Enrollee Identification Cards

To ensure efficient claims administration, NCPPO?s and HealthLink?s name and logo are required on all Member Identification cards. The NCPPO/HealthLink name and logo identify NCPPO/HealthLink as the network, and are readily identifiable by our providers as a point of reference for 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 the claim for the provider?s benefit. NCPPO/HealthLink educates providers about the nature of this network/payor relationship.

Member ID cards produced by third party administrators should conform to NCPPO/HealthLink standards. These standards assist our providers in identifying and routing claims for repricing. The information assists our members and providers with the necessary information for proper servicing.

View Sample ID Card Layout

 

ID Card Elements

• Payor Name *
• Payor Logo *
• NCPPO and HealthLink Logo 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 HealthLink logo remaining on the front of the card *
• Toll-free Number for Benefit Verification and Eligibility Information *
• Subscriber Name *
• Dependent Name
• Subscriber ID Number *
• Group Name
• Group Identification Number
• Most Common Co-Payment amounts (ER, Rx, Outpatient Visits)
• Medical Management Nationwide Telephone Number (877) 284-0102 Call to precertify outpatient surgery, diagnostic and ancillary services. Notification is required prior to any elective hospital admission (if applicable). *
• Customer Service Nationwide Telephone Number (800) 272-5911 *
• Claim Filing Address 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 *
• NCPPO EDI Vendor Numbers for filing PPO claims electronically, #90001.
• NCPPO strongly recommends payor ID cards include group and member ID numbers to facilitate providers electronic billing.

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

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.