Hospitals are a peculiar world, where life and death situations are starkly juxtaposed against the mundanity of billing and insurance. Result: no one really pays attention to what’s going on in between. Especially when there’s a nameless, faceless layer—the third party administrators (TPAs)—that quietly handles the legwork of processing insurance claims.
The segment is a vital cog in India’s sprawling healthcare setup. At Rs 14,952 crore ($2 billion), TPAs processed about two-thirds of the amount claimed by policyholders for the year ended March 2020, with private insurers processing the rest in-house.