health-family

Health Resources For Members

At Allegiance Benefit Plan Management, Inc. your health care is our first priority and we work hard to make sure you have access to everything you need to be an active member in your benefit plan. Our online system allows you to look-up claims, review your plan document, see your enrollment by coverage, and provides access to programs/information that can help you focus on getting and staying healthy.

Cost Transparency

Healthcare Blue Book provides a comprehensive transparency solution that enables consumers to compare healthcare costs and quality. With Healthcare Blue Book, employers can be confident that their employees will be able to shop for care so that they get the most affordable, high quality care.


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Health Equity

HealthEquity is the nation’s oldest and largest dedicated health savings trustee. They help members build health savings while helping control premium costs. They provide hassle-free Health Savings Account administration through innovative technology and online tools, seamless end-to-end solutions, and 24/7/365 service excellence.

The following link will provide you with many helpful tools as well as allow you to login to the HealthEquity account.


Health Equity

FAQ

MEE means the maximum dollar amount considered for payment by a Plan for any of its services or supplies. Keep in mind, these services are also subject the Plan maximums. This would be any annual or lifetime visit or dollar maximums on the policy.
The provider search page. Click here.
The EOBs can be viewed after logging into your personal account under “Claims History” by clicking the claim number associated with the service.
You can locate your claims history by logging into your personal account. This login page is on the upper left hand side of this page. Once you are logged in you can view claims under 'Claims History'. There will be a description of the claim status in the far right column after the provider listed. For Example: "processed" or "reviewed & waiting to be paid".
Due to privacy laws in place, any dependent child or spouse who is 18 yrs of age or older will need to create their own account to login to view their claims history.
health-family

Health Resources For Employers

At Allegiance Benefit Plan Management, Inc. your health care is our first priority and we work hard to make sure you have access to everything you need to be an active member in your benefit plan. Our online system allows you to look-up claims, review your plan document, see your enrollment by coverage, and provides access to programs/information that can help you focus on getting and staying healthy.

Allegiance Webinar Powerpoints

Optional Products

  • Ability to integrate with many Pharmacy Benefit Managers (PBM)
  • Send and receive capabilities for eligibility and claims feeds
  • Customized report and benefit design analysis
  • Online participant information and interaction
  • Plan participant communications and education
  • COBRA General Notice, Election Notice to Qualified Beneficiaries, and other required and customized notices
  • Federal-mandated COBRA documentation and monitoring of regulations
  • Customer service
  • Toll-free services number
  • Invoicing and collection of COBRA premiums
  • Convenient banking options available
  • Complete and accurate disclosure to health care providers
  • State-specific continuation coverage administration
  • Dependent Care, Transportation (mass transportation, parking garage, etc.)
  • Multiple funding options available
  • Debit card available
  • Joint processing for health, flex, and HRAToll-free services number
    • Joint processing allows claims to be forwarded to the HRA and/or the Health FSA after health adjudication
  • Online access
    • Checking account balance
    • Check the status of pending claims
    • View the explanation of benefits for processed claims
    • Browse frequently asked questions
    • View plan document and summary plan description
    • Download, print, and/or submit enrollment, claim, and direct deposit forms
    • Change address
    • Enrollment assistance tools, such as tax savings calculator
    • Browse examples of eligible expenses
    • Contact us to ask question about your account
  • Premium Only Plan (POP)
  • COBRA administration

Allegiance has extensive experience in providing the following services:

  • Fund management
  • Provision of claim forms and instructions for employers
  • A computer-assisted claims/reimbursement process, operated by qualified technicians. Our software has been designed to meet all federal requirements for separating accounts
  • Checks issued and mailed to participants according to plan document specifications.
  • Immediate access to account information and to trained customer service personnel, available through our toll-free number and our website
  • Claims submission using the Allegiance toll-free claims fax number
  • Electronic claims submission using Allegiance online service

The HSA is a portable and non-forfeitable account. Each employee’s HSA funds are held in an individual trust or custodial account.

  • Complete data integration with our HSA vendor ensures accurate records
  • Intuitive online tools and capabilities, including online payments
  • Access to a knowledgeable team that offers expert advice and insight to maximize savings
  • Communications provide a clear, positive message that encourage employee engagement

Allegiance offers a pricing transparency tool that allows participants to compare price differences in procedures and/or facilities. The Healthcare Bluebook (HCBB) helps reduce the cost of healthcare by enabling participants and employers to make better use of the high-value providers within their existing network.

