Looking for a Healthcare TPA? Make Sure You Get Everything You Need.

What’s on your checklist for a good TPA?

When you’re looking for a TPA to support you with operational services and benefits, you want skill and experience. An expert TPA should relieve an employer of the day-to-day processes involved in delivering strong employee benefits.

But there’s a couple of vital aspects of a TPA offering that might not have made your “must-haves” list: flexible services and strong communication. This powerful combination will set up your benefits package for success.

This article breaks down exactly what you should be looking for in a communicative TPA so you can spark a seamless partnership.


Flexibility is at the heart of successful service

Who wants a TPA that offers rigid health plans and benefits?

A one-size-fits-all approach rarely works. That’s why TPAs should focus on being flexible and finding out exactly what you — and your employees — need.

Getting what you need starts with asking the right questions:


Can your TPA create any health plan you want?

A good TPA will know how to work with a client to design a plan that’s an exact fit.

When it comes to health plans, you’ll have your own goals, so it’s important to get support from a TPA that can customize plan designs but still factor in cost savings.


Do you have access to preferred doctors and in-network providers?

You need a TPA that has the capability to allow members to choose preferred providers —ideally with benefit tiering in place.

It’s important to have the flexibility to add providers or health systems that aren’t already in the TPA’s network so you aren’t restricted in terms of what you can offer.


Do you have the option of dedicated case management?

Some complex and chronic conditions need dedicated 1-2-1 management. In these cases, you need a TPA that can offer tailored case management programs designed to promote better health.


Can your TPA support with health and wellness benefits?

Adding mental health and wellness coverage to your healthcare plan can create powerful benefits for your business:

  • You’ll see up to a 13% increase in productivity.
  • You’re more likely to retain talent by keeping employees happy.
  • You’ll have a reduction in absenteeism costs — as much as $340 per day.

Find a TPA that has experience with health and wellness benefits — you’ll be surprised at how much difference it can make to your employees’ happiness, as well as your budget.


Confidentiality builds trust

TPAs often handle sensitive information and complex processes for clients, so confidentiality is a big part of the offering.

You need a TPA that provides clear, timely and accurate communication to build your trust so you can maintain a strong relationship.


Problem resolution is key

Health insurance can be complex, which means issues and misunderstandings can easily arise.

A TPA should be able to solve these issues quickly and efficiently so you feel valued and know you can count on them when future problems arise.

And let’s be honest: the less time you have to spend dealing with problem resolution, the better — right?


Keeping you compliant

TPAs have a responsibility to clearly explain processes, rights and responsibilities to clients.

Good customer service ensures clients are well informed, helping employers meet their regulatory obligations. When you’re looking for a TPA, make sure they’re on board with compliance and are happy to take the time to explain everything to you.


Final thoughts

Excellent customer service and strategic communication create the cornerstone of a successful TPA. These attributes help build trust, enhance reputation, and facilitate client retention.

Strategic communication will help you get the best healthcare plan for your business and retain your top talent.

When choosing a TPA, remember to ask these questions:

  • Will we have a dedicated account administrator? It’s far easier for you to contact the one individual who is familiar with your situation and understands the nuances of the plan.
  • Will it be easy to make changes? If something isn’t working, you should have options on the table in order to make changes quickly.
  • Will you be able to manage benefits from a single technology platform? It’s a lot easier to do business with a TPA that is up to date with the latest technology than with one that has limited technological capabilities.

Remember, communication and flexibility make for strong relationships — and TPAs should be experts in providing both.

Do you have any questions about how we do strategic communication at MagnaCare? Contact us at [email protected]

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