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:
Members also enjoy the advantage of a dedicated portal to access more affordable healthcare options!
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!
FAQs – The Answers You Need!
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 HealthWallet app under the Benefits tab.
HealthWallet is an app designed to store your benefit information, PPO information, ID card, and prescription information in one secure location—your smartphone! Get it today in the Apple or Google Play Store.
Go to your HealthWallet app to view your Summary of Benefits. For additional information, contact the Concierge customer service team at 888.820.5687, option 2.
You can view a list of participating network medical providers and their contact information in the HealthWallet app under the PPO Network tab.
You can contact a Telemedicine doctor using the HealthWallet app under the Telemedicine tab. If it is your first time requesting a consult, make sure to register first by providing your personal information. A licensed physician will call you back within an average of 16 minutes.
Yes! Each Concierge plan includes various preventive care services, which can all be found in your Employee Enrollment Guide.
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 the HealthWallet app. You can also email us at firstname.lastname@example.org.
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.
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.
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, option 2.
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.
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.