About HealthSmart

HealthSmart is one of the largest third party administrators in the country and the premier provider of innovative, customizable and scalable healthcare and claims solutions for plan sponsors, brokers and payers. We partner to provide key services needed to reduce healthcare costs and manage members with dignity and respect.

We know self-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 its 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
• HealthSmartRx Solutions, including 340B pharmacy discounts for significantly reduced prescription medication prices
• Care management and wellness programs to improve member health
• Predictive population health modeling to identify at-risk members and predict future costs

HealthSmart’s tribal-focused solutions are tightly integrated to manage all the components of your self-funded health plan. We leverage innovation, technology and customer service to deliver better healthcare solutions at lower costs from a single partner who understands Tribal health.