,
8 a.m. – 5 p.m.
new to GH c–scw? new to GHc–scw?
1. ACTIVATE Your GHCMyChartSM Account
With GHCMyChartSM, you may schedule appointments online, view selected test results, refill your prescriptions and more. See pages 50–51 for details.
2. CHOOSE a Primary Care Provider (PCP)
GHC–SCW network Providers can be found in this Provider Directory. You have the right to choose any PCP who participates in your network and is available to accept you or your family members. Learn more about choosing a PCP on page 11.
3. TRANSITION Your Care
To help you transition your care to GHC–SCW from your previous Provider(s), consider:
• Do You Have Medical Records?
Visit ghcscw.com, select the Privacy tab, then click on “Request for records from outside GHC–SCW”
to authorize your previous Provider to release your medical records to GHC–SCW.
• Do You Have an Existing Specialist?
Visit ghcscw.com, select “Agent/Employer” under the Insurance Services section, then click on “Smooth Transition” to transition to a GHC–SCW Specialist or for continuity of your care.
• Do You Have Existing Medications?
See page 8 for GHC–SCW Pharmacy Services information.
4. MAKE An Appointment
After you choose your Primary Care Provider (PCP), you may wish to schedule an appointment.
How to use tHis directory
networks section (PaGes 4–5)
GHC–SCW members can choose one of six possible networks. Your network is considered the path you take to receive needed care. To help you choose a network that works best for you, turn to pages 4–5.
These pages list where to go for needed care depending on your network choice.
NETWORK LOCATIONS:
GHC Clinics
UW Health – Family Medicine Clinics UW Health – Cottage Grove Clinic UW Health – Stoughton Clinic Access Community Health Centers Access – Wingra Family Medical Center H = Hospital Locations
DeForest
East
Cottage Grove
Stoughton Wingra Capitol
William T. Evjue Northeast
Sauk Trails
Hatchery Hill South Side
Verona
Belleville
dane county, wi
HHH
H
networks Provider network GHc–scw clinics uw HealtH –
faMily Medicine
uw HealtH – cottaGe Grove PriMary care
Care must be received at:Capitol Clinic, DeForest Clinic, East Clinic, Hatchery Hill Clinic or Sauk Trails Clinic.
Care must be received at:
Belleville Family Medical Clinic, Northeast Family Medical Center or Verona Family Medical Clinic.
Care must be received at:
UW Health – Cottage Grove Clinic.
sPecialty care
Prior Authorization may be required for some of these services.
Care must be received at GHC–SCW Clinics for:
Chiropractic, Complementary Medicine, Dermatology, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry. Specialty Care is also provided by contracted Providers at UW Hospital and Clinics, UW Health Clinics or in some special cases, Meriter Clinics.
Care must be received at GHC–SCW Clinics for:
Chiropractic, Complementary Medicine, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry. Specialty Care is also provided by contracted Providers at UW Hospital and Clinics, UW Health Clinics or Dean Medical Group.
Care must be received at GHC–SCW Clinics for:
Chiropractic, Complementary Medicine, Dermatology, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry. Specialty Care is also provided by contracted Providers at UW Hospital and Clinics, UW Health Clinics or in some special cases, Meriter Clinics.
urGent and eMerGency care
For details regarding Urgent and
Emergency Care, see pages 6–7. For details regarding Urgent and
Emergency Care, see pages 6–7. For details regarding Urgent and Emergency Care, see pages 6–7.
inPatient care
Care must be received at UW Hospital and Clinics or Meriter Hospital. Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.Care must be received at UW Hospital and Clinics or St.
Mary’s Hospital. Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.
Care must be received at UW Hospital and Clinics or Meriter Hospital. Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.
inPatient labor and delivery care
Care must be received at
St. Mary’s Hospital. Care must be received at
St. Mary’s Hospital. Care must be received at St. Mary’s Hospital.
PHarMacy services
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see pg. 8 for details).
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see pg. 8 for details).
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see pg. 8 for details).
lab / radioloGy
Care must be received atGHC–SCW Clinics. Care must be received at your assigned UW Health – Family Medicine Clinic.
Care must be received at UW Health – Cottage Grove Clinic.
networks
find your network–tHen refer to tHe cHart to see wHere you Go for needed care.
Prior Authorization may be required for some of these services. Please refer to your Benefits Summary and Member Certificate.
networks networks
find your network–tHen refer to tHe cHart to see wHere you Go for needed care.
Provider network uw HealtH –
stouGHton access coMMunity
HealtH centers access–winGra
faMily Medical center
Care must be received at:
UW Health – Stoughton Clinic. Care must be received at:
South Side Clinic or William T. Evjue Clinic.
Care must be received at:
Access–Wingra Family Medical Center.
Care must be received at GHC–SCW Clinics for:
Complementary Medicine, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry. Specialty Care is also provided by contracted Providers at UW Hospital and Clinics, UW Health Clinics or Dean Stoughton Clinic and Stoughton Hospital Rehab & Sports Medicine Clinic.
Care must be received at GHC–SCW Clinics for:
Chiropractic, Complementary Medicine, Dermatology, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry. Specialty Care is also provided by contracted Providers at UW Hospital and Clinics, UW Health Clinics or in some special cases, Meriter Clinics.
Care must be received at
GHC–SCW Clinics for: Chiropractic, Complementary Medicine, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry.
Specialty Care is also provided by contracted Providers at UW Hospital and Clinics, UW Health Clinics or Dean Medical Group.
For details regarding Urgent and
Emergency Care, see pages 6–7. For details regarding Urgent and
Emergency Care, see pages 6–7. For details regarding Urgent and Emergency Care, see pages 6–7.
Care must be received at Stoughton Hospital, UW Hospital and Clinics, Meriter Hospital. Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.
Care must be received at UW hospital and Clinics or Meriter Hospital. Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.
Care must be received at UW Hospital and Clinics or St. Mary’s Hospital.
Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.
Care must be received at
St. Mary’s Hospital. Care must be received at
St. Mary’s Hospital. Care must be received at St. Mary’s Hospital.
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see pg. 8 for details).
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see pg. 8 for details).
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see pg. 8 for details).
Care must be received at
UW Health – Stoughton Clinic. Care must be received at South Side Clinic or William T. Evjue Clinic.
