Streamlining Administrative Workflows: The Transformative Power of TPA Software

Third-party administrator (TPA) software is designed to assist TPAs in managing the claims administration aspect of their business operations. FileHandler Enterprise, our Third Party Administrator (TPA) software, optimizes claims administration for TPAs by improving efficiency, accuracy, compliance, cost-effectiveness, customer service, and overall competitiveness in the insurance industry. A robust claims management system allows TPAs to better meet the needs of their clients and deliver faster, more reliable claims processing services.
Our TPA software helps clients by:

Improved Efficiency: Through automation, FileHandler Enterprise streamlines manual tasks such as data entry, document processing, and workflow routing, reducing the need for manual intervention and minimizing errors.
With streamlined automation, TPA's can expect faster processing no matter the complexity of the claim, reducing cycle times and improving customer satisfaction. All while reducing the workload burden on administrators. The system can allocate claims to adjusters based on their workload and expertise, ensuring efficient resource allocation.

Enhanced Accuracy: Automation reduces the likelihood of errors, ensuring that data is consistently accurate, which is crucial in the insurance industry. TPA software with enhanced accuracy also helps with:

  •  Data Validation: Claims management software can perform data validation checks in real-time, reducing data entry errors and ensuring that claims information is accurate.
  • Consistency: Standardized processes and templates help ensure that all claims are handled consistently and comply with regulations.

Cost Reduction: TPA software can help reduce operational costs by automating tasks and improving efficiency. 
Cost reductions can include:

  • Reduced Labor Costs: Automation and efficiency improvements can reduce staffing needs, saving labor costs.
  • Lower Error Costs: Fewer errors mean fewer costly claims disputes and rework.

Better Compliance: TPA software includes features and tools to help TPAs stay compliant with industry regulations and legal requirements. It can automate compliance checks and generate necessary reports. 

  • Regulatory Compliance: CMS systems can integrate compliance checks and reporting to ensure that claims processing adheres to industry regulations and standards.
  • Audit Trail: A robust Claims management system provides an audit trail of all claim activities, facilitating compliance and auditing requirements.

Customization: We offer a TPA software solution that is highly customizable, allowing TPAs to tailor the software to their specific needs and workflows. Customizations enable TPA software to integrate with other systems, such as accounting software and CRM (Customer Relationship Management) systems, to provide a more comprehensive view of your business operations.

Data Analytics: Our TPA software includes analytics and reporting capabilities that provide valuable insights into claims trends, cost drivers, and other key performance indicators. This data can inform decision-making and strategy, including:

  • Business Insights: CMS software often includes reporting and analytics tools that help TPAs gain valuable insights into claims trends, which can inform decision-making and strategy.
  • Fraud Detection: Advanced analytics can identify potentially fraudulent claims, saving the TPA and insurer money.
  • TPA software's analytics and reporting capabilities can provide TPAs with valuable data-driven insights, helping them make informed decisions and optimize their operations.

Client Self-Service: FileHandler Enterprise includes client portals that allow clients to access their accounts, submit claims, check the status of their claims, and access important documents, enhancing customer satisfaction and reducing administrative workload.

  • Real-Time Updates: Customers can receive real-time updates on the status of their claims, improving transparency and satisfaction.
  • Self-Service Portals: Some CMS systems offer self-service portals, allowing customers to submit and track claims online.

Scalability: An enterprise system such as FileHandler Enterprise works with TPAs and will grow with your business. It can handle increased workloads and adapt to changes in your client base. 

  • TPAs can easily scale their operations up or down as needed, adapting to changes in workload and client demands.

Improved Communication: Our TPA software includes communication tools, such as email notifications and messaging systems, which can help streamline communication with clients, insurers, and other stakeholders. 

  • Integrated messaging and notifications can streamline communication with clients, insurers, and other stakeholders.
  • Automate communication: Our system helps TPAs update their clients and claimants with integrated tools such as merge field letters.

Security: FileHandler Enterprise includes robust security measures to protect sensitive client and company data, including encryption, access controls, and data backups.

Competitive Advantage: Implementing our TPA software can give TPAs a competitive edge by allowing them to offer clients more efficient and accurate services. 

  • Risk Management: TPA software such as FileHandler Enterprise includes features for identifying high-risk claims early, allowing TPAs to implement proactive risk management strategies.
  • Time Savings: With automation and streamlined processes, a TPA software can save employees significant time on routine tasks, allowing them to focus on more strategic and value-added activities.

FileHandler Enterprise offers TPAs a comprehensive solution for efficient claims management, ensuring accuracy, compliance, cost savings, and improved client service. It empowers TPAs to navigate changing market conditions and remain competitive in the insurance and benefits administration industry.
We help TPAs manage their operations more effectively, adapt to changing market conditions, and stay competitive in the insurance and benefits administration industry. With our continuous, dedicated Support Team, our TPA Clients can be sure to receive the tools they need to grow in this expanding market. Contact us to schedule a demo and find out how our system can help your Third party Administrators today.


Manage and Close Claims

Manage claims, process payments to parties or vendors, and provide advanced reporting necessary to manage your business - no matter the size of your company or business.


Streamline the Policy Life Cycle

PolicyHandler Enterprise's capabilities include data-driven rating tools, quoting, automated renewal processes, billing, and optional workflow tools while staying up-to-date with the latest policy tools.

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