What is circular?
While selling the policy, the insurance company will provide the customer with a list of all the TPAs he has, from which he will choose the TPA of his choice. If the insurance company terminates the TPA service, it will provide a list of all the TPAs it holds to the insured, out of which the insured will choose the TPA of his choice. Even at the time of renewal of the policy, the insured will have the right to choose the TPA of his choice.
What is third party administrator?
The third party administrator acts as an intermediary between the insurer and the person taking the insurance. Its main function is to assist in the claim and settlement process. The TPA issues a card to the person taking insurance, which can be treated as cashless treatment in a hospital only by showing it. At the time of making a claim, the person taking the insurance informs the TPS first. He is then asked to go to the concerned hospital. It is the hospital of the insurance company’s network. Apart from this, if the customer gets treatment in another hospital, then he can get the cost through reimbursement.