oDoc, Sri Lanka’s largest digital health company, has partnered with Vidal Health, India’s first TPA with a growing presence in international markets, to enable insurance companies to outsource their entire process insurance administration.
The Third Party Administration supports insurance companies in their operational services for enrolling policyholders, managing benefits, cashless hospitalization, handling claims and preventing fraud.
“We believe that providing world-class TPA services will enable insurance companies in Sri Lanka to reduce overhead costs, ensure negotiated and time-limited rates with hospitals, and reduce fraud while gaining greater confidence. ability to focus on their core business. Policyholders will benefit from a superior customer experience in terms of easier access to information (via an application and a 24/7 call center), shorter waiting times at the exit of hospitality and industry-leading customer service levels. In mature and dynamic markets, all insurance companies outsource these services to APTs; So it is only a matter of time for Sri Lanka. We believe this will increase the overall efficiency of the insurance industry in the country, ”commented Heshan Fernando, CEO of oDoc.
The solution will be powered by Vidal Health’s state-of-the-art software system, “Vings”. The best-in-class system currently manages over 120 million policyholders and combines rule-based automatic adjudication with AL / ML-based fraud management, advanced analytics and predictive modeling. Thus, providing significant comprehensive benefits to insurance companies who adopt the platform.
Developing further, Fernando said, “We are building the digital gateway to the healthcare and insurance industry. After laying the foundation for the health industry, we are now starting on the insurance industry. This TPA layer will allow us to create a seamless customer experience across the healthcare and insurance verticals in Sri Lanka. Thus, moving us closer to our vision of making high quality healthcare universally accessible, affordable and personal.
Girish Rao, President and CEO of Vidal Health Group, said: “We are delighted to partner with oDoc, I am sure the complementary skills that we both bring to the table will be a game-changer and will go transforming the health insurance administration space. in Sri Lanka.