What is it about?
The study aims to explore the role played by external TPAs in terms of value addition done by them for insurers, policyholders and healthcare providers. The study aims to find the benefits of roping in an in-house team to settle health claims and the benefits accruing out of this decision to policyholders and hospitals. The role of TPAs in claim processing, issues faced by customers while making a claim, and improvement areas in the process have also been examined
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Why is it important?
The study brings out the concerns of customers and hospitals regarding the settlement of health insurance claims and suggests improvement areas required for both TPAs and in-house teams in claim settlements by evaluating the same
Perspectives
The study aims at comparing the advantages of having an in-house claims processing team by the insurance companies as compared to external TPAs. The satisfaction levels as experienced by the key stakeholders in the claim process, namely the policyholders, and the healthcare providers
Dr. Manoj Pareek
Bennett University
Read the Original
This page is a summary of: Comparative Assessment of External Third Party Administrators and In-house Teams of Insurers in Health Insurance Claims Settlement Process in Bangalore, India, Journal of Health Management, March 2024, SAGE Publications,
DOI: 10.1177/09720634241229555.
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