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Have you ever peeked into how payroll, healthcare, and insurance systems work? This is a genuine question, I'm not trolling. The reason I'm asking is because yo

Have you ever peeked into how payroll, healthcare, and insurance systems work? This is a genuine question, I'm not trolling. The reason I'm asking is because you can't really have automation and APIs for systems that have literally zero automation to begin with. The entire industry is a combination of fax machines shuttling paper back and forth between the different players. It doesn't matter how much software you throw at this problem if you're just a broker because from the perspective of the other players you're just another fax machine. That is the level of electronic and computer sophistication of the healthcare insurance industry, fax machines. ADP, Trinet, etc. are just as manual and full of error prone human processes. It's all just heroic human effort on all sides. If anything Zenefits has shown the incumbents and everyone else in the space that you can indeed provide a software solution that integrates well with human processes and in the long run make things much more automated and efficient.

manyxcxi 11y ago
Having had to work with ADP and a number of insurance agencies before on technology projects- I can't imagine what a nightmare scenario it would be to try and automate all of these companies together. I could see how a company could try to fake it until they make it- as in, until they get enough clout (via money, customer base, important friends) that the companies they're trying to automate realize that it is in their best interest to work with them. However, while trying to make it, I would think that you would do everything humanly possible not to screw up even one piece of data for even the lowliest of customers. If you are 100% above board and have a really good process in place, when things happen you can be pretty sure it wasn't you, and you can be in a better position to actually help the client. FFS, Zenefits is screwing up the only thing about employment that matters to a lot (most?) people: the freaking paycheck and the health care. Hearing all these horror stories it becomes hard to see how Zenefits gave a crap doing their job at all- I can understand a mistake, but a mistake with a devil may care attitude means you've lost my business forever.
- api 11y ago
  I think this was exactly their strategy and it failed since these industries are stubborn and moribund to an extent that's hard for us to imagine. I've had a little exposure to health insurance and the medical bureaucracy and I've worked as a government contractor, and in my experience the healthcare world is far more sclerotic than the Federal bureaucracy in many areas. The Feds are also much more open to automation and newer technology, while in medicine they literally do everything with paper files and fax machines and will not budge.
  - mattmcknight 11y ago
    Which is partially due to regulations that oscillate from excruciatingly vague to demanding particular outdated technologies, that make it very difficult to sanely comply with the ever expanding regulation of Health IT systems. A second factor is that the domain is quite complex, leading to serious challenges in automating systems. The reason certain transactions between providers and third-party payers (like Medicare) are hard to automate is that they are often essentially negotiations.
achow 11y ago
That may be true but seems like Zenefits did not really focus on product building. Otherwise these kind of incidences should not be happening (customer details getting ‘lost’).. Arroyo, who runs the Los Angeles software agency, made Zenefits his company’s health insurance broker in 2014. He experienced a string of minor problems at first, he said — annoyances like an inability by Zenefits reps to explain a mysterious charge on his insurance bill. Then, last fall, he was told he would have to submit to a random audit by his insurance carrier. He gave his information to Zenefits, trusting that it would make its way to the carrier. “A week or two later, I got a letter saying I wasn’t compliant, and our insurance had been canceled,” he said. Zenefits, he said, “never gave me an answer of what happened. They just said, ‘Oh, it must have gotten lost somewhere.’” Arroyo dropped Zenefits in December.
- dkarapetyan 11y ago
  The adversarial nature of integrating with payroll, insurance, and healthcare providers does not help when it comes to building such systems. Everyone is mistrustful and there are no APIs or SLAs to speak of. So I agree that Zenefits can and should do more to smooth out the wrinkles in the system as much as possible and dropping the ball is not cool. Even large company payroll and insurance systems go awry more frequently than you'd think would be acceptable. My paycheck at pretty large companies has been adjusted more than a few times because of "clerical" errors in ADP or the in-house integration component. There have also been a few times where my insurance paperwork has been lost in the sea of other paperwork and I've had to reach out to HR to get things fixed. Go around and ask people how much they like ADP and Trinet. Chances are you'll find more than a few customers that hate them with a passion. Not just because of clerical errors like the ones I mentioned but because of how bloated and error prone their products are. I recently had to change my address in the ADP online portal and I couldn't do it. I had to reach out to both their customer support and my previous employer to get them to change a single text field.
rtpg 11y ago
[Dunning-Kreuger Warning!] Maybe Zenefits lacked imagination? You can automate sending things via fax machine. OCR exists. You can use web scraping tech (well that's kinda what got them in trouble with ADP right?) I feel like it's always possible to automate a bit more (or at least enough to where you don't have staff manually copying numbers onto a piece of paper)
- sithadmin 11y ago
  > You can automate sending things via fax machine. OCR exists. You can use web scraping tech I've spent a fair amount of time working on infrastructure and operations projects for insurance MGAs (a particular kind of broker), and can assure you that these approaches are definitely in use by many players within this space. If Zenefits hasn't implemented these methods, it would be pretty unusual. Granted, even in spite of heavy automation in the broker space, there's still a ton of very old school paper shuffling and processes that resist automation because of a combination of the following factors: * lack of standards * process complexity * the sheer number of 'one off' cases that pop up in the insurance world * when you do the cost analysis, it's often cheaper to rely on a manual process with manual controls than it is to automate, thanks to relatively inexpensive clerical labor
- semerda 11y ago
  The issue is people. When we ripped out the back end manual fax process in favor of a better system with OCR, APIs et al we also had to change the interface phone number from ph#1 to ph#2. Changing that alone proved to be a bigger headache than building the technology. Not to mention the education part of people. lol.. I think the movie Idiocracy was onto something ;-)

