Our Mission
TrailBlazer employees work to continually improve processes and seek ways to better serve Medicare beneficiaries and providers. TrailBlazer’s effectiveness is maximized through training, teamwork and innovation, and its employees continually strive to satisfy the needs and expectations of TrailBlazer’s customers.
Background
TrailBlazer administers the Medicare program under contracting arrangements with the Centers for Medicare & Medicaid Services (CMS). As Medicare Administrative Contractor (MAC), Part A intermediary and Part B carrier, TrailBlazer administers some aspect of the Medicare program for beneficiaries and providers in virtually every state.
TrailBlazer is the Part A and Part B Jurisdiction 4 MAC for:
- Colorado.
- New Mexico.
- Oklahoma.
- Texas.
- Indian Health Service.
As a Fiscal Intermediary (FI), TrailBlazer is the:
- National Part A Intermediary for the Veterans Affairs (VA) claims recovery project.
- National FI for many dialysis and skilled nursing facility chains.
- Regional processor for freestanding rural health clinics for central United States.
- Regional FI for End Stage Renal Disease claims for Arkansas, Colorado, Louisiana, New Mexico, Oklahoma and Texas.
As a carrier, TrailBlazer is the:
- Part B carrier for Virginia.
- National Part B carrier for mass billers of influenza/pneumococcal vaccine.
- National Part B carrier for the VA claims recovery project.
As MAC, intermediary and carrier, TrailBlazer is one of the largest Medicare contractors.
Since the inception of the Medicare program in 1966, TrailBlazer has been the government’s choice in administering both Part A and Part B contracts of the Medicare program. First, the organization functioned as a division of BlueCross BlueShield of Texas and later as a subsidiary of both BlueCross BlueShield of Texas and BlueCross BlueShield of South Carolina. TrailBlazer continues in its fifth decade of uninterrupted service to the Medicare program and is working to expand its service areas and range of specialization.
Non-Traditional Contracting
TrailBlazer also administers contracts not funded by the Medicare system. These include:
- National Disaster Medical System (NDMS) Reimbursement Program – This NDMS program, which was awarded to TrailBlazer in January 2006, is operated by the Federal Emergency Management Agency (FEMA) under the Homeland Security Act with funds appropriated by Congress. NDMS provides reimbursement to hospitals and physicians/practitioners who provided inpatient hospital services to evacuees of Hurricanes Katrina and Rita.
- Section 1011 – This four-year, cost-plus-fixed fee contract was awarded in July 2005. Section 1011 of the Medicare Prescription Drug Improvement, and Modernization Act of 2003, Federal Funding of Emergency Health Services Furnished to Undocumented Aliens, provides $250 million per year for federal fiscal years 2005-2008 for payments to eligible hospitals, certain physicians and ambulance providers in all 50 states and the District of Columbia for emergency health services provided to undocumented aliens and other specified aliens.
Our Company
From its headquarters in Dallas, Texas, TrailBlazer also operates a major operational office in Denison, Texas. An additional field audit office is located in San Antonio, Texas.
TrailBlazer employees proudly serve Medicare beneficiaries and providers from these offices with claims processing, customer service and general program administration operations. TrailBlazer’s primary information technology environment is located in the large, state-of-the-art BlueCross BlueShield of South Carolina data center in Columbia, South Carolina, with additional network operations and client/server platforms supported at all TrailBlazer major operational facilities.
About the Medicare Program
Medicare is a federal health insurance program established by Congress in 1965 to provide health care insurance for seniors and people with disabilities (added in 1972). The Medicare program has two components, Part A and Part B. Part A provides coverage for services from institutional providers such as hospitals and skilled nursing facilities. Part B provides coverage for services from physicians, non-physician practitioners, laboratories and suppliers.