Claims, Eligibility, and Member Requests Keep Getting Delayed. How Can TPAs Improve Coordination?
A self-insured employer group onboard a new employee, a healthcare provider submits a high-dollar outpatient claim, and a covered member calls to confirm prior authorization for a scheduled procedure. In an ideal Third-Party Administrator (TPA) ecosystem, these transactions execute seamlessly within 24 hours. Instead, administrative handoffs stall across fragmented claims adjudication engines,...