Care must be received at
Access–Wingra Family Medical Center.
GHc–scw
urGent care clinic*
(608) 257–9700
675 West Washington Ave., Madison, WI 53703 Monday – Friday, 8 a.m. – 9 p.m.
Saturday – Sunday, 9 a.m. – 9 p.m.
*GHC–SCW Members who belong to the UW HEALTH – STOUGHTON network (Stoughton Clinic) may get Urgent Care at:
STOUGHTON HOSPITAL – URGENT CARE (608) 873–2264
900 Ridge St., Stoughton, WI 53589 6 a.m. – 11 p.m. (daily)
990 Janesville St., Oregon, WI 53575 Monday – Friday, 5 p.m. – 10 p.m.
Saturday – Sunday, 12 p.m. – 10 p.m.
OR
GHC–SCW URGENT CARE CLINIC (608) 257–9700
675 West Washington Ave., Madison, WI 53703
need Medical care and not sure wHat to do?
urGent care
How to Get urGent care
Your first line of defense should be to call your Primary Care Clinic for an appointment (see the Reference Card on the back cover for clinic hours and numbers). If after hours, call the GHC–SCW Urgent Care Clinic* at (608) 257–9700.
wHat is urGent care?
• Same–day or after hours care for conditions that require immediate attention • Care for non–life threatening conditions
• Care for persistent or unusual discomfort associated with an illness • Physical Therapy in urgent care is available for some injuries
exaMPles:
• Back Pain • Ear Pains • Migraine Headaches • Sore Throats
• Colds and Flu • Eye Irritation • Simple Bone Fractures (not through skin) • Sprains
• Cuts, Scrapes, Bruises • Fever • Skin Rashes • Urinary Burning
find your network clinic tHen Go to your desiGnated HosPital
GHC–SCW Clinics
UW HEALTH – COTTAGE GROVE Clinics
ACCESS COMMUNITY HEALTH CENTERS Clinics
UW HEALTH – FAMILY MEDICINE Clinics
ACCESS–WINGRA FAMILY MEDICINE CENTER Clinic
UW HEALTH – STOUGHTON Clinic
call our 24–Hour nurse advice line, GHcnurseconnect.
Coming January 2013! See page 9 for details.
eMerGency care
How to Get eMerGency care
If you require Emergency Care, please go to your designated hospital emergency room for treatment (see below).
If this is not possible, go to the nearest hospital emergency room or call 911.
wHat is eMerGency care?
Care for a life–threatening medical condition that includes severe symptoms, which could cause serious jeopardy to a person’s health.
exaMPles:
• Alcohol/Drug Overdose • Facial or Eye Trauma • Loss of Consciousness • Severe Burns • Amputations or Severe Lacerations • Heart Attack/Chest Pain • Poisoning • Stroke • Complex Bone Fractures (through skin) • Knife/Gunshot Wounds • Respiratory Problems
UW HOSPITAL AND CLINICS (608) 263–6400
600 Highland Ave., Madison, WI 53792 OR
MERITER HOSPITAL (608) 417–6000
202 S. Park St., Madison, WI 53715 UW HOSPITAL AND CLINICS (608) 263–6400
600 Highland Ave., Madison, WI 53792 OR
ST. MARY’S HOSPITAL (608) 251–6100
700 S. Park St., Madison, WI 53715 STOUGHTON HOSPITAL (608) 873–2264
900 Ridge St., Stoughton, WI 53589 OR
UW HOSPITAL AND CLINICS (608) 263–6400
600 Highland Ave., Madison, WI 53792
GH c- scw PH ar M acy GHc–scw PHarMacy
Prescription Drug Coverage is one of the many benefits GHC–SCW offers. To find out if prescription drugs are a covered benefit under your plan, refer to your GHC–SCW Benefits Summary,* which is included in your member materials. If your plan does have Prescription drug coverage, a basic list of covered drugs can be found on the GHC–SCW formulary.
new MeMber courtesy refill
Your existing prescriptions may be temporarily honored, which gives you time to make an appointment with your Primary Care Provider.
Bring your prescription bottle to any GHC–SCW Clinic Pharmacy and we will contact your existing pharmacy to transfer the prescription.
First time appointments:
• Bring a medication list or existing medications to your first GHC–SCW appointment.
• If you are taking medications not covered by GHC–SCW (non–formulary),
contact GHC–SCW Pharmacy Administration or discuss with your Primary Care Provider.
to fill your PrescriPtion
Order Online: Order your prescriptions online through your GHCMyChartSM account.
(For sign–up information, see pages 50–51.) OR
Order by Phone: Call your clinic Pharmacy to order your prescription.
GHc–scw PHarMacy locations & nuMbers
CAPITOL CLINIC
Phone: (608) 257–9732
Address: 675 W. Washington Ave.
Madison, WI 53703 Hours: Monday – Friday, 8 a.m. – 7 p.m.
Saturday – Sunday, 9 a.m. – 5 p.m.
EAST CLINIC
Phone: (608) 257–4829 Address: 5249 E. Terrace Dr.
Madison, WI 53718 Hours: Monday, 8 a.m. – 7 p.m.
Tuesday – Friday, 8 a.m. – 6 p.m.
HATCHERY HILL CLINIC Phone: (608) 661–7242 Address: 3051 Cahill Main Fitchburg, WI 53711 Hours: Monday, Wednesday, Thursday & Friday, 8 a.m. – 6 p.m.
Tuesday, 8 a.m. – 7 p.m.
SAUK TRAILS CLINIC Phone: (608) 257–4869 Address: 8202 Excelsior Dr.
Madison, WI 53717 Hours: Monday, 8 a.m. – 7 p.m.
Tuesday – Friday, 8 a.m. – 6 p.m.
PHARMACY ADMINISTRATION Phone: (608) 828–4811 or (800) 605 4327, ext. 4811 Hours: Monday – Friday, 8 a.m. – 5 p.m.
Out–of–Area Emergency Prescription Drug Services: If you are out–of–area and require emergency prescription drug services, call GHC–SCW Urgent Care at (608) 257–9700, or contact Pharmacy Administration for details on how to proceed.
