TPA Executive

Role & responsibilities

• To guide the patients and attendants regarding the TPA services provided by the hospital
• To be ready to help the patient
• Ensure first experience to be a great experience for the patients
• To counsel the patients/attendants regarding the TPA formalities and consents
• To help the patients/attendants fill the pre-authorization forms
• To fill the estimate of the treatment of the pre-authorization forms
• To send the pre-authorization forms to the respective TPAs/insurance companies
• To coordinate with the TPAs/insurance companies for the approval
• To update the patient/relatives regarding their claim status
• To enter the approval amount in the system on EHIS
• To send the interim bills to the TPA/insurance companies for enhancement
• To arrange for the documents required by the TPA/insurance companies for the approval
• Filing & Updation of the TPA files
• To answer patient queries regarding cashless & reimbursement claims
• To collect all the documents related to claim submission & maintaining the file
• To be a part of the Quality Improvement Initiative & Protocols of the organization.