  • Participants can get free and private health information over the phone
  • This service is available 24 hours a day, 7 days a week
  • Callers can discuss treatments, lifestyle choices and self-care strategies with the nurse
  • Participants have access to recorded health topics such as:
    • Vaccinations
    • Managing a chronic condition
    • Choosing a doctor
    • Beginning an exercise program
    • All topics are available in English and Spanish

A toll-free number gets participants connected to a doctor within minutes. The On Call Service provides telephone access to a physician when participants are seeking information on medical conditions, want advice or recommendations for common conditions. Other available tools include:

  • On-demand physician care
    • Call or e-mail a doctor 24/7
    • Obtain information, treatment recommendations, and prescription medication, when appropriate
  • Request prescription medication (if appropriate)
    • Get timely prescription refills, convenient pickup at your nearest pharmacy
  • Nationwide medical expertise
    • All physicians are U.S.-based, state-licensed, and NCQA-certified
  • Easy-to-use online health tools
    • Powerful online applications to help identify and optimize lifestyle factors
    • Store and share personal health records

Allegiance works with our on-site sister-company, StarPoint Healthcare Group, LLC, for Utilization Review (UR) services. StarPoint is URAC accredited and is a leader in utilization review, case and chronic condition management services.

Because of the system integration, and shared ownership within the Allegiance family of companies, we are able to integrate utilization review and case management into the daily operations of your health plan administration. Together, we have developed an integrated risk management program that is unmet in the industry. This integrated approach results in costs savings, close collaboration on high-dollar cases and immediate notification of inpatient admissions.

Allegiance works with our on-site sister-company, StarPoint Healthcare Group, LLC, for Case Management. StarPoint is committed to providing case management services that will help effectively coordinate and manage your most medically challenging needs. Case managers are paired with participants and are in regular contact with them by phone. Case managers will provide written information upon request and work with participants to:

  • Provide education on an individual’s medical condition
  • Work with participant, participant’s family and health care providers to support physician’s plan of care
  • Help navigate the medical waters to ensure that appropriate and cost effective care is obtained
  • Provide coordination and access to appropriate health care treatment and community resources

Allegiance works with our on-site sister-company, StarPoint Healthcare Group, LLC, for our Maternity Management Program, StarBaby. StarBaby provides a prevention-focused approach to early identification, intervention, and management of pregnancy complications with the goal to improve newborn outcomes.

We strive to reach all pregnant women within the first trimester and to identify individuals at risk for prenatal complications or premature labor. Early identification occurs through promotion of the program, coordination with the claims processor, coordination with individual campus human resource contacts, and through the StarPoint utilization management process.

We utilize the Versend predictive Modeling tool, Sightlines Medical Intelligence Software, which is standard to our program. This tool incorporates claims, pharmacy, and eligibility in one model to enable higher prediction accuracy for identifying members with health conditions or those at risk of developing health conditions. We accept medical and pharmacy claims monthly and are able to achieve a 15-business day turn-around for identification. This is best-in-class in the industry which supports timely outreach and engagement to targeted members.

Also referred to as “reinsurance,” stop loss is insurance coverage purchased by a self-funded employer group to limit their risk in paying healthcare claims. Stop loss is a reimbursement contract meaning that the employer group pays the claims and the stop loss carrier reimburses the group.

  • Coordinate with 20+ stop loss vendors
  • Shop annually
  • No laser renewals
  • Specific and/or aggregate

Allegiance offers comprehensive wellness options designed to allow employers to customize their company’s wellness goals.

  • Engagement tools help employers incentivize employees
  • Health Risk Assessments
  • Biometric screening
  • Online resources and reporting

Allegiance can bill fees and premiums for other employee benefits including, but not limited to, group life, group AD&D and/or group short term and long term disability to the Plan Sponsor, and will remit the premium collected to the applicable carrier.

  • Flexible, URAC-accredited program focuses on eight prevalent conditions
  • Advanced predictive modeling identifies individuals with chronic conditions
  • Registered Nurses assist participants one-to-one to achieve clinical improvements through evidence-based care guidelines
  • Nurse Coaches use participant-centric, motivational interviewing techniques to empower individuals to self-manage their conditions
  • Wellness and Disease Management Consultant assists in developing a plan for optimal program engagement

Health Resources For Providers

Welcome to the Allegiance Online Provider Portal. Here you will find information, forms, and services to improve your experience working with Allegiance. In addition to tools to help you verify benefits, request allowable charges, and check your credentialed status, you will find practical and concise forms to make sure your provider directory listing is up-to-date for all of Allegiance's members.

To access our Verification of Benefits, click below
Verification of Benefits

Electronic EOB's and EFT
Please have your name, contact information, and Tax ID available and contact Zelis at the following information: 877-828-8770 | PayorService@zelispayments.com

Credentialing Information - Effective April 1, 2016

Allegiance Benefit Plan Management, Inc. groups will require credentialing of in-network providers. Providers who have not completed credentialing with Allegiance will be considered out-of-network for all Allegiance and Cigna members.

