To support efficient claims administration, the NCPPO and HealthLink network program name and logos are required on the front of all Enrollee Identification Cards. The name and logo position NCPPO and HealthLink as the network, and are readily identifiable by participating providers as a point of reference in the filing and follow-up of their claims.

The name and logo of the benefit administrator is also noted on the card. This establishes the name of the entity administering benefits on the plan participant’s behalf and processing payments to the provider of service. The payor’s logo should be larger than the network logo and located on the front of the card.

We educate participating providers about the nature of this network/payor relationship. This helps to direct claims to the proper payor.

Enrollee ID cards produced by payors should conform to NCPPO and HealthLink standards. These standards assist providers in identifying and routing claims for repricing. The information provides enrollees and participating providers with the necessary information for proper service.

View Sample ID Card Layout

Requirements for Payor Produced ID Cards:

• Payor name *
• Payor logo *
• NCPPO and HealthLink logos and network information on the front of the card *
  For clients with travel networks, the travel network logo is to be positioned on the back of the card with the NCPPO and HealthLink logos remaining on the front of the card.
• Toll-free number for benefit verification, eligibility information and claim inquiries *
• Subscriber name *
• Dependent name
• Subscriber ID number *
• Group name
• Group identification number *
• Most common co-payment amounts (ER, Rx, Outpatient Visits)
• Utilization Management nationwide telephone number: (877)-284-0102. Call to precertify outpatient surgery, diagnostic and ancillary services. NCPPO and HealthLink must also be notified prior to any elective hospital admission (if applicable).
• Customer Service nationwide telephone number for network information: (800)-272-5911 *
  Nationwide: 800/624-2356 *
• Claim Filing Address: HealthLink P.O. Box 419104, St. Louis, MO 63141-9104 *
• Disclaimer: This card is not a guarantee of coverage. For confirmation of eligibility, contact the benefit administrator. *
• EDI vendor numbers for filing PPO claims electronically (EDI# 90001). *
• NCPPO and HealthLink strongly recommends payor ID cards include group and member ID numbers to facilitate provider’s electronic billing.

Required information on the list above is indicated by an asterisk (*).