Find "In-Network" Providers
Unless you have a medical emergency, you (and any covered spouse or partner) must use UHS for all available primary, urgent and preventive care during business hours. This requirement does not apply to covered dependent children, since UHS does not provide pediatric care. Other exceptions are listed in the “Waiver of Primary Care Provider Requirements” section in the online Plan Document.
Covered visits to “In-Network” providers are subject to applicable deductible, coinsurance, or copayment responsibilities as detailed in the online Plan Document. Please remember that benefits are payable in accordance with the Plan Document. For specific plan benefits questions, call the SHIP Claims Administrator, Consolidated Health Plans at 1-877-657-5031.
How to find an “In-Network” provider for services not available at UHS
SHIP has contracts with two provider networks for “In-Network” coverage – The Alliance and First Health.
The Alliance network service area includes most of Wisconsin (including Madison) and extends into Northern Illinois, Eastern Iowa, and Eastern Minnesota.
If you are trying to find a provider within this service area, click here. (Note that if you receive a message asking if you want to “Create an Account”, you can still click “Continue Without Logging In” if you prefer).
For example, to search for a list of Pediatric Providers:
- Select UW SHIP from the "Choose Your Employer" drop-down
- Enter the location where you want care – then click “Continue”
- Select Pediatrics/Adolescent Medicine (primary care) under the "Specialty"drop-down
If you are having difficulty using the Online Provider Directory, a customer service representative from The Alliance can help you. For assistance, call 800-223-4139. After the Spanish prompt, press 3, then 2, then 2, then 1, and then 1.
Using cost and quality information as you select providers can help you make more informed decisions about where to go for care. When you see the QualityCounts logo in the Online Provider Directory it means you can access cost and/or quality information about that facility.
Simply click on the QualityCounts logo and “Create an account” (or log-in if you are a returning user). You can then click “View Reports” to access the following information:
- QualityCounts Inpatient Hospital Report – provides quality and cost information for 15 different inpatient procedures at hospitals that participate with The Alliance. Inpatient care means that patients stay overnight at the facility after the procedure.
- QualityCounts Outpatient Procedures and Tests Report – provides quality and cost information for 16 different outpatient procedures and tests at facilities that participate with The Alliance. Outpatient care means that patients are sent home the same day as their procedure or test.
As a part of The Alliance cooperative, SHIP has added an in-network benefit to SHIP for 2017/18 called “QualityPath”. Under “QualityPath” certain procedures, including MRIs, will be fully covered at participating providers. Those providers are required to meet or exceed quality standards that are based on national measures and recommended practices for care. Members that utilize “Quality Path” also receive a warranty.
To learn more about utilizing the QualityPath program for Tests (MRI and CTs), click here. Details on QualityPath are also in the SHIP Plan Document.
First Health provides “In-Network” coverage when you are unable to find a provider in The Alliance network. First Health is a national network, with providers throughout the United States, including Wisconsin. To locate a provider in the First Health network, click here.
If you are having difficulty using the Online Provider Directory, a customer service representative from First Health can help you. For assistance, call 800-226-5116. After the initial message press 2, then 1, and then 1.
If you have any questions or need further assistance identifying an “In-Network” provider for either The Alliance or First Health, you can also contact our office. The SHIP office is open from 9am-5pm, Monday through Friday.
Just present your SHIP card to receive these discounts