Program profile
Reference the client, claim type, authority band, service standard and reporting segment.
DELEGATED CLAIMS
TPA claims management software for delegated authority and client service
Run a repeatable claim lifecycle while preserving the program, client, authority and reporting differences that make third-party administration operationally demanding.
The first view shows client programs, SLA milestones, delegated authority, reporting state and blockers together, followed by the supporting claim and authorization records.
Free for up to five users. No credit card required.
Adapt fields, workflows, and dashboards without code. Explore 1,000+ app templates and use cases
The gallery shows populated sample data in Jodoo. Open a view to inspect the records and decisions, then install a copy to adapt fields, roles and workflow.
Program contextclient and authority stay attached
SLA visibledue, overdue and paused with reason
Client reportingready, shared or returned
Keep the client mandate visible inside the daily workflow
The same handler may work across programs with different evidence, authority and reporting rules.
Handler execution
Use a consistent claim file while revealing program-specific intake, evidence and escalation requirements.
Authority escalation
Show when a recommendation exceeds delegated authority and route it to the correct client or senior reviewer.
Client reporting
Give each client a bounded view of volume, age, exposure, service and exception without exposing unrelated portfolios.
Measure the handoffs a TPA can actually manage
Aging alone does not explain whether a claim was handled well.
Acknowledgement
Track whether the claimant or client received the reference, owner and next step on time.
Action cadence
Keep the next meaningful action and due date visible even while an external response is pending.
Authority turnaround
Separate handler completion from the time waiting for client or senior approval.
Commitment completion
Close the communication promise only when the promised update or action is recorded.
Move from totals to the claims behind them
A client should be able to understand why age, exposure or service changed.
Stage and age
Drill from portfolio trend into claims waiting at each lifecycle point.
Exposure movement
Retain the current exposure and the evidence or event that changed it.
Exception reason
Distinguish claimant, provider, employer, authority and internal delays.
Reopen and complaint
Show where incomplete closure or new evidence created post-close work.
Evaluate workflow against the delegated mandate
A configurable system should make program differences explicit, not rely on handler memory.
| Area | Configure by program | What to test |
|---|---|---|
| Intake | Required facts and documents | Incomplete submission reaches the right queue |
| Authority | Amount bands and reviewers | Over-authority recommendation cannot self-authorize |
| Service | Milestones and pause reasons | Due and overdue views match the contract |
| Reporting | Client segmentation and definitions | Drilldown reconciles to claim records |
| Handoff | Core, client and finance integrations | Authorized outcomes reach the correct owner |
WHY TEAMS BUILD THIS IN JODOO
Configure delegated claims work without hiding client-program differences
A TPA can use one operating foundation while varying required facts, service milestones, authority and reporting for each mandate. Business administrators can maintain those differences without code.
TPA teams can launch a substantial client-program workflow quickly and keep refining milestones, queues and reports as mandates change.Carry program rules into the claim
Attach the client, mandate, reporting segment, evidence requirements and authority band to the operating record.
Separate handler time from external wait
Track claimant, provider, employer, client and internal blockers so service reporting explains who owns the next move.
Give clients bounded visibility
Build portfolio views and drilldowns for the relevant program without exposing unrelated clients or internal fields.
Use Jodoo for delegated execution and connect the systems each client keeps authoritative
The TPA layer should make program obligations and handoffs visible while respecting the client, carrier, finance and document platforms that own specialist controls.
Operate in Jodoo
Program-aware intake, handler actions, evidence follow-up, service milestones, authority escalation, client commitments and management reporting.
Integrate by mandate
Reference or synchronize policy, customer, payment, recovery and document data according to each client’s agreed system ownership.
Keep regulated decisions with their owners
Coverage, regulated benefits, fraud detection, reserves and payment execution remain with the qualified systems and teams responsible for them.
Questions about TPA claims management software
What makes TPA claims software different?
It must preserve the client program, delegated authority, service commitments, data boundaries and reporting definitions while handlers execute a consistent claim lifecycle.
Can one App support different client programs?
Yes. Use program references, conditional fields, authority paths and filtered reporting so shared work remains consistent while client requirements stay explicit.
How should TPA service levels be measured?
Track each meaningful milestone, its owner, due rule and pause reason. Separate work completed by the TPA from time waiting for a claimant, provider, employer or client decision.
Can clients receive their own claims view?
Yes. Configure bounded views and dashboards for the appropriate program and role, then verify record and field permissions against the client data agreement.
EXPLORE THE POPULATED APP
Build delegated claims operations without hiding program differences
Open the populated client-program view, then adapt authority, service milestones, reporting and exception handling to the mandates you administer.
Use this TPA claims App