Enhancing communications in claims with digital solutions for third-party administrators (TPAs)

Third-party administrators, or TPAs, play a critical role in the insurance industry, providing the administrative expertise that helps insurance carriers keep operational expenses low. However, the collaboration also introduces risks and challenges for TPAs. On one hand, TPAs are responsible for maintaining the increasingly strict and complex regulatory standards of the insurance industry. TPA staff are also often in direct contact with customers when filing, adjusting, and verifying claims, and are expected to provide an excellent customer experience at all times.  On the other hand, they aren’t employees of the insurance carrier and often don’t have access to all relevant data and systems in real time.

Effective communication between TPAs and carriers is critical to overcoming these challenges and processing claims quickly and efficiently. However, there are many communication barriers that can make it difficult for that to happen.  

Communication challenges in claims management

There are multiple stakeholders involved in the claims management workflow, including assorted departments of the insurance carrier company and the TPAs themselves. The various stakeholders need to communicate with one another throughout the claims process, but they face challenges when trying to collaborate or get updates in real time, for example: 

1. Lack of clarity: There can be a lack of clarity in communication between the insurance carrier and the TPA about workflows, requirements, and procedures. This can lead to misunderstandings, delays, and errors in the claims-handling process.
2. Data security: Insurance data is sensitive and therefore subject to strict data protection regulations. Without a secure communication channel in place, claims data and information can’t be shared safely. 
3. Siloed communication channels: Insurance carriers and TPAs often use different technology platforms for claims management, especially if the TPA works with more than one carrier. In many cases, the data isn’t standardized, and can’t be easily integrated and accessed by all parties involved. This may result in confusion, duplication, and inefficiencies in the claims handling process.
4. Difficulty in tracking progress and ensuring accountability: Without a centralized system that is accessible to all, it can be hard for any individual stakeholder to track the progress of a claim or be accountable for its accuracy and timely processing. 

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These communication problems often lead to delayed response times or inaccurate or incomplete information exchange between the TPA and the carrier, that in turn lead to customer frustration and a poor customer experience. 

The advantages of digital data intake solutions for TPAs

Leveraging technology platforms like digital data intake can facilitate efficient communication and collaboration between the insurance carrier and TPA, help all stakeholders overcome communication challenges, and provide a better experience to customers. Advantages of digital data intake include:

Better collaboration and information sharing

With digital data intake, data is automatically standardized and securely stored in the cloud, making it easy for all stakeholders to access and share it safely. Whenever information or documents are updated, all stakeholders see the updated information in real time and all parties have the information they need to make informed decisions and improve the overall claims management process.

Streamlined communication channels and real-time updates

Emailing updates back and forth is slow and inefficient. If one person is out of the office, the entire process can be delayed, and various stakeholders may not be able to access updated information until that person returns. Digital data intake prevents those delays and inefficiencies with real-time updates that are accessible to all stakeholders, including both TPAs and carriers.

Improved accuracy and completeness in data exchange

Digital data intake solutions include real-time validation, which means that forms simply can’t be submitted if they aren’t complete and accurate. Real-time validation prevents the hassle and delays caused when forms need to be returned and corrected and improves the overall quality of claims data. 

Enhanced tracking and accountability through digital records

With digital data intake, all records are standardized and accessible to all the stakeholders involved in the claims management process. That makes it easier for individual stakeholders to see the status of a claim at any given time, and therefore be accountable for its proper progress. 

Integrating communication tools into existing workflows

Employees are more likely to adapt to the new tech when it integrates easily into the platforms and workflows they are already familiar with. New technologies like digital data intake should easily connect with existing tools and workflows to make them easier for employees to use. 

A mobile-friendly solution for remote and on-the-go communication

More consumers are using mobile devices to access the internet than ever before and mobile-friendly platforms are accessible to a larger audience, including those who primarily use mobile devices to access the internet. Mobile-friendly digital data intake solutions are optimized for smaller screens, touch-based navigation, and slower internet speeds, which can result in a better user experience for both customers and staff.

Built-in communication features (co-browsing)

Co-browsing—a feature that allows two parties to see the same website or application simultaneously— can help achieve faster, more accurate issue resolution in the claims process. With co-browsing, a customer service representative and customer, or TPA team member and insurance carrier employee can work together to troubleshoot an issue, which can lead to a more collaborative and positive experience as well as a faster and more efficient resolution. 

Examples of digital solutions for TPAs

Many TPAs are already using digital solutions to improve communication in the claims process. Below are some examples of digital tools available to TPAs. 

FNOL template

FNOL processing often makes up a significant portion of TPA activity. In fact, the majority of FNOLs are still made over the phone, monopolizing costly agent time.  Moreover, if customers don’t have all of the information when making the initial report, repeat calls and additional resources are often needed, sapping additional resources and often causing delays and a poor customer experience. 

EasySend has solved the problem with a ready-to-launch digital FNOL template. Instead of bogging clients down with complex forms and paperwork following a stressful accident, theft, or damage to their property, the FNOL template makes filing the initial report simple and reduces stress. 

TPAs can create a customized digital FNOL process that makes it easy for clients to understand exactly what they need to upload. With the template, the TPA can text or email a link to the clients where they can upload all the relevant images, docs, and timestamps to clarify the claim and then support clients in real time with co-browsing. The template helps to shorten the claims lifecycle, save valuable resources, and support customers when they need it most.

Digital auto claim experience

Customers are usually shaken up after a car accident, and the last thing they need in an already  stressful situation is complicated paperwork. EasySend’s digital auto claim experience reduces customer stress with an intuitive, mobile-friendly process that makes it easy for customers to add all the relevant info and images without taking up costly agent time. Even better, the information is automatically available to all stakeholders involved in the process, including both the carrier and the TPA. 

It’s easy to customize the process and emails by adding a logo, font, image, and colors, or even changing the fields in the template to match unique workflows. Once the template is ready, any auto-claim process can be launched simply by sending a link to customers. 

Choose the right tools to meet the needs of TPAs and stakeholders

Technology is only effective when it's actually used. That’s why it’s important to choose a communication solution that is easy for all parties to adopt and work with. In addition, technology shouldn’t force you to invent the wheel—you’ll have more success with a solution that seamlessly integrates into existing workflows and processes. Last but not least, it’s important to provide sufficient training and support to ensure successful implementation and adoption.

Digital data intake solutions can do all this and more, helping TPAs improve their claims management process, reduce costs, and provide a better customer experience. By leveraging these technologies, TPAs can stay competitive and provide more efficient and effective services to their clients.