State of WI employees, UW Graduate Assistants, and local government employees (WPEG): Navitus Health Solutions administers the pharmacy benefit for participants covered under the State of Wisconsin Group Health Insurance Program. GHC–SCW Clinic Pharmacies are approved Navitus Providers and may be used for your prescription needs. For more information, please contact Navitus at (866) 333–2757 or visit navitus.com.
*Prescription drugs administered during a GHC–SCW–approved hospitalization will be subject to your plan’s Benefits for Inpatient/Outpatient Hospital Services.
Please refer to your GHC–SCW Benefits Summary and Member Certificate for details.
Visit ghcscw.com and select
“Pharmacy” for more information about the GHC–SCW formulary, additional
GHC–SCW Pharmacy services, and information about GHC–SCW participating pharmacies (including
most major pharmacy chains).
STARTING JANUARY 2013
All clinics in the GHC–SCW Network will have the flexibility and convenience to go to the participatingPharmacy of their choice.
introducing your GHcnurseconnect team
Your 24-hour Nurse Advice Line
GHcnurseconnect team
(608) 661–7350 local or (855) 661–7350 toll-free
GHCNurseConnect is a new service designed to give
you fast answers to your health-related questions. It’s staffed exclusively by nurses you already know and trust.
And they’re all right here in Dane County – not a distant call center.
The goal? To give you the information you need when
you need it. Maybe it saves you a trip to the Emergency Room or provides answers to your health concerns over the phone. We can even schedule an appointment with your GHC–SCW Provider to follow up with your medical issue.
coMinG
January 2013!
exaMPles of wHen to call:
• General care advice & triage
• If you’re unsure if you need an appointment
• Cough, cold, fever, flu, sore throat
• Possible broken bones, sprains,
PriMary care
cH oosin G t H e ri GH t Provider cHoosinG tHe riGHt Provider
GHC–SCW members have an assigned Primary Care Provider (PCP) for their care. Choosing the right PCP that meets your needs is important. By doing so, you create a relationship of trust and comfort between you and your PCP.
Get started
1. REVIEW PCPs in this Provider Directory.
2. ASK yourself if the following are important in your PCP choice:
• Provider gender
• Medical discipline (e.g. Family Medicine, Pediatrics) • Location
• Medical interests
3. LEARN more about PCP options online:
• More information about PCPs in this Provider Directory may be found
at ghcscw.com under “Find a Provider.” Search by PCP name or by your network.
4. CHOOSE a PCP. To choose a PCP:
• Log on to your GHCMyChartSM account (see pages 50–51 for sign up information) and select the “Message Center” tab, then type in your PCP request under “Contact Member Services”.
• Or if you wish to discuss PCP options, call GHC–SCW Member Services at (608) 828–4853 or toll free at (800) 605–4327, ext. 4504.
As a GHC–SCW member, you may change your PCP and clinic location within your network at any time.
PcPs exPlained
A Primary Care Provider (PCP) provides and coordinates your general care. Qualified PCPs include:
• Physician
– Doctor of Medicine (MD) is a qualified, health care professional licensed to provide the full scope of medicine and surgery.
– Doctor of Osteopathy (DO) is a qualified, health care professional licensed to provide the full scope of medicine and surgery. DOs place emphasis on the whole person and they strive to restore health, often incorporating improvement in musculoskeletal function and balance.
• Certified Physician Assistant (PA–C) is a qualified, licensed health care professional with academic training and clinical experience. A PA–C provides a range of services such as routine physical examinations,
evaluation, and management of common medical problems and clinical health education.
• Advanced Practice Nurse Prescriber (APNP) is a qualified, licensed health care professional with academic training and clinical experience. An APNP provides a range of services such as routine physical examinations, evaluation, and management of common medical problems and clinical health education.
PCPs focus on one of the following:
• Family Medicine focuses on health care for the entire family, with an emphasis on continuity of care for all ages.
GH c- scw P ri M ar y care network
GHc–scw network
Refer to the chart below to see where you go for needed care.
Prior Authorization may be required for some of these services. Please refer to your Benefits Summary and Member Certificate.
GHc–scw care teaMs (PaGes 14–17)
Throughout pages 14–17, you will find GHC–SCW Providers arranged according to care teams. A care team is a team approach to patient care that uses the expertise and skills of all health care staff to better serve members. Care teams allow staff to work in a more coordinated way to provide better member satisfaction, better access to Providers and better health care for our members.
Who’s on your Care Team?
• Primary Care Providers (PCPs) coordinate care on a care team. PCPs include Physicians (MDs/DOs), Certified Physicians Assistants (PA–Cs), or Advance Practice Nurse Prescribers (APNPs).
• RN Coordinators assist patients with complex health questions and needs, and they coordinate with PCPs as needed. This team member is a Registered Nurse (RN).
• Case Managers assist members with hospitalization needs, referral questions, follow–up care, and transitioning of care among various health care Providers.
• Clinical Staff coordinate with PCPs to help with patient communication. Team members include Licensed Practical Nurses (LPNs) and Certified Medical Assistants (CMAs).
If a PCP is unavailable in the clinic, staff on the care team will monitor messages, test results and prescription refill requests to ensure member needs are met in a timely fashion.
GHc–scw clinics PriMary care
Please see page 13 for a listing of available Primary Care Providers.
Care must be received at: Capitol Clinic, DeForest Clinic, East Clinic, Hatchery Hill Clinic or Sauk Trails Clinic.
sPecialty care
Prior Authorization may be required for some of these services.
Care must be received at GHC–SCW Clinics for: Chiropractic, Complementary Medicine, Dermatology, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry. Specialty Care is also provided by contracted non–GHC–SCW Providers at UW Hospital and Clinics, UW Health Clinics or is some special cases, Meriter Clinics.
urGent & eMerGency care
For details regarding Urgent and Emergency Care, see pages 6–7.inPatient care
Care must be received at UW Hospital and Clinics or Meriter Hospital.Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.
inPatient labor and delivery care
Care must be received at St. Mary’s Hospital.
PHarMacy services
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see page 8 for details).lab / radioloGy
Care must be received at GHC–SCW Clinics.GH c– scw P ri M ar y care clinics & P roviders
caPitol clinic
Phone: (608) 257–9700
Address: 675 W. Washington Ave.
Madison, WI 53703 Hours: Monday, Wednesday,
Friday, 8 a.m. – 5 p.m.
