About Us
Florida Health Administrators, Inc. d/b/a (FHA-TPA) is a licensed Third Party Administrator (TPA).
The company has been in the business of claims administration, PPO network management, product development, stop-loss/reinsurance placement, and group health plan marketing for over 8 years.
FHA-TPA’s list of clients includes, but not limited to
- Insurance companies
- Law firms
- Manufacturing companies
- Engineering firms
- Medical practices
- Construction companies
- Municipalities
- Service companies
Our founders and management team have 100+ years of experience in the healthcare market. We are dedicated to become a proven leader in the industry by exceeding our customers’ standards in service.
Florida Health Administrators, Inc., as a corporate entity, was established on January 1, 2001 as the Florida Health Choice PPO/EPO Healthcare Networks, and Self-Funded blocks of business separated from a parent company in a corporate merger/acquisition transaction.
The Florida Health Choice PPO and Select EPO networks have operated continuously since 1984, and in fact was one of first discount networks available to Self-Funded Employers in South Florida.
In April of 2005, FHA-TPA acquired a separate administrative center to rapidly grow and prosper as a professional Third Party Administrator.
FHA-TPA will customize our services to meet your needs.
Examples of the types of services offered are eligibility maintenance, benefit confirmation, pre-certification, claims payment and discounting, provider referrals, underwriting, plan design, reinsurance, case management, and bill auditing.
These services are offered both to international insurance companies covering international policyholders and U.S. companies self-funding various health benefits.
Having access to multiple PPO Networks, FHA-TPA matches each client with the most appropriate network in terms of cost and savings to the group. An emphasis may be placed on steerage of patients to the most appropriate and cost effective providers, further improving savings to the group.
Our Key Contact Personnel
Saul Murillo
VP of Information Technology
He has amassed 18 years of experience specializing in computer sciences and data processing with an emphasis on third party administration including corporate and Taft Hartley funds.
Doug Falcon
Chief Operating Office
Has over 35 years of experience in self-funded and fully insured health plans, market trends, benefit plan design, reinsurance contracting, life, long and short term disability, dental, vision, and prescription drug plans.
Terry Grahn
Supervisor of Claims
She has over 30 years experience with medical, dental, disability, and vision plans and is responsible for all FHA-TPA’s claims operations, including internal auditing and bill audit review.
Florence Saint-Albin
Pension/Union Representative
Has worked exclusively in this industry for many years, performing all necessary duties including customer relations, acting as the liaison for the actuary and custodian of the account, managing annuity funds, and maintaining member records.
Our Objective
To provide our clients with the highest level of quality medical care at the most cost effective rate.
Philosophy
FHA-TPA has taken a different approach to “cost containment”. When we make a provider referral for one of our members, we take into account all of the following items to ensure the most cost-effective rate for the client and the best outcome for the patient:
- Network status.
- Is this the most appropriate specialist/specialty and will they provide the best medical care available?
- If the patient needs additional services including surgery, we will make sure to refer to a physician that has privileges at a facility with the best rate possible and that will utilize our ancillary providers ensuring we obtain the best “overall” rate and outcome for this case.
- Would this case require selective outsourcing to vendors such as Delphi (MAP), use of our specialized transplant or radiology networks?
FHA-TPA has also created innovative programs such as the “Coordination of Care” program for our clients to achieve maximum saving to the Plan with the use of financial incentives and penalties to the members.