A guide to TPA & the role they play in modern healthcare
The origin of Third Party Administration
Third Party Administrators are organizations that are contracted by insurance companies to service their members. They provide administrative and business support for the product lines they are responsible for, including claims handling, billing, marketing and more.
Why should you work with a TPA ?
Third-party administrators (TPAs) are the go-to experts for managing employee benefits in exchange for a fee. They have a wide range of experience and can help you pick the right insurance plan for your company, track claims and payments, and more. A specific case: Youna-IMS; helps members get the right care at the right time by intelligently guiding people to the right care and delivering incredible support by providing:
STRATEGIC PLANNING
EXPERIENCE ANALYSIS
BENEFIT DESIGN CONSULTING
PREPARATION AND MANAGEMENT OF TENDERS
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Deliver a better healthcare experience for your people and your team
Industry observers have identified the following services provided by TPA to be of great value to organizations:
Greater efficiency/quality (delivery of services)
Improved standardisation (procedures and due diligence)
Increase knowledge base of healthcare services
New management system
Greater penetration of health insurance
Minimize costs/expenditure
Develop protocols to streamline investigation and avoid unnecessary delays
Pave way for lower insurance premiums
All the same, there is much discrepancy between the aims and the ground realities of functioning of TPAs. As a result, the jury is still out on the efficacy of TPAs in the growing and complex health insurance sector in the country.
