Find a Doctor - Prestige NE Plans

I am looking for a doctor

The providers in this search are in-network for our Prestige individual and family plans in Outagamie, Winnebago and Calumet counties in northeast Wisconsin.

Choosing a Primary Care Provider (PCP) or Personal Doctor

You will need to choose one of our network providers listed in this directory to be your Primary Care Provider, also known as your personal doctor. Generally, you will get your health care services from your personal doctor. You will choose from one of the following practices:

  • Family Practice
  • General Practice
  • Internal Medicine
  • Pediatrics

If you need assistance selecting a personal doctor, please call 800-769-3186.

Finding a Specialist
For a complete listing of specialists, please contact us at 800-769-3186. Your personal doctor can also help refer you to a specialist, if needed.
The Right to Choose Your Doctor
With a Medicare PPO plan, you have the right to choose in-network or out-of-network doctors. This means you can select any doctor who accepts Medicare beneficiaries. Plus, unlike HMO plans, Network Health does not require a referral from your primary care doctor to see specialists.
Provider-Owned to Provide Outstanding Care
Co-owned by Froedtert Health and Ministry Health Care, a part of Ascension Wisconsin, we understand the importance of quality health care, and we believe it should be convenient. With roots in northeast Wisconsin and new partnerships in southeast Wisconsin, we’re able to offer access to a large network of high-quality providers.
Large, Strong Doctor and Hospital Networks
With a Medicare PPO plan, you have the freedom to choose any doctor who accepts Medicare beneficiaries. Network Health contracts with in-network doctors, hospitals and facilities.
How We Validate Information

For contracted providers, Network Health (NH) obtains provider’s data, (i.e., name, gender, office location, board certifications, specialty, hospital affiliations, medical group affiliations, accepting new patients, and languages spoken) on the credentialing application and validates it every three years as part of the re-credentialing process.

Practitioner name, office location, acceptance of new patients, hospital affiliations, medical group affiliations, board certification and specialty are verified quarterly by the NH Provider Informatics department by contacting the provider offices for updates.Updates to the provider directory are completed within 30 calendar days of receiving new information from the provider.

For contracted facilities, Network Health(NH) obtains facilities data on the credentialing application and validates it every three years as part of the re-credentialing process.

Facility data is updated by the NH Provider Informatics department by contacting the provider offices for updates.Updates to the facility directory are completed within 30 calendar days of receiving new information from the facility.

Hospital Quality Information

Use the Hospital Compare database to compare the quality of care at more than 4,000 hospitals. You can check the current accreditation status of hospitals by visiting the following sites:

Member Experience Information
Use HCAHPS database the to compare the member experience measures via hospital consumer assessments of healthcare providers and systems.
Request a Hard Copy of Provider or Facility Directory

If you would like assistance or want a provider or facility directory mailed to you, please call us at 800-769-3186. We are available Monday, Wednesday, Thursday and Friday 8 a.m. to 5 p.m. and Tuesday 8 a.m. to 4 p.m.

Information in the printed directory is accurate as of the time of printing. For the most recent information on providers or facilities in the network or for help selecting or changing your personal doctor, please refer to the “Find a Doctor” tool or call us at 800-769-3186. These results are updated on a daily basis.

Report Inaccurate Information
Members and potential members should report possible inaccurate, incomplete or misleading information by contacting us at NHPManagedCareContracting@networkhealth.com. This email box is for individuals to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mailbox will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies by calling 800-769-3186.
It’s Your Choice

We will provide you with information to help you make informed choices, such as physician’s and health care professionals' credentials. This information, however, is not an endorsement of a physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of Network Health contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact Customer Service at 800-769-3186. We also recommend that, prior to seeing any physician, including any specialists and mental health providers, that you call the physician's office to verify their participation status and availability, since a provider's availability to see new patients may change frequently.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Referrals
Network providers help you and your covered family members get the care needed. Your plan may have limitations regarding accessibility and referrals to specialists, as well as other restrictions imposed by your limited provider network. Access to specialists may be coordinated by your primary care provider.
Provider Information
You are strongly encouraged to contact us to verify the status of the providers involved in your care including, for example, the anesthesiologist, radiologist, pathologist, facility, clinic or laboratory, when scheduling appointments or elective procedures to determine whether each provider is a participating or nonparticipating provider. Such information may assist in your selection of provider(s) and will likely affect the level of co-payment, deductible and amount of co-insurance applicable to care you receive. The information contained in this directory may change during your plan year. Please call the Customer Service phone number at 800-769-3186 to learn more about the participating providers in your network and the implications, including financial, if you decide to receive your care from nonparticipating providers.

Network Health
1570 Midway Place
Menasha, WI 54952
Hours
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.