Coastal TPA, Inc. is pleased to provide a self service online tool, which is HIPAA compliant for patient privacy, and provides you with free online access to your benefit information. Take a minute and review the exciting online services available to you.

Member/Provider Log-in:

Username: Password:  

System features allow members to:

View paid claim information
Check eligibility status
Retrieve the summary plan description
Access to online customer service
Verify provider participation
And much, much more!

Coastal Programs: TPA and PPO

Coastal's business model has been built around our two flagship programs: our Third Party Administration (TPA) and our Preferred Provider Organization (PPO). And, best of all, with Coastal you have the freedom to mix and match services to design the ultimate health benefits for each employer group.

Third Party Administration

Provided through Coastal TPA, Inc, Third Party Administration includes medical, dental and vision claims adjudication, eligibility management, preparation of identification cards, PPO network management, utilization management, pharmacy benefit management, preparation of the Plan Document and Summary Plan Description, coordinating the purchase of stop-loss insurance, and detailed claims and financial reporting. Another vital function of Coastal TPA is to provide employer groups with consultation on best-practice funding and reconciliation procedures in compliance with ERISA regulations.

By contracting with Coastal, an employer group gains control of their health benefits while getting expert assistance to manage the administrative responsibilities that come with self-insuring.

With Coastal, self-insured employer groups can:

  • control plan design
  • improve cash flow
  • reduce State premium tax and minimize State regulations
  • lower administration costs
  • select ideal vendor partners (PBM, PPO, stop loss) offered through Coastal
  • refer to reports and analysis tools to impact and manage cost

Coastal's partially self-insured clients have a level of flexibility to customize their benefit plans not available working with large insurance carriers. For a complete list of available services, schedule a meeting or request a proposal today.

Preferred Provider Organization

Coastal Healthcare Administrators operates a regional California PPO network in the five-county area of Monterey, Santa Cruz, San Benito, San Luis Obispo, and Santa Clara. Offering a PPO network of over 6,800 credentialed physicians, ancillary providers, surgery centers and hospitals, our PPO network also provides access to a variety of preferred provider networks throughout California and across the United States. Coastal's PPO network delivers substantial discounts to reduce your total plan costs. Clients may combine Coastal's PPO network with other managed care services and networks.

 

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Customer Service: (831) 754-3800 | Toll Free: (800) 564-7475

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