| Type | Private |
|---|---|
| Industry | Insurance |
| Founded | Milwaukee, Wisconsin (1946) |
| Headquarters | Madison, Wisconsin, USA |
| Key people | Ray Koenig, First President Jim Riordan, President & CEO |
| Employees | 5,000 |
| Website | www.wpsic.com |
Wisconsin Physicians Service Insurance Corporation (WPS) is a not for profit service insurance corporation based in Madison, Wisconsin. WPS offers commercial health insurance products in the state of Wisconsin and provides insurance claims processing services under various U.S. Government contracts. In addition, WPS has subsidiary corporations in the life insurance [1] and temporary staffing [2] lines of business.
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Wisconsin Physicians Service was established in 1946 as a division of the State Medical Society. In 1975 the Wisconsin legislature passed legislation requiring that service insurance corporations be legally separate from the parent professional society.[1] In order to comply with this new regulation, Wisconsin Physicians Service Insurance Corporation was established and incorporated on April 27, 1977.
WPS became involved in the Medicare program in 1966, the year Medicare was established, as the Medicare Part B administrator for the state of Wisconsin. WPS has continued in that role, and has acquired additional contracts from the Centers for Medicare and Medicaid Services (CMS) to provide Part B administration in Illinois, Michigan and Minnesota.
In 2005 WPS and Mutual of Omaha announced the acquisition of Mutual of Omaha's Medicare Part A division.[2] Under this agreement, Mutual of Omaha's Medicare Part A division was transferred to WPS. This facilitated WPS to compete for the new Medicare Administrative Contract (MAC) regions, which requires combined Part A and Part B administration. Previously, CMS awarded separate Part A and Part B contracts by state.
WPS has served the Military Health System continually as a claims administrator since 1956. WPS managed the first regional plan for Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) and was the first to connect as a carrier to the central Defense Enrollment and Eligibility Reporting system (DEERS). WPS was also the first to submit TRICARE Encounter Data (TED) records on claims to the Department of Defense. As of 2012, WPS has contracts with the Department of Defense TRICARE Management Activity, TriWest Healthcare Alliance and International SOS to provide TRICARE claims administration functions. These functions include claims processing, system design and customer service for the TRICARE West Region, TRICARE Overseas and TRICARE for Life. WPS processes more than a million TRICARE healthcare claims per week for beneficiaries worldwide.