IPS Blog
Insights on Claims Administration, Compliance, and Healthcare Operations
Read the latest blogs from Integrated Payor Solutions covering healthcare claims administration, the No Surprises Act (NSA), the Transparency in Coverage Rule (TiC), operational strategy, and trends impacting TPAs, ASOs, networks, and health plans.
Why Scalability Matters in Medicare Advantage
Organizations that want to enter Medicare Advantage or grow what they already administer understand that CMS compliance matters. The harder question is whether their systems can support the work when enrollment grows, reporting gets more complex, or an audit request lands without warning. In this article, Shawn discusses what Medicare Advantage scalability really requires behind the scenes.
Independent Security Reviews: The Missing Layer of Protection Healthcare Organizations Can’t Afford to Skip
When you manage healthcare data, “secure enough” is never enough. Third-party administrators (TPAs), brokers, consultants, health plans, and employer groups all rely on platforms that must process sensitive information accurately and safely. But here’s the problem: Most platforms claim strong security — very few actually prove it.
Outdated Platforms are Putting TPAs and Brokers at Fiduciary Risk
New technology and platforms seem to appear overnight, and it can be a struggle to keep up. The unfortunate truth behind this rapid change is that it is necessary to stay one step ahead of bad actors who pose a threat to your data and clients’ sensitive medical information. That’s where you come in. As a TPA or a broker, you have a fiduciary responsibility to your clients to keep their data safe and secure. Using or recommending an outdated platform can expose client data to security threats, and in the event of a breach, you may face significant financial and legal repercussions.
SIIA 2025: Modernization, Risk, and Opportunity for TPAs
This year’s SIIA conference made one thing clear: the market is shifting faster than many TPAs are ready for. Across meetings and side conversations, the same topic kept coming up: large, established TPAs facing serious operational and financial challenges because their technology hasn’t kept up with client expectations. Investors and clients alike are losing patience with outdated systems, long implementation timelines, and rigid infrastructure. Some organizations are even watching their valuations drop as a result.
Keeping Eyes on HIPAA
HIPAA compliance has never been static. Since it first passed, the regulation has evolved in response to technological advancements, new threats, and changing expectations from regulators, payors, and members. For third-party administrators (TPAs), this creates a unique challenge. Staying compliant isn’t just checking a box one time and calling it a done day. Instead, it requires maintaining vigilance in an environment where the rules, risks, and repercussions are constantly shifting.
Old Tech, New Risks: Why Security and Compliance are a TPA Priority
As technology rapidly evolves, Third Party Administrators (TPAs) can no longer afford to rely on outdated systems. From increasing cybersecurity threats to rising compliance risks, legacy platforms are putting sensitive data, and your reputation, at risk. Don’t let legacy systems and software hold you back. Here, learn how to stay ahead in an industry where the tech is stuck in the past.
The Value of Member Experience
In today’s digital-first world, outdated tools and slow systems won’t cut it. In this blog, we explore how member expectations have evolved, and why tech-driven solutions like intuitive portals, real-time data, and secure cloud platforms are now essential for TPAs. Learn how IPS helps organizations stay ahead with flexible, scalable, and future-ready technology that delivers the seamless experience members, and TPAs, demand.
Modern Solutions for Complex Healthcare Operations
IPS delivers flexible, cloud-based technology for claims administration and healthcare compliance workflows.
