Who We Serve



Interested in teaming with WPS?

Fill out our Teaming Partner contact form.


Government Services


WPS Health Solutions' modular and integrated technology handles the full experience of health plan benefits from navigation and enrollment through claims administration and care management—all delivered on a compliant, secure, and interconnected platform. Integration is available to all federal and state agencies through a standardized connection library.

WPS makes benefit plan enrollment and participation easy for government employees and citizens alike by “connecting the dots” quickly, accurately, and in a compliant manner, using leading back-office capabilities we’ve built over 75 years in business.

Grounded with a solid federal compliance program, core claims administration, and information and workflow management for government customers at scale, WPS has experience supporting a wide spectrum of beneficiaries from TRICARE, Department of Veterans Affairs, Medicare, and Medicaid to commercial members and other health insurance providers.

Government Contracting Experience

  • Administering foreign medical claims for the TRICARE Overseas Program
  • Processing more than 750,000 claims annually for nearly 550,000 beneficiaries
  • Paying more than $330 million in benefits annually
  • Providing multilingual customer support call center for both overseas providers and beneficiaries
  • Processing TRICARE claims
  • Offering customer service, supporting providers, and responding to questions and concerns with billing and enrollment
  • Coordinating Managed Care Support Contractor and Defense Manpower Data
  • Verifying beneficiary eligibility via Defense Enrollment Eligibility Reporting System (DEERS) interface
  • Submitting TRICARE Encounter Data (TED) records
  • Serving 6 million beneficiaries (two out of three in the TRICARE population) while processing 45.1 million claims and paying $9.5 billion in benefits per year
  • Processing claims for TRICARE-eligible beneficiaries who have Medicare Part A and B coverage
  • Providing high-quality customer service to beneficiaries and health care providers
  • Maintaining full-function beneficiary and provider portals for 24/7 self-service access to claims, program information, and educational materials
  • Coordinating with the Defense Manpower Data Center for Defense Enrollment Eligibility Reporting System (DEERS) interface
  • Submitting TRICARE Encounter Data (TED) records
  • Preserving effective cost containment through medical review and program integrity units to ensure reimbursement of medically necessary services and covered benefits
  • Serving 2.34 million beneficiaries annually while processing 57.3 million claims and paying $4.2 billion in benefits
  • Subcontracting on a 10-year, $1 billion contract vehicle for professional consulting and health care services covering health system transformation and innovation, implementation and operations support, and health care business-enabling services
  • Managed veterans' PC3 claims, initially for three regions serving 750,000 beneficiaries while processing 4 million claims and paying $1 billion per year, and then for the entire nation during the transition to Community Care Network
  • Served approximately 1.5 million CCN beneficiaries
  • Received, processed, adjudicated, and paid provider claims for 13 states over the western United States
  • Enrolling providers in four states as well as additional Medicare Part A providers in 47 states
  • Delivering customer service
  • Processing claims and appeals
  • Performing medical reviews, provider audits and reimbursements, and data analytics
  • Serving 4 million beneficiaries and 67,000 providers annually and processing 65 million claims while paying $30 billion in benefits
  • Enrolling providers in two states
  • Delivering customer service
  • Processing claims and appeals
  • Performing medical reviews, provider audits and reimbursements, and data analytics
  • Serving 3 million beneficiaries and 78,000 providers annually, processing 61 million claims while paying $17 billion in benefits

   

Government Seals

NAIC Codes

NAIC is the standard classification system used by federal agencies that classifies the type of work the business performs.

  • 524114—Direct health and medical insurance carriers
  • 524292—Third-party administration of insurance and pension funds
  • 541611—Administrative management and general management consulting services
  • 541990—All other professional, scientific, and technical services
  • 541690—Other scientific and technical consulting services
  • 561110—Office administrative services
  • 524210—Insurance agencies and brokerages
  • 541211—Offices of certified public accountants
  • 541219—Other accounting services

Note: Beneficiaries and annualized claims estimated and rounded as of Dec. 31, 2022.