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Overview
TribalCARE has extensive experience working with Tribal Enterprises and understands the special rules and regulations that apply to its plans and members. True coordination requires a partnership between your organization, our organization, IHS and Tribal Sovereignty to accomplish the following:
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Maximize federal dollars
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Maximize Tribal dollars
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Coordinate approvals and discounts
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When TSIPs are treated as a third party billing organization, the extent of tribal subsidies and actual budget needs can be hidden. In addition, when TSIPs are “primary,” they often pay at higher rates. With TribalCARE, our procedures ensure that:
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MLR are applied for qualifying care
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proper approvals are attained
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claims are paid quickly and accurately to each provider
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federal and Tribal dollars are maximized
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