PROVIDER-TO-PAYOR CONTRACT LANGUAGE

In an effort to negotiate contracts with our network providers, some of our key provider organizations require more restrictive and tighter payor obligation language in their contracts than the standard HealthSmart contract provisions. Often it is large hospital systems or large provider medical groups that stipulate these payment requirements. In order to keep all of our payor partners up to date and aware of the payment and requirement language in the provider contracts that deviate from our standard contract, we have implemented the following for you in order to ensure compliance:

  • HealthSmart has launched an online search application to provide clients and payors access to non-standard language in our provider contracts. CLICK HERE to visit the site.
  • We will send you regular email communications to alert you to any recent changes regarding non-standard language.
Online Non-standard Language Search Application

To get started and access the online search tool, you will have to register. If you are an existing client or payor with the HealthSmart Preferred Care network, you may already be registered. If you are a payor with any of our other networks, such as Interplan Health Group (IHG), Emerald Health Network (EHN) or Preferred Plan, Inc. (PPI), than you will need to register to use the site. (Registration is quick and easy. Be sure to select the link next to "sign up" to get started.) In addition, we have developed detailed instructions on how to use the site. CLICK HERE to view or save these instructions.

Non-standard Language Email Updates

You will be receiving a regular email communication that will include changes, additions or other information regarding non-standard payment language. Look for monthly emails from NSL.Communication@healthsmart.com. (To better ensure that these emails get to your inbox, add this email address to your email application's address book.)

Important Notice

Please note that some providers continue to reserve the right to deny access to specific clients and payors. If your company is denied access, your Account Management representative will be in direct contact with you and available for any questions or concerns you may have.