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Welcome Health Care Providers HealthLink

Details: HealthLink is a provider advocate and we strive to maintain high levels of provider satisfaction.

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› Url: https://www.healthlink.com/provider/ Go Now

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Health Care Tools & Resources for Members HealthLink

Details: Find a doctor or hospital that participates in your health plan. COVID-19 Resource Center. Information and resources for COVID-19. Educational Library. Be an informed health care consumer and make the health care system work for you. Member Toolbox. Programs to help you stay healthy and save money.

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› Url: https://www.healthlink.com/member/ Go Now

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Health & Wellness Programs HealthLink

Details: Health & Wellness Programs and Cost Management Solutions. Help members stay healthy and manage their health care spending with HealthLink's industry-leading portfolio of preventive health & wellness and cost reduction programs. Utilization management and heath care cost reduction has become a key business strategy for alternative-funded health

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› Url: https://www.healthlink.com/about/wellness Go Now

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Find A Doctor Near You HealthLink

Details: Select your health plan and network from the drop-down lists. Health Plan. - Select - AIKCU HealthLink HTH Lake Regional Health System Private Healthcare Systems (PHCS) Quincy Medical Group Quincy Tri-State Coalition SEIU Healthcare Southern Illinois Laborers SSM State of Illinois CMS Trustmark Small Business Benefits. Network - Select -.

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Health Care Forms & Guidelines for Members HealthLink

Details: 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).

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› Url: https://www.healthlink.com/member/forms-and-guidelines Go Now

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HealthLink MemberAccess

Details: 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.

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› Url: https://memberaccess.healthlink.com/MemberAccess/public/Home Go Now

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State of Illinois Learn More HealthLink

Details: Welcome State of Illinois Benefit Plan Members. HealthLink offers State of Illinois members a variety of free tools and resources to help you get the most from the money you spend on healthcare. Even if you're not enrolled in a HealthLink health plan, we've got tools to help you take charge of your health. And if you're already a HealthLink

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› Url: https://www.healthlink.com/soi/learn-more Go Now

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Welcome to HealthLink®, Inc

Details: hospitals and other health care professionals. Our primary objective is to provide outstanding service within the framework of a common goal – providing enrollees with convenient access to quality health care at a reasonable cost. This administrative manual was created as a …

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› Url: https://www.healthlink.com/documents/chapter%201%20-%20introduction.pdf Go Now

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Precertification & Utilization Management

Details: recovered from the health plan or patient. Please contact HealthLink, the health plan claims administrator or the Utilization Management firm listed on the health plan enrollee identification card if you have any questions about a patient’s Utilization Management requirements (or the effect of noncompliance) prior to the delivery of service.

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› Url: https://www.healthlink.com/documents/chapter%207%20-%20utilization%20management.pdf Go Now

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State of Illinois Employee Health Care Plan Summary Plan

Details: You have chosen to be covered under the State of Illinois Health Benefits Plan. The State of Illinois has a contractual arrangement with HealthLink, Inc. and its subsidiary, HealthLink HMO, Inc., the Claims Administrator, to access two provider contracted networks, to provide Medical Management services and to provide claims administration.

› Verified 6 days ago

› Url: https://www.healthlink.com/documents/spd_fy20_160000.pdf Go Now

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COVID-19 Information HealthLink

Details: "Health insurance coverage" and "health insurance issuer" shall have the meanings given in Section 5 of the Illinois Health Insurance Portability and Accountability Act, 215 ILCS 97. Section 5. Telehealth Services subject to this Executive Order's coverage requirements may be provided by any in-network physicians, physician assistants

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› Url: https://www.healthlink.com/provider/covid-19 Go Now

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Contact Us HealthLink

Details: Please contact the health plan benefit administrator listed on the enrollee ID card. For specialist referral authorization, certification of hospitalizations and outpatient procedures: HealthLink Medical Management Hours: 7:00 a.m. to 5:00 p.m. CST Open business days. Toll-free 1-877-284-0102

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› Url: https://www.healthlink.com/contact Go Now

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Payor Administrative Manual

Details: health care services. To provide, to the best of the enrollee’s knowledge, accurate and complet. e information about current health coverage to health care providers of service. To contact HealthLink for questions or concerns about the managed care plan or the health care service received.

