Personalized solutions
through real understanding
Tribal Solutions

Providing Personalized Tribal Solutions through Real Understanding

The CCStpa Tribal Solutions team partners with Tribes to create programs and services that meet the unique needs of each Tribal Community. We offer:

  • Administration of 506 legislation of “Medicare-like” rate (MLR) pricing, re-pricing capabilities at the point of claim and other reliable cost management tools
  • Flexible in-house or Tribal-site administration processing service models
  • Customized group self-insured medical plans that maximize use of Indian Health Services, Tribal clinics and other Tribal resources
  • Implementation and plan design support for plans with a health savings account (HSA), health reimbursement accounts (HRA) or flexible spending account (FSA)
  • Stop-loss reinsurance
  • Local, regional and national network offerings
  • Comprehensive pharmacy management
  • Dedicated, Tribal services team

A new model of health care delivery

Medication management Care navigation Integrated health management Cost-saving care administration Wellness and prevention Administration tools and services
Medication Management Care navigation Integrated health management Cost-saving care administration Wellness and prevention Administrative tools and services

Medication management

  • Premier partner: Prime Therapeutics
  • Preferred vendors

Care navigation

  • 24-hour nurse advice line
  • Comprehensive, personalized condition support
  • Employee assistance program (EAP)
  • Prenatal support that lowers incidence of preterm births

Integrated health management

  • Pre-admission notification
  • Concurrent review/discharge planning
  • Case Management with one-to-one support
  • Mental health/chemical dependency case management
  • Utilization review
  • Program integrity (fraud and abuse)

Cost-saving care administration

  • Administrative Processing Services (APS) in-house, Remote Processing Services (RPS) at Tribal Site, or MLR Repricing
  • Provider notification of payments at substantial additional MLR savings

Wellness and prevention

  • Fitness discounts with 2,000+ fitness centers
  • Access to web-based information and tools
  • Online health assessment
  • Online health coaching
  • Stop-smoking support
  • Options for onsite health screenings, education and health fairs
  • Telephonic lifestyle coaching

Administration tools and services

  • Adherence to Tribal-related regulations
  • Identification and processing of claims
  • Member ID cards
  • Billing and accounting services
  • Comprehensive reporting with customizations

Medication management

  • Premier partner: Prime Therapeutics
  • Preferred vendors

Care navigation

  • 24-hour nurse advice line
  • Comprehensive, personalized condition support
  • Employee assistance program (EAP)
  • Prenatal support that lowers incidence of preterm births

Integrated health management

  • Pre-admission notification
  • Concurrent review/discharge planning
  • Case Management with one-to-one support
  • Mental health/chemical dependency case management
  • Utilization review
  • Program integrity (fraud and abuse)

Cost-saving care administration

  • Administrative Processing Services (APS) in-house, Remote Processing Services (RPS) at Tribal Site, or MLR Repricing
  • Provider notification of payments at substantial additional MLR savings

Wellness and prevention

  • Fitness discounts with 2,000+ fitness centers
  • Access to web-based information and tools
  • Online health assessment
  • Online health coaching
  • Stop-smoking support
  • Options for onsite health screenings, education and health fairs
  • Telephonic lifestyle coaching

Administration tools and services

  • Adherence to Tribal-related regulations
  • Identification and processing of claims
  • Member ID cards
  • Billing and accounting services
  • Comprehensive reporting with customizations


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