Indian Health Service, Tribal 638 and Urban Indian Health Programs (I/T/Us)
Continuing Care as an I/T/U Provider
Whether the I.H.S. and Tribal 638 providers choose to contract with the managed care organizations (MCOs) or not, Native Americans will still be able to seek care from these I/T/Us. I/T/U providers will be paid the Office of Management and Budget (OMB) rates (the federal rate) regardless of whether the I/T/U provider is in a managed care network or not.
The MCOs are required to make their best efforts to contract with the I/T/Us. However, no I/T/U provider will be forced to contract with an MCO. If an I/T/U provider decides NOT to contract with the MCO, Native Americans may still access I/T/Us and the provider is still paid the OMB rate for services.
The MCOs have a contractual requirement to make prompt and accurate payments to all providers, including the I/T/Us. The MCOs are required to work closely with the I/T/Us to train all providers on filing a clean claim to speed processing of payments.
I/T/U Benefits for Joining an MCO
As an "in network" provider under an MCO in Centennial Care, your patients will have access to expanded care coordination, increased access to specialty providers within the MCO network. This will allow you to provide better management of limited resources thereby stretching contract health dollars for use to other Tribal members.