}
Employee Benefits // Health Administration / Employee Benefits & Member Services
TribalCare Administration offers affordable rates, extensive service, and access to the nation’s leading health networks. This comprehensive platform connects your members to a first class healthcare experience that places their needs at the forefront.
- Claims administration
- Purchased/Referred Care (PRC), formerly Contract Health Services (CHS), Support Services*
- Medicare-Like-Rates (MLR) implementation and enforceability
- Sponsorship candidate identification, enrollment, and coordination
- Payer of last resort administration and coordination
- Catastrophic Health Emergency Fund (CHEF) identification, claim preparation/submission, and claim flow
- Integration with tribal health facilities
- Integration with best-in-class networks
- Aetna
- Anthem
- Blue Cross Blue Shield of Arizona
- Blue Cross Blue Shield of Minnesota
- Blue Cross Blue Shield of Nebraska
- Blue Cross Blue Shield of North Dakota
- Cigna
- Health Care Service Corporation (Blues of Montana, New Mexico, Oklahoma, and Texas)
- Premera (Alaska and Washington)
- Wellmark (Blue Cross Blue Shield of South Dakota and Iowa)
- End stage renal disease prevention and cost containment services
- Dialysis programming
- Comprehensive care management
- Disease management and predictive population management
- Single-platform reporting and analytics
- Dedicated platform exclusively servicing Native Americans
- Compliance ERISA/Indian Health Law expertise
*MLR implementation/enforcement
