Category: Services

By combining these competencies and process expertise, Vidal Health is able to explore newer areas for growth.

Empanelment and Contracting

For its insurer clients, Vidal Health can empanel and contract with hospitals as required by the insurer (and/or its employer/government clients) based on precise specifications relating to access. Vidal Health already enjoys a direct relationship with over 7000 hospitals across India. Also, if a preferred network is required, it can accomplish that set up very quickly.

Enrollment

Whether transitioning an existing customer account or on-boarding a new account, insurers find Vidal Health technology platforms the perfect way to enroll members—be it by the hundreds or by the millions. On large government contracts, Vidal Health has frequently helped its insurer clients on-board more than a million members from the most remote locations. That too within a short time frame. Large employers transitioning to new insurance relationships also find this capability of Vidal Health of great value.

Call Centers and Help Desks

In addition to investing heavily in technology to deliver a superior stakeholder experience, Vidal Health believes that healthcare often requires a high-touch. This is why it has a full-service call center, staffed with over 100 executives drawn from various backgrounds, including clinical. In addition to receiving in-bound calls from members on a variety of concerns like eligibility, claims status, customer satisfaction etc., and the call center also provides disease-specific support, toll-free support for specific clients and processes as well as out-bound calling if required.

When Vidal Health first offered the e-claims platform to its network hospitals, it set up help desks in hospitals with high volumes of insured members to support them take advantage of the technology platforms. Vidal Health continues to provide this support by setting up hospital help desks at the behest of an insurer or employer or government client from time to time. This makes it easier for members to avail themselves of the benefits under their policies. These help desks are staffed with resources who use technology extensively and are connected via telephone and internet to the Vidal Health back-end to offer a speedy response to the members.

Claims Processing

Vidal Health was the first third-party administrator to provide its empanelled hospitals with access to an e-claims platform that allowed pre-authorisation requests and final claims to be submitted online. This allowed turnaround times for pre-authorisations approvals to drop drastically benefiting members tremendously. It has continued building on similar innovations to make it easier for members whether they seek cashless hospitalisation or re-imbursement of a hospital bill they may have already paid. In areas outside India, Vidal Health processes on the fly cashless requests for outpatient services like doctor consultation, prescription filling at a pharmacy, diagnostics etc. which makes it convenient for members by helping them avoid having to fill out forms for reimbursement of medical spending.

Analytics

Vidal Health has expertise in data capture as well as extraction of insights from large volumes of transaction data. Owing to this, it has made solid investments in analytics talent and developed the expertise to assist insurers to design and implement their own reporting and analytics projects, either on a consulting approach or a completely out-sourced approach.

Pricing and Actuarial

Other than insurance companies, Vidal Health is among a handful of health services management companies that have invested in building expertise in actuarial and underwriting skills. The Vidal Health actuarial team is already assisting insurance companies globally on matters such as pricing and new product designs; it’s also consulting on analytics and process improvement.

Technology Platforms

Owing to the massive scale of its operations (35 million members, 1 million
Hospitalizations claims every year, 800 thousand pre-authorization requests for these hospitalizations from an empanelled network of over 7000 hospitals) Vidal Health heavily invests in technology to deliver a superior experience to all its stakeholders. Over the years, these investments have resulted in the evolution of a world-class proprietary technology platform that can be licensed for use by insurers, healthcare administrators (including third-party administrators), hospitals and health systems, and pharma companies for deployment across their businesses.