Episode 198: Empowering Plans: P159 – Putting the Patient First: Challenges to Common TPA Operations

31/03/2023 20 min Episodio 198
Episode 198: Empowering Plans: P159 – Putting the Patient First: Challenges to Common TPA Operations

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Episode Synopsis


In this episode of The Phia Group's Empowering Plans podcast, attorneys Katie Malkin and Jon Jablon take a dive into three aspects of TPA operations designed to try to make the TPA's job more manageable: simplifying EOB denial codes, sending family EOBs, and recouping overpayments by offsetting. These are three common strategies used by TPAs, but applicable law places certain limits on all of them that are not always so intuitive. Tune in as Jon and Katie discuss some best (and worst) practices, and examine critical issues facing TPAs and health plans in today's self-funded industry.

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