What is the Full Form of TPA?

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The full form of TPA is Third Party Administrator. They are licensed mediators between the health insurance company provider and the insurance policyholder. In other words, the agent of the health insurance company is the TPA. This makes it a significant term in the healthcare sector. The primary aim of third-party administrators is to look after all the insurance claims that are linked to hospitalization. Let’s learn more about TPAs.

Also Read: What is the full form of LIC?

What is the Role and Functions of TPA?

The role of the TPA is as follows:

  • Claim and Settlement Process
  • Cashless Claims Approval
  • Maintenance of Database
  • Premium Collections
  • Hospital Bill reimbursement with cash 
  • Health Card Issuance
  • Stress-Free Claim Settlements Help Provided
  • Cure at TPA Network Hospitals 
  • Helpline Facilities that are Toll-Free and Available 24×7
  • The Exact Record of Claims is Maintained 

Also Read: What is the Full Form of ESI?

What are the Advantages of TPA?

The Advantages of TPA are:

  • Containment of cost
  • Guidance from an expert
  • Thorough knowledge of the industry
  • Save time and money

How do Health Insurance TPAs help Policyholders?

Health Insurance TPAs help policyholders through the following ways:

  1. Hospitalisation Assistance 
  2. Cashless Claim Facility
  3. Standardisation is Improved 
  4. A Reduction in the Claim Processing Time 

Also Read: MBA in Healthcare Management

The popular TPAs in Health Insurance are:

United Health Care Parekh Insurance TPA Private Limited
Medi Assist Insurance TPA Private Limited
MD India Health Insurance TPA Private Limited
Heritage Health Insurance TPA Private Limited
Raksha Health Insurance TPA Private Limited
East West Assist Insurance TPA Private Limited
Genins India Insurance TPA Limited
Good Health Insurance TPA Limited
Park Mediclaim Insurance TPA Private Limited
Anmol Medicare Insurance TPA Limited
Ericson Insurance TPA Private Limited

What is the Revenue Model of TPAs?

The Revenue Model of TPA in Health Insurance is commissions on premiums offered by the TPA that are already set by the Insurance Regulatory and Development Authority(IRDA). Some other income sources are:

  • Management of the Network
  • Medical Management
  • Data Management
  • Claim Administrations

Also Read: All About the IRDA Exam 2023

How to Cancel TPAs?

If you need to cancel your TPA due to dissatisfaction with the services. 

  • You can email or call your insurer. 
  • Share your details regarding the policy and your UID
  • Give the reasons for cancellation.
  • After cancellation, select another TPA. 

Also Read: Study Abroad Insurance

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We hope this blog has helped you understand the full form of TPA and everything related to it. If you want to know more, find the general full form list on our blog. In the world of short forms, you can rely on the Leverage edu page to know about more full forms like this! Connect with us study abroad experts to achieve your international dream today!

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