Payors Wanting to do Business with HealthLink

Payors (Insurers, TPAs, and Self-Funded Groups) wanting to do business with HealthLink can contact HealthLink Payor Relations Department. Prospects will be evaluated on a case-by-case basis by the Regional Vice President of Payor Relations.

Payor Type	Contact	Number
Insurers	Payor Relations	(314) 925-6132
TPAs	Payor Relations	(314) 925-6132
Self-Funded Groups	Payor Relations	(314) 925-6132

Insurance Companies wanting to do business with HealthLink:

• Must be actively licensed to sell health insurance in state of sale.
• Have an AM Best financial rating of B+ or greater (unless just entering the insured market).
• Rollover at least 500 existing subscriber lives or expect at least 500 subscriber lives to be sold by the end of the first year.
• Already have a WebMD clearinghouse connection established to receive ANSI 837-4010A1 repriced claims from PPOs (or a suitable alternative).
• Must have a methodology in place to submit electronic eligibility files to HealthLink.
• Have a 20% plan differential in place between in- and out-of-network benefit tiers.
• Have processes in place to protect the PPO participating providers:
  • use of PPO logo on ID cards.
  • use of network-specific remarks on EOBs.
  • pay claims timely (average of 30 days from receipt).
• Agree to contract with HealthLink for services.
  • avoid network stacking and “silent” PPOs.

Insurance Companies can contact Payor Relations:

(314) 925-6132
PayorRelations@HealthLink.com

*Note: TPAs administering fully insured business follow the Insurance Company parameters above.

Third Party Administrators (TPAs) wanting to do business with HealthLink:

Must adhere to all of the above parameters, except the insurance licensure and contracting parts. HealthLink contracts directly with each self-funded group. Generally, at least 500 subscriber lives are needed to establish a new TPA/self-funded group relationship, primarily due to the cost of implementing and maintaining an EDI (claims) trading partner connection.

TPAs may contact Payor Relations for more information by calling (314) 925-6132 or by email to PayorRelations@HealthLink.com .

Self-Funded Groups using TPA services from a TPA already implemented, active with HealthLink and in “good standing” with HealthLink may contact HealthLink to:

• Obtain services and access fee rates;
• Establish a mutually agreeable implementation date;
• Initiate discussions with the TPA about eligibility and EDI claims; and
• Receive the HealthLink self-funded group contract (referred to as HSA – Health Services Agreement).

Large, self-funded, self-administered clients should contact Payor Relations for detail information, by calling (314) 925-6132.

HealthLink®, Inc., is an Illinois corporation.  HealthLink, Inc. is an organizer of independently contracted provider networks, which it makes available by contract to a variety of payors of health benefits, including insurers, third party administrators or employers.  HealthLink has no control or right of control over the professional, medical judgment of contracted providers, and is not liable for any acts or failures to act, by contracted providers.  HealthLink, Inc. is not an insurance company and has no liability for benefits under benefit plans offered or administered by payors.  HealthLink® is a registered trademark of HealthLink, Inc. and a separately incorporated and capitalized subsidiary of WellPoint, Inc. Any reference in the material to other organizations or companies, including their Internet sites, is not an endorsement or warranty of the services, information or products provided by those organizations or companies. Discount offerings made available by third-party vendors.