Tuesday & Thursday, 8 a.m. – 7 p.m.
FAMILY MEDICINE Terence Galka, PA–C Jack Hayes, PA–C Robert Matthew, MD John Perry, PA–C Holly Schmidt, APNP Monique Simmons, APNP Michelle Thomas, MD Julie Vander Werff, PA–C Patricia Witte, MD FAMILY MEDICINE WITH OBSTETRICS Michele Brogunier, MD Rebecca Bull, MD Leah Ederer, MD
Rosemarie Schumacher, MD Monica Vohmann, MD INTERNAL MEDICINE David Eckerle, MD
Deborah Williams, MD PEDIATRICS
Arnold Benardette, MD Alison Craig, MD
deforest clinic
Phone: (608) 846–4787 Address: 815 South Main St.
DeForest, WI 53532
east clinic
Phone: (608) 222–9777 Address: 5249 East Terrace Dr.
Madison, WI 53718 Hours: Monday, 9 a.m. – 7 p.m.
Tuesday – Friday, 8 a.m. – 5 p.m.
FAMILY MEDICINE Marcia Bolles, PA–C Nancy Deaton, MD Jeanette Everson, MD Mary Evenson, PA–C Jeff Huebner, MD Allison Philipps, APNP Marilee Thoresen, PA–C FAMILY MEDICINE WITH OBSTETRICS George Leydon, DO Stephanie Skladzien, MD INTERNAL MEDICINE Holly Benson, MD
PEDIATRICS Renee Burk, MD Kristin Seaborg, MD
HatcHery Hill clinic
Phone: (608) 661–7200 Address: 3051 Cahill Main
Fitchburg, WI 53711 Hours: Mon, Wed–
Friday, 8 a.m. – 5 p.m.
Tuesday, 8 a.m. – 7 p.m.
FAMILY MEDICINE Carol Ballweg, APNP
FAMILY MEDICINE WITH OBSTETRICS Eric Hilquist, MD PEDIATRICS Stephen Lo, MD
sauk trails clinic
Phone: (608) 831–1766 Address: 8202 Excelsior Dr.
Madison, WI 53717 Hours: Monday, 8 a.m. – 7 p.m.
Tuesday – Friday, 8 a.m. – 5 p.m.
FAMILY MEDICINE Ward Dieter, PA–C Ivy Dowd, PA–C
Crystal Frohmader, PA–C Ann Stein, MD
Teresa Sizer, MD Mary–Anne Urtes, MD Megan Weimer, APNP FAMILY MEDICINE WITH OBSTETRICS Christian Kastman, MD INTERNAL MEDICINE &
GERIATRICS Claudiu Gherlan, MD PEDIATRICS Ann Behrmann, MD Mala Mathur, MD
GHc–scw PriMary care clinics & Providers
See page 11 for a description of Primary Care Providers.
GH c – scw P ri M ar y care P roviders
caPitol clinic caPitol clinic urGent care
deforest clinic
Rebecca Bull, MD Family Medicine
with Obstetrics
Robert Matthew, MD Family Medicine
Monica Vohmann, MD
Family Medicine with Obstetrics Julie Vander Werff,
PA–C Family Medicine
Paul Steichen, RN Lisa Van Natta,
RN
blue sPruce teaM
bircH teaM cyPress teaM
case ManaGer aPPle teaM
RN Coordinators RN Coordinators RN Coordinator
RN Coordinator
PROVIDERS
PROVIDERSPROVIDERS PROVIDERS
Michele Brogunier, MD Family Medicine
with Obstetrics
Leah Ederer, MD Family Medicine with Obstetrics
Terence Galka, PA–C Family Medicine
Rosemarie Schumacher, MD
Family Medicine with Obstetrics Holly Schmidt,
APNP Family Medicine
Karen Cooper,
RN Mary Knispel,
RN
Michelle Thomas, Family Medicine MD
Joyce Lynch, RN Jillian Jurgens,
RN John Perry,
PA–C Family Medicine
Patricia Witte, MD Family Medicine David Eckerle,
Internal MedicineMD
Jack Hayes, Family MedicinePA–C
Deborah Williams, Internal MedicineMD Nancy Hoenisch,
RN Alison Craig, MD
Pediatrics Arnold Benardette,
PediatricsMD
GH c – scw P ri M ar y care P roviders caPitol clinic urGent care
deforest clinic
deforest teaM
RN Coordinator
PROVIDERS
(these providersarenotavailableas apcp)
Terence Galka, PA–C Ted Haglund, MD Pam Heilman, MD Jolene Huber, PA-C Kris Knoepke, MD
James Long, MD Amy Wagner,
PA–C, MPAS
Photo not available:
Stephanie Salas, PA–C;
Aimee Passini, PA–C Bonnie Sommers–Olson,
APNP
Scott Miller, MD Family Medicine/
Geriatrics
Julie Vander Werff, Family MedicinePA–C
Becky Dorn, RN
case ManaGer
Leslie Anderson, CSW
GH c – scw P ri M ar y care P roviders
Renee Burk, MD Pediatrics Marcia Bolles,
PA–C Nancy Deaton,
MD Family Medicine
Jeanette Everson,
MD Kristin Seaborg, MD Pediatrics
Marilee Thoresen, PA–C Family Medicine
Becky Dorn, RN
Holly Benson, MD Internal Medicine
Allison Philipps, Family MedicineAPNP
Jeff Huebner, MD Family Medicine Mary Evenson,
PA–C
Stephanie Skladzien, MD Family Medicine
with Obstetrics
Nettie Beyer, RN George Leydon, DO
Family Medicine with Obstetrics
cHerry teaM
PoPlar teaM oak teaM
willow teaM
Jon Bohman, PA–C
Family Medicine Mark Huth, MD
Family Medicine Ann Statz,
RN Mark Olinger, MD
Family Medicine
Stephen Lo, MD Pediatrics Eric Hilquist, MD
Family Medicine with Obstetrics Carol Ballweg,
APNP Family Medicine
Katie Burrs, APNP
Family Medicine Jill Nilsson,
RN Joan Young, APNP
Prenatal Coordinator/
Lactation Consultant
Julie Sager, MD Family Medicine
PROVIDERSPROVIDERSPROVIDERS PROVIDERS
RN Coordinator RN Coordinator
RN Coordinator
RN Coordinator
case ManaGer
Leslie Anderson, CSW
east clinic
HatcHery Hill clinic
GH c – scw P ri M ar y care P roviders
redwood teaM
L. Nisha Rajagopalan, MD
Family Medicine
Deb Shenoi, MD
Family Medicine Pam Sprecher, PA–C Family Medicine
Carolyn Hedrington, RN
Nichole Nellen, RN
PROVIDERS RN CoordinatorRN Coordinator
east clinic
HatcHery Hill clinic
Rebecca Connors, RN, BS, CCM
Lisa Behl, RN, BSN, CCM Ivy Dowd, PA–C
Family Medicine Christian Kastman, MD
Family Medicine with Obstetrics
Ann Stein, MD
Family Medicine Alicia Hynek, RN
Mary Hedrick, RN Crystal Frohmader,
PA–C Family Medicine
MaGnolia teaM
Ward Dieter, PA–C Family Medicine
Claudiu Gherlan, MD Internal Medicine
and Geriatrics
Teresa Sizer, MD Family Medicine
PalM teaM
Ann Behrmann, MD
Pediatrics Mala Mathur, MD
Pediatrics Megan Weimer, APNP
Family Medicine Mary Anne Urtes, MD
Family Medicine
sassafras teaM
PROVIDERSPROVIDERSPROVIDERS RN CoordinatorRN Coordinator
case ManaGer
case ManaGer
sauk trails clinic
HatcHery Hill clinic
uw H eal tH – fa M il y M edicine network
Prior Authorization may be required for some of these services. Please refer to your Benefits Summary and Member Certificate.
