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.

The Human Impact of Modern Claims Administration

Claims administration is often discussed through the language of systems, workflows, and processing capacity. Those are important considerations, but they only describe part of the story. Every claim represents someone waiting for an answer. A member may be trying to understand what was covered after a procedure, or a provider may be waiting for payment. Behind each interaction is an administrative process that can either move the experience forward or create another question. Modernization offers…

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The Enablement Era: The Future Belongs to Flexible Payors

The next era of payor administration will be defined by enablement, not systems. As markets fragment, regulations evolve, and growth models diversify, platforms built around fixed operating assumptions are becoming a structural risk. This blog explores why enablement must be treated as a design principle, one that puts control back in the hands of payors, allowing business strategy to move at its own pace without being constrained by technology. It examines how flexibility, not scale alone, is emerging as the true determinant of long-term viability in U.S. healthcare.

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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.

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Outdated Platforms are Putting TPAs and Brokers at Fiduciary Risk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.

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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.

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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.

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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.

Modern Solutions for Complex Healthcare Operations

IPS delivers flexible, cloud-based technology for claims administration and healthcare compliance workflows.