Here is a list of Frequently Asked Questions about USA TPA
and the services we provide. The answers to these questions
will help to provide a more thorough understanding of the
benefits we offer to your organization.
What is USA TPA?
USA TPA, Inc. is an affiliated company of New York
Compensation Managers, Inc., a leading provider of group self-insurance
services. USA TPA, formerly Lake Effect Claims, has been providing
professional claim services for over 40 years. We employ an
aggressive, integrated approach to claim administration resulting
in lower costs to our member clients.
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Where are the USA TPA offices located?
USA TPA operates offices in New York and South Carolina. We
are licensed to administer claims in New York, South Carolina
and Connecticut with licensure in several other states pending.
Many other states do not require administrators to be licensed.
Please contact us to determine if we can assist you.
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Why should I consider self-funding
my workers compensation or other disability claims?
Employers who self fund their workers compensation claims
realize a cost savings from improved claim handling, managed
care, loss control and cash flow, as well as more direct control
over their claims and reduced overhead. Impact of large claims
can be minimized by purchasing excess insurance with a suitable
self-insured retention.
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Is self-funding regulated by the state?
Generally, self-funding is regulated by the state but not
to the extent that insured programs are regulated. Unless
it is a municipal program self-funders are required to guarantee
their ability to meet future claim obligations and adjudicate
claims according to state statute. We can assist with any
compliance issues that may arise.
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What advantages does USA TPA offer over other
administrators?
The USA TPA team of experienced staff professionals including
claim adjusters, nurse case managers and loss control specialists
provide an integrated, cost effective approach to management
of workers compensation and other disability claims. This
approach results in reduction of frequency and duration of
claims and program cost savings. In addition, our XCLAIM technology
allows our staff and clients to operate in a paperless environment
creating many operating efficiencies while improving quality.
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What is the USA TPA adjuster and case
manager claim load?
The company standard is an average claim load of 160 files
for an adjuster and 60 files for a nurse case manager. This
allows our experienced staff members to devote full attention
to the important issues of a claim and reduce the length of
disability and the costs associated with workers compensation
claims.
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How do you price your services?
USA TPA services are competitively priced based on the number
and types of claims. Service plans are customized to meet
specific client needs. Services are available on an integrated
or unbundled cost basis.
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