Frequently Asked Questions
1. As a TPA, processing claims is our main business. Why should we have someone else do it?
Why spend your valuable staff and resources on claims processing when NM&A delivers high-quality work results with a faster turnaround all at a lower cost? NM&A can also be a valuable partner to help alleviate backlogs and seasonal overflows. We understand the TPA business and are already trained on your software system and deliver high quality results - we are growing quickly because clients recognize this and are satisfied with our work.
2. We auto adjudicate 60% of our claims, leaving only complex claims to be adjudicated by a claims examiner. How can we work with NM&A?
If you have claims examiners on staff, NM&A can benefit your TPA by reducing costs and improving quality - even if you auto adjudicate your claims. With respect to handling claims rejected by auto adjudication, NM&A auto adjudicates as well and thus has extensive experience handling these types of claims. NM&A has auto-adjudication capabilities and can also manually adjudicate claims that are rejected.
3. How do you handle potentially sticky areas such as PPO re-pricing and specific and aggregate filings? Our TPA has confidentiality agreements with each PPO we work with and I am not sure we feel comfortable with NM&A working with our stop-loss insurance carriers?
NM&A re-prices claims on your claims processing system, re-pricing information never leaves your secure server. We operate as your own employees and thus are able to re-price claims within the confines of your confidentiality agreements. With respect to specific and aggregate filings, NM&A completes the required reports using information from your system and emails the reports to your staff. Your staff reviews these reports and works with the stop-loss insurance carrier from that point forward.
4. We don't have a backlog or face hiring/ managing issues. Why should I work with NM&A?
Even if you don't face these issues now, you can free up more time to focus your efforts on expanding your business and improving your profitability. Forming a relationship with NM&A now allows you the flexibility of increased capacity without having to invest capital prior to signing up new business.
5. What experience does NM&A have?
NM&A is an established TPA, staffed with experienced, college-educated claims examiners that are managed by executives with extensive experience in the TPA industry.
6. As an NM&A client, how am I assured of adequate personal attention?
Each NM&A client is assigned a dedicated client coordinator to service their account and serve as a liaison to the client's staff. Our client coordinator communicates daily with your staff. Many other service providers do not offer a dedicated liaison and fall considerably short of NM&A's customer service level.
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