Shasta is honored to be the Northwest's only tribally owned Third Party Administrator (TPA)
Our implementation of the "Golden Rule" philosophy works well with the cultural traditions and values of the tribes we serve. Respect for elders, concern for future generations and the protection and health of nature and families is our mutual goal.
Shasta's staff is uniquely qualified to administer plans for tribes and tribal entities. We focus on providing top-notch services that are critical to success and allow eligible tribal members many great opportunities to maximize savings such as MLR/CHEF/PRC-formerly CHS, and Payor of Last Resort. Many of these plans are extremely complex and must be administered, leveraged and managed properly to be successful. By identifying and navigating these programs, we help you protect your plan, manage risk, maximize savings, and strengthen your sovereignty. We understand the need for balance in compassionate care and cost containment and seek advantages for Tribes/business enterprises and for members/employees.
In addition to our standard products and services, Shasta's Tribal Differences are:
- Every Tribal claim is reviewed and audited for the optimum savings opportunity
- Integration and back room administration for Purchased Referred Care (PRC), formerly known as Contract Health Services (CHS)
- Tribal Claims Management, including Eligibility, Coordination of Benefits, Payor of Last Resort
- Applying Medicare Like Rates (MLR) for every claim that qualifies
- Obtaining reimbursement from the Catastrophic Health Emergency Fund for every claim that qualifies
- Pharmacy Integration-340B, Federal Supply Schedule Pricing, Tribal Pharmacy Mail Order
- Integration with Tribal clinics, drive steerage, increase utilization, decrease administrative burden
- Administering Tribal Plans since 2008