05/13/2026
TPA Tip:
Read the patient-facing language on the TPA websites carefully. Sometimes it tells you exactly how the workflow is intended to operate.
For example, NationsHearing’s website states they help coordinate “any necessary follow-up visits.”
Operational takeaway?
If the TPA is positioning itself as part of the follow-up scheduling process, providers should consider routing those scheduling requests back through the TPA rather than automatically absorbing the administrative workload internally.
Example:
“Because your benefit is administered through NationsHearing, please contact NationsHearing directly to coordinate covered follow-up visits.”
Why this matters:
• Reduces front desk administrative burden
• Reinforces the managed care workflow structure
• Ensures the TPA participates in managing the care pathway they designed
• Creates clearer documentation of service utilization and visit tracking
• Helps prevent providers from unintentionally absorbing unmanaged operational costs
Managed care only works for TPAs if providers manage the operational burden for them behind the scenes.