Looking at the vital role a TPA plays in the health insurance field

We all know how important a health insurance policy can really be. Everyone needs financial protection from hospitalisation expenses, and this is where your policy does just that. But while most of us are well-versed with health insurance policies, not many are aware of a Third-Party Administrator (TPA).

Doesn’t ring a bell? Let us go through details regarding the role of a TPA in detail for you to gain a better understanding:

What exactly is a TPA?

A Third-Party Administrator is an organisation that processes the insurance claims you make under your health insurance policy. Usually, these administrators, which are licensed by insurance regulatory IRDAI, work independently. However, they can also function as an insurance company’s entity.

Role of a TPA

1. Ensuring a smooth claims process and settlement

A TPA is tasked with the responsibility of settling your claim as soon as you inform them. They will then check all of the documents that you have submitted while making the claim. The TPA can also inquire about information that they would need to verify all the details. If you have opted for cashless treatment, the TPA can get all the documents from the hospital directly. If you are going to get reimbursed, the TPA can ask you for all documents and bills that they need.

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