WHAT IS A THIRD-PARTY ADMINISTRATOR (TPA)?

A Third-Party Administrator (TPA) is an administrative services entity that provides support for self-funded health plans- often referred to as self-insured health plans. The TPA is primarily responsible for claims adjudication and processing, member eligibility, payments to providers, and various reporting components related to the plan.

In self-funded benefit plans, the employer acts as its own insurer. The TPA, in conjunction with the provider network, provide the infrastructure for the medical benefits offering.

Refer to your Member ID Card provided by your employer for more information regarding who your TPA is and when you should contact them.

WHAT THIRD PARTY ADMINISTRATORS DOES FRONTPATH WORK WITH?

FrontPath works closely with reputable and reliable TPAs to ensure all aspects of your health plan are delivered promptly and effectively. As an independent Preferred Provider Organization (PPO) network, FrontPath allows full flexibility on selection of TPA and has established relationships with over 20 for transmission of electronic repriced claims.

Additionally, our Coalition supports plan sponsors and their TPAs by providing price transparency Machine Readable Files (MRFs) and a No Surprises Act (NSA) solution in compliance with the Consolidated Appropriations Act (CAA).