Singapore-based DocDoc, a virtual network of physicians and hospitals supporting patients to find quality medical care in Asia has partnered with healthcare technology provider SpesNet Global Group to integrate its digital third party administrator (TPA) technology and provide a first-of-its-kind complete digital health ecosystem to insurers, supporting their policyholders through the continuum of care.

According to Investopedia, TPAs are companies that provide operational services such as claims processing and employee benefits management under contract to another company. Insurance companies and self-insured companies often outsource their claims processing to third parties.

WHAT’S IT ABOUT

Under the agreement, DocDoc will integrate SpesNet’s digital TPA technology with DocDoc’s telemedicine platform and AI-powered doctor discovery platform, HOPE (Heuristic for Outcome, Price and Experience), which matches policyholders to relevant healthcare providers, to power a holistic offering.

Through this integration, DocDoc will be able to offer cashless services, as well as seamless claims processing to payers, including insurance companies, brokers, employers, and bancassurance partners across Asia and beyond.

WHY IT MATTERS

The largely analogue and highly manual method of operations endemic in most TPAs make them ripe for disruption. The claims data processed from the digital TPA will help to increase quality data collection, feeding back into DocDoc’s HOPE algorithms that are designed to improve policyholders’ healthcare journeys by improving quality of care and reducing costs.

The partnership also benefits healthcare providers in two ways: risk mitigation and benefits validations. For the former, there is a risk engine which identifies anomalies from policyholders in real-time, flagging it for rapid intervention.

For the latter, the system enables providers to instantly verify a policyholder’s eligibility and benefit coverage, improving the policyholder experience while avoiding claims disputes.

THE LARGER TREND

In June 2020, DocDoc partnered with Kaitaiming Technology (KTM) to bring doctor discovery services to China, MobiHealthNews reported. Under the agreement, KTM, which operates the world’s leading insurance risk control platform for insurers will integrate DocDoc’s doctor discovery service into their insurance agent application.

ON THE RECORD

Cole Sirucek, Chief Executive Officer and Co-Founder of DocDoc, said: “We have received considerable demand for digital third-party administrative services in the region, and we are excited to partner with one of the world’s leading TPA providers, SpesNet, to enhance our product offerings.

Traditionally, claims processes have been highly manual, and SpesNet’s digital TPA technology is ideally suited to helping our customers create paperless, real-time and data driven claims procedures. Together with our doctor discovery and telemedicine services, we are creating a first-of-its-kind platform which offers an end-to-end suite of healthcare solutions to our insurance partners and their policyholders.”

“We believe that claims processing should be a seamless and data-driven process. DocDoc delivers the most robust doctor analytics in the world, making them our ideal partner in Asia. By integrating our TPA technology with DocDoc’s doctor discovery platform, we will be able to provide our clients with hassle-free claims services.

DocDoc is a high-tech outsource partner, delivering value across every level of the organization and we are confident that through our partnership, we will be able to follow the patient through the continuum of care,” commented Sanet Kock, President & CEO of SpesNet Global Group.

Source: Mobilehealth News