Maintaining Transparency and Accountability
Wellpoint Care Network’s policies are designed to ensure that we provide the highest quality of operations and service to those in our care, while also maintaining a safe, efficient and sustainable business model. Here, you can download the most up-to-date PDF copies of these forms.
Our Commitment to You
Wellpoint Care Network is committed to maintaining the privacy of your Protected Health Information. This Notice explains how that information may be used and disclosed to others, effective as of February 24, 2025.
DOWNLOAD FULL NOTICE [PDF]
Medical Records Policy
All individuals who have received services at Wellpoint Care Network have the right to access their medical records in accordance with DHS 51.30. Requests for clients age 14-17 must contain client and parent signatures.
DOWNLOAD REQUEST FORM [PDF]
Financial Assistance Policy / Sliding Fee Schedule
Wellpoint Care Network offers a Financial Assistance Program, which determines eligibility using a Sliding Fee Schedule calculated annually based on the Federal Poverty Guidelines.
DOWNLOAD FULL POLICY [PDF] EN ESPAÑOL
Good Faith Estimate Policy
Under the law, you have the right to receive a “Good Faith Estimate” explaining how much your health care will cost before it is provided.
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Surprise Billing Policy
When you get emergency care or are treated by an out-of-network provider at an in-network care facility, you should not be charged more than your plan’s copayments, coinsurance and/or deductible.
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Discrimination is Against the Law
Wellpoint Care Network complies with Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, religion, language, ethnicity, socioeconomic status, sexual orientation, gender identity, veteran status or political beliefs.
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Your Privacy Matters
Wellpoint Care Network’s Terms of Use and Privacy Policy are governed by the laws of the United States and the state of Wisconsin, effective March 11, 2022.
READ MORE ABOUT WEB PRIVACY >>
Committed to Accessibility for All
Wellpoint Care Network is committed to ensuring all visitors have full and equal access to our website. To ensure our digital offerings remain accessible, we strive to conform to the Web Content Accessibility Guidelines (WCAG) 2.0 AA. standards.
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