TPA is an abbreviation for Third Party Administrator. These companies assist the health insurance companies with their back end processing of claims and are responsible for coordinating all aspects of claims arising due to health insurance policies.
These companies are licensed by IRDA (Insurance Regulatory & Development Authority) and enter into agreements with health insurance companies to provide them with support on claims administration and management. When you purchase a health insurance policy, the insurance company will inform you of it TPA and provide you with its contact details. In the case of hospitalization and associated claims, you will need to contact the TPA who in turn will assist you with the settlement of your claims.
TPAs will be your point of contact in case of both emergency as well as planned medical procedures and will provide necessary authorization to hospitals for ‘cashless’ treatments or in other cases coordinate with you for the settlement of claims for expenses incurred by you.