Who is a Third Party Administrator ?

TPA is an abbreviation for Third Party Administrator. These companies are BPO of insurance companies and are responsible for coordinating all aspects of claims arising due to health insurance policies.
These companies are licensed by IRDA (Insurance Regulatory & Development Authority) and are having:

• Telecom facility generally with phone number starting with 1600 (toll free no.)
• Computer network having details of all policies holders.
• Medical specialists, for assessing need for hospitalization treatment being given in the hospital and for passing of the claim bills.

The role of TPA is to coordinate with hospitals with respect to treatment and also pass the bills on behalf of the insurance companies. The actual payment is made by the insurance company. As far as the legal contract is concerned, it is between the insurance company and the person insured.
The individual insured will get an ID card issued by the TPA. This ID Card is useful and needed at the time of hospitalization.