Third Party Administrators
Provide Peace of Mind
TPA SOC Audit
TPAs are processing huge amounts of information, and very sensitive private information at that. financial information, payment information, Insurance information and claims, and social security numbers. The need for proper controls in this type of environment is strong. Companies who partner with a TPA need assurance like never before in the modern era. These companies and clients are pushing for organizations to invest in a TPA SOC Audit, so they have the peace of mind and security that the internal controls and measures in place are sound and effective.
Why a SOC 1 Instead of SOC 2 for a TPA?
The SOC 1 Report is the correct report due to the services the TPAs provide which are often linked to the outside user’s controls and they relate to finances and financial reporting.
A Larger Focus on Internal Controls of Financial Reporting
Agreeing on and testing the internal controls related to a TPA’s business processes and financial transactions is crucial. After all, users of the report are wanting to know specifics about certain processes and procedures, such as the following (which are sample control objectives used for assessing and testing controls for a TPA):
- Controls provide reasonable assurance that all new plans are setup properly and established in a timely, accurate, and complete manner.
- Controls provide reasonable assurance that all incoming claims, electronic or paper based, are received, handled, and processed in a timely, accurate, and complete manner.
- Controls provide reasonable assurance that the billing & eligibility department (B&E) facilitates, processes, and maintains all necessary and vital information relating to member eligibility for clients.
- Controls provide reasonable assurance that the claims process is conducted and administered in a timely, accurate, and complete manner.
- Controls provide reasonable assurance that all new claims are established and priced in a timely, accurate, and complete manner.
For more information on a TPA SOC Audit, don’t hesitate to contact us.
