Claims Management

TPS takes a comprehensive, well-structured and expertly managed approach to every claim. Our claims professionals communicate clearly with all parties involved and continuously monitor and manage all of the issues that can affect the cost of a claim. Through our experience in all aspects of claims management, we’ve developed an exemplary set of best practices for the day-to-day conduct of our business. The result is a cohesive, consistent service delivery from the first report of a claim through to its successful resolution.

Claims Management encompasses an overall effort from the following services which TPS includes in its package to you. It’s a quality cost savings package for everyone’s program.

• Average adjuster experience 20 years
• Bilingual adjusters
• Designated adjusters & supervisors on your account
• Less than 3% employee turnover rate
• Claims guide/kits provided
• Claims indexing standard
• In-house continuing education program
• Monthly loss run reporting
• On-site claims reviews

RMIS

A web-based risk management information system that delivers real-time access to adjusters notes, financial information and reports through any web browser.

• Online reporting of DWC and P&C forms
• Online access to claim and risk data in an easy to use, web-based format
• Online report writing and viewing capabilities

Managed Care

An integrated cost containment and quality assurance program provides a complete range of managed care services which include Peer Review, Utilization Review, PPO & WC networks, Preauthorization/Precertificaiton, Medical Bill Review, & Case Management.

• Designated bill processing professionals on your account

Loss Control

Loss Control focuses on prevention by identifying areas of risk through loss control surveys and assessments. Recommendations generated by these surveys are followed by client/member consultations, education and training on ways to implement programs/procedures that will minimize hazards & exposures.

• On-site evaluations within 30 days of new account set-up
• Free comprehensive disaster response program
• Periodic site evaluations per year
• Designated loss control consultant
• Trending and loss analysis
• Training programs
• Comprehensive emergency preparedness plan
• Video library

Subrogation Recovery Management

TPS evaluates the claims process completely and determines whether a member’s property has residual value and can be sold or if another party is liable for damage or injury. Our team of claim professionals will manage the auto, property and workers’ compensation claims with the goal of maximizing subrogation, contribution and salvage recoveries.

Toll Free Claims Reporting (FirstCall)

TPS’s call center services simplify the time-consuming and difficult process of claim reporting, increase the efficiency of claims management programs and save carriers considerable time and money. Our customer care center receives loss reports and other client communications by phone, fax, e-mail, EDI and internet services 24 hours a day everyday of the year.

Prescription Card Program

TPS provides a comprehensive cost savings prescription card program which provides cost savings to the employer and enhanced level of care to the injured worker.

Workers’ Compensation Networks

The CompKey Network is certified by the Texas Department of Insurance as our workers’ compensation health care network. The CompKey Network is a health care provider network that improves the quality of care provided to injured workers. Additionally, it is projected to save entities between 8-10% on losses per year (source NCCI). And most importantly, unlike other networks that are bound by contract to pay 55% of billed charges, CompKey is not obligated to pay a predetermined percentage.

Program Outline

TPS is member owned and Governed by an elected Board of trustees. Membership gives you the opportunity to serve on the board of trustees and committees as well as gain local insurance agent representation. Additionally, membership provides an exemption from going out to bid each year, and provides DWC representation at no charge. And most importantly, TPS purchases reinsurance through A-rated carriers who require an independent annual actuarial study, which maintains the financial integrity and stability of our program. TPS is fully funded for losses, loss development and incurred but not reported losses (IBNR). We are SAS 70 Type II compliant.

Home Office

• Dallas, Texas

Claims Offices

• Austin, Texas

• Dallas, Texas

• Houston, Texas