Most employers who decide to self-insure are not equipped to take on the day-to-day operations formerly carried out by an insurance carrier. TPA of Georgia handles all aspects of self-insurance, including: 

• Preparing all necessary plan documents, descriptions, employee booklets and identification cards. 
• Prompt and accurate adjudication of all claims in accordance with the benefit levels and provisions of the self-funded plan document, including the determination and administration of reasonable and customary charges, the coordination of benefits with other group plans, and appropriate claims control practices. 
• Providing all administrative material for claim processing. 
• Maintaining current, complete and confidential records and files of claims for each covered person for determination of plan benefits and satisfaction of deductible. 
• Maintaining records for determination of over-utilization or plan abuse by users or providers. 
• Providing pre-certification material and administer pre-certification program. 
• Preparing itemized monthly premium statements and disbursing collected premiums to reinsurers. 
• Providing management reports to employers and assisting in data interpretation. 

Have more questions about our services? Use our on-line interactive form.

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