Network Strength

HealthLink delivers broad regional access to contracted providers who have agreed to accept competitively discounted payments for health services. HealthLink service areas include: Arkansas, Illinois, Missouri and Texas; Mid- Atlantic service areas of Maryland, Virginia and Washington DC; and expansion markets of Ohio and Kentucky. Network development efforts are underway in Indiana and Wisconsin. HealthLink also provides a national network solution for clients with enrollees who reside or travel outside the service area.

Competitively Discounted Payments
Our disciplined approach to fixed payment methodologies, precise modeling/ forecasting of rate changes and actuarial calculations allows us to establish aggressive pricing targets by market and product.

Plan Performance Management
Our sophisticated rate modeling techniques analyze and evaluate how current market trends, enrollee demographics and client objectives affect plan design. We make this information available to you so that you may evaluate your health benefit program and have the ability to recognize the cost/benefit value of changing or adding programs and services when the time is right.

Stability
Our provider retention rate of 98% reflects the high levels of satisfaction that have become a HealthLink standard.

Flexible Plan Options
HealthLink has the flexibility to work with a wide range of plan administrators. Employers may choose the plan administrator along with the HealthLink network. The HealthLink Open Access III (OAIII) program can be integrated into company benefit plans to support any plan design. Clients may purchase the basic Open Access III program package, add components on a menu basis, or purchase a comprehensive Open Access package of programs and specialty components at a special, discounted rate. Most pricing is PEPM. Please contact a sales representative for pricing information.

Specialty Programs
HealthLink’s Workers’ Compensation network, CompManagement, helps employers control medical and related costs associated with work-related illness and injury. Through our affiliation with WellPoint, HealthLink offers a broad portfolio of other specialty programs, including: Reinsurance; Life and AD&D; Dental Network; Vision Program; and Employee Assistance Program.

Cost Management

HealthLink’s Health Care Management Program is an extensive suite of health promotion and wellness information, case management and care coordination services to help physicians help their patients achieve optimal health outcomes. The program includes three levels of services: HealthLink Signature; HealthLink Wellness Plus; and HealthLink Personal Care Resources.

HealthLink Signature Services
Medical Management – HealthLink Medical Management is comprised of two components: Utilization Management and Case Management.

• Pre-Admission Certification of Planned Hospital Admission
• Notification of Emergency Hospital Admission
• Concurrent Hospital Stay Review
• Discharge Planning
• Pre-Certification of Selected Ambulatory/Outpatient Services
• Pre-Certification of Selected Ancillary Services

HealthLink’s Case Management program is a collaborative process among HealthLink and other health professionals who manage the resources necessary to support individuals with catastrophic or chronic medical conditions. Case Management helps the treating health care professional(s) help the patient achieve optimal and timely medical outcomes.

HealthLink Signature Services also include the following:

• Condition Management Programs – Individualized programs for members with Asthma, Chronic Obstructive Pulmonary Disorder, Coronary Artery Disease, Diabetes and Heart Failure.
• MaterniCall^™ – Maternity management program helps participants make informed decisions during pregnancy and after childbirth.
• MedCall^® – 24/7 nurse hotline and audio library of more than 300+ health topics.
• WellPoint NextRx – Aggressive pharmacy benefit manager targets costs and includes a national retail network, mail order and specialty prescription programs.

HealthLink Wellness Plus
The following programs are offered at no charge to the client or member:

• SpecialOffers Online Discount Program – Helps promote health and well being. More than 20 vendors provide discounts on services related to family and home, fitness and health, and vision/hearing/dental treatment.
• TLC^® (The Last Cigarette) – Smoking cessation program. Members request a TLC quit kit to assist in their efforts to be smoke-free.

The following programs are available on a fee-for-service basis. Please contact a sales account representative for pricing information:

• Worksite Wellness Programs – Health educators and registered dietitians visit your workplace to share knowledge on a variety of health and lifestyle topics.
• Lifestyle Management Programs – Engaging online programs and inspiring coaches use proactive outreach activities and support strategies to help employees in the areas of: tobacco cessation, weight management, stress management, physical activity and diet/nutrition.

HealthLink Personal Care Resources
The following value-added electronic member resources are available at no cost to clients and members:

• Healthy Living Web Site – Health and wellness tips and tools available online 24/7.
• eHouseCall – Monthly wellness newsletter for members.
• Women’s Health eNewsletter – Monthly publication for women of all ages.
• Preventive Health Guidelines – As recommended by the U.S. Preventive Services Task Force and other health related agencies.
• Healthy Habits for Healthy Kids – Nutrition and activity guide from the American Dietetic Association.
• Enrollee Rights and Responsibilities – General guidelines for health care consumers.

Administrative Accountability

Accurate, efficient service and support are the foundation of all HealthLink network programs. We deliver results.

Administrative Services
HealthLink is committed to supporting your health plan’s benefit administration through maximum use of technology throughout our organization. We offer fast, efficient electronic claim repricing, eligibility management, a state-of-the-art customer service response system, a provider portal and a fully interactive web site, www.healthlink.com.

Account Management Services
HealthLink account managers serve as liaison between HealthLink and contracted clients. They are responsible for the timely resolution of day-to-day service issues. Account managers also make on-site service visits and compile/present management reports.

Management Reporting Timely reporting tracks membership, health care services, claims accuracy, payments and utilization.