If your grievance/appeal is denied, you may have an opportunity to request an independent external review through an independent review organization. Box 7062 Madison, WI 53707-7062 Phone: 87 (toll-free) Email: Fax: 60. Group Health Plan (GHP): The term 'GHP' means any arrangement of, or contributed to by, one or more employers or employee organizations to provide health benefits or medical care directly or indirectly to current or former employees, the employer, others associated or formerly associated with the employer in a business relationship, or their families. Employees living out of state can also access the First Health Network for in-network care.įor other products, the First Health Complementary Network can be used to help lower out-of-pocket costs for emergency services outside Wisconsin.Ĭontact us if you have specific questions about your potential options.Īll Cancer Treatment Centers of America (CTCA)/Midwest Regional Medical Center (MRMC) locations and the physicians billing at these locations through Patient First, SC or CTCA Prof Corp are considered to be out of network. WPS Health Plan Grievance and Appeals Department P.O. For those products, the First Health Network can be used as a wrap network for employees whose children attend school out of state and employees and their families that travel outside Wisconsin. Moira Klos is the chief people officer at WPS Health Solutions, a Wisconsin-based health insurance company with 2,500 employees. Reward yourself, learn more and apply now. WPS EDI will not be able to reset your passwords. We offer a wide range of business, personal and online banking services. Salaries, reviews, and more - all posted by employees working at WPS Health Solutions. WPS Gateway Express also enables you to reset your own account password as needed. See what employees say its like to work at WPS Health Solutions. The First Health Network is a large national network of directly held contracts with more than 6,000 hospitals, more than 130,000 ancillary facilities, and more than 1 million health care professional services locations in the United States, including Puerto Rico. WPS Gateway Express allows you to view your EDI transaction history, including which claim files you’ve previously submitted and which electronic remittance files you’ve previously received. For some products, in-network coverage is available outside of Wisconsin. One of the largest health benefits providers in the state, WPS remains not-for-profit and offers health plans to the public and private sectors.
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