MultiPlan - National Travel Network Option

Network Strength
HealthLink, Inc. and MultiPlan, Inc. have joined forces to provide nationwide delivery of health care products and services, with significant cost savings and administrative ease. HealthLink offers MultiPlan's network solutions for clients with members residing or traveling outside the HealthLink service area. While MultiPlan's networks are primarily ASO/self-funded national solutions, they are also options for payors. Each payor or client determines what is sold for national access. Please refer to the carrier, third party administrator or group health plan to verify what the plan offers.

HealthLink PPO
Members residing in Arkansas, Illinois, southwest Indiana, Kentucky, and central, southern, and eastern (St. Louis) Missouri will use the HealthLink PPO network as the primary PPO network. The HealthLink PPO network offers access to more than 53,000 health care professionals and 750 hospitals in these service areas.

PHCS Extended PPO (Travel)
Members residing within the HealthLink service areas have access to the majority of PHCS Network providers when they seek care outside the HealthLink service area. PHCS Extended PPO (Travel) is a national PPO network which serves as an extension of the HealthLink networks.

The MultiPlan Network
Some health plans include access to the MultiPlan Network, a national complementary PPO network, which gives members an additional choice of providers at discounted rates when seeking care inside or outside the HealthLink service areas. The MultiPlan network includes approximately 4,000 acute-care hospitals, 100,000 ancillary facilities and 550,000 practitioners in all 50 states. Out-ofnetwork co-payment and co-insurance applies.

PHCS Network
HealthLink clients with multi-sited locations (membership residing outside the HealthLink service areas) may use the PHCS Network as the primary PPO network. The PHCS Network offers access to more than 525,000 health care professionals and 3,800 hospitals in all 50 states. Seventy-five percent of the client's membership must reside in the HealthLink service areas in order to access the PHCS Network.

Fee Negotiation Process
Clients accessing the PHCS Extended PPO (travel) and MultiPlan (complementary PPO) Network may utilize the program's Fee Negotiation process to help manage non-contracted health care services costs. Through this arrangement, negotiators work individually with non-contracted providers to obtain mutually beneficial cost reductions. When a negotiated settlement is reached through this service, members are not billed for the difference between the original charges and negotiated amount.

Flexible Plan Options
HealthLink, Inc. and MultiPlan have the flexibility to work with a wide range of third party administrators, including most TPAs chosen by a contracted client. Clients may purchase the basic PPO program package, add components on a menu basis, or purchase a comprehensive PPO package of programs and specialty components at a special, discounted rate. Most pricing is based on a percentage of savings. Please contact a sales representative for pricing information.

Basic PPO Program Package Includes:

Comprehensive PPO Program Package Includes:

PPO Components Available on a Menu Basis:

Specialty Programs
Through the affiliation with WellPoint, HealthLink offers a broad portfolio of specialty programs, including: Reinsurance; Life and AD&D; Dental; Vision; and Employee Assistance Program.

Cost Management Program
The HealthLink Cost Management Program is an extensive suite of health promotion and wellness information, case management and care coordination services to help physicians help their patients achieve optimal health outcomes. The program consists of three components: Signature Services, Wellness Plus and Personal Care Resources.

Signature Services
HealthLink Signature Services include the following:

Medical Management
Medical Management is comprised of two components: Utilization Management and Case Management.

The URAC-accredited Utilization Management program provides clinical review of the medical necessity for medical care to help clients determine eligibility in accordance with health benefit plan provisions. Utilization Management includes the following components:

The Case Management program is a collaborative process among WellPoint and other health professionals who manage the resources necessary to support individuals with catastrophic or chronic medical conditions. Case Management enables the treating health care professional(s) to help the patient achieve optimal and timely medical outcomes.

Signature Services also include the following:

Wellness Plus
Wellness Plus includes the following programs, available on a fee-for-service basis. Please contact a sales account representative for pricing information.

Personal Care Resources
The following value-added electronic member resources are available at no cost to clients and members:

Administrative Services
HealthLink is committed to supporting your health plan's benefit administration through maximum use of technology throughout our organization. We offer fast, efficient electronic claim repricing, eligibility management, a state-of-the-art customer service response system, a provider portal and a fully interactive website, www.healthlink.com.

Account Management Services
Our account managers serve as liaisons between HealthLink and contracted clients. They are responsible for the timely resolution of day-to-day service issues. Account managers also make on-site service visits and compile/present management reports.

Management Reporting
Timely reporting tracks membership, health care services, claims accuracy, payments and utilization.

National Capital Preferred Provider Organization, Inc. ("NCPPO") is a Maryland corporation. HealthLink®, Inc., is an Illinois corporation. Both are organizers of independently contracted provider networks, which are made available by contract to a variety of payors of health benefits, including insurers, third party administrators or employers. Neither has control nor right of control over the professional, medical judgment of contracted providers, nor are they liable for any acts or failures to act, by contracted providers. Neither is an insurance company and neither has liability for benefits under benefit plans offered or administered by payors. HealthLink® is a registered trademark of HealthLink, Inc. Both companies are subsidiaries of WellPoint, Inc.