Roberto Ceniceros, comp columnist for Risk & Insurance, wrote about auditing TPAs for performance. Though, as Ceniceros notes, the practice is becoming less common, independent quality assurance audits ensure that weaknesses in service are identified before they become widespread. Although TPAs usually have internal quality assurance structures in place, an outward facing review can yield insights. For example, an independent review might find that workloads unintentionally encourage a TPA’s adjusters to relinquish control of claim files to (often expensive) specialists more often than optimal.
Read the column in full here.