- Administering foreign medical claims for the TRICARE Overseas Program
- Processing more than 750,000 claims annually for nearly 550,000 beneficiaries
- Paying more than $330 million in benefits annually
- Providing multilingual customer support call center for both overseas providers and beneficiaries
- Processing TRICARE claims
- Offering customer service, supporting providers, and responding to questions and concerns with billing and enrollment
- Coordinating Managed Care Support Contractor and Defense Manpower Data
- Verifying beneficiary eligibility via Defense Enrollment Eligibility Reporting System (DEERS) interface
- Submitting TRICARE Encounter Data (TED) records
- Serving 6 million beneficiaries (two out of three in the TRICARE population) while processing 45.1 million claims and paying $9.5 billion in benefits per year
- Processing claims for TRICARE-eligible beneficiaries who have Medicare Part A and B coverage
- Providing high-quality customer service to beneficiaries and health care providers
- Maintaining full-function beneficiary and provider portals for 24/7 self-service access to claims, program information, and educational materials
- Coordinating with the Defense Manpower Data Center for Defense Enrollment Eligibility Reporting System (DEERS) interface
- Submitting TRICARE Encounter Data (TED) records
- Preserving effective cost containment through medical review and program integrity units to ensure reimbursement of medically necessary services and covered benefits
- Serving 2.34 million beneficiaries annually while processing 57.3 million claims and paying $4.2 billion in benefits
- Subcontracting on a 10-year, $1 billion contract vehicle for professional consulting and health care services covering health system transformation and innovation, implementation and operations support, and health care business-enabling services
- Managed veterans' PC3 claims, initially for three regions serving 750,000 beneficiaries while processing 4 million claims and paying $1 billion per year, and then for the entire nation during the transition to Community Care Network
- Served approximately 1.5 million CCN beneficiaries
- Received, processed, adjudicated, and paid provider claims for 13 states over the western United States
- Enrolling providers in four states as well as additional Medicare Part A providers in 47 states
- Delivering customer service
- Processing claims and appeals
- Performing medical reviews, provider audits and reimbursements, and data analytics
- Serving 4 million beneficiaries and 67,000 providers annually and processing 65 million claims while paying $30 billion in benefits
- Enrolling providers in two states
- Delivering customer service
- Processing claims and appeals
- Performing medical reviews, provider audits and reimbursements, and data analytics
- Serving 3 million beneficiaries and 78,000 providers annually, processing 61 million claims while paying $17 billion in benefits
NAIC Codes
NAIC is the standard classification system used by federal agencies that classifies the type of work the business performs.
- 524114—Direct health and medical insurance carriers
- 524292—Third-party administration of insurance and pension funds
- 541611—Administrative management and general management consulting services
- 541990—All other professional, scientific, and technical services
- 541690—Other scientific and technical consulting services
- 561110—Office administrative services
- 524210—Insurance agencies and brokerages
- 541211—Offices of certified public accountants
- 541219—Other accounting services
Note: Beneficiaries and annualized claims estimated and rounded as of Dec. 31, 2022.
