Start Your Own TPA
Resolve Health Plan Administrators will set up your physician organization's or ACO's own third-party administration (TPA) company to keep the claims processing function right in your neighborhood. Resolve helps physician organizations and ACOs create competition, gain control of cash flow and utilization information, and earn profits now paid to other companies. The TPA is a turnkey program, requiring minimum capital investment.
What is a TPA?
A TPA applies the guidelines and coverages of a benefit plan to the medical bills of the employees who are covered by it. This includes more than 250 activities surrounding administration, accounting, and claims adjudication.
A TPA is not an insurance company. It does not take financial risk with regard to the delivery of healthcare services. A TPA is more of a clearinghouse. It simply applies the rules of coverage to the medical bills of employees who are covered by it. Then it arranges for payment of authorized claims and collects a fee for this service.
Why Should You Own One?
A TPA is an extra layer of bureaucracy inserted between the physician and the consumer. But if you as a physician own the TPA, you change the dynamics of the marketplace:
- You regain control of your practice by defining the rules under which payment is received for services.
- You connect directly with employers in the community.
- You earn the profits that are currently flowing into someone else's pocket.
How Does It Work?
Each Resolve office is jointly owned by one or more local physician organization, hospital organization, and/or ACO. The organization provides funding and controls the bank account.
If you are interested in Resolve, we invite you to watch our video, visit our website, review our brochure, or contact us for more information and a discussion about how Resolve can stimulate the growth and profit of your physician organization.