TPSC Benefits
TPSC Benefits is a third-party administrator (TPA). For an ASC, what matters isn't the logo. It's how TPSC Benefits pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete TPSC Benefits analysis
Tell us where to send it. Our team will prepare an analysis of TPSC Benefits covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How TPSC Benefits pays
See how TPSC Benefits reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
See where TPSC Benefits concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for TPSC Benefits and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive TPSC Benefits's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking TPSC Benefits up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with TPSC Benefits
- Payer ID
- 91078 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to TPSC Benefits through a clearinghouse.
- Eligibility verification
- Coverage and benefits for TPSC Benefits members are verified before the date of service, through a clearinghouse using payer ID 91078or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with TPSC Benefits directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of TPSC Benefits the way it pays.
- What is TPSC Benefits's payer ID?
- TPSC Benefits's electronic payer ID is 91078. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to TPSC Benefits through a clearinghouse.
- How do ASCs verify eligibility for TPSC Benefits members?
- Eligibility and benefits for TPSC Benefits members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 91078) or through the payer's provider portal.
- Does TPSC Benefits require prior authorization for ASC procedures?
- Prior-authorization requirements for TPSC Benefits are set per plan and per procedure. Confirm whether an authorization is required with TPSC Benefits directly before the date of service.
- What type of payer is TPSC Benefits?
- TPSC Benefits is a third-party administrator (TPA).
- How does TPSC Benefits compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where TPSC Benefits pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is TPSC Benefits paying my ASC below market?
- Put your own TPSC Benefits contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.