Division of Public Health
F-00681 (08/2017) / THREE OPTIONS / STATE OF WISCONSIN
PARTNERSHIP –MANAGED CARE ORGANIZATION (MCO) Serving Insert Name of Regional ADRC or County
Office for Resource Center Development
This chart may be useful in providing enrollment counseling to people in areas where three Managed Care Organizationsare available. The categories found in the chart provide consumers with more detailed and factual information about each MCO that may be useful when weighing their options.
Service Detail / Insert Name of MCO / Insert Name of MCO / Insert Name of MCO
The Partnership Managed Care Organizations / MCO insert corporate address, phone numbers and email as posted on MCO website. Note: local offices must be staffed and open to the public during normal business hours. / MCO insert corporate address, phone numbers and email as posted on MCO website. Note: local offices must be staffed and open to the public during normal business hours. / MCO insert corporate address, phone numbers and email as posted on MCO website. Note: local offices must be staffed and open to the public during normal business hours. /
Branch offices open during normal business hours / MCO insert up to three branch office address, phone numbers and email as posted on MCO website (if different form above). Note: branch offices must be staffed and open to the public during normal business hours. / MCO insert up to three branch office address, phone numbers and email as posted on MCO website (if different form above). Note: branch offices must be staffed and open to the public during normal business hours. / MCO insert up to three branch office address, phone numbers and email as posted on MCO website (if different form above). Note: branch offices must be staffed and open to the public during normal business hours. /
By appointment only offices / MCO insert up to three “by appointment only” local address, phone numbers and email as posted on MCO website (if different from above). / MCO insert up to three “by appointment only” local address, phone numbers and email as posted on MCO website (if different from above). / MCO insert up to three “by appointment only” local address, phone numbers and email as posted on MCO website (if different from above). /
Managed Care Organization Website / MCO insert website address / MCO insert website address / MCO insert website address /
Service providers included in the MCO provider network / MCO insert link to provider network listing / MCO insert link to provider network listing / MCO insert link to provider network listing /
Type of agency / MCO insert legal status (Not-for-Profit or For-Profit) / MCO insert legal status (Not-for-Profit or For-Profit) / MCO insert legal status (Not-for-Profit or For-Profit) /
Care Managers employed or contracted / MCO insert care managers relationship (contracted, employed, both) / MCO insert care managers relationship (contracted, employed, both) / MCO insert care managers relationship (contracted, employed, both) /
Special information about the MCO that would be helpful to know / MCO insert no more than one hundred characters / MCO insert no more than one hundred characters / MCO insert no more than one hundred characters /
Counties the MCO now serves / MCO insert name of counties / MCO insert name of counties / MCO insert name of counties /
On average the number of members a Care Manager and Nurse works with / MCO insert number of members per care manager and nurse. / MCO insert number of members per care manager and nurse. / MCO insert number of members per care manager and nurse. /
Total Number of Primary Care Physicians / Insert number of Primary Care Physicians / Insert number of Primary Care Physicians / Insert number of Primary Care Physicians /
Medicare Prescription Drug Plan Coverage / Insert Medicare Prescription Drug Plan Coverage / Insert Medicare Prescription Drug Plan Coverage / Insert Medicare Prescription Drug Plan Coverage /
Location of Urgent Care Facilities / Insert locations of Urgent Care Facilities / Insert locations of Urgent Care Facilities / Insert locations of Urgent Care Facilities /
Hospitals Affiliated with Plan / Insert names of Hospitals / Insert names of Hospitals / Insert names of Hospitals /
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