Claims & Enrollment Integration Software
Why TPA Stream
The lifeblood of the Third Party Administrators (TPAs) are the client companies that they fight so hard to win! However, once won, the battle has just begun as the TPAs work so diligently to provide quality service with profitability as their motive. TPA Stream is dedicated to making every facet of a TPA’s challenges both easier and more profitable. Beginning with the sales cycle, TPA Stream offers competitive advantages by adding paperless Explanation of Benefits (EOBs) processing through electronic retrieval of EOBs to the TPA’s offerings along with automated provisioning of the TPA’s Benefit Administration System (BAS) through innovative integrations with popular HR and Payroll systems. By embracing TPA Stream, new customers can be ready for claims processing and substantiation in a fraction of the time that it took previously. Then as TPA Stream retrieves claims are adjudicated, accuracy is outstanding and claim turnaround time pleases even the most difficult of customers! Also, if you are fortunate enough to have a carrier(s) providing you with data feeds it won’t be necessary to engage your internal IT experts or external consultants to manipulate the data into a format that will be compatible for automated processing with your BAS. TPA Stream has the expertise to do it for you more cost effectively than any other alternative.
Through TPA Stream you will win more new clients, TPA overtime is reduced, staff stress is lessened, turnover is of little concern and customers are significantly happier and become a permanent part of your TPA family. TPA Stream is a win for all involved!
How TPA Stream Works
TPA Stream is designed to reduce or eliminate all of the clerical tasks associated with the implementation and claims processing associated with employers and their member employees. As a new employer is added to the TPA’s client list, TPA Stream begins to work its magic Initially, enrollment rosters can be electronically retrieved from popular payroll and HR systems totally eliminating any manual effort in populating the TPA’s BAS and enrolling the respective employees into TPA Stream for automated EOB retrieval. TPA Stream keeps on giving throughout the benefit year by automatically enrolling new employees. New employees are enticed to enroll for automated EOB retrieval with a sophisticated effortless email campaign. Once an employee enrolls, TPA Stream retrieval EOBs daily on behalf of the member.. The paperless EOBs can then me formatted and seamlessly submitted to the TPA’s BAS for automated payment or in the case of debit cards, aid significantly in swipe substantiation.
Additionally, the retrieved EOBs are presented to processors or customer service personnel in a simply understood format that is easily searchable by name or EOB content to include provider name, carrier claim number and member or patient name. No paper, no lost claims and accuracy and integrity of processing and claim support. Year end crunches become a thing of the past with consistent and accurate claims flow from TPA Stream. If you receive data feeds from carriers for larger employers, TPA Stream will receive them directly, process them overnight and submit them directly to your BAS each evening for almost instantaneous processing. Your client companies will never be happier!
What: TPA Stream
TPA Stream has an elegant solution for FSA, HRA and HSA processing. TPA Stream is a cloud based software offering that acts as an electronic representative for each member in your client base. TPA Stream through its proprietary integrations with major HR and Payroll systems first automates the provisioning process of your BAS and then keeps that information current with individual employee changes or new employee additions. Then on a scheduled basis, TPA Stream communicates over the web with the appropriate provider(s) for each member and reviews their account for both new and updated claims. The claims can be electronically reviewed and/or transmitted to the TPA’s benefits administration software. If you are receiving claims feeds, TPA Stream will present them in its cloud based portal along with individually retrieved claims providing a repository for all claims that makes an excellent source of answers for your customer support organization. A near perfect world can be available to you today with TPA Stream!