Who We Serve

Native American Tribes

Improving healthcare while lowering costs for Native Americans

tribal.jpgSelf-funded health plans for Native American Tribes and Native American Governments and Enterprises are very unique. They face complex government requirements, special rules and regulations that apply to their plans and members. HealthSmart has extensive experience working with Tribal Enterprises, and we know IHS processes and regulations require a partnership between your organization, our organization, IHS and Tribal Sovereignty.

With a strong history of complex claim coordination and coordination with Tribal Facilities, HealthSmart delivers:

  • Benefit administration, including Medicare-like rate (MLR) coordination for lower out-of-pocket expenses and Catastrophic Health Emergency Fund (CHEF) coordination to meet extraordinary medical costs facing victims of disaster or catastrophic illness
  • Best-In-class PPO network partnerships
  • Member-centric care management and wellness programs to improve member health
  • Predictive population health modeling to identify at-risk members and predict future costs
  • Focus on member advocacy that is tailored to client and member needs
  • Intelligent fraud, waste and abuse solutions that demonstrate plan savings of more than five percent over other solutions