Improved TPA:
Customize Member and Provider Portal

Organizations need full control of their operations in order to better manage and run their businesses according to how they see fit. The same is true for the healthcare industry and applies the same objective. Taking into account that the cost of healthcare services is only going up, many strive to get an improved hold of their business while curbing the rising expenditures. As a means to counter it, organizations choose a self-insured program and opt for third-party administrators (TPA).

The market for TPAs has increased in the last decade. With the onslaught of the COVID-19 pandemic, it has grown even more at an unprecedented rate. Employer companies are finding ways to cut costs and outsourcing became the most ideal measure. However, certain factors are preventing TPAs from giving optimum administrative services for providers and members due to the lack of a configurable and suitable TPA platform.

Without an all-in-one system to utilize, TPAs are exposed to administrative problems that compromise their productivity and the service they provide. When that happens, employers and their operations potentially suffer. Delivering quality service and high results demands equally high-caliber and dated administrative tools that keep up with the ever-changing needs of the organization. Poor technological integrations cause issues that leave TPAs vulnerable and unable to execute processes, including the following:

• Failure to collate necessary data that can be used to prioritize care and manage disease and case for high-risk populations.
• Unable to effectively apply programs and initiatives and generate actionable reports and insights.
• Losing engagement and wasting relevant programs created to curb cost while mitigating patient risk.

All of these challenges can be deflected by simplifying a workflow with powerful solutions. Luckily there is a certified management software that continues to break grounds in the market. Having a diverse platform like QuickCap by your side guarantees success and notable returns.



Administration Solution Improves TPAs’ Management Performance

Switching back and forth to different programs to access records for providers and members can bar smooth progress for TPAs. From verifying member’s eligibility to processing claims, getting all the required data in a systematic management makes a difference. 

A technology-led solution permanently frees TPAs from the administrative challenges they face today. With a configurable provider and member portal, it allows them to utilize features and functionalities that can provide these key main criteria:

• Provider-member connections
• Personalized information 
• Unified data
• Actionable reporting
  
  

QuickCap’s Customizable Provider and Member Portal Configuration

QuickCap enables TPAs to get ahead of their processes, making each transaction seamless and easy. This software is proven to be secure and offers reporting capabilities that drive better data analysis, improve TPA management performance, and boost savings.

Customizable Provider and Member Portal Configuration. View provider and member details in one software. Customize the network between providers and members with the portal configurations that you create.

• Customize setting configuration for provider and member portal
• Access all necessary provider or member data in the same system
• View authorizations, claims, and eligibility conveniently

Unlimited Case Management Programs. Identify high-risk populations and initiate suitable health and care arrangements. 

• Manage diverse health population risk levels 
• Assess data and classify priority for care

Automated Claims Adjudication. Check claims status and view important processing information between providers and members.

• Automate adjudication of claims 
• Search and access claims and refunds of a member

Advanced Eligibility and Benefit Plan Platform. Determine whether or not a member is eligible and access coverage details from benefit plan documents with ease.

• Configure settings based on the agreed health plan contracts
• Set up and view the relevant member details
• Obtain benefit plan information of a member

The best all-in-one administration solution is right here with QuickCap. Help your organization perform effectively by investing in the right comprehensive healthcare solution.

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