Plug, Play, Transform: How Openness Powered Our Hybrid Approach for Modernizing Healthcare TPA Contracting

OVERVIEW

Enterprise leaders are wrestling with a common challenge: how to stitch together and and automate disconnected business processes without a complete overhaul

This was particularly apparent in our recent work with a U.S. healthcare third-party administrator (TPA). Manual handling of business contracts for their Administrative Services Only (ASO) business revealed a broader industry issue.

 

True Transformation Is Not One-Size-Fits-All

TPAs play a vital role managing contracts in ASO arrangements, where employers self-fund employee health plans but outsource administrations like claims processing and compliance to TPAs. They generate contracts to formalize agreements with providers, insurers, and employers—ensuring compliance, defining terms, and managing complex relationships.
The challenge was to stitch together and automate this critical part of their business, without tearing down contracting systems that already worked.
Instead of rebuilding from scratch, we connected the best tools available in the market to create a flexible system that can be customized based on business needs.

Tech Snippet

Which technologies were proven to automate contracting in complex healthcare environments?

We connected an AI-powered workflow automation platform , a document generator, and a reliable e-signature tool to automate healthcare contracts from group intake through to final distribution. Plug-and-play allows TPAs to keep systems that already worked while making contracting processes faster, more flexible, and efficient for healthcare.

Going Beyond Solving The Immediate Business Problem

 

A defining insight from this work wasn’t just “how do we digitize contracts?” but rather “how do we create a scalable strategy” for automating document generation, review, and signing with at least 50% less manual intervention.
More than just a one-off solution, we focused on building a framework that could grow, adapt, and be reused for many other document use cases across any organization.
By incrementally connecting existing workflows with maximized interoperability, we were able to rapidly deliver measurable outcomes for a healthcare business, without reinventing the wheel.
Biz Snippet

What Was The “Aha” Moment Along The Journey?

Rather than spending months building one system that tries to do everything (and often failed), we realized we could assemble a contracting solution like connecting Lego blocks! Using proven tools and tech that are open, customizable, and extensible, we’ve launched the solution in eight weeks without the typical, proprietary vendor lock-in.

How Healthcare Enterprise Can Speed Up Innovation with A Repeatable Modernization Framework

Key Takeaways:

While the principles described apply broadly, they hold special significance for healthcare TPAs and benefit managers. These sectors often grapple with complex contractual relationships and compliance imperatives, making automation an essential enabler of operational excellence.
 

  1. Adopt open architecture with API-first methodology.
  2. Orchestrate human expertise, don’t just try to replace it.
  3. Build compliance and auditability.
  4.  

We have proven this with Allied Benefit Systems, enabling them to cut contracting turnaround by half in less than 3 months. Discover how you can use the same approach to improve your SLA compliance on distribution with faster business turnaround.

 

Expert Speak

Successful healthcare tech transformation means combining

the right tools with critical healthcare data to cut down redundant work. That way, TPA experts can focus on the part that only people can do well—making thoughtful decisions and building relationships.

Scalable Workflow Automation, Delivering 50% Productivity Growth and ROI Gains. Link to Allied case study page.
Go to Case Study

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