Third Party Administrator (TPA)
Guiding stakeholders in streamlined benefits and advanced administration solutions
TPA: Guiding Stakeholders in Streamlined Benefits Administration Solutions
As a Third-Party Administrator, managing benefits and related processes for self-funded employer groups can be a daunting task. However, when a TPA employer and their healthcare stakeholders are mutually aligned, an ability to reduce benefit costs while managing risk associated with high cost claims can be realized.
Because TPAs can manage customized plan designs, employers receive what they expect in outsourced management solutions helping to control or decrease benefit utilization. Providing a collaborative approach in managing current risk, mitigating potential risk, and focusing future cost management efforts in a targeted meaningful way leads to successful outcomes desired by all related constituents in self-funded businesses.
We Provide Methods Focused on Managing
Multiemployer configurable environments
Utilization management - referral/authorization processes
Automated claim adjudication and workflow routing
Integrated evidence-based care guidelines
Stop loss configuration and tracking
Audit and reporting management
Configurable provider and member portal setup
HIPAA-based EDI functionality to facilitate data movement
Executive and department level dashboard and actionable oversight
Flexible platform in managing risk and delegated responsibilities
Why QuickCap for TPAs?
QC7’s flexible platform today provides TPAs with a unique strategic advantage in managing their employer-client base. From oversight of a single plan versus managing many diverse employer/plan structures, QC7 is designed to manage each business segment and process with ease.
QC7’s structure adheres to how a TPA must manage each specific client—from managing their core benefit design to more complex full-risk arrangements where needed. QC’s configurable design is staged to meet virtually any TPA requirement today and toward the future.
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