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oDoc offers a cutting edge technological solution to insurance companies for claims processing and policyholder management

oDoc, Sri Lanka’s largest digital health company, having successfully partnered with Vidal Health, the world’s largest Third Party Administrator, is leading the way in revolutionising the Sri Lankan Health Insurance industry through innovative solutions to digitise the processing of claims and improving the policyholder journey.

The oDoc TPA solution was launched at an event held on the 8th of March at the Cinnamon Grand Hotel, attended by senior management teams of all prominent Insurance companies in the country.

“The healthcare system is incentivised to over-prescribe medicines, investigations and procedures. This is something we want to fundamentally change. At oDoc, we are putting healthcare on the same side as insurance. We believe that providing world-class TPA services will enable insurance companies to reduce overheads, obtain negotiated rates with hospitals, and reduce fraud. All while gaining the ability to focus on their core operations. Policyholders will benefit by getting a superior customer experience with our self-care app, shorter wait times at hospital discharge, and industry-leading customer service levels. We believe this partnership will enhance the standard of TPA services in the country. Driving significant competitive advantage to insurance companies that partner with us,” commented Heshan Fernando, CEO of oDoc.

Having spent the last 6 months setting up operations and empanelling their network of hospitals, oDoc launched the service with their first client, Arpico insurance, earlier this year and have a second client launching next month.

“oDoc is not only providing us with just a system for claims processing but an end-to-end holistic digital solution for some of the manual operations we carry out on a daily basis. oDoc TPA benefits us by helping optimize our processes and benefits our policyholders by offering them a quick, hassle-free experience. We are delighted to be the First Sri Lankan Insurance company to partner with oDoc on the TPA front and we are eager to work with them on more ground-breaking future initiatives,” said Kelum Senanayake, Cheif Executive Officer of Arpico Insurance PLC.

The solution powered by Vidal Health will provide multiple benefits to Insurance companies, including total visibility on policyholder claim requests supported by a fully automated rule-based system for claims adjudication. Furthermore, policyholders will have access to a self-care app that will enable them to check their balances, see claims status, and even submit reimbursement requests.

Elaborating further, Heshan stated, “This TPA layer will enable us to create a seamless customer experience across the healthcare and insurance sectors in Sri Lanka. Driving us closer to our vision of making high-quality healthcare universally accessible, affordable and personal.”

“We are extremely happy to partner with oDoc and its innovative team. We are excited to extend our expertise to the Sri Lankan insurance industry and looking forward to the journey ahead,” said Girish Rao, Chairman & Managing Director of Vidal Healthcare Services.

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