What is a TPA?

TPAs are Third Party Administrators. You can see their definition in Wikipedia, but essentially they are companies that process claims, help manage risk, and often provide other functions in areas such as Flexible Spending Accounts for self-funded employers.

The key to TA success has always been. That TPAs provide intimate, personalized services to client-employers and plans. This means lots of hand-holding and assistance in understanding and gearing up for new laws, requirements and concepts as they will best fit for that particular employer or workforce.

. (Fred Hunt, past president, Society of Professional Benefit Administrators, Employee Benefit News, Feb 2012)

In general, the complexity of the regulated healthcare industry is good for the TPAs that specialized in helping their clients navigate this maze and create a customized plan that meets their needs. Of course, in this like other industries, TPAs are focused on using technology and other differentiators to demonstrate value for their clients.

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2 Responses to “What is a TPA?”

  1. TPAs can add better benefits far more effectively than a single company as well, because they are often servicing thousands.

  2. To coordinate the primary care providers, specialist providers, hospitals, and pharmacies the Third Party Administration business model is very effective. With their new IT for collection and collation of medical data, required by the Medicare Shared Savings Program, TPAs are aheadof the curve.

    Expanding a Third Party Administration business model to include collation of pharmacy data and health outcomes to meet the requirements set by the Medicare Shared Savings Plan to become an ACO for its provider networks is here and ready.

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