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Health Care Forms & Guidelines for Members

As a health care consumer, and HealthLink member, you have certain rights and responsibilities when it comes to the quality of care you receive from providers, your health plan benefits and your private health information (PHI).

We have compiled all of the most important information and health care forms you may need as you utilize your health plan benefits.

Grievance and Appeal Form

You have the right to document a grievance or request an appeal.  >>

Restriction and Authorization Forms

Submit the appropriate form to give authorization or request a restriction on your PHI.  >>

Medical and Clinical Policies

Access the latest medical policies and clinical UM guidelines.  >>

Non-Participating Provider Reimbursement

If you visit a provider that does not participate in the HealthLink Network, you may be required to pay more.  >>

Telemedicine Waiver

Check with your Employer and/or Benefit Administrator to determine if your plan includes telemedicine services.  >>

Member Rights and Responsibilities

Health care guidelines for consumers when receiving medical care.  >>

Nominate a Doctor to Join Our Network

Fill out a quick form to nominate a doctor, hospital or other health care facility to be added to the HealthLink network.  >>

Information about Utilization Management

How we make coverage decisions for care and hospital stays.  >>