Claims Management System – TPA’s

One of the preferred tools in the industry, the TPA or third party administrator claim management system comes with many unique features, particularly the one which enhances the value for the self- funded scheme clients. The system provides with features such as contracting empanelment, network management, discount & rate configuration and rate negotiation management that makes the process of claim management seamless and efficient. In the dynamic world of insurance, the TPAs can leverage the automated client management systems as a value add to the services being offered to their customers. The embedded efficient benefit administration that supports auto-adjudication is one of the well-known characteristics of the system. As the third party administrator plays a vital role in health insurance, it is equipped to process both cashless and reimbursement settlements in a minimal turnaround time frame.

Our product aims to reduce or almost do away with loss of value claims for TPAs that arise due to inefficiency, unorganised or disconnected claim management process. We help TPA monitor every claim on a real time basis using the third-party administrator insurance. The claim audit, fraud predictive KPIs and grievance management options empower to provide the settlement that is accurate and secure. Our customised reporting formats for third party administrator in health insurance are inbuilt and helps overcome the obstacles arising due to repeated changes and statutory updates which need to be done periodically.