TPA Consideration

Consideration for new TPA contracting is contingent upon timely submission of a TPA Questionnaire to HealthLink’s Payor Relations Department. Such TPA Questionnaire is available from HealthLink’s Payor Relations Department. Please contact HealthLink at PayorRelations@Healthlink.com or 1-877-284-0101 ext 6132. Completion of the TPA Questionnaire is not a guarantee of a working relationship.

Requirements of a new TPA include the following:

  1. Roll a minimum of 500 new member lives upon implementation, or pay a set up fee of $2,500 if less than 500 members and meets remainder of requirements.
  2. Compliance with HIPAA Standard Transactions (including the 997 Acknowledgement).
  3. Compliance with HealthLink’s ID card standards.
  4. Compliance with HealthLink’s EOB standards.
  5. Compliance with HealthLink’s electronic Eligibility standards.
  6. Compliance with HealthLink’s Provider InfoSource requirements.
  7. Maintain a minimum 10% benefit differential (and 20% for Open Access) between the PPO and out-of-network benefit tiers.
  8. Sign a HealthLink TPA Agreement and require each of their client groups to sign the required (TPA) Payor Agreement with HealthLink.

If all requirements cannot be met, please contact HealthLink’s Sales/Marketing division at 1-800-235-0306 for further discussion and/or consideration.

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.