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FY 25 Tribal Management Grant - Health Services First Party Administrator

Award Number: D255IHS0506
ORGANIZATION: INDIAN HEALTH SERVICE
OPDIV: IHS
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: DEMONSTRATION
PERIOD OF PERFORMANCE START DATE: 03/01/2025
PERIOD OF PERFORMANCE END DATE: 02/29/2028

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FY 25 Tribal Management Grant - Health Services First Party Administrator - The Grand Traverse Band of Ottawa and Chippewa Indians is working to provide the best healthcare services possible. We want to continue to manage efficiently to positively impact our operations budgets and create better health programs for our Tribal members. By becoming our own Third-Party Administrator, we will provide intimate oversight to the billing of our healthcare and improve the provision of healthcare services to our Tribal Members. GOAL: GTB Health Services First Party Administrator Objectives: 1. Train Purchase referred care and billing staff on Medicare-like rate (MLR) repricing software with Forest County Potawatomi (FCP) and Sundancer (SD) 2. Work with Forest County Potawatomi (FCP) and Sundancer (SD) MLR experts to purchase the MLR repricing software and ensure our IT needs are compatible with the software 3. Full implementation of MLR repricing and billing for the GTB Health Services Clinic, Dental, Behavioral Health, and PRC billing. 4. Determine ongoing consulting needs of the Health Services Department for Third-party billing. Activities: What will you do to complete the objectives? 1. PRC and billing staff to attend training for MLR repricing: a. Reprice Inpatient and Outpatient health care claims to Medicare Like Rates b. Organize CHS/PRC service operations * Educate staff on utilization management of all healthcare claims * Develop, organize, and structure the referral process * Filing and managing CHEF cases * Develop and organize CHS/PRC and Managed Care Committee operations 2. 2 years for full training, software purchase, and MLR repricing and billing implementation with ongoing consultation with FCP and SD.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $94,999 )
2025	2025	GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS	2605 N WEST BAY SHORE DR	SUTTONS BAY	MI	49682	LEELANAU	USA	Indian Health Service, Health Management Development Program	01	1	3/31/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2025	2025	GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS	2605 N WEST BAY SHORE DR	SUTTONS BAY	MI	49682	LEELANAU	USA	Indian Health Service, Health Management Development Program	00	1	3/7/2025	NEW	$94,999
														Subtotal = $94,999

Grand Total All Awards = $94,999

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FY 25 Tribal Management Grant - Health Services First Party Administrator

Award Number: D255IHS0506

ORGANIZATION: INDIAN HEALTH SERVICE

OPDIV: IHS

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: DEMONSTRATION

PERIOD OF PERFORMANCE START DATE: 03/01/2025

PERIOD OF PERFORMANCE END DATE: 02/29/2028

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