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Provider Login

Login to access patient data, documents, resources and more.

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Common Ground Healthcare Cooperative, a health plan network offering through Group Health Cooperative of Eau Claire.

State of Wisconsin/ETF
Provider Resources

 

Portal Access

Provider Portal Access Authorization Form


Claims & Appeal Forms

ACH Credits Enrollment Available Electronic Data Partners Claims Status Inquiry 276-277
 
Electronic Claims Submission 837 Electronic Transfer Remittance 835 Eligibility Benefit Inquiry 270-271
Medical Claim Notes Provider Appeal
 

Prior Authorization Resources

Prior Authorization Guidelines


Prior Authorization Forms

Cardiac/Pulmonary Rehab DME PT/OT/ST Intensive Outpatient Treatment
Home Health   Inpatient Admission  Out of Network  Day Treatment/Partial Hospitalization
Service/Procedure Behavioral Health Inpatient Admission Neuro/Psychological Testing