HealthLink policies and procedures for working with physicians, hospitals and other health care professionals.
CAQH ProView ™
CAQH ProView ™
Each provider must complete a Physician Nomination Form when applying for initial participation in one or more of HealthLink Plan Programs or Networks. Upon completing, the Physician Nomination Form, full credentialing may take 90 – 120 days.
All HealthLink providers applying for initial or continuing participation will be required to utilize CAQH ProViewTM by accessing the CAQH website https://proview.caqh.org. Providers must have a CAQH Provider ID to complete the application, if you do not have a CAQH Provider ID, visit https://proview.caqh.org to register.
To learn more about CAQH, visit their web site at www.CAQH.org.
If you need further assistance please click here to locate your Network Consultant.
Electronic Data Interchange
HealthLink Electronic Data Interchange
HealthLink has been encouraging providers to submit electronic claims for over ten years. All of your claims can be sent to HealthLink electronically. Electronic claims are less expensive for you to send and provide faster processing.
To start sending electronic claims to HealthLink you must:
Contact your clearinghouse and tell them you want to send claims electronically to HealthLink. Your clearinghouse will need to know your National Provider Identifier (NPI) number and that HealthLink uses the (NEIC) Payer ID numbers:
PPO (this includes Open Access)
HMO (this includes POS and State of Illinois claims)
Your clearinghouse should help you get started and do all testing necessary to assure the electronic pathway between you and HealthLink is working. All claims can be sent to HealthLink electronically.
If you are mailing claims to the following P.O. Boxes and can file electronic claims, please update your billing information to the following:
HealthLink PPO P.O. Box 419104 St. Louis, MO 63141
HealthLink HMO and State of Illinois P.O. Box 411580 St. Louis, MO 63141
Change to electronic: 90001
Change to electronic: 96475
HealthLink will return two types of reports:
This report is returned for every file sent to HealthLink. The confirmation report verifies that HealthLink received your claims.
This report is returned only for claims that HealthLink cannot process. This is due to inability to identify the member. This report will follow the Confirmation Report by several days.
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