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Everything You Should Know About Third Party Administrator Healthcare

If you’re a business owner, you may be interested in third party administrator (TPA) healthcare services. Let’s explore what third party administrator healthcare is, how it works, and what its benefits are.

What Is TPA? How Is it Related to Health Insurance?

Third party administrator healthcare is a term that’s pretty easy to break down. As the name implies, you have another person or a third party that takes over administrative duties for your business’s healthcare needs. The TPA is not directly involved in contracts between policyholders and insurers. Instead, they’re only involved when the claims settlement aspect of the contract comes up. The TPA is appointed by the insurance company to facilitate the claim settlement process on behalf of the company.

What Are the Duties of a TPA?

A TPA has a wide range of administrative tasks to complete to ensure a smooth claim settlement process for health insurance companies. For instance, they become the link between policyholders who file a health insurance claim and the insurer. They’re also tasked with record keeping, overseeing claim settlements, providing policyholders with a support system, and various other services. The TPA will ensure that crucial records containing policyholder information are stored safely and correctly. They help insurance companies and hospitals navigate the claim settlement process while offering a support system that addresses customer concerns. As stated, the TPA also takes care of other administrative tasks, as outlined in the details of the contract.

What Are the Benefits of Hiring a TPA?

When you look at the role played by a TPA, it’s not hard to see why third party administrator healthcare might be beneficial for your business. To begin with, they are well versed with the health insurance industry and familiar with important statistics. For instance, according to the CDC, 83.4% of adults in the U.S. saw a doctor or other healthcare professional in 2020. Since seeing healthcare professionals is important, your employees need to be well-insured and well-taken care of when it comes to health insurance.

TPA will also provide professional assistance that enables you to streamline your claims settlement processes. A qualified and experienced TPA will handle many administrative tasks related to the claims settlement process, so you don’t have to. This frees up a lot of time so you can attend to core business matters.

This information will help you understand what third party administrator healthcare is all about. The benefits of hiring a TPA have been specifically outlined and what’s left is to find the services of a reputable and reliable TPA who can meet your organization’s needs. Contact us today to learn more.