Paragraph match score 83.5%
Page A-021
What a Third Party Administrator (TPA) does in the claims settlement process
A TPA often manages pre-authorisation, bill verification and cashless coordination with the hospital on behalf of the insurer, acting as the operational link between the policyholder, the hospital and the insurer during claim settlement.
Page A-034
The role of a Third Party Administrator (TPA) vs insurer-managed networks
A TPA often manages the cashless authorisation process and hospital network on behalf of the insurer, while some insurers manage their network directly; either way, the network list determines which hospitals offer cashless access.