TPA Claim Filing
Third-Party Administrator (TPA) claims filings need to be analyzed and managed differently than direct claims from consumers. TPA information and authorizations should be cross-checked to validate the inbound claim before finalizing adjudication or payout.
Simplify this process with WorkFusion® Intelligent Automation – use the bots to streamline, route and validate TPA claims based on your business rules.
Customers who viewed this use case also viewed
Not In Good Order (NIGO) Claims Identification
With endless checkboxes and documents required to process claims safely, effectively, and compliantl...
Benefit Calculation and Payment
Once teams have analyzed and approved a claim, manual work remains to calculate the final benefit am...
Claims Fraud Investigation
Fraud detection and investigation are a critical part of the claims process. Nearly 10% of all claim...
Claims Payout Evaluation
Competing tech-first insurers are promising delivery of payment in seconds. But case management team...
Claims Subrogation and Recovery
Insurance company subrogation efforts are a critical step in the claim management process. With so m...