Intake and imaging
Associate intake batches, cases and document images, with missing-document and supplementation records.
ITPA / LDM+Tech
ITPA | Intelligent TPA Claims Intelligence & Review Platform
Intelligent TPA (ITPA) supports insurers and third-party administrators with intake, imaging, assignment, data entry, adjudication, review, quality checks and settlement receipts. Intelligent-assistance upgrades focus on traceable evidence, explainable calculations and recorded human review.
Connect source evidence, explainable adjudication and recorded human review.
Designed for Insurers, third-party administrators, claims service centres and specialist operations teams
CAPABILITIES
Capabilities organised around practical workflows.
Assignment and operations
Coordinate entry, review, quality checks, exceptions and insurer review with an auditable activity trail.
Coverage and adjudication
Record adjudication evidence across invoices, coverage, deductibles and payment decisions with human review.
Settlement and receipts
Connect settlement batches, channel receipts, exceptions and reporting, including agreed integrations with IMS.
WORKFLOW
Make every step connect.
- 01
Receive and validate evidence
- 02
Create and assign a case
- 03
Enter, adjudicate and review
- 04
Check quality and reconcile receipts
MARKETS & DELIVERY
Local requirements. Global perspective.
China
Scope Chinese-language workflows, local integrations, data permissions and delivery responsibilities with the operating organisation. Channel support is agreed per project.
International projects
Use English-language solution discussions to assess local workflows, language, time zones, data hosting, coding and payment systems. Product suitability is confirmed for each market.
The solution covers existing claims workflows and upgrade architecture. Production scope, insurer interfaces and payment channels require project-specific confirmation.
FAQ
Frequently asked questions
How does ITPA relate to TPA?
ITPA means Intelligent TPA. TPA usually refers to a Third-Party Administrator. The platform supports claims administration, with intelligent-assistance capabilities confirmed module by module.
Can it modernise a legacy claims system incrementally?
Start by reconciling cases, document images, rules and financial semantics, then plan migration by business domain. Historical evidence and processing records require an explicit continuity plan.
Can AI independently approve payment?
Potential upgrades include evidence extraction, missing-document prompts and adjudication assistance. Coverage decisions, amounts and consequential actions follow authorised business rules and review.