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› Url: https://www.healthlink.com/documents/manual_payor.pdf Go Now

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Medical Claim Form

Details: HEALTH CARE SERVICES: Use this section to report any COVERED health service that has not already been reported to HealthLink by the provider of service (the physician, clinical, ambulance company, private duty nurse, etc.) Attach itemized bill or photocopy. Please be sure that duplicate bills are not submitted. Where was the service rendered?

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› Url: https://www.healthlink.com/documents/hl_hicf.pdf Go Now

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HealthLink ProviderInfoSource

Details: The ProviderInfoSource web site makes extensive use of the Adobe Acrobat Reader plug-in. This plug-in will allow you to view the various documents throughout the ProviderInfoSource website. If you do not already have the plug-in, click on the logo to download the Adobe Acrobat Reader plug-in.

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› Url: https://providerinfosource.healthlink.com/ Go Now

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Restriction & Authorization Forms HealthLink

Details: Restriction Request Form. Fill out this form to request that HealthLink restrict its use or disclosure of PHI. You may restrict what type of information is utilized and supplied to an organization as well as who can access your file and obtain PHI. Please return to the address listed at the end of the form. Authorized Representative Form.

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› Url: https://www.healthlink.com/member/restriction-and-authorization Go Now

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HealthLink Medical Management Services Requiring Pre

Details: 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.

› Verified 9 days ago

› Url: https://www.healthlink.com/documents/mm-aim_pre-cert_list_provider_20200101.pdf Go Now

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Group Health Plans & Self-Funded Insurance HealthLink

Details: HealthLink builds customized self-funded health plans to fit any workforce or corporate objective to control health care costs like never before.

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› Url: https://www.healthlink.com/about/ Go Now

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HealthLink MemberAccess

Details: 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.

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› Url: https://memberaccess.healthlink.com/MemberAccess/public/Resources Go Now

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Search Medical Policies and Clinical Guidelines

Details: Medical Policies and Clinical UM Guidelines. Note: The Medical Policies and Clinical UM Guidelines on this site may not always be the criteria used for benefit determinations for a covered individual. Certain payors who conduct business with HealthLink determine their own covered benefits. Please see the covered individual's plan document for covered or excluded services.

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› Url: https://provider.healthlink.com/missouri-provider/medical-policies-and-clinical-guidelines?content_path=medicalpolicies%2Fnoapplication%2Ff1%2Fs0%2Ft0%2Fpw_a092203.htm&label=Overview Go Now

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Non-Participating Provider Reimbursement

Details: to interpret the health benefit plan and its plan documents a nd to determine all questions arising in the administration, interpretation and application of the health benefits plan, including, but not limited to, eligibility, benefits, limitations and exclusions under the health benefit plan. July 2012 Non-Participating Provider Reimbursement

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› Url: https://www.healthlink.com/documents/network_rental_plans_members-healthlink_modified_content_ingenix-ucr_5_4%20_3.pdf Go Now

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Health and Wellness Videos HealthLink

Details: Health and Wellness Videos. Previous Video Next Video. Foods to Eat for High Blood Pressure. If you have high blood pressure, there is more you can do than just cut back on salt. The Dietary Approaches to Stop Hypertension - or DASH - diet can help lower your blood pressure. Try …

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› Url: https://www.healthlink.com/member/hltv?v=3 Go Now

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Build Your Own Customized Health Plan HealthLink

Details: BUILD YOUR OWN CUSTOMIZED HEALTH PLAN. HealthLink offers maximum flexibility for employer-specific plan designs. Each of our core programs deliver regional access to a wide-range of area doctors and hospitals, can be designed to include up to three different tiers of benefit coverage, and feature the many unique advantages of self-funding insurance.