uw HealtH – faMily Medicine PriMary care
See below for a listing of Primary Care Providers.
Care must be received at: Belleville Family Medical Clinic, Northeast Family Medical Center or Verona Family Medical Clinic.
sPecialty care
Prior Authorization may be required for some of these services.
Care must be received at GHC–SCW Clinics for: Chiropractic, Complementary Medicine, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry. Specialty Care is also provided by contracted Providers at UW Hospital and Clinics, UW Health Clinics or Dean Medical Group.
urGent & eMerGency care
For details regarding Urgent and Emergency Care, see pages 6–7.inPatient care
Care must be received at UW Hospital and Clinics or St. Mary’s Hospital.Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.
inPatient labor and delivery care
Care must be received at St. Mary’s Hospital.
PHarMacy services
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see page 8 for details).lab / radioloGy
Care must be received at your assigned UW Health – Family Medicine Clinic.uw HealtH – faMily Medicine network
Refer to the chart below to see where you go for needed care.
BELLEVILLE FAMILY MEDICAL CLINIC Phone: (608) 424–3384 Address: 1121 BellWest Blvd
Belleville, WI 53508 Hours: Monday – Friday,
8 a.m. – 5 p.m.
FAMILY MEDICINE Byron Crouse, MD David Deci, MD Valerie Gilchrist, MD Stephen Olcott, MD Melissa Stiles, MD FAMILY MEDICINE WITH OBSTETRICS Sarah GaleWryck, MD Jennifer Lochner, MD Richard Roberts, MD
NORTHEAST FAMILY MEDICAL CENTER Phone: (608) 241–9020 Address: 3209 Dryden Dr.
Madison, WI 53704 Hours: Monday – Friday,
8 a.m. – 5 p.m.
FAMILY MEDICINE Caitlin D’Agata, MD Russell Lemmon, DO Ashley Lienhardt, PA–C Jeffrey Patterson, MD Shannon Reed, DO Joan Uminski, PA–C Maureen Van Dinter, APNP Jo Ann Wagner–Novak, APNP FAMILY MEDICINE WITH OBSTETRICS Jennifer Edgoose, MD Ronni Hayon, MD Kathy Oriel, MD David Rabago, MD Louis Sanner, MD
UW HEALTH VERONA Phone: (608) 845–9531
Address: 100 N. Nine Mound Rd.
Verona, WI 53593 Hours: Monday – Friday,
8 a.m. – 5 p.m.
FAMILY MEDICINE Bruce Barrett, MD John Beasley, MD Kathleen Carr, MD Janice Cooney, PA–C Ellen Evans, PA–C Sarah James, DO Jason Ricco, MD Heidi Stokes, PA–C Karen Wendler, PA–C FAMILY MEDICINE WITH OBSTETRICS Jane Anderson, MD Brian Arndt, MD Ann Evensen MD William Scheibel, MD Douglas Smith, MD Sarina Schrager, MD
William Schwab, MD
uw H eal tH – cott aG e G rove network
Prior Authorization may be required for some of these services. Please refer to your Benefits Summary and Member Certificate.
uw HealtH – cottaGe Grove PriMary care
See below for a listing of Primary Care Providers.
Care must be received at: UW Health – Cottage Grove Clinic.
sPecialty care
Prior Authorization may be required for some of these services.
Care must be received at GHC–SCW Clinics for: Chiropractic, Complementary Medicine, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry. Specialty Care is also provided by contracted non–GHC–SCW Providers at UW Hospital and Clinics, UW Health Clinics or is some special cases, Meriter Clinics.
urGent & eMerGency care
For details regarding Urgent and Emergency Care, see pages 6–7.inPatient care
Care must be received at UW Hospital and Clinics or Meriter Hospital.Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.
inPatient labor and delivery care
Care must be received at St. Mary’s Hospital.
PHarMacy services
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see page 8 for details).lab / radioloGy
Care must be received at: UW Health – Cottage Grove Clinic.uw HealtH – cottaGe Grove network
Refer to the chart below to see where you go for needed care.
COTTAGE GROVE CLINIC Phone: (608) 839–3104 Address: 500 Westlawn Dr.
Cottage Grove, WI 53527 Hours: Monday – Friday,
8 a.m. – 5 p.m.
FAMILY MEDICINE Louis Falligant, PA–C Edward Kramper, MD
uw H eal tH – stou GH ton network
UW HEALTH – STOUGHTON CLINIC Phone: (608) 877–2660
Address: 1001 Nygaard St.
Stoughton, WI 53589 Hours: Monday – Friday,
8 a.m. – 5 p.m.
