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TPA INSURANCE SERVICES

WE ARE CREATIVE AGENCY

We provide sales solutions, technology, and claim services for insurance products: Mobile protection (Mobile insurance), Extended warranty for electronic devices and motor, healthcare, and personal accident.

Utilize our highly trained and proven sales professionals without the risk of hiring. They have all the tools and training to be successful, without you incurring the long-term expenses or regulations associated with full-time employees.

CUSTOMER SERVICE & CALL CENTER

PPO NETWORKS

COMMUNITY PLANS

REGULATORY COMPLIANCE

PREMIUMS & ELIGIBILITY

FLEXIBLE

CLAIMS ADMINISTRATION

DIRECT CONTRACTING

HOSPITAL BILL AUDITING

MEMBER ADVOCACY

TECHNOLOGY

CLAIMS SYSTEM

SELF-SERVICE PORTALS

ONLINE ENROLLMENT

ADVANCED RISK ADJUSTERS

COMBINED BILLING

GENERAL ANALYTICS

CODE EDITING

HEALTH ANALYTICS

REPORTING

PLAN REPORTING

PREDICTIVE MODELING

PLAN ANALYTICS

NORMATIVE DATA

CARE GAP ALERTS

A third-party administrator (TPA) is an organization that processes insurance claims or specific aspects of employee benefit plans for a separate entity. It is also a term used to define associations within the Insurance industry which “administer” other services such as Underwriting, Customer Service and the like. This can be viewed as “outsourcing” the administration of the claims processing since the TPA is performing a task traditionally handled by the company providing the insurance or the company itself. Often, in the case of insurance claims, a TPA handles the claims processing for an employer that self-insures its employees. Thus, the employer is acting as an insurance company and underwrites the risk. The risk of loss remains with the employer, and not with the TPA. An insurance company may also use a TPA to manage its claims processing, provider networks, utilization review, or membership functions. While some third-party administrators may operate as units of insurance companies, they are often independent.

Third-party administrators also handle many aspects of other employee benefit plans such as the processing of retirement plans and flexible spending accounts. Many employee benefit plans have highly technical issues and difficult administration that can make using a specific entity such as a TPA more cost effective than doing the same processing in-house.