TPAs must manage claims across multiple carrier clients — each with different rules, reporting requirements, and SLAs
Your TPA handles claims for 8 carrier clients. Each carrier has different approval thresholds, different SLA requirements, different reporting formats, and different data access restrictions. Managing this complexity in email and Excel doesn't scale. Regure gives you configurable workflows per carrier with complete data isolation.
TPAs must juggle multi-client complexity while scaling efficiently
Third-party administrators process claims on behalf of insurance carriers, self-insured employers, and captive programs — each with unique operational requirements. A TPA handling workers comp claims for 12 different clients must maintain separate workflows, reporting formats, and data access controls for each client.
But most TPAs operate with shared systems where client-specific requirements are enforced manually through training and procedures — not system controls. Adjusters must remember which carrier requires supervisor approval above $25K versus $50K. Operations staff must remember which carrier wants weekly bordereaux versus monthly. Data access is controlled through folder permissions that break when someone leaves or changes roles.
This manual complexity doesn't scale. When a TPA wins a new carrier client, the onboarding process takes weeks: create new folder structures, train staff on that carrier's requirements, build custom Excel templates for reporting. Growth means proportional headcount increases because there's no operational leverage.
Regure is third party administrator claims software built for multi-client operations: configurable workflows per carrier, automated reporting per client, role-based data isolation, and scalable document processing without proportional headcount growth.
Configurable workflows per carrier client with client-specific rules and SLAs
Each carrier client has unique requirements. Regure configures separate workflows per client: approval thresholds, SLA timelines, required documentation, settlement limits, and escalation rules — all enforced automatically without relying on adjuster memory.
Client-Specific Workflows
Carrier A requires supervisor approval above $15K. Carrier B requires approval above $50K. Carrier C requires medical review for all health claims regardless of amount. These rules are configured once per carrier and enforced automatically — adjusters can't settle outside client-defined limits.
When a new carrier client is onboarded, their workflow requirements are configured in Regure, and the system enforces them immediately across all adjusters handling that client's claims.
SLA & Performance Tracking
Each carrier contract specifies SLA requirements: claim acknowledgment within 24 hours, initial assessment within 5 days, settlement within 30 days. Regure tracks SLA compliance per carrier client with automated alerts as deadlines approach.
Monthly performance reports show SLA compliance per carrier, average cycle time per carrier, and claim volume trends — providing the metrics carriers expect in TPA oversight reviews.
Client-Specific Document Requirements
Some carriers require specific forms (carrier-branded settlement releases, specific medical authorization forms, custom loss reports). Regure maintains document libraries per carrier client, ensuring adjusters use the correct forms for each carrier's claims.
When generating settlement documentation, the system pulls the carrier's branded templates — not generic forms — maintaining the professional presentation carriers expect.
Rapid New Client Onboarding
When a TPA wins a new carrier client, onboarding happens in days, not weeks. Configure the carrier's workflow requirements, upload their document templates, set up reporting formats, and assign adjusters. The system enforces all client-specific rules from day one — no extensive training required.
This rapid onboarding enables TPAs to scale faster, taking on new clients without proportional operational overhead increases.
Automated carrier reporting and bordereaux generation per client specifications
Every carrier wants reports in their format, on their schedule. Regure automates bordereaux and status reports per carrier's requirements — eliminating the manual Excel assembly that takes days every month.
TPAs are contractually obligated to report claim activity to their carrier clients — typically monthly bordereaux showing new claims, reserves, payments, and closures. Each carrier specifies their preferred format: some want detailed line-by-line reports, others want summary-level, some want specific data fields that others don't require.
For most TPAs, bordereaux assembly is manual: export claim data from the system, reformat it in Excel per the carrier's template, validate totals, and email. For a TPA with 10 carrier clients, this process consumes 3-5 days every month.
Regure automates the entire workflow:
- Configure bordereaux templates once per carrier client with required fields, formatting, and calculation logic
- Bordereaux generate automatically at month-end from claim transaction data — no manual export or reformatting
- Multi-carrier support: each carrier gets their report in their format delivered via email, SFTP, or API on their schedule
- Validation & reconciliation: system validates bordereaux totals match source claim data and flags discrepancies before delivery
- Custom reporting: Beyond standard bordereaux, create custom reports per carrier requests — weekly status reports, loss run summaries, reserve development reports
For audit trail compliance, all carrier reports are logged with delivery timestamps and recipient confirmations — proving timely reporting during carrier audits.
Role-based access control that isolates carrier client data
Carrier clients expect data isolation — their claim data should not be visible to other carriers or unauthorized TPA staff. Regure enforces role-based access at the carrier client level with complete audit trails.
Client-Level Access Control
Configure role-based permissions per carrier client: adjusters assigned to Carrier A see only Carrier A's claims, not Carrier B's or Carrier C's. Supervisors can be granted access to multiple carriers if they oversee multiple books of business.
Carriers accessing the client portal see only their claims — complete data isolation with no risk of cross-carrier data exposure.
Audit Trails Per Client
Every action on every claim is logged in immutable audit trails — who accessed which document, when, and why. When carriers audit TPA operations, you produce complete evidence showing exactly who had access to their claim files and what actions were taken.
For regulatory compliance (state insurance departments auditing TPA operations), audit trails prove data access controls are enforced and logged.
Carrier Client Portals
Carriers log into secure portals to view real-time claim status, download reports, and access documentation for their programs. Portal access is restricted to each carrier's data only — they can't see other carriers' information.
This self-service access reduces inbound calls from carriers requesting status updates and allows carriers to monitor TPA performance in real time.
What TPAs ask about Regure
Can we configure different workflows for each carrier client?
Yes. Each carrier client has separate workflow configurations: approval thresholds, SLA timelines, required documentation, settlement limits, and reporting requirements. Configure once per carrier, and the system enforces client-specific rules automatically across all adjusters handling that carrier's claims.
How does carrier data isolation work?
Role-based access control ensures each adjuster sees only the carrier clients they're assigned to. Carrier A's adjusters can't access Carrier B's claims. Supervisors can be granted multi-carrier access if needed. All access is logged in audit trails for carrier oversight reviews. See security architecture.
Does Regure automate bordereaux reporting for multiple carriers?
Yes. Configure bordereaux templates per carrier client with their required format, fields, and delivery schedule. Bordereaux generate automatically at month-end from claim transaction data and are delivered via email, SFTP, or API. Each carrier gets their report in their format — no manual Excel reformatting.
How fast can we onboard a new carrier client?
New carrier onboarding typically takes 2-3 days: configure workflow requirements, upload carrier document templates, set up reporting formats, assign adjusters, and configure access permissions. The system enforces all client-specific rules from day one without extensive staff training. See multi-office workflows.
Can carriers access their claim data directly?
Yes. Carriers log into secure client portals showing real-time claim status, settlement details, and documentation for their programs only. They can download reports, view claim histories, and monitor TPA performance without calling for updates. Portal access is restricted to each carrier's data with complete audit trails.
What does pricing look like for a TPA?
Regure pricing is per user per month. A mid-size TPA with 50-100 staff (adjusters, supervisors, operations) handling multiple carrier clients would typically be on Professional tier at $150/user/month — including multi-client workflows, automated bordereaux, data isolation, and audit trails. See full pricing.
See how Regure handles multi-carrier TPA operations
Book a 20-minute demo. We'll configure separate workflows for two sample carrier clients and show you automated bordereaux, data isolation, and client portals.