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Understanding the Role of a TPA

The article below entitled, “Everything You Wanted to Know About TPAs but Were Afraid to Ask,” is the most useful and comprehensive single resource, and therefore, the best place to start. The TPA concept is basically very personalized, customized service.  

The main considerations in learning about TPAs are:

  • The firm is not an insurance company.  
  • Corporate and service formats are highly individualized to the service, needs and preferences of that TPA’s clients. So, heed the advice that “When you’ve seen one TPA, you’ve seen only one TPA.”  Also, different types of client plans generate different patterns or needs of service.
  • SPBA has been chosen twice by the U.S. Government to be on a Panel of Experts to advise leading government statistical agencies on why their reported statistics for the same things vary tremendously.  SPBA’s answer to the prestigious statistical researchers (and which you must remember as you proceed with any report or research) is this: Any number or statistic related to health, insurance, coverage, TPAs or self-funding has a built-in 1,000% distortion factor. It is not because of intentional lying. It is because the most basic vocabulary of items being tabulated has vastly different meanings.  For example, in health coverage, “one life” can mean one person, or it may refer to mom, dad and six children, which leads to very different statistics.