TPA

While many TPAs are no more than “store-fronts” that use outside processing facilities for all their services, others offer a complete range of in-house services, including claims adjudication and payment, securing insurance contracts, and drug card printing and delivery.

When choosing a TPA, employers must ultimately understand which critical services reside in-house, which are contracted, and how those may impact the accuracy, security, and quality of the service they can expect to receive.

The Benefits Trust is a full-service Third Party Administrator.  We help you regain control of your benefits plan and offer the following in-house services:

  •  Daily claims adjudication, payments, and maintenance of employee benefits records
  •  Pay-direct prescription drug cards, electronic dental-claims processing, and direct deposit of employee claim payments
  • Monthly billing statements (by division and department), identifying per-employee costs
  • Formal documentation satisfying legislative requirements for private health-services plans
  • Complete Administration Manual for procedures and forms for notification of employee status changes
  • Monthly financial status reporting, including the current month, year-to-date, and prior year-to-date for on-going monitoring and trend analysis

Ultimately, we help successful business owners build a better benefits plan than they can get anywhere else.

>> Submit the form to immediately receive our complimentary, informative whitepaper entitled, “How to Choose Your TPA.”

 


 
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Eligible Expenses Include:

  • Paramedical Practitioners: such as Physiotherapy & Massage Therapy.
  • Vision Care including Laser Eye Surgery, Contact Lenses, Glasses & Examinations.
  • Medical Facilities including Convalescent Homes & Substance Abuse Facilities.
  • Medical Devices such as Orthotics, Hearing Aids & CPAP machines.
  • Nursing Care to help you recuperate in the comfort of your own home.
  • Expenses Related to Disabilities including special programs tuition, tutoring and home or vehicle modifications.
  • Dental Services Orthodontic & Major Services including Dental Implants.
  • Out of Country Expenses for non-emergency expenses while travelling.
  • Prescription Drugs excluding only over-the-counter medication.
  • PHSP Premiums including any employee-paid premiums for health care or dental care benefits.
  • Private Hospital Room