Daily Mirror (Sri Lanka)

Odoc to transform health insurance industry with launch of TPA services

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odoc, Sri Lanka’s largest digital health company, has partnered with Vidal Health, India’s leading Third Party Administra­tion (TPA) with a growing presence in internatio­nal markets, to enable insurance companies to outsource their entire insurance administra­tion process.

TPA supports insurance companies in their operationa­l services of policyhold­er enrolment, benefits management, cashless hospitalis­ation, claims processing and fraud prevention.

“We believe that providing worldclass 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 and 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 odoc CEO Heshan Fernando.

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.”

Vidal Health Group Chairman and Managing Director Girish Rao 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.”

 ??  ?? From left: CEO Heshan Fernando, Chief Growth Officer Nare Bandaranay­ake, Chief Medical Officer Dr. Janaka Wickramasi­nghe and COO Ashik Bari
From left: CEO Heshan Fernando, Chief Growth Officer Nare Bandaranay­ake, Chief Medical Officer Dr. Janaka Wickramasi­nghe and COO Ashik Bari

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