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› Url: https://www.healthlink.com/about/solutions Go Now

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Employee Health Plans & Self-Funded Insurance HealthLink

Details: Tools and resources to get the most from your health plan. Expanded Portfolio. We are more than just a network of doctors and hospitals. We can help you fill in the gaps of your health plan. Expert Insights. A variety of white papers to educate you on industry topics and business.

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› Url: https://www.healthlink.com/employer/ Go Now

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Contracted Insurance Carriers & TPAs HealthLink

Details: HealthLink contracts with several regional and national health insurance carriers to provide network programs and help benefit administrators manage health care costs. HealthLink also offers a national, travel network option. Prior to the completion of a group sale, please contact our Sales department at …

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› Url: https://www.healthlink.com/broker/find Go Now

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MENTAL HEALTH STIGMA ANSWERS TO COMMON QUESTIONS …

Details: MENTAL HEALTH STIGMA: ANSWERS TO COMMON QUESTIONS. Everyone faces challenges in life, and for some people, those challenges can affect their mental health. Going through a pandemic may add to that pressure. One out of every five people experience a mental health condition, according to the National Institute of Mental Health.

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› Url: https://www.healthlink.com/covid/covidlibrary/mental-health-stigma-answers-to-common-questions Go Now

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Medical Necessity Criteria

Details: health practitioners, and physicians) to determine when services are medically necessary, federal and State law, as well as the Covered Individual’s contract language, including definitions and specific contract provisions/exclusions, take precedence over the criteria, and must be considered

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› Url: https://www.healthlink.com/documents/behavioral_health_medical_necessity_criteria.pdf Go Now

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CG-MED-23 Home Health

Details: Medically Necessary: Home health services are considered medically necessary when all of the following criteria A through D are met: . The individual is confined to the home: The individual’s overall physical/medical condition poses a serious and significant impediment to receiving intermittent or occasional, skilled, medically necessary services outside the home setting.

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› Url: https://provider.healthlink.com/dam/medpolicies/healthlink/active/guidelines/gl_pw_a053760.html Go Now

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What to Ask Doctor

Details: If your doctor finds you have a health problem, you want to understand, in simple language, what the problem is. Because health issues can come up at any time, prepare yourself by bringing the following list of questions:4 By the end of your visit, you

› Verified 9 days ago

› Url: https://www.healthlink.com/documents/questions_to_ask_your_doctor.pdf Go Now

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Health Insurance Portability

Details: Health Insurance Portability & Accountability Act. The Administrative Simplification provisions were enacted by U.S. Congress to regulate and standardize the exchange of information, and establish standards for privacy and security of individually identifiable health information.

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› Url: https://www.healthlink.com/hipaa Go Now

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State of Illinois Provider Locator HealthLink

Details: Local Government Health Plan (LGHP) Teachers' Retirement Insurance Program (TRIP) College Insurance Program (CIP) Guest Membership (Enrollment into this program is required to be eligible.) Guest Membership provides national network access to Dependents, under age 26.

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› Url: https://www.healthlink.com/ipf-soi Go Now

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Coronavirus Information HealthLink

Details: The requestor is a group health plan representative and, The purpose of the request is related to the operations of the health plan. Under the current circumstances, information regarding COVID diagnoses is unlikely to relate to the health plan's operations.

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› Url: https://www.healthlink.com/covid-19-faqs.asp Go Now

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HealthLink Medical Management Services Requiring Pre

Details: HealthLink Medical Management Services Requiring Pre-Certification Effective March 1, 2018 MM-PROV 2-18 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

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Health Care Library for Members HealthLink

Details: At HealthLink, we believe our members should not only understand health care basics, they should also have an understanding of their health plan benefits, how to maximize those benefits and the importance of maintaining a healthy lifestyle. The Educational Library is full of the useful tools and educational information that can help you become

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New Requirements for Credentialing and Certification

Details: ProView is a free, online service that allows health care providers to fill out one application to meet the credentialing data needs of multiple organizations. ProView allows healthcare providers to: Complete and attest to multiple state credentialing applications in one workflow design.

