Your Third-Party Administrator’s Hidden Revenue

Your TPA makes more money from processing out-of-network claims than from doing its job—administering your health plan!

Employers pay a fee to a third-party administrator (TPA) to administer, adjudicate, and pay claims on behalf of their company’s health plan. However, this investigation details how, in some cases, TPAs make MORE money on “negotiating” your out-of-network claims than they do actually administering the health plan itself. This not only presents several troubling conflicts of interest but it also costs your health plan thousands of dollars a month.

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