Continuous Oversight

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TPA Negotiator

Ensuring Compliance and Performance with Ongoing TPA Monitoring

Effective administration of TPA agreements goes beyond initial negotiations. Continuous oversight is essential to ensure that Third Party Administrators (TPAs) maintain their service obligations and comply with the latest legislative requirements. At TPA Negotiator, our Continuous Oversight service is designed to provide plan sponsors with the peace of mind that comes from knowing their TPA agreements are being proactively managed for optimal compliance, performance, and financial efficiency.

Why Continuous Oversight is Crucial

The health plan landscape is subject to frequent regulatory changes, with laws like the Consolidated Appropriations Act (CAA) and No Surprises Act (NSA) introducing new compliance requirements. Continuous oversight helps plan sponsors:

  • Maintain Compliance: Ensure that TPA agreements align with the most current legislative mandates, mitigating the risk of penalties.
  • Monitor Performance: Track TPA adherence to agreed service levels and transparency provisions, safeguarding plan quality and participant satisfaction.
  • Identify Cost Inefficiencies: Uncover ongoing cost-saving opportunities by monitoring service fees, rebates, and other financial components.
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Years of Experience

Our collective experience delivers consistent results.

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Cases

Relevant matters and negotiations, prepared for all the possibilities.

Our Comprehensive Oversight Process

At TPA Negotiator, we employ a structured oversight process that encompasses every aspect of TPA contract management. Our experienced team continuously evaluates your TPA’s performance and ensures compliance with changing laws and regulations. Our oversight service includes:

  • Regular Compliance Audits: Periodic reviews of TPA agreements to confirm adherence to legislative requirements and identify areas that may need updating.
  • Performance Tracking and Reporting: Ongoing monitoring of service level agreements (SLAs) to ensure that TPAs deliver the quality of service promised in the contract.
  • Cost Analysis and Adjustments: Evaluation of fees and cost-sharing terms to identify potential savings or necessary negotiations as market conditions change.
 
 

Client-Focused Oversight for Long-Term Success

At TPA Negotiator, our continuous oversight is not just a service—it’s a commitment to supporting plan sponsors with vigilant contract management and ongoing compliance support. Our client-centric approach means that we’re always available to address questions, review new legislative developments, and make recommendations to adapt your TPA agreement to changing requirements.

Delivering Value Through Vigilance 

Continuous oversight has tangible benefits for plan sponsors. For example, one of our clients was able to preemptively address non-compliance issues when our team detected discrepancies in their TPA’s cost-sharing reports. By identifying the issue early, we facilitated a swift negotiation that brought the contract back into compliance and resulted in a cost reduction for the client.

Key Benefits of Our Continuous Oversight Service

Partnering with TPA Negotiator for continuous oversight provides plan sponsors with:

  • Regulatory Confidence: Stay compliant with the latest legislative changes, including the CAA and NSA, with a team that actively monitors your TPA’s adherence to these laws.
  • Performance Assurance: Ensure your TPA is meeting all agreed SLAs, delivering the services your plan participants rely on.
  • Financial Safeguarding: Identify and address cost inefficiencies and potential overcharges, optimizing your contract’s value over time.
 

Experience Reliable Oversight with TPA Negotiator

Plan sponsors who choose TPA Negotiator for continuous oversight benefit from a team that combines deep legislative knowledge with proactive service monitoring. We ensure your agreements remain compliant and your TPA meets its obligations, fostering a relationship built on accountability and trust.

Take the next step in securing comprehensive oversight for your TPA agreements. Contact TPA Negotiator today to learn more about how our Continuous Oversight service can strengthen your health plan administration and protect your organization’s interests.

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