TPAs hop on to alliance bandwagon

In a first of its kind arrangement, two third-party administrators - the Bangalore-based TTK Healthcare Services and Raksha TPA of Haryana - have signed an agreement to ensure cashless hospitalisation for each other's customers.

The agreement will benefit around five million mediclaim policy holders, who will now have access to nearly 4,000 hospitals across the country.

The two signed a memorandum of understanding on April 1. The alliance called 'India One Alliance' will enable different networks of the two companies to act like a single entity.

Thus each of the TPA will have a better reach through one another's offices, infrastructure, network capacities and services, to help each other's customers.

TPAs are intermediaries on behalf of insurance companies to hospitals to ensure cashless hospitalisation to mediclaim policy holders.

Now, if a mediclaim policy holder of TTK Card in Bangalore wants his Kanpur-based parents to be treated, the parents can approach India One Alliance to provide the services even though TTK Healthcare Services does not have any hospital network in Uttar Pradesh.

"Raksha TPA will direct the customer to its networked hospital, ensure cashless treatment and submit his papers back to TTK for re-imbursement of claims from the insurance company to the respective hospital," Girish Rao, managing director, TTK Healthcare Services, told Business Standard.

Similarly, TTK Healthcare Services will provide Rakha's customers with services in the south. "It's like a code sharing agreement of airlines," Rao added.

TTK Healthcare services is one of the leading national TPAs in India with a strong presence in the south and west - Karnataka, Tamil Nadu, Kerala, Andhra Pradesh, Maharashtra, Delhi and Kolkata - and services close to three million health insurance policy holders.

Raksha TPA is one of the leading national TPAs in the country with a strong presence in the north, especially in UP, Rajasthan, Punjab, Jammu and Kashmir and Haryana. It serves over two million policy holders.

The two TPAs are working on developing a bridge software to enable seamless processing of data.