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.

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.