GuideWell Source

What GuideWell Source does

GuideWell Source (legal name: Diversified Service Options, Inc.) is a Jacksonville, Florida-based administrative services company that operates as a Medicare Administrative Contractor (MAC) for the Centers for Medicare and Medicaid Services (CMS). The company delivers full-service administrative solutions for federal health programs, with core scope covering claims processing, customer service, appeals adjudication, education and outreach, and program integrity for Medicare Part A and Part B. It serves as the platform company for three wholly-owned subsidiaries: First Coast Service Options (MAC for Jurisdiction N — Florida, Puerto Rico, and the U.S. Virgin Islands), Novitas Solutions (MAC for Jurisdictions L and H — covering Delaware, DC, Maryland, New Jersey, Pennsylvania, Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas), and GuideWell Allegiance. Together, these entities administer services for more than eleven million Medicare beneficiaries and over 500,000 healthcare providers, representing approximately one-third of the entire Part A and Part B Medicare landscape across 12 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.

The company's go-to-market is exclusively B2G: contracts are secured through federal procurement and renewed on multi-year cycles. There are no proprietary technology platforms, AI/ML capabilities, or commercial product offerings disclosed in the source material; the value proposition rests on operational excellence, regulatory expertise, and the exclusive jurisdiction-based contracts themselves. Leadership is heavily legal-trained, with multiple JDs across the C-suite, and the company is ISO certified with an independently certified "Navigator" compliance program. GuideWell Source is a wholly-owned subsidiary of GuideWell, a not-for-profit mutual holding company that also owns Florida Blue and related insurance, care delivery, and consumer-engagement businesses.

Revenue mechanics are entirely contract-based, with no publicly disclosed pricing, no commercial channel exposure, and no diversified customer base. The company is therefore best characterized as a regulated, contract-protected services platform whose economics are tightly coupled to CMS procurement outcomes and the cadence of MAC re-competes. A material CEO transition is in progress in 2026, with Harvey Dikter retiring after 21 years at the company.

Name

GuideWell Source

Legal name

Diversified Service Options, Inc.

Website

https://guidewellsource.com

Company type

Private

Founded year

1998

Operating status

Operating

Headcount range

101–250 employees

Short description

GuideWell Source is a Jacksonville-based Medicare Administrative Contractor (MAC) operating through First Coast, Novitas Solutions, and GuideWell Allegiance subsidiaries. It provides claims processing, appeals, customer service, and program integrity services to CMS, serving 11M+ Medicare beneficiaries and 500,000+ healthcare providers across 12 states and territories.

Ownership category

akta.pro rank

Product category

Medicare Administrative Services

NAICS

Health and Welfare Funds (525120), Funds, Trusts, and Other Financial Vehicles (525), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)

SIC

Services-Membership Organizations (8600), Communications Services, Nec (4899), Services-Computer Programming, Data Processing, Etc. (7370), Services-Help Supply Services (7363)

akta.pro primary industry

Public Health Program Grants Management & Administration (HLAJALAC)

akta.pro secondary industries

Credit Counseling & Debt Management Plans (DMP) (FSAKAJAH), Medicare Plan Distribution & Brokerage (Captive, Independent, FMOs) (FSAIAGAH)

Keywords

• Medicare administrative services
• Government health programs
• Claims processing services
• Medicare Administrative Contractor
• Health program administration

Headquarters

HQ city

Jacksonville

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Government Administrative Services Contracts: GuideWell Source generates revenue through CMS contracts as a Medicare Administrative Contractor (MAC), providing claims processing, customer service, appeals adjudication, education and outreach, and program integrity functions for Medicare programs. Revenue is derived from government-funded administrative services contracts.

Go-to-market motion1 record

Distribution channels1 record

Marketing channels3 records

Core offering

GuideWell Source is a private administrative services company that delivers full-service business solutions for federal and state health programs, primarily operating as a Medicare Administrative Contractor (MAC). Through its wholly-owned subsidiaries First Coast Service Options, Novitas Solutions, and GuideWell Allegiance, the company provides claims processing, customer service, appeals adjudication, education and outreach, and program integrity functions for Medicare Part A and Part B programs.

Product overview

GuideWell Source is a single administrative services platform providing full-service business solutions for government health programs. The company operates through three wholly owned subsidiaries: First Coast Service Options (MAC for Florida, Puerto Rico, and U.S. Virgin Islands - Jurisdiction N), Novitas Solutions (MAC for Delaware, DC, Maryland, New Jersey, Pennsylvania - Jurisdiction L; and Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas - Jurisdiction H), and GuideWell Allegiance. Together, First Coast and Novitas serve approximately one-third of the entire Part A and Part B Medicare landscape, providing claims processing, customer service, appeals adjudication, education and outreach, and program integrity services to more than eleven million beneficiaries and 500,000 healthcare providers.

