The Challenge: After migrating to a new benefits administration system, OCA realized it needed a better way to automate invoicing, commissions, and more.
The Solution: TPA Stream built the Billing platform to connect its software with OCA’s benefits administration platform and streamline these important financial functions.
The Result: OCA has saved significant time and resources thanks to this automation. It is also able to better serve brokers as they introduce OCA to new business opportunities.
OCA, or Office of Compliant Administration, is a third-party administrator (TPA) that works closely with brokers, employer groups, and plan participants to efficiently substantiate medical claims. OCA had already worked with TPA Stream to automate this important process, enabling them to gain a greater competitive advantage when presented with new sales opportunities as well as to focus more on growing their business.
When OCA decided to transition its manual-intensive benefits administration process into a new system, TPA Stream worked closely with OCA to make the process as automated as possible. While OCA realized significant benefits from this automation as a result, two important aspects of its business remained unautomated: invoicing and commissions.
Previously, OCA was invoicing clients for services provided through a separate platform that still required a fair amount of manual work. OCA would post an invoice to this secure system, which would then generate and send an email to the client. However, this email wasn’t customizable and didn’t reflect how OCA wanted its communications and invoices to be received.
The system wasn’t integrated with the new benefits administration system, so it couldn’t automatically identify fees for certain services. More importantly, the platform didn’t account for client and broker billing preferences.
For example, OCA might have one or more product or service lines with an employer group (e.g., HRAs or COBRA services). As part of a new relationship, some brokers — one of the primary sources of new business for OCA — opt to cover payment for specific services and have OCA invoice them directly rather than the client. For others, the client would be invoiced.
Some larger clients also requested different invoicing based on divisional reporting requirements, financial arrangements with multiple groups, differing bank reconciliation procedures, and other separate invoicing preferences. And finally, OCA also issues commissions to brokers for new business. Previously, OCA used another separate system to track and issue commissions for its brokers. OCA didn’t have the capability to handle these specific invoicing requests in its previous system — much less automate them.
Ultimately, the use of multiple external systems to handle specific financial tasks led to more time spent managing them and greater costs in terms of software and administrative overhead.
That’s when OCA asked TPA Stream to build an integration between its benefits administration system that would add further benefit and automation to its existing EOB automation.
TPA Stream worked closely with OCA to collect all of its requirements and developed a new billing system to handle invoices, commissions, and more. The new Billing platform connected OCA’s benefits administration software with powerful functionality that now identifies the appropriate fee for certain services and automates the process entirely.
“While TPA Stream is a separate system, they have the ability to connect via their platform and find out the fee for their applicable groups and automate the process from start to finish,” said Ross Honig, Senior Vice President of Business Development for OCA.
“The Billing platform brought a number of outside functions in-house for us. The fact that it’s integrated with our system is amazing. The overall flexibility makes managing billing and commissions so much faster and easier for my team.”
With the new Billing platform in place, OCA is able to further accelerate its upward growth momentum and strengthen its strategic position as a reliable, efficient partner for brokers looking to get in with new employer groups.
“I can definitely see its impact already in my business,” Honig said. “TPA Stream has been a great partner for us and has made so much of our process more efficient and automated.”