Payer Types
Third-Party Administrator (TPA)
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (Original definitions; regulatory facts to be verified against CMS-0057-F (89 FR 8758) and X12/HL7 documentation). Do not rely on it for production configuration until this notice is removed.
In more depth
Self-funded employer plans are not impacted payers, yet TPAs increasingly adopt CMS-0057-style capabilities (APIs, turnaround discipline, transparency) because provider networks, vendors, and clients converge on one operating standard. TPAs running UM for multiple clients are a natural audience for multi-tenant PA tooling.