FAMILY MEDICINE George Gay, MD Danalyn Rayner, MD INTERNAL MEDICINE Karen Griffin, PA–C Ahsan Khalid, MD PEDIATRICS Anne Means, MD Karen Pletta, MD Prasanna Raman, MD
Prior Authorization may be required for some of these services. Please refer to your Benefits Summary and Member Certificate.
uw HealtH – stouGHton network
Refer to the chart below to see where you go for needed care.
uw HealtH – stouGHton PriMary care
See below for a listing of Primary Care Providers.
Care must be received at: UW Health – Stoughton Clinic.
sPecialty care
Prior Authorization may be required for some of these services.
Care must be received at GHC–SCW Clinics for: Complementary Medicine, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry. Specialty Care is also provided by contracted Providers at UW Hospital and Clinics, UW Health Clinics or Dean Stoughton Clinic and Stoughton Hospital Rehab & Sports Medicine Clinic.
urGent & eMerGency care
For details regarding Urgent and Emergency Care, see pages 6–7.inPatient care
Care must be received at Stoughton Hospital, UW Hospital and Clinics or Meriter Hospital. Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.inPatient labor and delivery care
Care must be received at St. Mary’s Hospital.
PHarMacy services
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see page 8 for details).lab / radioloGy
Care must be received at: UW Health – Stoughton Clinic.access co MM unity H eal tH centers network
SOUTH SIDE CLINIC Phone: (608) 443–5480 Address: 2202 S. Park St.
Madison, WI 53713
Hours: Monday – Friday, 8 a.m. – 5 p.m.
Some evening hours FAMILY MEDICINE
Don Carufel–Wert, MD William Kinsey, MD Ken Loving, MD Sarah Rowe, NP.
Anne Slaughter–Perrote, PA–C Rebecca Tharaud, MD
PEDIATRICS Dipesh Navsaria, MD
WILLIAM T. EVJUE CLINIC Phone: (608) 443–5480
Address: 3434 E. Washington Ave.
Madison, WI 53704
Hours: Monday – Friday, 8 a.m. – 5 p.m.
Some evening hours FAMILY MEDICINE
Vanessa Chen, PA–C Carey Dachik, PA–C Kevin Fehr, MD
Cynthia Galloway, APNP Mollie Kane, MD
Ken Loving, MD Nancy Pandhi, MD Elizabeth Poi, MD Alexander Young, MD
Prior Authorization may be required for some of these services. Please refer to your Benefits Summary and Member Certificate.
access coMMunity HealtH centers network
Refer to the chart below to see where you go for needed care.
access coMMunity HealtH centers PriMary care
See below for a listing of Primary Care Providers.
Care must be received at: South Side Clinic or William T. Evjue Clinic.
sPecialty care
Prior Authorization may be required for some of these services.
Care must be received at GHC–SCW Clinics for: Chiropractic, Complementary Medicine, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy, and Podiatry. Specialty Care is also provided by contracted non–GHC–SCW Providers at UW Hospital and Clinics, UW Health Clinics or is some special cases, Meriter Clinics.
urGent & eMerGency care
For details regarding Urgent and Emergency Care, see pages 6–7.inPatient care
Care must be received at UW Hospital and Clinics or Meriter Hospital. Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.inPatient labor and delivery care
Care must be received at St. Mary’s Hospital.
PHarMacy services
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see page 8 for details).lab / radioloGy
Care must be received at: South Side Clinic or William T. Evjue Clinic.access– w in Gra f aM il y M edical center network
Prior Authorization may be required for some of these services. Please refer to your Benefits Summary and Member Certificate.
access–winGra faMily Medical center network
Refer to the chart below to see where you go for needed care.
access–winGra faMily Medical center PriMary care
See below for a listing of Primary Care Providers.
Care must be received at: Access–Wingra Family Medical Center.
sPecialty care
Prior Authorization may be required for some of these services.
Care must be received at GHC–SCW Clinics for: Chiropractic, Complementary Medicine, Clinical Health Education, Mental Health, Occupational Therapy, Optometry, Physical Therapy and Podiatry. Specialty Care is also provided by contracted Providers at UW Hospital and Clinics, UW Health Clinics or Dean Medical Group.
urGent & eMerGency care
For details regarding Urgent and Emergency Care, see pages 6–7.inPatient care
Care must be received at UW Hospital and Clinics or St. Mary’s Hospital.Members who are more than 20 weeks pregnant must deliver at St. Mary’s Hospital.
inPatient labor and delivery care
Care must be received at St. Mary’s Hospital.
PHarMacy services
Receive prescriptions through GHC–SCW Clinic Pharmacies and/or GHC–SCW–participating pharmacies (see page 8 for details).lab / radioloGy
Care must be received at: Access–Wingra Family Medical Center.ACCESS–WINGRA FAMILY MEDICAL CENTER Phone: (608) 263–3111
Address: 701 Dane St.
(2100 block of S. Park St. at Dane St.) Madison, WI 53713
Hours: Monday – Friday, 8:30 a.m. – 5 p.m.
FAMILY MEDICINE Randall T. Brown, MD Jessica Dalby, MD Mary Giblin, PA–C Joel Hill, PA–C Jonas Lee, MD David Lessens, MD Andrea Martonffy, MD Jonathan Temte, MD Angela Vitcenda, PA–C
FAMILY MEDICINE WITH OBSTETRICS Lee Dresang, MD
Beth Potter, MD Kirsten Rindfleisch, MD Patricia Tellez–Giron, MD
sPecialty care
GH c– scw s Pecial ty care loca tions
GHc–scw sPecialty care locations
Services vary by GHC–SCW clinic.
cHiroPractic
(page 25) Capitol ClinicEast Clinic Sauk Trails Clinic Hatchery Hill Clinic
clinical HealtH education
(page 25) Capitol ClinicEast Clinic Sauk Trails Clinic Hatchery Hill Clinic
coMPleMentary Medicine
(page 31–32) See pages 29–30 for details.derMatoloGy
(page 25) Hatchery Hill Cliniceye care center
(page 27) Hatchery Hill ClinicGHc–scw locations & nuMbers
CAPITOL CLINIC Phone: (608) 257–9700
Address: 675 West Washington Ave.
