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Compliance: Cornerstone of Concierge

Concierge’s collaboration with WLT and TALON ensures adherence to the No Surprises Act (NSA), Consolidated Appropriations Act (CAA), and Transparency in Coverage (TiC) Rule. Benefits include but are not limited to the following:

On-demand access to machine-readable files (MRFs)

A price comparison tool to shop for lower-cost care

Ability to verify claim payments

Members also enjoy the advantage of a dedicated portal to access more affordable healthcare options!

Shop for Lower-Cost Care
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HSA and FSA Store

Through your health plan with Concierge, you may be eligible to enroll in a Health Savings Account (HSA) or Flexible Spending Account (FSA). Both types of accounts have dedicated online platforms, and each website offers a wide selection of qualifying products, making using healthcare funds simple. Click below to learn more and start shopping!

The Clever Health App

We’re simplifying care for our members with Clever Health, the app that provides smart virtual round-the-clock healthcare services.

Board-certified providers

Licensed therapists

Virtual urgent care

Specialized veterinary services for cats and dogs

And more!

Download Clever Health Today!
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Forms

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FAQs – The Answers You Need!

FOR MEMBERS

Please reference your Employee Enrollment Guide for details about your benefits. If you do not have a copy of your Employee Enrollment Guide, please contact your employer to request a copy.

You’ll receive an electronic ID card from us via email or text! Once your coverage starts, you can print copies of your ID card or access them on your phone via the Clever Health app.

Clever Health provides smart virtual round-the-clock healthcare services. This gives our members access to board-certified providers, licensed therapists, and great care where and when they need it. Clever Health can include specialized veterinary services to help keep furry family members healthy, too.

You can text us directly at 918.876.5015 with any questions or concerns. Alternatively, you can call our team at 888.820.5687. If you’re requesting information, we’ll email or text you directly.

Go to your HealthWallet app to view your Summary of Benefits. For additional information, contact the Concierge customer service team at 888.820.5687.

You can view a list of participating network medical providers and their contact information in the Clever Health app under the PPO Network tab.

You can contact a virtual urgent care provider using the Clever Health app under ’virtual urgent care.’ If it is your first time requesting a consult, make sure to register by providing your personal information.

Yes! Each Concierge plan includes various preventative care services, which can all be found in your Employee Enrollment Guide. If you do not have a copy, please contact your employer.

EOBs are sent to members following a visit to a provider. An EOB is not a bill. It simply outlines the total charges for your visit as well as what was covered by your health plan.

The dental and vision benefits administered by Concierge do not require a network provider. Plan members may see any provider.

You can get your prescription coverage information through your plan’s portal and mobile application. You can also email us at eligibility@ctpa.com or text us at (918) 876-5015.

FOR BROKERS

We’re happy to help design a plan that works for your group. No matter the size of the member population or the programs needed, we’ll work with you to deliver a plan that satisfies the needs of any client. Contact our sales team to learn more.

We’ve invested in industry-leading partnerships to ensure your clients’ compliance with all state and federal laws. Healthcare legislation is everchanging, but you can rest assured knowing your clients remain compliant with Concierge. 

Just like our compliance partnerships, we’ve carefully selected our PBM partners. Each member will have access to the medication they need, and our partners will ensure you pay the lowest price possible. To learn more about our PBM partnerships, contact our sales team.

We’re happy to explain how we set up our partnerships with our brokers. Contact our sales team to learn more about our structure. In the meantime, be sure to check out the values we pride ourselves on here at Concierge.

All sizes! We have plans for any company in any industry, no matter how many employees they have. Contact our sales team to learn more.

FOR EMPLOYERS

A formulary is a list of drugs covered by your health plan. They vary by plan and are often referred to as a preferred drug list (PDL).

Please contact your dedicated account manager to discuss any necessary changes to your plan.

There are a few reasons why a claim can be denied, but each case is different. If you have a question about a specific claim, contact your dedicated account manager or give us a call at 888.820.5687.

PBM stands for pharmacy benefit manager. The role of PBMs is to provide employers with discounts on costly specialty and non-specialty drugs, or to recommend more affordable alternatives to medications.

Think of stop-loss coverage as a ‘protection plan’ for your group. It helps avoid catastrophic costs associated with one or multiple expensive group claims. With stop-loss coverage, employers don’t have to pay out medical expenses past a certain threshold.

FOR PROVIDERS

We understand that not being able to access the Provider Portal is frustrating. Our team is here to help set things up correctly for you. Give us a call at 888.820.5687.

There are several reasons a patient’s information might not appear in your provider portal. Contact our team at 888.820.5687, and we’ll be happy to assist.

Send electronic claims to our Payer ID - CAS01. Paper claims should be sent to P.O. Box 4070, Bartlesville, Oklahoma 74006.

Send electronically to our Payer ID - CAS01. Paper requests should be sent to P.O. Box 4070, Bartlesville, Oklahoma 74006.

You can check member eligibility easily via the Provider Portal. You can also reference your digital ID Card on the HealthWallet mobile App. Call our customer service team at 888.820.5687 to check eligibility.

We have ACH available for provider payments. Please contact our team at 888.820.5687, to receive the form required to set it up.

Send it to: P.O. Box 4070, Bartlesville, Oklahoma 74006.

Yes, the appeal must be made within 180 days of the adverse benefit determination. If after careful review, it is determined that an error has been made, an additional payment may be made.

Need to Talk to us Directly Instead?

We’ve designed our FAQ section to answer the most common questions we receive. However, we know that each case and each person is different. If your question hasn’t been answered above, or if you need additional clarification on anything, we’re happy to help.

Contact Concierge