Third Party Administrator Health Insurance

By | August 11, 2018

Pillars are the foundation of any building. Likewise TPA’ (Third Party Administrator) is the pillar of health insurance companies. Not many of us know that behind every health claim there is a great team which helps us with stress free claims.

We buy health insurance policies to ease some burden off our shoulders. It not only helps us financially, but also gives a major peace of mind. I am sure we are all aware of the benefits of having a health insurance policy. However, we go clueless when a health claim arises!

Hence, a special agency was set by the IRDAI in 2001 to help insurance companies in claim assistance. This agency or company helps in claim assistance and other activities on behalf of the insurer. This agency/ company is called as a ‘Third Party Administrator’ commonly known as TPA.

Third party administrator and its role in health

The third party administrator or the TPA holds license from the IRDAI to process claims and cashless facilities to the insurer. They act as an intermediary between the insurance provider and the insured. Let’s see how they provide assistance.

  • Claim settlement
  • Processing of cashless claims
  • Providing list of network hospitals
  • Online pre-authorization with hospital
  • Tracking claims
  • Ambulance services
  • 24 hour toll free helplines
  • Other health facilities

Need for TPA

  • Immense knowledge of health care services
  • Better quality of services
  • Proper management and investigation of cases
  • Adhering to the Cashless and reimbursement TAT’s

HIGHLIGHTS

Since the TPA is directly in touch with the insurance company, brokers etc, processing of claims and other duties will be done by TPA and Insurers and brokers will be one point of contact for them. Let’s see how they provide assistance.

During health claims :TPA will assist at the time of a medical emergency and you can rely on them completely as they will look after the payment of bills of your hospital i.e. cashless settlement.

Authenticity of claims: As per IRDAI regulations, they have their own team of doctors, legal experts, insurance consultants who study the case in depth and ensure there are no fake claims.

Hospital Network: They are also responsible in building hospital networks for cashless claims and negotiating rates with hospitals.

