Tribal nations

Tailored solutions that address health and cultural needs

As a Tribal community, enterprise, or government organization, you know that your health plan membership, rules, and regulations are unique. And you need a partner that gets it. AmeriHealth Administrators does.

We are the largest provider of health plan administration solutions to Tribal nations in the country, serving Tribes in ten states. To each, we bring 25 years of experience, a dedicated team of Tribal health program experts, and a deep understanding of the legal, socioeconomic, and sovereignty needs of your members.

A full menu of unique and essential third-party administration services

In addition to classic TPA services, such as claims administration and cost management, AmeriHealth Administrators offers:

  • Payer of last resort administration and coordination
  • Coordination for sponsorship using Tribal First’s health program
  • Catastrophic Health Emergency Fund (CHEF) coordination
  • Compliance and Indian law expertise

Tribal sovereignty, self-governance, and compliance

As a sovereign nation, your health plans and their administration come with unique rules and regulations. Compliance expertise is a necessity. And you can trust AmeriHealth Administrators to provide it for Section 506 legislation, facility Medicare-like rates (MLR), purchased/referred care (PRC), and more.

Partnering with your partners

By joining with a variety of ancillary vendors and organizations like Tribal First, we bring coordinated, notable benefits for Tribal members. For instance, we can share front and back-office administrative services including facilitating custom provider contracts, Medicare-like rates, and PRC administration.

Partnering with our partners

By joining with national and regional carriers and organizations like Tribal First, we help coordinate and strengthen TPA offerings. Working collaboratively, we share front and back-office administrative services and provide custom contracting that includes administration, Medicare-like rates, and network access.

Learn more about our TPA services and areas of expertise

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Compliance and fiduciary

See how our knowledgeable team can help mitigate risk and reduce headaches.

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Analytics and reporting

Get the deep, customizable insights necessary for your plan management and strategy.

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Dedicated account management

Our team of experts is committed to your members’ health and your success.

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