Third Party Administrator

Problem: A Third Party Administrator (TPA) needed to switch claim processing systems to keep current and competitive. The transition could result in the loss of claims history and effect follow-up on pending claims.

Action: Health Decisions was able to translate all files from both old and new systems so that they were compatible. In addition, known pending cases and new cases warranting recovery pursuit were identified and tracked across the system transition.

Result: A successful transition to the new claims processing system occurred without a loss of data history. Cases follow-up was not only maintained but enhanced.