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The role of third party administrators (TPAs) continues to expand. Today, the average TPA not only builds and maintains relationships with brokers who rely on them to keep clients happy and manage the details, they also have to work closely with employers who increasingly expect high levels of service and results for their employees. TPAs must also work directly with employees and navigate their expectations as they eagerly expecting reimbursement for medical claims.

This great balancing act is on top of their actual day-to-day workload. While TPA inefficiency may seem systemic and endemic to the industry, its actually a two-fold problem that includes the TPA’s internal processes. One of the biggest aspect of a TPA’s workload, explanation of benefits (EOB) processing, is rife with challenges that may feel like the norm, but can and should be addressed.

Industry inefficiency leads to processing inefficiency

According to The Commonwealth Fund, healthcare administration is one of the most inefficient aspects of the U.S. health care system, a system which already ranks far behind other countries.

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