› Verified 8 days ago

› Url: https://www.healthlink.com/documents/credentialing_update_060916.pdf Go Now

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State of Illinois

Details: For inquiries Behavioral Health services, please telephone about 877-284-0102 and select Option 3for Behavioral Health . Services requiring pre-certification authorization include: • All Inpatient Admissions • Partial Hospitalizations and Intensive Outpatient for Behavioral Health S ervices (mental and

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HealthLink Open Access III

Details: 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

› Verified 7 days ago

› Url: https://www.healthlink.com/documents/62056%2020%20mile%20radius.pdf Go Now

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TIPS FOR HEALTHLINK MEMBERS

Details: Your health plan requires pre-certification for certain planned in-patient or out-patient services. This means you and/or your doctor need to receive approval from HealthLink before you have non-emergency surgery. You may pay a penalty if you are not pre-approved. 3. Double-check that your primary care doctor works with HealthLink network

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CG-SURG-83 Bariatric Surgery and Other Treatments for

Details: Severe obesity is defined by the National Institutes of Health (NIH) as a BMI of 40 kg/m 2 or greater, or a BMI of 35 kg/m 2 or greater along with other medical complications. The NIH defines obesity as a BMI of greater than or equal to 30 kg/m 2 and considers a person overweight with a BMI of 25 to 29.9 kg/m 2.

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Contact Insurance Broker Sales & Support HealthLink

Details: CONTACT THE HEALTHLINK SALES TEAM. At HealthLink we know that when you have questions, you want answers. We offer direct access to our team of industry professional so that your questions and concerns can be resolved quickly, with minimal disruption.

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CG-SURG-51 Outpatient Cystourethroscopy

Details: Rodgers M, Nixon J, Hempel S, et al. Diagnostic tests and algorithms used in the investigation of haematuria: systematic reviews and economic evaluation. Health Technol Assess. 2006; 10(18):iii-iv, xi …

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ADMIN.00006 Review of Services for Benefit Determinations

Details: No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, or otherwise, without permission from the health …

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Inquiries, Complaints, Grievances & Appeals

Details: HealthLink offers participating health care providers two levels of internal review. If a participating health care provider remains dissatisfied with the resolution to the issue or has additional relevant information to present, he or she may initiate a second level review by request, including any …

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Tools to Help Members Live Healthier HealthLink

Details: TOOLS TO HELP MEMBERS LIVE HEALTHIER. Everyone wants to live a long, healthy life. But with all of the information available today, it can be hard to decide how to live healthier. HealthLink is here to help. Below is your Member Toolbox to help you start reaching your goals today! As a HealthLink member, it pays to live healthy.

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Healthy "Know-How" Fact Sheets HealthLink

Details: Download these easy-to-read fact sheets to access valuable information on a variety of health topics. The ABC's of PCPs. Here are some tips for finding a primary care physician you like and trust. What to Ask Your Doctor. Plan ahead to ask the right questions. Pedal Your Way to Better Health.

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Fill in the Gaps of Your Health Plan with HealthLink

Details: Fill in the Gaps of Your Health Plan with HealthLink. From medical management, health and wellness programs and exclusive member tools, we offer all of the additional products and services needed to fill in the gaps of a health plan. You can decide which programs to include and which to leave out.

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www.healthlink.com Email

Details: information to a health plan. 834 may be used for the network business, but care should be taken to include network access effective and termination dates, and specific network designations (as applicable). Files are usually submitted on a monthly basis. For large blocks of business (over 10,000

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NETWORK SOLUTIONS

Details: products and services needed to fill in the gaps of a health plan. Regional Network Advantages Our network of doctors and hospitals is contracted specifically to serve Missouri and Illinois. Our regional presence is a unique advantage we pass on to you through expert

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