Third-party administrators take over the management of the employee benefit plan, including health care, employee, and retirement programs, thus offering businesses outsourced services. As these plans become more intricate, the need for improved methods to process claims and maintain member data accuracy daily has arisen. This has led to a significant demand for faster and more efficient methods to manage claims and handle daily operations. In response to such demand, TPA software provides TPAs with a straightforward, customer-friendly approach to optimize their workflows and reduce errors.
What TPA Software Actually Does
TPA software helps administrators handle daily benefit tasks more efficiently by automating key processes. This includes processing claims, verifying member eligibility, managing billing, and keeping records organized. By automating these tasks, TPAs can save time, minimize mistakes, and focus on delivering better service to their clients and members.
Top Features That Help TPAs Work Smarter with TPA Software
Now, let’s see what features third party claims administrator software has that help TPAs work smarter.
Automated Claims Handling
The Automated Claims Handling application provides an automated method of dealing with claims, resulting in reduced turnaround times for the TPA by eliminating the need for manual data entry (as well as the possibility of data entry errors in processing benefit payments).
Management of Eligibility and Enrollment
The TPA can verify eligibility for benefits faster, process changes in member status, and create efficiencies in the processing of eligibility due to real-time updates of member data. Additionally, by not having to utilize manual methods of tracking eligibility or enrollments, there is less chance of miscommunicating or misplacing information.
Secure Document Management
All TPA documents are available to the TPA through this system, allowing the TPA to access all documents from one source and allowing the TPA to streamline the process of locating and storing files in an organized and secure manner. Document management ensures that TPAs remain compliant with the regulatory requirements of their industry.
Member and Provider Self-Serve Portals
The member, employer, and provider can access a member's benefit plan and track the process of claims as they are submitted through the use of their own personalized portals. The availability of this portal helps TPAs reduce the number of telephone inquiries while at the same time giving the user greater control over their benefit plans.
Real-Time Reporting and Analytics
The TPAs can have access to development dashboards that summarize information regarding trends in performance, claim volumes, and other related organizational developments. The information provided in these dashboards provides greater visibility to support better decisions, improve operations, and address issues early on.
Strong Security and Compliance Tools
The software comes with a variety of enhanced and effective security options, such as secure encryption and role-specific access controls, that help to protect sensitive files, as well as provide and reinforce compliance with the rules and regulations that govern Third Party Administrators without due diligence on the TPA's part. Collectively, these security features enable TPAs to become more efficient and reduce the amount of manual tasks that they complete, allowing them to provide better service for both their customers and the people that they have been assigned to serve.
Conclusion
Benefit administrators are no longer required to rely only on manual processes to administer their benefits; they can now utilize TPA software. Utilizing this software, Third Party Administrators can enhance their efficiency by automating many of the routine tasks they once performed by hand. If you want to make your employee benefits administration more efficient, consider implementing this software today!