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This coming year is shaping up to be the “Year of Automation” for third-party administrators.
After years of wrestling with manual, time-intensive work, TPAs say they’re finally leaning into the unglamorous but essential work of streamlining internal processes to scale more effectively, improve turnaround times, boost accuracy, and reclaim valuable resources.
A recent Goodbill survey of a dozen independent TPAs reinforced the trend. The majority said their top focus this year is automating claims adjudication workflows. Close behind were coordination of benefits and eligibility verification, followed by claims repricing and member communications. Document retrieval, provider communications, and dispute resolution also emerged as areas ripe for automation.
The top reasons are clear: TPAs want to handle more volume without adding staff, and they want to improve accuracy while they do it.
When asked to pinpoint the biggest opportunities, TPAs got even more specific.
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