TPA (Third-Party Administrator)

A Third-Party Administrator (TPA) is a licensed intermediary that manages health-insurance claims on behalf of insurers, handling pre-authorisation, cashless approvals and claim settlement between the hospital and the insurance company on the patient's behalf.

Why it matters in a hospital

For an insured patient, the TPA relationship decides how much they pay out of pocket versus how much the insurer covers, and how quickly a cashless admission can actually proceed once the estimate is sent. For the hospital, a slow or disputed TPA approval directly affects both the patient's experience at an already stressful time and how quickly the hospital itself gets paid for the care it provided. TPA relationships also shape a hospital's cash flow at a portfolio level: a hospital with a large share of cashless-insured patients is, in effect, extending credit to insurers for the duration of the claims cycle — a real financial-planning consideration distinct from any single patient's bill.

How Trisvio handles it

Trisvio has no TPA, insurance or claims workflow today — billing is direct, on a cash, UPI or card basis; a hospital handling insured patients would manage the TPA pre-authorisation and settlement process outside the system and record the resulting payment once it clears. A hospital that primarily serves cash-paying patients feels this gap less; one with a significant insured caseload would need a separate process alongside Trisvio to manage TPA correspondence, pre-authorisation paperwork and claim follow-up outside the core billing screens, then record the net cash, UPI or card payment the patient actually makes once that process concludes.