Company Fact Sheet

Profile
TMG Health offers technology enabled Business Process Outsourcing (BPO) services for insurers, employers, health plans, and providers in the Medicare, Medicaid and Group Retiree health plan markets. As the largest and most experienced BPO processor in the Medicare Advantage market, TMG Health offers an innovative and comprehensive suite of services designed to minimize a plan’s capital investment, lower their ongoing operational costs and reduce the risks associated with Medicare and Medicaid plan administration. Our efficient implementation process reduces the time required to launch new products or expand into new service areas. Compliance with all CMS requirements is our foremost concern and customer satisfaction is our driving goal.

Founded
1998

Number of Employees
879

Corporate Address
TMG Health, Inc.
150 South Warner Road
Suite 400
King of Prussia, PA 19406
Telephone: (610) 964-8440
Fax: (610) 964-8112

Operations Center Address
201 Lackawanna Ave.
Scranton, PA 18503
Telephone: (888) 924-3905

1205 O'Neill Highway
Dunmore, PA 18512
Telephone: (888) 924-3905

Web Address
www.tmghealth.com

Key Management
John T. Tighe III, Founder, President and CEO
Robert Dunn, Senior Vice President of Operations and Technology
Olga Thornton, Vice President Program Development & Chief Compliance Officer
Alan N. Vinick, Chief Financial Officer
Vincent M. Dadamo, Vice President and General Counsel
Mark Biancucci, Vice President of Enrollment, Billing and Reconciliation
Eric Corkhill, Vice President Sales and Marketing
Kimberly Line Courtois, Vice President of Human Resources
Barry Walsh, Vice President of Claims

Target Markets
Medicare, Medicaid and Group Retiree markets with focus on the array of insurance plans and products that derive from these public health programs.  Examples include:  PPO, PFFS, HMO, SNP and MSA. In addition, TMG Health has the ability to seek out and support new and innovative plan types.

Customers
TMG serves over 40 separate health plans and insurers in 50 states.  Customers serviced by TMG Health include:

  • One of the nations largest PBMs for Part D administration
  • Fourteen Blue Cross Blue Shield plans
  • The largest and fastest growing SNP in the Country
  • More than 100 retiree groups for MA, MAPD and PDP products
  • 15 PFFS products (successfully launched over the past 5 years)
  • Provider owned Medicare Plan

Workload Volumes
TMG Health supports over 1.5 million Medicare and Medicaid members and handles over 20 million health claims, 300,000 enrollments and 1.5 million Medicare service calls annually.

Service Portfolio/Delivery Models
TMG Health offers a comprehensive suite of services which can be utilized in a fully integrated manner or as individual components. The available services include:

  • Managed Care IS systems, data management/reporting
  • Enrollment and eligibility processing
  • Premium billing and reconciliation
  • Claims imaging, OCR and processing
  • Member and provider services and call center
  • Fulfillment for claims processing and premium billing
  • Health risk screening, working aged and Part D COB surveys
  • Medical management system support and consulting
  • Support marketing services

Operational Security and Flexibility
TMG Health’s Operations Center uses the most sophisticated and reliable technology available to ensure non-stop service and fail-safe operations. The core technology includes TriZetto’s Facets Managed Care Information System, specifically configured to address the unique requirements of Medicare and Medicaid processing. TMG Health enhances this core system with proprietary and third-party applications and technology to achieve unparalleled operational productivity.

Processing services are available in a variety of delivery options including:

  • Full Business Process Outsourcing (BPO) service suite
  • Flexible bundling of turnkey services
  • Transaction services (e.g., claims pre-processing)
  • Medicare Advantage Part D or MAPD standalone processing

Contact
Eric A. Corkhill
Vice President, Sales and Marketing
610-964-8440 x 211
ecorkhill@tmghealth.com


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