Questions to Ask Your TPA: Third Party Administrator

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If you’re currently in the market for a new Third Party Administer, it is essential that you find a TPA that will be the right fit for your organization. The optimal Third Party Administrator will offer your organization the best claim solutions available, all the way from simplifying claim investigations, dealing with loss reserves, issuing settlements, to systemizing provisional work and making payments. But before you go searching for a TPA that’s ‘the best fit’, it is essential that you establish a firm set of parameters for them to fulfill. With that in mind, here are some key questions to consider asking potential TPAs.

Do you have an authorized adjuster for all of my business locations?

It is critical that every organization has a licensed adjuster on-site with sound qualifications and the necessary experience to handle uncommon affairs. Otherwise, an organization risks being caught by their ankles in a time when they need absolute dexterity. In addition, they need to have a thorough knowledge of specific on-site guidelines, agreement issues, and state laws. The accumulation of which, will guarantee compliance with local rules.

Do you have any client testimonials? Can you show your client portfolio?

An expert TPA should always have an expansive portfolio readily available to share with any potential clients. They should also be more than happy to provide references to the quality of their work from long term patrons. This will allow you to accurately assess their credibility and receive unbiased feedback for any questions regarding their work. If a TPA is hesitant to indulge in such a request and is unable to provide a viable reason, it would be astute to take it as a warning against their reliability.

Who will be maintaining the interface between our computer system and the claim management system?

This question is primarily up to the hiring company to decide if they want the TPA or the software company to manage the data transfer process. This makes it essential that regardless of who you choose, they must have a firm understanding of all of your operating systems so that they can better work with you, and not against you.

Can your claim management system deliver ad hoc reports at a moment’s notice?

A proficient TPA and risk management system will allow you to have immediate access to any questions on finance, work performance, and pending statuses without any delays or inaccuracies. This will immensely benefit your business by making the analysis process both easier and faster, which will deliver a complete picture of the background processes that are responsible for running your company.

How safe is client information in your claim management system? What security measures do you use to safeguard your client’s privacy?

Not only does your data contain personal information on you and your company, but it also contains critical data on clients and pending contracts, among other things. The process of ensuring that all of this information is safe is of paramount importance. At a minimum, there should be multiple levels of identification and advanced customized passwords. These days, 256-bit bank grade security encryption is the standard that all companies and individuals should strive to use.

What type of financial information will be available on each claim?

A capable claim system must be able to reflect multiple expenses like restoration, legal, and other assorted costs. These include the total reserve amount, total paid, and the remaining balance in the reserves. This makes sure that there are never any surprises and that the claim system will be able to adequately handle all associated costs.

What advantages does using an efficient RMIS system offer?

The duties for Third Party Administrators regularly entail being responsible for a number of important agendas that cannot risk mistake. To help mitigate the chance of a mistake occurring, the use of an automated RMIS system will make sure that all work has been completely complied with in accordance to the necessary regulations and demands. Additionally, systems like Claims Manager® offer advanced safety measures to ensure total security for all of its users. Not to mention, it can also provide any information that a TPA may need at a quick glance. The added bonus of comprehensive ad hoc reporting that’s available at any time has the power to streamline a TPA’s work, and take your company to the next level.