List of TPA’s in India

NAME OF THE TPANAME OF CAO/CEO / ADDRESSCONTACT DETAILS
United Health Care Parekh Insurance TPA Private LimitedMr. Shiva Belavadi Chief Executive Officer, 3A Gundecha Enclave, Kherani Road, Saki Naka, Andheri (East), Mumbai – 400 072Phone: 022-28532400 Fax : 022-2852 7776 E mail: shiva.belavadi@uhcpindia.com
Medi Assist Insurance TPA Private LimitedMr. Ganesh K Chief Administrative Officer Tower D, 4th Floor, IBC Knowledge Park, 4/1, Bannerghatta Road, Bangalore, 560026Phone :+91 80 49698036 Toll Free Fax No.: 1800 425 9559 Email: ganeshk@mediassistindia.com; cao@mediassistindia.com Web:www.mediassistindia.com
MDIndia Health Insurance TPA Private LimitedMr. Suresh V. Karandikar Chief Executive Officer S.No. 46/1 E-space A-2 Building, 3rd Floor, Pune-Nagar Road, Vadgaonsheri, Pune – 411 014.020-25300000 skarandikar@mdindia.com Fax : 020-25300003 web:www.mdindiaonline.com
Paramount Health Services & Insurance TPA Private LimitedMr. R D Misra Chief Administrative Officer, Plot No. A-442, Raod No. 28, MIDC Industrial Area, Wagle Estate, Ram Nagar,Near Vitthal Rukhmani Mandir, Thane (W), MS – 400 604.022-6644 4600/6662 0800 Fax : 022-66444754/755 ramdaras.misra@paramounttpa.com Web:www.paramounttpa.com.
E-Meditek Insurance TPA LimitedDr.Dhiraj Kumar Singh Chief Administrative Officer, 577, Udyog Vihar, Phase – V Gurgaon – 122016 (Haryana)Ph : 0124-4466600 Fax : 0124-4466677 drdhiraj.singh@emeditek.com customercare@emeditek.com Toll free: 1800113242
Heritage Health Insurance TPA Private LimitedMr. Surendra Kumar Tiwari, CAO, NICCO HOUSE ( 5th Floor) 2, Hare Street Kolkata-700001Phones: 033-22482784, 22486430, Fax: 033-22100837/ 22310287 e-mail: stiwari@bajoria.in Toll free 1088-345-3477
Focus Health Insurance (TPA) Private LimitedMr.Hari Venkatraman Chief Executive Officer, Focus Healthcare Private Limited, B-127, FIRST FLOOR, SECTOR-2, NOIDA – 201301Phone no. 0120-4881400 ceo@focustpa.com Toll free no. 1800 112 999 web:www.focustpa.com e-mail: cao@focustpa.com
Medicare Insurance TPA Services (India) Private LimitedShri. Dipankar Roy Chief Administrative Officer Flat No 10, Paul Mansions , 6B, Bishop Lefroy Road, Kolkata – 700 020.033-2281 2826, 9831184120 2280 9510/ 2280 9791 Fax-033-2280 6111 Email :medicareho@medicaretpa.co.in
Family Health Plan Insurance TPA LimitedMs. G. Bharathamma Chief Administrative Officer M/s Family Health Plan Ltd. Ground Floor, F1, Srinilaya, Cyber Spazio, Road No. 02, Banjara Hills, Hyderabad – 500 034.040-23556464 bharathig@fhpl.net Fax : 040-23541400
Raksha Health Insurance TPA Private LimitedMr. Pawan Bhalla Chief Executive Officer C/o Escorts Corporate Centre , 15/5, Mathura Road, Faridabad, Haryana – 121 0030129-2564057, 2564083, 2250000 raksha@rakshatpa.com pawan@rakshatpa.com Fax: 0129-4018012/ 2250002
Vidal Health Insurance TPA Private LimitedMs. Sudha Suhas Kulkarni Chief Administrative Officer, Tower 2, 1st floor, SJR I Park, Plot No. 13,14,15, EPIP Zone, Whitefield, Bangalore – 560 066.080-40125678 sudha@vidalhealthtpa.com Fax : 080-28418216/17 Toll free: 1800 345 4051
Anyuta Insuance TPA In Health Care Private LimitedMs. Ratna Seetarama Chief Administrative Officer, No.: 31/18, Main Road, Loyola Layout, Ward No. 111, Shanthala Town, Bangalore – 560 047.Landline / Fax : 080-41128311 / 25364766 anyuta.anyuta@gmail.com, ravi@anyuta.com website:www.anyutatpa.com
East West Assist Insurance TPA Private LimitedMr. Neeraj Batra Chief Executive Officer 404 & 602 DLF Place, saket, 4th Floor, Mall Office Block, District Centre, Saket, New Delhi – 110017011-47222666 FAX: 011-47222640 assistance@eastwestassist.com nbatra@eastwestassist.com Toll free no. 1800-1111-46
Medsave Health Insurance TPA LimitedMr. Vivek Tiwari Chief Executive Officer F-701A, Lado Sarai, Behind Golf Course, Mehrauli New Delhi – 110 030011-29521061-66, 39001234 Fax – 29521067/71 Email: vt@medsave.in Website:www.medsave.in