Madison, WI 53703
CAPITOL REGENT MENTAL HEALTH CLINIC Phone: (608) 441–3290
Address: 700 Regent St.
Madison, WI 53703 EAST CLINIC
Phone: (608) 222–9777 Address: 5249 East Terrace Dr.
Madison, WI 53718
HATCHERY HILL CLINIC Phone: (608) 661–7200 Address: 3051 Cahill Main
Fitchburg, WI 53711
PRINCETON CLUB WEST PT/OT CLINIC Phone: (608) 662–5060
Address: Princeton Club West 8054 Watts Rd.
Madison, WI 53719 SAUK TRAILS CLINIC Phone: (608) 831–1766 Address: 8202 Excelsior Dr.
Madison, WI 53717
Mental HealtH
(page 26–27) East ClinicSauk Trails Clinic
Capitol Regent Mental Health Clinic Hatchery Hill Clinic
occuPational tHeraPy
(page 27) Capitol ClinicEast Clinic
Princeton Club West PT/OT Clinic
PHysical tHeraPy
(page 28) Capitol ClinicEast Clinic
Princeton Club West PT/OT Clinic
Podiatry
(page 28) East ClinicSauk Trails Clinic Hatchery Hill Clinic
GH c– scw s Pecial ty P roviders
Peter Leonhard, DC Daniel Futch,
DC Kelly Andrews,
DC
GHc–scw cHiroPractic Providers
Christine Tock,
MD, PhD Lai Thao,
PA–C
GHc–scw derMatoloGy Providers
Barb Lazaris, MS, LPC Carly DeGrood,
MS, RD, CD, CDE Lisa Hansen, RD, CD, IBCLC, RLC
Tim Ballweg, RRT, CPFT, AE–C
Ruby Bradt
Vanderzee, ICCE Anne Marie (Dolly) Wagner, ICCE Donna Twining,
APNP, CDE Diane Lillis,
APNP
Deborah Roussos, MS, RD, CD
Kelly Smith, RN, BSN, CDE Laurie deFiebre,
BSN, RN
Julie McLaughlin, MS, RD, CD, CDE
clinical HealtH education Providers
advanced diabetes
ManaGeMent astHMa educator
diabetes nurse educators
reGistered dietitians tobacco cessation
counselor cHildbirtH educators
advanced Preventive
cardioloGy
GH c– scw s Pecial ty P roviders
GHc–scw Mental HealtH Providers
Richard Adelman,
MSSW, LCSW Jeff Anders,
MD Stephen
Billingham, PhD
Graham Cody, MD
Caitlin Stone, PhD Kathryn Coleman,
MSSW, LCSW Floriane d’Oleire,
MD Ralph Froelich,
MD
Karla Handel,
MSSW, LCSW Lisa Hunter,
MD Michael Hussey,
LCSW, CSAC Paul Johnson,
LCSW, CSAC Sam Mak,
LCSW, CSAC
Sven Midelfort,
MSSW, LCSW Danielle Ogno,
LCSW, LMFT Carlene Oakley,
MD Michelle O’Meara,
LCSW, LMFT Barbara Roth, MSSW, LCSW
Dianne Ruch,
PhD, APNP Nancy Schiro,
MSN, LCSW Ed Sheldon,
MD Michael Smith,
EdS, LPC
Deborah Sullivan,
MS, LCSW Judith Utevsky,
MSW, LCSW Peter Weiss,
PhD Bill Windels,
APNP Nancy Yaffe,
MS, LPC Bethany Fucci,
MA, LPC Amy Bourne,
MD Jennifer Brandt,
CPNP, PMHNP–BC
Sarah Strong, MSSW, LCSW
GH c– scw s Pecial ty P roviders
Kelsey Barnes, OD Lisa Mowbray, MSSW, LCSW Certified Batterer Treatment Provider
Mark Seymour, MS, LCSW Certified Batterer Treatment Provider
Nathan Catterson,
OD, FAAO John Dabel,
OD
Brady Haferman,
OD Sacha Lundgren,
OD
Robert Mertz,
OD Timothy Schwefel,
OD, FAAO Kurt Walters,
OD, FAAO
GHc–scw eye care Providers
GHc–scw doMestic violence intervention ProGraM
GHc–scw occuPational tHeraPy Providers
GH c– scw s Pecial ty P roviders
GHc–scw PHysical tHeraPy Providers
Steven Crade,
PT Gina Droessler,
LPTA, CSCI, CPI Ted German, DPT, CIMT, CPRS
Judy Pellerin–Goll, PT
Jacqueline Kimble, PT, Cert MDT,
CSCS
Kate Latorraca,
PT Pranali Mhadolkar,
MPT Brenda Milbrath,
MS, PT, OCS, CIMT Wendy Parsons, MPT
Dan Russo,
MPT, LMT Marcy Schulz,
DPT, SCS, ATC Scott Theado, PT, CSCS Rama Ahuha,
MPT
Barb Urmann, MOMT, PT
Matt Brown, DPT
Jaime Reich, DPT
GHc–scw Podiatry Providers
William Chubb, DPM, FACFAS Stephen Bogue,
DPM Stephen Merckx,
DPM
GHc–scw coMPleMentary Medicine locations call (608) 662-5090
Get a massage, relax with yoga, or experience any of our Complementary Medicine Services* (see page 30).
Complementary Medicine is for anyone!
We focus on “building blocks for health,” such as prevention and addressing the underlying causes of a disease, rather than simply treating the external symptoms. We teach people to alter their responses to the stresses of daily life through self–care, a healthy diet and various manual and energy therapies.
Visit ghcscw.com and click on “Complementary Medicine”
to learn more.
GHc–scw coMPleMentary Medicine
call (608) 662–5090 for an appointment
(or schedule through your GHCMyChart
SMaccount)
massage...pilates...yoga...
GH c– scw co MP le M ent ar y M edicine services & classes
GHc–scw coMPleMentary Medicine services & classes
call (608) 662–5090 for an appointment.
Acupuncture is a method of encouraging the body to promote natural healing and to improve functioning.
This is done by inserting needles and applying heat or electrical stimulation at very precise acupuncture points.
CranioSacral Therapy is a very gentle hands–on bodywork technique that brings about equilibrium to the craniosacral system.
