TRIBALCARE POWERED BY HEALTHSMART

Medical claims management services, namely, re-pricing of physician, hospital, and ancillary medical care provider transactions; business services, namely, independent medical management services for self-funded major medical health plans; medical claims management services, namely, receiving, data entering, and repricing of transactions that are originated by physicians, hospitals, and ancillary health care providers; medical cost management; providing consumer information regarding health care plan options, products and programs in the field of state and federal medical care programs related to American Indian and Alaska Native Tribal health plans

Consulting and administrative services in the health care industry, namely, insurance claim adjudication, insurance claims processing, administration of employee benefit plans concerning insurance for others, medical insurance case and utilization review and insurance claim adjustment services for healthcare purchasers and payors and providers and Medicare beneficiaries; consulting services in the field of state and federal medical care programs related to administering American Indian and Alaska Native Tribal health plans; Insurance consulting, namely, assessing individual health insurance plan needs of patients to ensure adequate insurance coverage; Medical case management services, namely, assessing health insurance claims based on the medical services provided to patients