Tribal Services
Reduce health plan costs with RGA’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. RGA has proven to be a strong administrative partner to Tribal employers navigating Indian Health Services (IHS) programs by handling all PRC pricing administration and CHEF application support. |
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 RGA'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. RGA 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 application assistance | ||
Additional Options |
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| Payment of Claims at Direct Contract Rates (additional fee) | Payment of Tribal Clinic Claims | |
We're here to support you and your clients.
If your company is based in Oregon and you're interested in a self-funded healthcare plan, get started by requesting a quote. Whether you're new to self-funding or experienced, our expert team is here to assist you.