Add/Modify/Attach a TPA

Add/Modify/Attach a TPA


Third Party Administrator (TPA) is the entity that is responsible for the processing and payment of Claims.

  • A TPA can be added as an Employer (IS TPA) or can be attached to an Employer (HAS TPA).

Alert Set the System Setting TPASTATEMENTSPLIT to Yes to activate this functionality.

 Add a TPA to the Employer/Attorney Library

  1. From the Employer/Attorney Library, select the Add button.

  1. Complete the information as you would when adding an Employer/Attorney.
  2. In the Billing Information panel, choose Is TPA for the TPA field.
  3. Select Save [F2].

 

Attach a TPA to an Employer/Attorney

  1. From the Employers/Attorneys Library, select the Modify icon on the Employer.

  1. Ensure that Billable is chosen as the Type.
  2. In the Billing Information > TPAs panel, select Has TPA in the TPA dropdown.
  3. Select the Plus icon to add a TPA to the Employer.

  1. Use the Lookup icon to choose the TPA to attach to the Employer.
  2. Choose the CPTs that would be billed to this TPA (optional).
  • Multiple CPTs can be chosen in this multi-select field.
  1. Set an Effective/Expiration date (optional).
  2. Select Save [F2].


Modify a TPA on an Employer/Attorney

  • Select the Modify icon on the employer
  • In the TPA Panel, CPTs can be added or deleted.
  • The TPA can be Expired by entering a date in the Expiration field.
  • If an Effective date was not added, it can be entered in the Effective field.
  • The TPA can be Deleted by selecting the Minus icon.
  • Once the screen is Saved, this action cannot be undone but the TPA can be added again.





    • Related Articles

    • Attach Encounters to an ERA

      When ERAs are received, the Patient and Encounter number on the remit are matched to the Patient and Encounter in the system. When there is not a match or the account is 0, the remit and receipt are marked O (for Old system). If the Patient and ...
    • Add/Modify Insurance Profiles on an Existing Patient

      Add an Insurance Profile on an Existing Patient From the Patient Dashboard, click Insurance Management in the Active Policies panel. Click Add New Insurance Profile. Default is automatically checked. If this is not a default insurance, see Default ...
    • Open, Close, Attach, Detach, and Archive a Reference Batch

      You may not be able to see all Reference Batches depending on the User's Permissions. A Reference Batch remains OPENED until you change the Status button to CLOSED. The Chain Symbol highlighted in green indicates that you are attached to this Batch. ...
    • Add Students

      Add Students Select Manage Students Select the Add Student button Enter all relevant data on the Modify Student screen. Hover over the question marks for more information. Select Save [F2].
    • Add or Modify a User

      Add or Modify a User User Maintenance From Admin on the Left Side Menu, select User Maintenance. Search for existing Users by using the Filter Criteria. You will be prompted to enter your password when accessing or creating Users. If you have access ...