The Feldenkrais Method is for anyone who wants to reconnect with their natural abilities to move, think and feel. Whether you want to be more comfortable sitting at your computer, or playing with your children and grandchildren, these gentle lessons may improve your overall well–being.
Lymph Drainage Therapy involves the stimulation of the lymphatic vessels by employing specialized massage therapy techniques. Stimulation of the lymphatic vessels by massage helps to remove toxins, metabolic waste products, disease–causing agents and extra lymph fluid.
Massage Therapy encompasses many different techniques. In general, therapists press, rub and
otherwise manipulate the muscles and other soft tissues of the body. They most often use their hands and fingers, but may use their forearms, elbows or feet.
Mind/Body Therapy helps individuals process where and how emotions are held in the body. It may relieve headaches, chronic pain and emotional trauma.
Mindfulness Meditation techniques include specific postures, focused attention or an open attitude toward distractions, such as focusing attention or maintaining a specific posture. This helps to suspend the stream of thoughts and relax the body and mind, which increases calmness and relaxation, and improve psychological balance.
Naturopathic Medicine is a natural approach to wellness, that teaches diet, exercise and lifestyle changes along with cutting edge natural therapies to enhance the bodies’ ability to ward off and combat disease.
Personal Fitness involves working one–on–one with an instructor in private sessions to create a custom fitness or yoga program tailored to your needs and abilities.
Pilates is a method of exercise, which aims to encourage the use of the mind to develop core postural muscle strength, stability and flexibility, resulting in more efficient and graceful movement.
Reflexology includes pressure to areas on the foot that correspond to the affected organs, which may help to relieve symptoms such as pain.
Reiki is a form of meditation for stress reduction and relaxation that also promotes healing.
Self as Source is a cognitive behavior training using both mind awareness and body awareness. It is a set of learnable skills to harness power so that you can be in charge of your life experience.
Tai Chi is a martial art that combines breath with action, which may increase flexibility, strengthen the body, restore balance and generate peace of mind.
Thai Massage (or Thai yoga massage), involves the therapist using his or her hands, knees, legs and feet to move you into a series of yoga–like stretches. Thai massage is like doing yoga without any work.
Yoga, used for health purposes, typically combines physical postures, breathing techniques and meditation or relaxation. It is used as part of a general health regimen and for a variety of health conditions.
Zero Balance is a powerful body/mind therapy that uses skilled touch to address the relationship between energy and structures of the body. The therapist uses finger pressure and gentle traction on areas of tension in the body.
Zumba is a dance fitness program that combines Latin and international music with an effective workout system, in an effort to make exercise fun.
GH c– scw co MP le M ent ar y M edicine P roviders
acuPuncture
craniosacral tHeraPy
feldenkrais
MassaGe tHeraPy
infant MassaGe lyMPH drainaGe tHeraPy
GHc–scw coMPleMentary Medicine Providers
Amy Crikelair,
LAC, MAC, CA Kathi Drake,
RN, BSN, MSOM Richard Oberg,
MSOM Xuehui Wang,
MSOM
Patricia Smith Khadija Zayed, CMT, RMT Cyndi Fine,
CMT Linda Alanen,
CMT, RN
Linda Alanen, CMT, RN Miranda Mueller,
CMT
Miranda Mueller, CMT Photo not available:
Denise Duranczyk, GCFP
Patricia Smith
Deborah Clark,
CMT Alisha Cook,
CMT Jonathan Garber,
CMT Wendy Grapentine,
CMT Elizabeth Hanson,
CMT Gabrielle Laden, LMT
GH c– scw co MP le M ent ar y M edicine P roviders
John Santiago,
CMT Jon Schwier,
CMT Kimberly Suoja, CMT
MassaGe tHeraPy cont’d
self as source
yoGa zero balance
zuMba tai cHi tHai MassaGe
Mind/body tHeraPy
Personal fitness
reiki
Pilates reflexoloGy
Mindfulness Meditation
naturoPatHic Medicine
Sara Bartlett Bonnie Milgrim,
MA, CPC Michael Smith
(MH), EdS
Michael Smith
(MH), EdS Terri Pellitteri Ghadeer Alafifi Faith Dey
Faith Dey FNU Ruddy,
ND Katy Wallace,
ND
Mary Karls, CMT
Mary Karls, CMT Deborah Clark,
CMT Miranda Mueller,
CMT Khadija Zayed,
CMT, RMT
Jonathan Garber, CMT
Natilie Buster Faith Dey Maruti Landau Amber Thompson
Wendy Grapentine, CMT
Gabrielle Laden, LMT
Gabrielle Laden, LMT Linda Alanen,
CMT, RN
Linda Alanen,
CMT, RN Julie McNeil, CMT
seein G a sP ecialist outside of GH c– scw seeinG a sPecialist outside of GHc–scw
See your Benefits Summary and Member Certificate for full details on services requiring prior authorization.
When you see your Primary Care Provider (PCP), he or she may need a Specialist opinion regarding your care. Planned Specialty visits outside of the GHC–SCW Primary Care Networks require coordination by your PCP. Members must receive an approval letter from the GHC–SCW Care Management Department before receiving these services.
If you make an appointment without an approval letter from GHC–SCW Care Management, you may be responsible for full payment of the services provided.
1. referral reQuest
• The referral request begins when you visit your PCP and a decision is made to refer you to a specific Specialist.
• An order is placed in your Electronic Medical Record (EMR), which sends a message to the Care Management
Department. Care Management staff will evaluate the order to determine if it is a covered benefit and review it
against national care guidelines for whether the care is medically necessary.
• Most referral decisions occur within 4–5 business days.
Up to 15 days are allowed for review if additional
information is needed by the Care Management staff and/or the Medical Director or Physician Reviewer.
2. aPProval letter
• An approval letter will be mailed to you and the Specialist when Care Management approves the referral request.
At that point, you may schedule an appointment to see the Specialist.
• You may wish to take your approval letter to your appointment, as it is not always seen in the Specialty EMR.
Approval does not guarantee benefits:
GHC–SCW approves services or supplies based on the information that is available at the time of the approval/denial decision.
Approval does not guarantee a member’s eligibility or benefits under his or her health plan. It is the responsibility of the member to know their Deductible, Co–pay or Co–insurance amounts that apply to Specialty services.
