Why TPAs Need a Comprehensive Management Software

With the recent advancements in our medical technologies, it’s no surprise why the costs of healthcare services are also rising. And with all eyes on the increasing demands of medical expenses, we often overlook the administrative side of the industry. As a result, we tend to overlook how better administrative operations can solve our current problems. This is because the backbone of any business, regardless of the industry it’s in, will always rely on administrative and management workflows. And that’s why improving your management software means that you’ll also be improving your overall business outcomes. In fact, that’s exactly where the need for comprehensive management software comes into play.

Self-Insured Companies and Third-Party Administrators

Due to the rising costs of healthcare services, self-insured companies are becoming more common. 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. But small companies that are self-insured don’t normally have the resources to process their claims, benefit plans, and other healthcare needs. As a result, they often need a third-party organization to help them process all of their healthcare-related processes. And that’s exactly where third-party administrators (TPAs) come into the picture. 

TPAs are responsible for processing all the claims of a self-insured organization. Additionally, TPAs can also take care of other healthcare administrative processes that an employer needs. However, processing hundreds of healthcare-related data isn’t a walk in the park. And TPAs, or any payer organization, would rely on various software for their daily operations. But is it really efficient to rely on different software for all your data? After all, file formats, system integration, and other similar issues can significantly affect your workflow. And a slow workflow means slower turnaround time and less profit. So how do you fix this? Maybe getting comprehensive management software is a good place to start.

Business Data and Computer Software

We can safely say that we’ve come to a point in our society where technology plays a larger role in our business. For instance, acquiring better systems and software is now becoming more of a necessity for any organization’s success. In fact, 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. With this in mind, it’s no surprise why software developers are pushing more and more advanced software in the market. As a result, this digitalization of data processing is pushing companies to buy multiple software for different tasks. But what if you could process most, if not all, of your data with one simplified software? Wouldn’t this solution help TPAs and other healthcare-related organizations minimize costs and improve their workflow? 

Yes, having one system for all of your diverse operational needs can definitely help. However, this type of software has to be very advanced, customizable, and reliable. After all, each company does have its own specific needs. Luckily, these types of software are now available in the market. For example, QuickCap 7 is a comprehensive management software that allows organizations like TPAs, HMOs, and PPOs to easily process their claims, EDI files, and authorizations in one system. In fact, a fully integrated software like QuickCap 7 has built-in tools for workflow automation, contracting and billings calculations, and other customizable features. All in all, having a comprehensive management software can help TPAs to speed up their claims processing and other workflow operations so they can save more time and money with a single software.

QuickCap 7’s Comprehensive Management Features

QuickCap 7 is a comprehensive management software that allows organizations like TPAs to handle different workflows with one system. Which means that you can do most of your administrative tasks and more with one software. Here are the top administrative features that you’ll get with QuickCap 7:

• Claims Workflow - our extensive claims processing features allows you to easily manage, review, and adjudicate your claims with one software. In fact, our automation tools can help you automate your claims workflow so you can reduce your staff’s workload and improve your adjudication accuracy.

• Dashboard Feature - QuickCap 7’s dashboard tools can help your teams manage and assign tasks more efficiently so you can easily prioritize your claims and other tasks and improve your overall workflow.

• Contracting and Benefit Plans - our software is fully equipped to help you store and configure your provider contracts, health plan contracts, member details, and other important information. So you can store and process all your business data in one simple software.

• EDI Services - with QuickCap 7’s electronic data interchange features, you can easily send and receive various types of EDI files with other organizations. Simply enroll your trading partner, configure their file requirements, and transact your files with ease.

With a comprehensive management software like QuickCap 7, you can simplify your workflow, accelerate your processes, and improve your financial outcomes.