oDoc set to transform health insurance industry with launch of TPA services for insurance companies

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

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 (TPA) 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 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 Manging 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.”