Allegiance Provider Direct will require providers to credential through CAQH. CAQH ProView is available to providers free of charge. CAQH, the online tool for collection of Allegiance Provider Direct provider credentialing information, has launched the next generation of the Universal Provider Datasource (UPD), now called CAQH ProView. CAQH established CAQH ProView Provider Transition Support Center to help providers and practice managers with the transition. If you need assistance completing your application or have any questions, please email proview@caqh.org or call 844-259-5347. For communication and questions regarding credentialing for Allegiance and Cigna health plans, please email Credentialing@AskAllegiance.com.

Brokers

At Allegiance Benefit Plan Management, Inc., we know the critical role that brokers play in the sale and service of employer-sponsored or group health plans. We also know that for you to do your job, you need viable options in healthcare to offer your clients. That is why we are proud to offer health care plans that offer real choices and options for business owners and their employees. Our plans are designed to give the freedom to choose the benefits that are most important to your client. Your client has the ability to choose the deductible, co-insurance, and out of pocket amounts. From there you can add optional benefits such as co-payments, preventive benefits, and even ancillary benefits such as dental, vision, or an accident benefit.

Request a Proposal

Optional Products

  • Dependent Care, Transportation (mass transportation, parking garage, etc.)
  • Multiple funding options available
  • Debit card available
  • Joint processing for health, flex, and HRAToll-free services number
    • Joint processing allows claims to be forwarded to the HRA and/or the Health FSA after health adjudication
  • Online access
    • Checking account balance
    • Check the status of pending claims
    • View the explanation of benefits for processed claims
    • Browse frequently asked questions
    • View plan document and summary plan description
    • Download, print, and/or submit enrollment, claim, and direct deposit forms
    • Change address
    • Enrollment assistance tools, such as tax savings calculator
    • Browse examples of eligible expenses
    • Contact us to ask question about your account
  • Premium Only Plan (POP)
  • COBRA administration

The HSA is a portable and non-forfeitable account. Each employee’s HSA funds are held in an individual trust or custodial account.

  • Complete data integration with our HSA vendor ensures accurate records
  • Intuitive online tools and capabilities, including online payments
  • Access to a knowledgeable team that offers expert advice and insight to maximize savings
  • Communications provide a clear, positive message that encourage employee engagement

Allegiance offers a pricing transparency tool that allows participants to compare price differences in procedures and/or facilities. The Healthcare Bluebook (HCBB) helps reduce the cost of healthcare by enabling participants and employers to make better use of the high-value providers within their existing network.

  • Participants can get free and private health information over the phone
  • This service is available 24 hours a day, 7 days a week
  • Callers can discuss treatments, lifestyle choices and self-care strategies with the nurse
  • Participants have access to recorded health topics such as:
    • Vaccinations
    • Managing a chronic condition
    • Choosing a doctor
    • Beginning an exercise program
    • All topics are available in English and Spanish

A toll-free number gets participants connected to a doctor within minutes. The On Call Service provides telephone access to a physician when participants are seeking information on medical conditions, want advice or recommendations for common conditions. Other available tools include:

  • On-demand physician care
    • Call or e-mail a doctor 24/7
    • Obtain information, treatment recommendations, and prescription medication, when appropriate
  • Request prescription medication (if appropriate)
    • Get timely prescription refills, convenient pickup at your nearest pharmacy
  • Nationwide medical expertise
    • All physicians are U.S.-based, state-licensed, and NCQA-certified
  • Easy-to-use online health tools
    • Powerful online applications to help identify and optimize lifestyle factors
    • Store and share personal health records

We utilize the Versend predictive Modeling tool, Sightlines Medical Intelligence Software, which is standard to our program. This tool incorporates claims, pharmacy, and eligibility in one model to enable higher prediction accuracy for identifying members with health conditions or those at risk of developing health conditions. We accept medical and pharmacy claims monthly and are able to achieve a 15-business day turn-around for identification. This is best-in-class in the industry which supports timely outreach and engagement to targeted members.

Allegiance can bill fees and premiums for other employee benefits including, but not limited to, group life, group AD&D and/or group short term and long term disability to the Plan Sponsor, and will remit the premium collected to the applicable carrier.

FLEXIBLE BENEFIT PLANS

Allegiance was one of the first third-party administrators to offer comprehensive flex plans. Such plans can offer employers and employees considerable tax savings and other advantages. Sometimes referred to as cafeteria plans, these plans let each employee elect an annual dollar amount and choose services to be covered from a menu which may include various group medical insurance premiums, out-of-pocket medical expenses and dependent care expenses.We also offer administrative services for health reimbursement arrangements (HRAs) and qualified transportation plans (parking and mass transit).