Definition

In the context of healthcare, TPA stands for “Third-Party Administrator.” A TPA is an organization that processes insurance claims or certain aspects of employee benefit plans for a separate entity. TPAs are specialized agencies that handle the administration of various aspects of healthcare plans, including claims processing, billing, and member services. They act as intermediaries between the insurer and the insured, streamlining the claims process and often providing additional services like utilization review and network management.