TPA Best Practices for Workers' Comp Claims

This guide is designed to help HR professionals, operations managers, and risk leaders align their internal processes before onboarding a TPA. Whether you’re exploring options or already planning to outsource, these TPA best practices will reduce friction, improve coordination, and set the foundation for long-term success.

Why Internal Preparation Matters

Too often, businesses assume the TPA handles everything from day one. But in reality, the TPA model only works well when there is alignment and accountability on both sides. Without clear communication, accessible data, and well-defined responsibilities, even the best administrators will struggle to perform.

When a business is well-prepared, the TPA can step in smoothly to manage claims, mitigate risk, and support compliance. But when internal teams are disorganized, onboarding takes longer, claims pile up, and employee satisfaction drops.

Common Barriers That Delay TPA Onboarding

Businesses that aren’t ready for TPA support often face a handful of preventable roadblocks:

Missing or incomplete historical claims data
Lack of a designated internal contact for claims questions
Siloed or incompatible HR and finance systems
No internal workflow for documenting incidents
Unclear roles between HR, legal, and finance teams

Each of these gaps creates delays in onboarding and disrupts claims processing. Left unchecked, they can compromise the very outcomes businesses hope to improve.

TPA Best Practice 1: Audit Your Current Claims Process

Before you bring in a TPA, take inventory of how your workers’ compensation claims are currently handled. This includes:

Where incident reports are stored
Who initiates claims and tracks status updates
What systems or tools are used (e.g. spreadsheets, HR software)
How often data is reviewed or analyzed

This audit will help you identify gaps, redundant steps, and inefficiencies, all of which are easier to address before your TPA steps in. It also sets a baseline for measuring future improvements.

TPA Best Practice 2: Centralize and Digitize Your Claims Data

Disorganized records are one of the top causes of onboarding delays. If your historical claims data is spread across emails, file cabinets, and disconnected spreadsheets, your TPA won’t be able to start processing efficiently.

Create a single, secure, cloud-based folder or portal with:

Current and past claim records
Incident reports
OSHA documentation (if applicable)
Carrier information and policy numbers
Notes on open or disputed claims

Making this information accessible to the TPA on day one saves time and builds trust.

TPA Best Practice 3: Assign a Claims Point of Contact

The most effective TPA partnerships start with a clear communication path. Designate one person to serve as the internal claims liaison, or someone who can:

Share updated documentation
Facilitate TPA access to internal systems
Escalate urgent issues to HR, legal, or finance
Act as the go-to for questions and approvals

You don’t need a new hire for this role, but you do need someone with bandwidth, authority, and knowledge of your internal workflows.

TPA Best Practice 4: Align Stakeholders Across Departments

Workers’ compensation claims often involve HR, operations, legal, and sometimes finance. Make sure all stakeholders understand:

What the TPA will handle
What internal responsibilities remain
How and when communication will happen

This avoids finger-pointing and duplicate efforts during the first 30 to 60 days. You might even host a kickoff call with all parties, internal and external, to set expectations and define success.

TPA Best Practice 5: Document Escalation Procedures

One of the easiest ways to reduce confusion during TPA onboarding is to document what should happen when something goes wrong. Whether it’s a contested claim, a compliance concern, or a medical documentation issue, your TPA will need to know:

Who to contact
What steps to follow
What the expected turnaround time is

By putting this in writing, you give your TPA the power to respond quickly and appropriately, which protects both your business and your employees.

Discover how the TPA claims process works from start to finish. Learn how third-party administrators manage every stage to improve efficiency and compliance.

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Tools to Use Before Onboarding Your TPA

You don’t need a sophisticated tech stack to prepare for TPA success, but a few tools can make a big difference:

A shared drive (Google Drive, SharePoint) for documentation
A basic claims tracking spreadsheet or dashboard
Internal SOPs for incident reporting and documentation
A calendar for claims review or audit dates
Secure email or portal access for the TPA team

The goal is to make information easy to access, simple to update, and consistent across departments.

Building a Long-Term Partnership Mindset

Working with a TPA is not a one-time event—it’s an ongoing relationship. While onboarding sets the tone, long-term success depends on how both parties maintain the partnership over time. That means businesses need to think beyond initial setup and plan for continuous improvement.

Start by scheduling quarterly or biannual check-ins with your TPA to review performance, identify challenges, and adjust workflows. These reviews help ensure the relationship evolves alongside your business goals, legal requirements, or workforce changes. It’s also an opportunity to reinforce alignment and uncover additional ways the TPA can provide value, like benchmarking data, predictive analytics, or proactive claims mitigation.

Creating a shared scorecard or dashboard with KPIs like average resolution time, claim volume trends, or escalation frequency can help drive accountability. It also gives your internal stakeholders clear visibility into the impact of the TPA partnership, making it easier to justify the investment over time.

Empowering Employees Through Transparency

One overlooked aspect of successful TPA collaboration is how well employees understand the claims process. If your workers feel confused about how to report injuries, what documentation is required, or what to expect from the TPA, the entire system suffers.

Create clear, easy-to-follow guides for your workforce outlining how to initiate a claim, what happens next, and who to contact with questions. Providing this level of transparency improves compliance, reduces anxiety, and creates a more supportive claims experience, especially for employees navigating workers’ compensation for the first time.

Empowering your staff with this knowledge also reduces the burden on HR teams and helps the TPA get the information they need faster. The result is a more informed, efficient, and aligned process that benefits everyone involved.

Final Thoughts

Working with a TPA is one of the smartest ways to streamline workers’ compensation claims. But it takes more than a contract to make it successful. When your business is internally aligned, informed, and equipped, your TPA can operate as an extension of your team—not a disconnected vendor.

By following the steps in this guide, you can reduce onboarding time, protect compliance, and support a better experience for both your staff and your TPA partner. The result is fewer delays, fewer disputes, and more confident claims handling.

Partner With a TPA That Puts Preparation First

At GGA Solutions, we understand that successful TPA support begins well before the first claim is filed. Our team helps clients build strong internal frameworks so that TPA onboarding is seamless, predictable, and aligned with your business goals.

Contact us today to schedule a free consultation or get our TPA Readiness Checklist. Let’s lay the groundwork for smarter claims management—together.