Claims Management Just Got More Efficient and Flexible for TPAs

If you’ve ever worked for an insurance third-party administrator (TPA), then you know better than most that these companies have different needs from insurance carriers and other types of insurance-related companies.

Today, we’re happy to announce that our intuitive, cloud-native claims management solution (CMS) meets those needs better than ever before.

That’s because we’ve launched a new set of no-code tools specifically for TPAs, designed to empower them by adding flexibility and efficiency to their approach to managing claims. The new capabilities will make it easy for TPAs to customize and configure our CMS for each insurance provider they work with. This way, they can provide their customers with optimal workflows for managing claims quickly, shortening their time to market.

Because the new tools let TPAs configure our CMS and manage claims without development or IT support, they can save significant work hours. In addition to offering these companies greater agility and speed, this approach can help them manage and resolve claims more cost-effectively.

Making Five Sigma’s CMS even more user-friendly for TPAs

With cloud-native infrastructure, a data-focused approach to managing insurance claims, and a highly intuitive user interface for claims adjusters, our CMS already stood out for its user-friendliness. By providing just-in-time guidance and offering easy access to the key information for any given claim, our platform helps even inexperienced claims adjusters to optimize their job performance. And because our CMS automatically documents key steps performed by claims adjusters as they manage a claim, as well as both incoming and outgoing communication, its streamlined approach to claims management helps boost both operational efficiency and reliability.

Now, our latest no-code tools take our platform’s efficiency, user-friendliness, and flexibility up a level for TPAs, giving them a faster and more agile way to set up and use our CMS for their own clients.

Specifically, the new capabilities will make it easier for TPAs to:

  • Easily add new clients, including supported lines of business and dedicated workflows, with no need for IT or development support.
  • Configure coverages, claims assignment logic, system notifications, document templates  for each client. 
  • Configure users viewing permissions  per client, including read-only permissions for carriers and other external stakeholders.
  • Easily to identify which customer a given claim belongs to just by looking at the claim number, using a claim-number scheme.
  • Filter Reports and dashboards for each client.

This way, the new tools will supplement the capabilities at the heart of our claims management solution, making our platform an optimal match for TPAs.

For more on our latest no-code capabilities and how they empower TPAs, check out our press release.

Five Sigma - AI Claims Management Technology

Five Sigma offers AI and automation technology for claims handling. Clive™, the industry’s first Multi-Agent AI Claims Expert, working on top of any existing claims management system (CMS), and Five Sigma’s AI-native Claims Management Platform

For P&C carriers, MGAs, TPAs, and reinsurers, Five Sigma delivers tangible results through claims technology: cost savings, productivity boost, cycle time reduction, improved accuracy, and better policyholder service.

Clive™, our award-winning Multi-Agent AI Claims Expert, adds AI and automation to any existing system to automate routine tasks, dynamically plan claim handling, and advance the claim automatically according to the insurer’s operating procedure (SOP). Clive manages multiple AI agents that handle and automate different tasks and claim handling stages, including: intake, triage, liability assessment, coverage, communications, fraud detection, compliance, settlement, and more. 

Our customers can deploy Clive AI quickly, one agent at a time, and expand as they go. Adjusters are freed to focus on complex decision-making and better customer service. 

Five Sigma’s Claims Management Platform is an AI-native CMS, with Clive built-in. Our platform includes 360° claim visibility, an omnichannel communication hub, and easily configurable workflows — offering unmatched efficiency and cost savings.

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