Differentiator

Problem solved

Functional benefit

Products and services

• Medicare Administrative Contractor (MAC) Services Comprehensive Medicare administrative services including claims processing, customer service, appeals adjudication, education and outreach activities, and program integrity functions. Delivered under direct contracts with the Centers for Medicare and Medicaid Services (CMS) to serve more than 11 million Medicare beneficiaries and over 500,000 healthcare providers across 12 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.

Named customers1 record

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

Seven partnerships are on record, tiered core and minor.

• Centers for Medicare and Medicaid Services (CMS)coreOthersGuideWell Source subsidiaries First Coast and Novitas hold MAC contracts with CMS to provide Medicare administrative services. These are primary revenue-generating government contracts.
• First Coast Service Options, Inc.coreStrategic or Co-development PartnerWholly-owned subsidiary of GuideWell Source serving as the Medicare Administrative Contractor (MAC) for Florida, Puerto Rico, and the U.S. Virgin Islands (Jurisdiction N).
• Novitas Solutions, Inc.coreStrategic or Co-development PartnerWholly-owned subsidiary acquired by GuideWell Source, serving as the MAC for Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania (Jurisdiction L) and Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas (Jurisdiction H). The acquisition tripled the company's Medicare footprint.
• GuideWell Allegiance, Inc.coreStrategic or Co-development PartnerWholly-owned subsidiary of GuideWell Source providing additional administrative services within the family of companies.
• GuideWell (Parent Company)coreStrategic or Co-development PartnerGuideWell is a not-for-profit mutual holding company and parent to GuideWell Source, GuideWell Connect, and GuideWell Health. It is a leading health insurer in Florida and includes the Florida Blue Foundation.
• GuideWell ConnectminorStrategic or Co-development PartnerFellow member of the GuideWell family of companies focused on connecting clients to their customers through consumerism initiatives in health.
• GuideWell HealthminorStrategic or Co-development PartnerFellow member of the GuideWell family of companies focused on new models in the delivery of care providing superior health outcomes to patients.

Scale indicators5 records

Recent moves5 records

Expansion highlights5 records

Broad incumbents

• Maximus Federal Services: Maximus is a major federal government services contractor operating across Medicare appeals (QIC operations), Medicaid eligibility, and other federal health program administration. A broader incumbent in the same federal healthcare administration space.
• Elevance Health (Anthem): Elevance Health owns National Government Services, a major MAC, and is a leading national health insurer. Like GuideWell, Elevance combines commercial insurance operations with MAC administration, providing a broad incumbent comparison for the parent-subsidiary structure.
• Gainwell Technologies: Gainwell Technologies (formerly part of DXC/CSC) is one of the largest Medicaid Management Information Systems (MMIS) and federal/state healthcare IT contractors. A broader incumbent serving similar government health program administrative customers.
• BlueCross BlueShield of South Carolina (parent of Palmetto GBA): BCBS South Carolina is the parent organization of Palmetto GBA and a mutual insurance holding company structurally similar to GuideWell, the parent of GuideWell Source. Both combine insurance operations with government healthcare administration through shared subsidiaries.
• Conduent State Healthcare: Conduent operates government healthcare services including Medicaid fiscal agent operations, eligibility, and claims processing technology. A broader incumbent with overlapping technology and operations serving state and federal health programs.

Direct peers

• Noridian Healthcare Solutions: Noridian is one of the largest Medicare Administrative Contractors, holding MAC contracts across multiple jurisdictions (JE, JF, JK, J6) for Part A/B and DME. Directly comparable to GuideWell Source as a fellow MAC serving similar CMS-administered claims processing, appeals, and provider education functions.
• Palmetto GBA: Palmetto GBA, a subsidiary of BlueCross BlueShield of South Carolina, is one of the legacy Medicare Administrative Contractors. Holds multiple MAC jurisdictions (JM, JJ, J11) and operates as a direct peer in the same MAC claims processing market as GuideWell Source.
• CGS Administrators: CGS Administrators is a Medicare Administrative Contractor holding Jurisdiction 15 (J15) and Jurisdiction 65 (J65). It is a direct competitor to GuideWell Source in providing CMS claims processing, appeals adjudication, and provider education services.
• National Government Services (Anthem): National Government Services, a subsidiary of Elevance Health (Anthem), is a Medicare Administrative Contractor for Jurisdictions 6 (J6) and K (JK). Direct MAC peer providing similar CMS administrative services.
• Wisconsin Physicians Service (WPS Health Solutions): WPS Health Solutions operates the WPS Government Health Administrators division, which is a Medicare Administrative Contractor for Jurisdiction 5 (J5) and Jurisdiction 8 (J8). A direct MAC peer with comparable claims administration scope.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Subsidiaries3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about GuideWell Source