oDoc, Sri Lanka’s largest digital health company, has partnered with Vidal Health,
India’s leading TPA with a growing presence in international markets, to enable
insurance companies to outsource their entire insurance administration process.
Third Party Administration supports insurance companies in their operational services of
policyholder enrolment, benefits management, cashless hospitalisation, claims
processing and fraud prevention.
“We believe that providing world-class TPA services will enable insurance companies in
Sri Lanka to reduce overheads, ensure negotiated and time-bound rates with hospitals
and reduce fraud whilst gaining the ability to focus on their core operations.
Policyholders will benefit by getting a superior customer experience in terms of easier
access to information (through an app & 24/7 call centre), shorter wait times at hospital
discharge and industry-leading customer service levels. In mature and dynamic
markets, all insurance companies outsource these services to TPAs; hence it’s 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 bleeding edge software system, “Vings”.
The best-in-class system currently manages over 120 Million policyholders and
combines rule-based auto adjudication with AL/ML-based fraud management, advanced
analytics and predictive modelling. Thus, driving significant completive advantages to
insurance companies that adopt the platform.
Elaborating further, Fernando stated, “We are building the digital front door to the
healthcare and insurance industry. Having laid the foundation for the healthcare
industry, we are now starting on the insurance industry. This TPA layer will enable us to
create a seamless customer experience across the healthcare and insurance verticals
in Sri Lanka. Thus, bringing us closer to our vision of making high-quality healthcare
universally accessible, affordable and personal.
Girish Rao Chairman and Manging Director of Vidal Health Group commented, “We are
delighted to partner with oDoc, I am sure, the complementary skills both of us bring to
the table will be a game changer and is set to transform the Health Insurance
administration space in Sri Lanka.”