HealthLink, Inc. (“HealthLink”) is a preferred provider administrator that organizes networks of independently contracted health care providers and arranges through contracts with more than 200 insurance carriers, third party administrators and self-funded, self-administered health plans for access to the HealthLink networks and services. HealthLink receives and prices claims in accordance with the contracted allowed amount agreed upon between HealthLink and the provider of service. HealthLink is not the insurer or claims administrator in these arrangements. Therefore, HealthLink does not pay medical claims.

HealthLink HMO, Inc. (“HealthLink HMO”) is a licensed third party claims administrator and health maintenance organization, and is a subsidiary of HealthLink, Inc. HealthLink HMO administers the health benefit program and pays claims on behalf of self-funded health plans that contract with HealthLink HMO for these services.

While payors contracted or affiliated with HealthLink make reasonable efforts to pay claims properly upon receipt, occasionally overpayments may occur. If a health care provider becomes aware of an overpayment or mistake in payment (either through the provider's discovery, from the health plan's claims administrator or health carrier or through a written notification from HealthLink HMO), the provider is required to refund the amount due to the health plan.

Refund per Written Request from a Claims Administrator or Health Carrier Accessing the HealthLink Network

A claims administrator (other than HealthLink HMO) or health carrier may send a letter of explanation and request for return of amounts due to an overpayment. In this event, please send the check or money order along with the patient's name, enrollee identification number and/or claim number to the claims administrator or health carrier who has requested the information. Do not remit payment to HealthLink because HealthLink is not the claims administrator and does not administer the health plan's benefits or claim payments.

Refund per Written Request from HealthLink HMO:

In the event that HealthLink HMO is the claims administrator, HealthLink HMO will send a letter of explanation if an overpayment has been made. This letter usually accompanies the provider's weekly vendor statement of account with HealthLink HMO. The specific claim and claim payment information appears on the adjustment code remark on the provider's HealthLink HMO remittance advice. The physician should attach a check or money order to a copy of the written request. In 2006, HealthLink HMO will wait for a refund for 30 days from the post date of the notice. If HealthLink HMO does not receive the requested refund within 30 days, we will deduct the amount from future remittances until the overpayment is reconciled for the health plan.

Please remit payment for the total credit balance to the address listed below in order to reconcile the account.

HealthLink HMO, Inc.
Attn: Finance-Vendor Refunds
12443 Olive Boulevard
St. Louis, MO 63141

Also, discovery of overpayments or questions regarding an offset or recoupment balance may be addressed by calling HealthLink HMO, toll free 877-284-0101, extension 6238.