Third Party Administrators (TPA) - A Helping Hand in Claim Settlement

With soaring medical bills and hospitalization cost, you buy health insurance to live a stress-free and healthy life. But at the time of claim, you are not sure whom to contact for claim settlement or what is the process to file an insurance claim. In such cases, Third Party Administrators (TPA) comes to your rescue. You can coordinate with TPA anytime for any query or concern related to your claim settlement.

A Third Party Administrator (TPA) is an Insurance Regulatory Development Authority (IRDA) registered company or an organization that processes insurance claims on behalf of insurance companies. TPAs come into direct contact with customers and operate 24*7 to ensure faster processing of claims. TPAs ensure that in cash-less hospitalization the preauthorization is done within 90 minutes of receipt of claim request from customers.

You would be surprised to know about the various tasks performed by a TPA, all of which aims towards making claim settlement convenient for the customers:

1.  TPAs come into direct contact with customers and operate 24*7 to ensure faster processing of claims

2. TPAs ensures that in cash-less hospitalization the preauthorization is done within 90 mins of receipt of claim request from customers

3. In case of any medical emergency, TPAs should be immediately informed. The concerned authority there would assist you over the steps to be taken to file an insurance claim against the same.

4. The purpose of a TPA is to help process insurance claims of various insured customers. Hence, you should contact the TPA only regarding a claim process issue. In case of claim settlement problems, you should directly contact the insurance company.

5. If it so happens that the Third Party Administrator (TPA) takes more than 2 days to process your claim, you can straightaway contact the insurance company for further update regarding any development in your claim request.

6. It is the duty of a TPA to provide its customers with a friendly customer service. They are liable to respond to any insurance claim process related query that the customer produces.

7. A TPA has to provide the policy owners with an information guide. This guide contains details about the TPA’s role in helping the customers, right from the start to the end of the claim process.
8. One other interesting fact about a TPA's working is that they do not charge a single penny for the service they provide to the policyholders.

9. Third Party Administrators often have a widely branched network in various hospitals around various cities. As a result, they can provide you referrals of different surgeons and specialists, which will ease the burden of searching for a 'good' doctor. Apart from this, TPAs also helps you connect with different Ambulance services to tackle emergency situations.

10. Another interesting service that TPAs provide is the flexibility with which the insured can be shifted to another hospital during an ongoing treatment; without troubling the patient or their family members

List of TPAs:

Summary
Though TPAs make the entire claim settlement process convenient, customers must follow the claim process and documentations properly to ensure that they get the maximum claim benefits without any dispute or delays