Lucent Tribia

Lucent Tribia™ Provides Long-Term Cost Management Solution

Lucent Tribia™ is designed specifically for Tribal enterprises so they can achieve the greatest savings.

Through our proprietary processes, all tribal Members receive care at the lowest price — Medicare. In addition, non-tribal Member employees get the same great benefits at the lowest price through access to one of our national network partners: Anthem or Cigna.

ADVANTAGES

As a result of our recognized experience with tribal clients, we are able to engage with highly relevant information, data, guidance and suggestions on better managing both cash flow and Member quality of health. Several benefits include:

SAVINGS

Members receive care at the price of Medicare

CONTROL

Ability to intelligently influence member behavior

STABILITY

Year-to-year stability

CARE

Fully integrated and proprietary clinical and care management solution that put the member's care and experience above all

Approach

How It Works

Lucent Tribia™ works with the tribe’s healthcare network, physicians and hospitals to provide reduced rates and increased access to life-enhancing services:

Pre-Cert/HIS Authorizations:

Lucent Tribia™ coordinates with IHS, the doctor and the tribe to ensure every eligible tribal member gets the MLR for eligible services.

Claims Processing:

Lucent Tribia™ ensures all claims are paid quickly and accurately to each provider for each eligible MLR claim.

Reporting & Accountability:

Lucent Tribia™ provides detailed monthly reports denoting claim activities and the MLR claims along with tribal savings from month to month.

Sample Workflow

Tribal member requests services at Tribal facility

Lucent Tribia™ verifies Tribal Self-Funded Plan coverage

Lucent Tribia™ obtains IHS Authorization

Lucent Tribia™ coordinates claim payment & processes electronic / digital / paper claims

Lucent Tribia™ works with the tribe’s healthcare network, physicians and hospitals to provide reduced rates and increased access to life-enhancing services:

Pre-Cert/HIS Authorizations:

Lucent Tribia™ coordinates with IHS, the doctor and the tribe to ensure every eligible tribal member gets the MLR for eligible services.

Claims Processing:

Lucent Tribia™ ensures all claims are paid quickly and accurately to each provider for each eligible MLR claim.

Reporting & Accountability:

Lucent Tribia™ provides detailed monthly reports denoting claim activities and the MLR claims along with tribal savings from month to month.

Sample Workflow

Tribal member requests services at Tribal facility

Lucent Tribia™ verifies Tribal Self-Funded Plan coverage

Lucent Tribia™ obtains IHS Authorization

Lucent Tribia™ coordinates claim payment & processes electronic / digital / paper claims