Tribal Services
Reduce health plan costs with HMA’s Tribal Administration Services |
Receive up to a 70% discount on billed charges with our expert benefit administration and flexible solutions for tribal group health plans. Since 2009, HMA has been helping Tribal employers navigate Indian Health Services (IHS) programs by handling all PRC pricing administration and CHEF coordination assistance . |
PRC Services |
CHEF Services |
Purchased/Referral Care (PRC) is used when medical services are not available at the tribe’s health clinic or nearby Indian Health Services (IHS) facility. Members are referred to an outside healthcare provider for care. The resulting authorized claim, is reimbursed at a Medicare Like Rate (MLR). Under HMA's Tribal Administration Services a more advantageous pricing is applied which generates more savings for the plan.
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The Catastrophic Health and Emergency Fund (CHEF) was created by IHS to help defray the exorbitant medical costs associated with treating Tribal members (or eligible employees), who are victims of disasters or catastrophic illnesses. HMA provides the required key data points and documentation for the CHEF filing process, as part of our core Tribal administration service solution. Services include:
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We Offer Two Levels of Service
Level 1 | Level 2 | |
| Facility Claims Priced at Medicare-Like Rates | Both Facility and Professional Claims Priced at Medicare-Like Rates | |
| Both levels of service include CHEF coordination assistance | ||
Additional Options |
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| Payment of Claims at Direct Contract Rates (additional fee) | Payment of Tribal Clinic Claims | |
Request a quote.
If your company is based in Washington, Oregon, Idaho, or Utah, and you're interested in a self-funded healthcare plan, contact a sales representative, or use the link below to request a quote.