| TPA |
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| Enrollment
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Group Setup |
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Adding members & dependents
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Generating, printing & issuing ID cards
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Backend member & dependent information updates
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Reporting on member eligibility status
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Group & Employee reporting
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| Enrollment Maintenance and Update
: |
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Tracking group / employee / dependent changes
Making updates
Generating, printing & issuing ID cards; and
Group & employee reporting |
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| Front End Services
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| Mail sorting
Image scanning
Image indexing
Image storage
OCR conversion to EDI
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| COBRA Maintenance
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| Filing COBRA employee information
Issuing COBRA notifications
Reporting
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| Claims Processing |
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Claims data-entry
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Provider matching
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Claims status verification
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Claims re-pricing
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Claims adjudication
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Follow-up on pended claims
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Claims subrogation
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| Billing and Collection |
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Premium Invoice generation
Managing & realizing AR
Bad debts & late stage collections
Call center support
Reporting
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| Reports
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| Daily Reports
Weekly Reports
Monthly Reports
Member Reports
Specific Reports
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| Additional Services
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| Check printing
Lockbox facilitation
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