Genins India Insurance TPA LimitedMr. Subhash Chander Khanna, Chief Administrative Officer D-34, Ground Floor, Sector-2 NOIDA-2013010120- 4144 123 (10 lines) Fax -4144 170/ 171 sckhanna@geninsindia.com Fax : 0120-2430064 Toll free no.-1600-345-3323
Alankit Insurance TPA LimitedSudhir Kumar Malhotra Director & Chief Administrative Officer Flat Nos.201, Second Floor, Vikas Surya Mall , Sector-3, Rohini -NEW DELHI – 110 085011-49355621 to 49655627 sudhirm1@alankit.com Fax : 011-49355620 & 49355630
Health India Insurance TPA Services Private LimitedMr. Kamaljeet Gupta CAO and Joint MD Anand Commercial Co. Compound, 103-B L B S Marg, Gandhi Nagar, Vikhroli ) Mumbai 83022-42471900 (80 lines) fax 022-42471910/911/946, 25783382 e-mail: kamaljeetg@healthindiatpa.com
Good Health Insurance TPA LimitedMs. Saigeeta Dikshit, Chief Administrative Officer, 8-2-1/8/1, S.V.R. Towers, 4th Floor, Srinagar Colony Road, Panjagutta Hyderabad – 500 082.040 – 66825001/003, 23735006 Fax : 040-66828081/88 /89 e-mail: saigeeta@ghpltpa.com
Vipul Medcorp Insurance TPA Private LimitedMr. Rajan Subramaniam Chief Executive Officer, 515, Udyog Vihar, Phase V, Gurgaon – 122 016Ph : 0124-2438270-75 Fax: 0124- 2438276 e-mail: rs@vipulmedcorp.com
Park Mediclaim Insurance TPA Private LimitedSh Girish Verma Chief Executive Officer 702, Vikrant Tower Rajendra Place New Delhi-110008Tel: 4153 9498 (4 lines) 25747454-55 Fax: 41539390-91 Email : park@parkmediclaim.com / Website:www.parkmediclaim.com
Safeway Insurance TPA Private LimitedMr. Mahesh Sharma , CEO 815, Vishwasadan, District Centre, Janakpuri, New Delhi-1100058Website:www.parkmediclaim.com Tel.: 011-4142 5671, 25464823 Fax.: 011-41425672/912266466797 E-mail: support@safewaymediclaim.com drdivneet@safewaymediclaim.com Website:www.safewaymediclaim.com
Anmol Medicare Insurance TPA LimitedMr P. S. Kshatriya Chief Executive Officer No. 3, 2nd Floor, NBCC House, Near Shajanand College, Opp. Stock Exchange, Ambavadi, Ahmedabad – 380015, GujaratTel.: 079-40009926, 40009936, 40009999 Fax.: 079-40009990 E-mail: prithvi@anmolmedicare.com
Dedicated Healthcare Services TPA (India) Private LimitedMs. Anahita Daver, Chief Administrative Officer, Cambata Building, (Eros Theatre Building) East Wing, 2nd Floor, 42 Maharishi Karve Road, Mumbai 400 020. MaharashtraTel: 022-22875052 Toll free number 16 00 22 0201 Fax number: 022- 2287 4235 Tel: 022-66275900 Toll Free 18002090201 Fax No. 022-22874235 Email: contactus@dhs-india.com anahita@dhs-india.com Website:www.dhs-india.com
Grand Insurance TPA Private LimitedMr Bibhutosh Chattopadhyay Chief Administrative Officer 45A Hindustan Park, P.S.: Garighat Kolkata 700 029 West BengalTel: 033- 40274747 Mobile number: 9830063492 / 9051288050 Toll Free number 1800 102 4747 Fax Number 033-400433344 E-mail- adm.grandtpa@gmail.com / help.grandtpa@gmail.com
Rothshield Insurance TPA LimitedMs. Janki M Bhate Chief Executive Officer, 402 Raheja Chambers, Nariman Point, Mumbai 400 020Tel: 022- 2202 2147/22048144 Fax Number 022-2285 4415/ 39167430 E-mail- janki@rothshield.co.in WEB:www.rothshield.co.in Toll free: 1800 22 8144
Ericson Insurance TPA Private LimitedDr. Krishna P. Jaiswal, MD Ericson TPA Healthcare Pvt. Ltd. 4th Floor, New Vijay Cinema Building S.T.Road, Chembur Mumbai – 400 071 (MH)Phone 022 – 25280280 E-mail: krishna@ericsontpa.com Toll Free line: Toll Free FAX:
Health Insurance TPA of India LimitedSmt M Malti Jaswal, CAO Health Insurance TPA of India Limited 2nd Floor,Majestic Omnia Building, A-110,Phone: 0120-4765800 Fax: 0120-4765899 malti.jaswal@hitpa.co.in

Hence, TPA’s are now the backbone of any insurance company since they have undertaken major responsibilities on behalf of the insurance company.