Since 1946, we’ve earned countless accolades for our capabilities and they’ve grown with each passing year. It’s never been enough for us to be satisfied with our past successes or settle for our past capabilities.
With every claim and every year in service, our company and workforce has become more qualified and experienced. This is how WPS is able to deliver dependability and quality assurance to all the federal government contracts we support.
Through more than 75 years and millions of claims, we've proven ourselves to be an effective, efficient, and responsive claims processor. We have the technology, staff, and expertise to consistently beat deadlines and exceed quality requirements.
We handle all claims administration functions, from processing claims to program management, eligibility verification, provider services, financial services, and Medicare Secondary Payer services.
We process 237 million claims and make nearly $70 billion in payments each year. In all, WPS serves more than 7 million Medicare beneficiaries and 9 million active-duty military, veterans, and their families.
WPS has enrolled providers in Medicare for decades. WPS performs enrollment, rejection, denial, change of information, and revalidation for approximately 150,000 provider enrollment applications annually.
WPS has nearly 2,700 employees, including an experienced provider enrollment staff. Our experts can provide research on a wide array of sources, including Provider Enrollment, Chain, and Ownership System (PECOS), Office of Inspector General, SAM.gov., various state licensure websites, and supporting documentation for Adverse Legal Actions.
We interact with CMS staff daily to complete administrative actions on enrollment or referrals to the agency for further action.
As a Medicare Administrative Contractor, WPS uses CMS' Integrated Data Repository (IDR). WPS' data analytics and health informatics team leverages IDR data to support our claims processing and medical review functions.
Our knowledgeable and experienced provider audit and reimbursement team annually processes thousands of cost-report acceptances, desk reviews, and reopenings, creating efficient workflows from system to system.
The experienced Customer Service team at WPS ensures accurate, timely, and accessible program information is provided to our Medicare and Military and Veterans Health beneficiaries.
We’ve made health care easier for customers by making data available 24/7, easing the burden on providers.
To achieve our goals, we have a four-point strategy:
WPS has shown the ability to effectively develop, execute, monitor, and revise the MR Improper Payment Reduction Strategy (IPRS) to prevent inappropriate claim payments. The structure of our Medical Review Management team provides both strong clinical and operational support.
With decades of Medicare experience across several departments, the Medical Review Clinical Management and Operational Management teams bring nuance to medical review. WPS uses technology to increase efficiency, improve quality, and reduce costs. We’re always looking for ways to innovate and improve our medical review processes.
