The Medicare Modernization Act (MMA) of 2003 initiated the privatization of Medicare. This legislation created the Medicare Prescription Drug Plan and new Medicare Advantage (MA) health insurance plans now provided by private insurance companies. To continue full expansion into the new diversified markets opened by the MMA, InStil Health Insurance Company (InStil Health) was incorporated, approved and made a wholly owned subsidiary of BlueCross BlueShield of South Carolina. InStil Health was formally licensed and approved to do business by the State of South Carolina in September 2004.
InStil Health operated several Medicare Advantage (MA) and Prescription Drug Plans (PDP) plans in both South Carolina and Georgia from the inception of the Medicare Advantage program in 2005 through 2009. This operational experience has afforded InStil Health the opportunity to leverage "back office" expertise to companies who desire to forego the considerable demands of running a full service MA operation. Services available under ASO agreements include customer service call center operations, membership enrollment, premium billing, account reconciliation as well as patient appointment services. Subcontracting these services allows companies to concentrate resources on core business rather than operational requirements. InStil Health offers out-sourcing for both large and small-scale ASO operations.
Additionally, InStil Health through TRICARE HealthCare Services (HCS) provides managed care support services to TRICARE beneficiaries located in South Carolina.
InStill Health's TRICARE HCS team is responsible for the operation of TRICARE contract offices throughout South Carolina. Responsibilities include the establishment and credentialing of a network of providers and facilities. InStil Health has staff in five locations around the state. InStil holds accreditation by URAC in Health Networks.
Each South Carolina TRICARE contract office is responsible for providing beneficiary and MTF service support. This support ranges from education on the TRICARE program, enrollment issues, claims concerns, and questions about referrals and authorizations for care. Each contract office has a staff member who is responsible for working with local providers to resolve their concerns, recruit new network providers, and maintain the local TRICARE network.