Medigo, an established global third-party administrator (TPA), identified that were was a demand for a radical shift in healthcare claims management, particularly focusing on reimbursement claims.
The turning point for Medigo was brought about by hi.health’s groundbreaking payment card solution. The result? No more reimbursements, no upfront costs for members, and no more manual labour.
Historically, there has been significant friction for insured members navigating the claims reimbursement process. This old-fashioned approach of handling reimbursement claims is strenuous not only for insurers but also for TPAs.
Medigo, operating globally as a TPA for IPMI and PMI companies, found hi.health to be the ideal partner to address these issues and revolutionise the norm.
The partnership with hi.health, allowed Medigo to provide immense additional benefits to insurers and reinsurers, over and above its traditional claims management and cost-containment capabilities. The core of hi.health’s game-changing solution is a payment card, created in collaboration with Visa. This is not just another payment card, but a fully integrated mechanism that can access both the insurers’ and the members’ funds.
The payment card, which can be used physically or integrated into the digital wallet of the member’s mobile phone, allows for cashless experiences by eliminating upfront out-of-pocket expenses, thereby simplifying the administrative processes linked with the conventional claim submission procedure.
hi.health’s payment card mechanism is flexible, user-friendly, secure, and intelligent. It also features fraud prevention mechanisms. This card not only significantly streamlines claims adjudication but also reduces the risk of fraud. As per research by Mastercard, fraud, waste, and abuse may account for up to 10% of claim costs. By decreasing the risk of fraud, hi.health’s solution opens up significant avenues for cost savings, improving insurers’ financial stability.
An integral advantage of the hi.health solution is its built-in reward programme. hi.health skilfully prompts end-users to choose more cost-effective options from the thousands of medical facilities within Medigo’s network. As the users choose these preferred providers, costs for insurers become more predictable and controlled.
In an insurance market marked by stiff competition, the integration of the payment card as a result of this partnership, which you can read more about here, serves as a key differentiator.
Aurélien Gueye, Medigo’s CEO, said “Our alliance with hi.health has enabled us to elevate member experience while achieving considerable cost efficiencies. It proves the potential of innovation in tackling real-world claims challenges. We are now in a position to deliver a digital, cashless, and efficient end-to-end claims journey.”
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