Healthcare Benefits Administration

Streamline Interactions between TPAs and Insurance Companies

TPA Management Module helps insurance companies with end-to-end empanelment of Third Party Administrators (TPAs)

Overview

ClaimsLive Health, our state-of-the-art and customizable technology platform for end-to-end digital claims management for health insurance offers an exclusive ‘Third Party Administrator (TPA) Management Module‘ to help hospitals streamline the TPA related activities and reduce claims processing time.

Functionalities

Empowering TPAs with robust functionalities for achieving operational excellence and ensuring quick claims turnaround time

Manage servicing office details for each TPA included

Set up TPA fee based on various parameters

Configure penalties, billing cycle and SLAs for TPAs

Send claims intimation & reserve details

Configure notifications to TPAs and Insurance companies based on defined trigger events

Configurable workflow for service requests

Generation of settlement advice

TPA invoice management

Value Proposition

Leverage the various benefits of TPA Management Module and enhance customer engagement

  • Introduce Operational Agility

    Streamlined core administrative processes and workflows

  • Achieve Quicker TAT

    Enable quick Turnaround time (TAT) for claims processing

  • Enable Straight Through Processing (STP)

    Enable Straight-through processing (STP) of Pre-auth/Claims with real time claims data

  • Issue1 Real Time Quotes/Policies

    Instantly generate quotes and issue policies. Reduce load on your core insurance system

  • Provide Quick Turn Around Time (TAT)

    Delight your customers by providing quicker turnaround times for policy issuance, renewals, endorsements

  • Ensure Greater Flexibility

    Allows insurance companies to configure different privileges for pricing, underwriting and operations to
    different intermediaries

  • Gain Better Oversight

    Take complete control over your distribution network with configurable levels of pricing and underwriting
    privileges

  • Increase Transparency

    Manage complex commission structures and make payments online

  • Be Eco-friendly

    Help the environment by enabling end-to-end paperless process for policy issuance

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TPA Management Module?

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