Why TPAs Need Comprehensive Software Solutions

With the recent advancements in our medical technologies, it’s no surprise why the costs of healthcare services are also rising. As a result, self-insurance schemes are becoming more attractive to employers. In fact, according to a New York Times article, companies with 300 to 400 employees are now the most dominant practitioners of self-insured programs. In other words, smaller companies are now looking to reduce healthcare and benefit costs by taking care of these expenses themselves.

The growing number of self-insured companies means that the need for administrative services will also rise. After all, most of these companies aren’t equipped to handle healthcare-related processes like electronic data interchange (EDI) transactions, provider contracting, and claims adjudication. Some self-insured companies may require more extensive services from third-party administrators (TPAs). However, the real question lies in the capabilities of TPAs to cater to these growing demands.

Comprehensive TPA Management Software for TPAs

Acquiring the best systems and software is necessary for any organization’s success. An article from the World Economic Forum (WEF) predicts that by the year 2022, computers will be processing and storing 62 percent of most organizations’ business data. This means that TPAs and similar organizations need to make sure that their system can keep up with newer demands. Additionally, you want to avoid having different types of software solution for your daily operations. This is because relying on multiple systems puts you at risk of data integration issues, security breaches, and inaccurate results. Luckily, comprehensive management software or a value-based healthcare solution like QuickCap 7 is now available in the market.

Benefits of a Comprehensive Management Software

With a comprehensive management software solution, you can easily store and process your business data in a single system so you can avoid problems like incompatible file formats, inaccurate data processing, and inconsistent reports. Additionally, having one system can streamline your workflow and help you avoid unnecessary costs. Here are the top benefits you get when you upgrade to a better system:

• Workflow Automation - allows you to let the system automatically process your claims, authorizations, and referrals for you so you can minimize your staff’s workload and improve your turnaround time. Additionally, QuickCap 7 has extensive automation features that allow you to configure specific rules for different clients like pricing calculations and task assignments.
  
  
• Contracting and Benefits - are made easier when you have a system that has the right data storage and search features. In fact, with comprehensive management software, you can process your provider contracts, health plan contracts, member details, and benefit plans in one system so you can easily configure and search for the right data whenever you need to.
  
  
• Extensive EDI Services - are necessary when you cater to multiple clients and partners. That’s why QuickCap 7 is designed to cater to diverse file formats and other trading partner requirements.