MANSOQ RCM & insurance
Set up insurers, TPAs and their legal roles
Keep legal entities, role authority and routing identifiers distinct when configuring insurance.
Current source · source reviewed · 7 min read
Before you begin
- Verified registry evidence and legal identifiers.
- RCM configuration editing permission.
1. Search before creating
In the organization setup, search legal identifiers and aliases to prevent duplicate entities. A legal name, marketing name and portal display name are not reliable join keys.
2. Create one legal entity
Capture the bilingual name and registry evidence for the organization. When it acts as both insurer and administrator, add dated roles to the same entity rather than creating a second organization.
3. Establish each role
For each insurer or TPA role, record the routing identifiers, authority, licence information and validity dates supported by the source.
4. Review authority and publish
Confirm the role is appropriate to the transaction and submit the evidenced row through the configuration approval lifecycle. Suspend expired or invalid roles through their lifecycle rather than deleting history.
Risk bearer and administrator
The insurer is the risk-bearing organization. A TPA may administer delegated transactions, but routing capability does not prove that delegation. Transitional payer mappings must resolve to a canonical insurer; a TPA cannot be substituted for that insurer.
How this affects claims
A route built from an expired licence or duplicate organization can produce a plausible response from an unauthorized party. Legal-role and date checks must be completed before production routing.
Troubleshooting
The same company appears twice
Compare identifiers and dated roles with the contracting owner. Preserve historical links while correcting the master; do not merge by display name alone.
Source evidence
References are pinned to the private MANSOQ source repository. Repository access is required to open these links.