The NCPPO and HealthLink network program offers exciting opportunities to all types of employers. Learn more by calling a representative from the NCPPO and HealthLink Sales and Marketing Team.

Why Choose NCPPO and HealthLink?
NCPPO and HealthLink’s competitive edge is evidence by four core strengths:

• Broad Network Access
• Flexible Plan Options
• Cost Management
• Administrative Accountability

Broad Network Access
The NCPPO and HealthLink network program delivers broad regional access to contracted providers who have agreed to accept competitively discounted payments for health services.

NCPPO and HealthLink's service areas include:
Maryland, Virginia, Washington DC, Arkansas, Illinois, Missouri, Texas, Ohio and Kentucky. The NCPPO and HealthLink network program also offers a national network solution for clients with enrollees who reside or travel outside the service area.

Competitively Discounted Payments
A disciplined approach to fixed payment methodologies, precise modeling/forecasting of rate changes and actuarial calculations allows us to establish aggressive pricing targets by market and product.

Plan Performance Management
Sophisticated rate modeling techniques analyze and evaluate how current market trends, enrollee demographics and client objectives affect plan design. We make this information available to you so that you may evaluate your health benefit program and have the ability to recognize the cost/benefit value of changing or adding programs and services when the time is right.

Stability
NCPPO and HealthLink allocates substantial administrative resources to contracted physicians and facilities to ensure retention rates well above the market average. Our provider retention rate of 98% reflects the high levels of satisfaction that have become a NCPPO and HealthLink standard.

Flexible Plan Options
The PPO network can be integrated into company benefit plans to support any plan design. Clients may purchase the basic PPO, add components on a menu basis, or purchase a comprehensive PPO package of programs and specialty components. The NCPPO and HealthLink network program has the flexibility to work with a wide range of plan administrators. Employers may choose the plan administrator along with the NCPPO and HealthLink network.

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

Cost Mangement
Health Care Management 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 includes three levels of services: HealthLink Signature; HealthLink Wellness Plus; and HealthLink Personal Care Resources.

HealthLink Signature Services
Medical Management - NCPPO and HealthLink Medical Management is comprised of two components: Utilization Management and Case Management.

• Pre-Admission Certification of Planned Hospital Admission
• Notification of Emergency Hospital Admission
• Concurrent Hospital Stay Review
• Discharge Planning
• Pre-Certification of Selected Ambulatory/Outpatient Services
• Pre-Certification of Selected Ancillary Services

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

HealthLink Signature Services also include the following:

• Condition Management Programs - Individualized programs for members with Asthma, Chronic Obstructive Pulmonary Disorder, Coronary Artery Disease, Diabetes and Heart Failure.
• MaterniCall^™ - Maternity management program helps participants make informed decisions during pregnancy and after childbirth.
• MedCall^® - 24/7 nurse hotline and audio library of more than 300+ health topics.
• WellPoint NextRx - Aggressive pharmacy benefit manager targets costs and includes a national retail network, mail order and specialty prescription programs.

HealthLink Wellness Plus
The following programs are offered at no charge to the client or member:

• SpecialOffers Online Discount Program - Helps promote health and wellbeing. More than 20 third-party vendors provide discounts on services related to family and home, fitness and health, and vision/hearing/dental treatment.
• TLC^® (The Last Cigarette) - Smoking cessation program. Members request a TLC quit kit to assist in their efforts to be smoke-free.

The following programs are available on a fee-for-service basis. Please contact a sales account representative for pricing information:

• Worksite Wellness Programs - Health educators and registered dietitians visit your workplace to share knowledge on a variety of health and lifestyle topics.
• Lifestyle Management Programs - Engaging online programs and inspiring coaches use proactive outreach activities and support strategies to help employees in the areas of: tobacco cessation, weight management, stress management, physical activity and diet/nutrition.

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

• Healthy Living Website - Health and wellness tips and tools available online 24/7.
• eHouseCall - Monthly wellness newsletter for members.
• Women’s Health eNewsletter - Monthly publication for women of all ages.
• Preventive Health Guidelines - As recommended by the U.S. Preventive Services Task Force and other health related agencies.
• Healthy Habits for Healthy Kids - Nutrition and activity guide from the American Dietetic Association.
• Enrollee Rights and Responsibilities - General guidelines for health care consumers.

Administrative Accountability

Administrative Services
The NCPPO and HealthLink network program supports 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.

Account Management Services
NCPPO and HealthLink account managers serve as liaison between NCPPO and 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.