Northwest Wisconsin Provider Directory - UHCCommunityPlan.com

284 Pages·2014·3.58 MB·English

Directory of Physicians and
Other Health Care Professionals
Northwest Wisconsin
Member Services
1-800-504-9660, TTY 711
CSWI18MC4260825_000
12/31/2019
Welcome to UnitedHealthcare Community Plan
We care about you and your family's health.
This directory will help you find doctors and specialists in your area who participate with
UnitedHealthcare Community Plan. You can find a current list of providers on the UnitedHealthcare
Community Plan website at myUHC.com/CommunityPlan. If you need help to translate, understand
or find a doctor, call Member Services at 1-800-504-9660, TTY 711. We'll be happy to help you.
You can call the same phone number for emergencies after regular business hours.
Member Services 1-800-504-9660, TTY 711
Available 7:00 a.m. – 7:00 p.m. CST
Our office is closed on major holidays.
As a member of UnitedHealthcare Community Plan, you will receive all your health care from
UnitedHealthcare Community Plan doctors and other health care professionals. This directory lists
the UnitedHealthcare Community Plan providers that have agreed to provide health care to you and
your family. If you have questions or need help choosing a provider, please call our Member Services
Department at 1-800-504-9660.
Visit UnitedHealthcare's Community Plan secure member website at myUHC.com/CommunityPlan
to view the current directory online. Follow the directions below to access the directory.
1. Type myUHC.com/CommunityPlan into the address bar of your Internet browser.
2. Click on “Register Now.”
3. Enter your name, birthday, ZIP code and member ID or Social Security number.
Create a username and password.
4. Once registered, click on the “Find a Doctor” button on the welcome page.
5. Fill out the online form to find the doctor or health care facility you are looking for.
6. You may also view an electronic copy of this directory on this part of our website as well.
Providers listed in this directory are current as of the date listed on the cover.
Information is subject to change.
myUHC.com/CommunityPlan
Remember to:
• Call your Primary Care Providers first if you have questions about your health.
• Present your ForwardHealth ID card for health care services.
• Call the Member Services Department if you have questions about benefits and services.
UnitedHealthcare Community Plan does not discriminate on the basis of race, color, religion, sex,
sexual orientation, age, disability, national origin, veteran status, ancestry, health status or need for
health services in the receipt of health services.
We're glad you are a member of UnitedHealthcare Community Plan!
myUHC.com/CommunityPlan
How to Use This Directory
Choosing a Primary Care Physician (PCP)
for you and your family is easy.
There are several types of PCPs listed in this directory.
Primary Care Physicians
Family Practice: Adults and Children
Internal Medicine: Adults
Pediatrician: Children
In order to find a provider, please go to the table of contents and find the listing for your county. The
providers are listed by their specialty. When you find the specialty that you want, go to the page that is
listed. Then, you can choose the provider that meets your needs. Members may receive care from a
resident physician or a certified registered nurse practitioner under the supervision of a PCP.
On the next page, you can find sample provider and hospital listings with descriptions of what each
field means.
myUHC.com/CommunityPlan
Sample Provider Listing
Description of Provider Listings
Board Certification shows a physician's expert knowledge in a medical specialty. Certification
1involves a process of testing and evaluation by specialists in the specific area of medicine.
A board-certified specialist participates in continuing education to learn about the latest advances
in medical science and technology in his/her specialty. You can check the provider's board
certifications on the American Board of Medical Specialists (ABMS) website. Go to www.abms.org
and click on “Is Your Doctor Certified?”
This chart will help you understand
Limitations of the practice, such as
each doctor's listing
2age restrictions or the inability to accept
Listing Example
new patients.
Family Practice
Group Affiliation
Medical Associates
Wheelchair picture tells you the provider
3is wheelchair-accessible. Group Phone Number 302-222-2222
Group Address 123 Main Street
Health Valley, WI 54321
Provider Name John Smith, MD
Provider ID Number 00000012345 3
Provider Gender Gender: Male
1 B oard Certification Board Certified: Family
2 Limitations Limitations: Min. age 18 years
old, Existing patients only
All of the information in these provider listings is based upon the provider’s application.
UnitedHealthcare Community Plan checks this information when these providers join our network
and every three years (or sooner) when the provider is re -credentialed.
myUHC.com/CommunityPlan
Sample Hospital Listing
Description of Hospital Listings
This chart will help you understand
each hospital's listing
Listing Example
Hospital Name GoodCare Hospital
Hospital Phone Number 302-123-4567
Hospital ID Number 000000074980
Hospital Address 627 South Wellness Street
Health Valley, WI 54321
Accreditation Accredited by: The Joint
Commission (Accredited)
Accreditation shows that the hospital has been evaluated by experts in hospital care. An accredited
hospital must participate in ongoing reviews to make sure that its operations are up to the latest
standards. Please see below for the possible rankings.
The Joint Commission is one entity that accredits hospitals. The following ratings are possible:
• Accredited: The hospital was in compliance with all standards when surveyed or within 90 days
of the survey.
• Preliminary Accreditation: The hospital passed a brief review of its compliance with the Joint
Commission's standards and will be surveyed more fully shortly.
• Conditional Accreditation: The hospital complies with some, but not all, of the Joint
Commission's standards, but will be surveyed more fully shortly.
• Provisional Accreditation: The hospital was not able to address all of the requirements for
improvement that the first survey suggested within 45 days, or the hospital failed to show that it
has been able to sustain compliance.
Accreditation can also be granted by the American Osteopathic Association (AOA), in which case the
listing will read, “Accreditation: AOA (Accredited).”
All of the information in these provider listings is based upon the provider’s application.
UnitedHealthcare Community Plan checks this information when these providers join our network
and every three years (or sooner) when the provider is re-credentialed.
myUHC.com/Communit yPlan
UnitedHealthcare Community Plan does not treat members differently because of sex, age, race,
color, disability or national origin.
If you think you were treated unfairly because of your sex, age, race, color, disability or national origin,
you can send a complaint to:
Civil Rights Coordinator
UnitedHealthcare Civil Rights Grievance
P.O. Box 30608
Salt Lake City, UTAH 84130
UnitedHealthcare Community Plan no da un tratamiento diferente a sus miembros en base a
su sexo, edad, raza, color, discapacidad o origen nacional.
Si usted piensa que ha sido tratado injustamente por razones como su sexo, edad, raza, color,
discapacidad o origen nacional, puede enviar una queja a:
Civil Rights Coordinator
UnitedHealthcare Civil Rights Grievance
P.O. Box 30608
Salt Lake City, UTAH 84130