Fri Feb 26th, 2021
Tags: Erika Atencio, Forest County Potawatomi Community (FCPC), Forest County Potawatomi Community reservation, Forest County Potawatomi Insurance Department (FCPID), Health Plan Manager, Health Services/Purchase Referred Care administration, HIPAA certified, HIPAA compliant, Medicare Like Rates, Medicare Like Rates (MLR, Southern Ute Tribal Health Department, THD Benefits Team, third-party administrator (TPA)
Greetings Southern Ute tribal membership,
The Southern Ute Tribal Health Department would like to continue the effort to help individuals understand the sometimes-complex world of health. This article will cover some facts about the Tribe’s Third-Party Administrator, Forest County Potawatomi Insurance Department.
The Forest County Potawatomi Community (FCPC) is a federally recognized Indian tribe located in northern Wisconsin. In recent years, revenues from gaming and other business ventures have propelled FCPC to self-reliance and prosperity.
The Forest County Potawatomi Insurance Department (FCPID) is a department within the Forest County Potawatomi Community Government. FCPID was established in 1999 in response to FCPC’s need for a Third-Party Administrator (TPA) and a Health Plan Manager. FCPID is located on the Forest County Potawatomi Community reservation in Crandon (Stone Lake), Wis. Their mission statement is to be dedicated to providing superior customer service and innovative administrative services to Tribal Nations.
In 2002, FCPID began processing their own claims in-house for their self-funded tribal member health plan. By June of 2003, they had assumed the administration of all the FCPC health plans including the employee health plans for the Tribal Government and Casinos.
In 2008, they began providing benefits administration solutions to other tribal nations. Today they provide health program solutions to more than 40 tribal nations. The services provided include employee health plan administration, Contract Health Services/Purchase Referred Care administration for health clinics, Medicare Like Rates repricing, Section 506 recovery, third party billing for health clinics, custom plan designs, consulting and training for their clients’ team members.
All technology systems used to provide tribal health program solutions are HIPAA compliant along with their physical setting; all staff members are HIPAA certified. FCPID staff is covered under Error and Omissions coverage and fidelity bonded.
FCPID has provided data to stop loss carriers to assist them with understanding the positive impact of Medicare Like Rates on the Tribal health plan experience. Therefore, they have been able to maintain access to, and administration approval to multiple stop loss markets.
Over the course of providing Medicare Like Rates (MLR) re-pricing data they have identified savings over two hundred and sixteen million dollars ($216,000,000) for their tribal clients
Thank you for your time and please look forward to the next article. The THD Benefits Team is continuing to work through the tribally issued “Stay at Home” Order. Office phones are forwarded to assist the tribal membership between 8 a.m. through 5 p.m. Monday through Friday. We hope that each and every one of you are continuing to stay safe and follow the public health orders issued to help slow or stop the spread of COVID-19.