PGBA's record of providing administrative services to government health plans is unparalleled in the industry. A comprehensive knowledge of the nuances that distinguish these programs from private health plans is at the root of our success.
We have served as the largest processor of TRICARE claims for the United States Department of Defense, and we are the sole, nationwide medical claims adjudication contractor for the United States Department of Justice Federal Bureau of Prisons. Our knowledge and experience allow us to provide a number of private fee-for-service and coordinated care products for our customers.
PGBA uses its experience and performance processing electronic claims to significantly improve the efficiency and effectiveness of the claims adjudication process for the Federal Bureau of Prisons (BOP) and the North Carolina Department of Public Safety (NCDPS). PGBA’s medical claims adjudication expertise has helped BOP & NCDPS accurately assess inmate medical care costs. We continue to work with the our partners to refine processes ensuring success.
Humana Government Business
UnitedHealthcare Military & Veterans
PGBA has served in a number of capacities for the North, South and West regions of the TRICARE health plan, administered by Humana Government Business, Health Net Federal Services and UnitedHealthcare Military & Veterans, respectively. We processed more than 50 million TRICARE claims in the last year alone, and responded to almost 1 million pieces of correspondence and more than 3.1 million phone calls.
Each interaction with a TRICARE beneficiary is equally important, and we have developed proven processes to support every interaction while exceeding industry best practices. J.D. Power and Associates named our North region TRICARE contract call center one of the top call centers in the country. And our myTRICARE.com web site has won numerous national awards, recognized by health communications professionals for its web-based claims submission and customer service capabilities.