Third Party Administrator Services (TPA)
Reduced Costs & Expert Innovation Make TPA a Necessity
What is a Third Party Administrator (TPA)?
1. Third Party Administrators (TPA) are specialized in handling claims processing as well as other administrative duties for organizations that self-insure their employees.
2. TPAs are beneficial for sizable companies who often have Employee Compensation Policies under self-insured retention. Having a Third Party Administrator take on the claims processing has been proven to be more cost effective & efficient.
Why Enterprise Level Insurers Need a TPA Service?
Because Ever Bright strives to reduce the cost of claim administration, we offer an innovative and integrated Third-Party Administrator service program. As experts in claims related medical knowledge, our staff allows us to control costs carefully, avoiding unnecessary expenses.
Our TPA services are provided on a savings fee basis, and can be individually crafted to meet the specific needs of your business… aiding your company in cost management of claims, and reducing the frequency and severity of losses.
General Claim Management
We make it a point to contact each and every injured employee on the same day the respective claim is reported to the TPA; in addition to maintaining regular & frequent on-going contact, along with timely reports. We monitor injured employees, guide them through the Medical Assessment Board (MAB) to determine the extent of permanent disability, and fully process the claims administrative tasks.
We will meet directly with injured employees to examine their specific medical condition through their regular medical consultation, if needed, we will suggest the necessity of further treatment or independent medical examinations, and aid in the arrangement of such services.
Our team will also take care of obtaining light-duty work restrictions from medical providers, and liaise with the employer to transition the employee’s work assignment.
Monthly reports are provided for each claim, detailing all possible action plans to prevent potential litigation.
Direct Settlement / Investigation
On the grounds that injured employees fail to seek assessment from the Medical Assessment Board (MAB), a work injury is not treated or left alone for unsound reasons, or the injured employee has intent to pursue legal action; we propose that a direct settlement be reached.
We initiate the investigation, obtain recorded statements, and fully investigate the claim for the potential of suspicious activity or malicious intent. After our investigation, a full report will be prepared to ensure the claim is genuine.
"Many employee benefit plans have highly technical aspects and difficult administration that can make using a specialized entity such as a TPA more cost effective than doing the same processing in house."