manyxcxi 11y ago

Having had to work with ADP and a number of insurance agencies before on technology projects- I can't imagine what a nightmare scenario it would be to try and automate all of these companies together. I could see how a company could try to fake it until they make it- as in, until they get enough clout (via money, customer base, important friends) that the companies they're trying to automate realize that it is in their best interest to work with them. However, while trying to make it, I would think that you would do everything humanly possible not to screw up even one piece of data for even the lowliest of customers. If you are 100% above board and have a really good process in place, when things happen you can be pretty sure it wasn't you, and you can be in a better position to actually help the client. FFS, Zenefits is screwing up the only thing about employment that matters to a lot (most?) people: the freaking paycheck and the health care. Hearing all these horror stories it becomes hard to see how Zenefits gave a crap doing their job at all- I can understand a mistake, but a mistake with a devil may care attitude means you've lost my business forever.

api 11y ago
I think this was exactly their strategy and it failed since these industries are stubborn and moribund to an extent that's hard for us to imagine. I've had a little exposure to health insurance and the medical bureaucracy and I've worked as a government contractor, and in my experience the healthcare world is far more sclerotic than the Federal bureaucracy in many areas. The Feds are also much more open to automation and newer technology, while in medicine they literally do everything with paper files and fax machines and will not budge.
- mattmcknight 11y ago
  Which is partially due to regulations that oscillate from excruciatingly vague to demanding particular outdated technologies, that make it very difficult to sanely comply with the ever expanding regulation of Health IT systems. A second factor is that the domain is quite complex, leading to serious challenges in automating systems. The reason certain transactions between providers and third-party payers (like Medicare) are hard to automate is that they are often essentially negotiations.

achow 11y ago

That may be true but seems like Zenefits did not really focus on product building. Otherwise these kind of incidences should not be happening (customer details getting ‘lost’).. Arroyo, who runs the Los Angeles software agency, made Zenefits his company’s health insurance broker in 2014. He experienced a string of minor problems at first, he said — annoyances like an inability by Zenefits reps to explain a mysterious charge on his insurance bill. Then, last fall, he was told he would have to submit to a random audit by his insurance carrier. He gave his information to Zenefits, trusting that it would make its way to the carrier. “A week or two later, I got a letter saying I wasn’t compliant, and our insurance had been canceled,” he said. Zenefits, he said, “never gave me an answer of what happened. They just said, ‘Oh, it must have gotten lost somewhere.’” Arroyo dropped Zenefits in December.

dkarapetyan 11y ago
The adversarial nature of integrating with payroll, insurance, and healthcare providers does not help when it comes to building such systems. Everyone is mistrustful and there are no APIs or SLAs to speak of. So I agree that Zenefits can and should do more to smooth out the wrinkles in the system as much as possible and dropping the ball is not cool. Even large company payroll and insurance systems go awry more frequently than you'd think would be acceptable. My paycheck at pretty large companies has been adjusted more than a few times because of "clerical" errors in ADP or the in-house integration component. There have also been a few times where my insurance paperwork has been lost in the sea of other paperwork and I've had to reach out to HR to get things fixed. Go around and ask people how much they like ADP and Trinet. Chances are you'll find more than a few customers that hate them with a passion. Not just because of clerical errors like the ones I mentioned but because of how bloated and error prone their products are. I recently had to change my address in the ADP online portal and I couldn't do it. I had to reach out to both their customer support and my previous employer to get them to change a single text field.

rtpg 11y ago

[Dunning-Kreuger Warning!] Maybe Zenefits lacked imagination? You can automate sending things via fax machine. OCR exists. You can use web scraping tech (well that's kinda what got them in trouble with ADP right?) I feel like it's always possible to automate a bit more (or at least enough to where you don't have staff manually copying numbers onto a piece of paper)

sithadmin 11y ago
> You can automate sending things via fax machine. OCR exists. You can use web scraping tech I've spent a fair amount of time working on infrastructure and operations projects for insurance MGAs (a particular kind of broker), and can assure you that these approaches are definitely in use by many players within this space. If Zenefits hasn't implemented these methods, it would be pretty unusual. Granted, even in spite of heavy automation in the broker space, there's still a ton of very old school paper shuffling and processes that resist automation because of a combination of the following factors: * lack of standards * process complexity * the sheer number of 'one off' cases that pop up in the insurance world * when you do the cost analysis, it's often cheaper to rely on a manual process with manual controls than it is to automate, thanks to relatively inexpensive clerical labor
semerda 11y ago
The issue is people. When we ripped out the back end manual fax process in favor of a better system with OCR, APIs et al we also had to change the interface phone number from ph#1 to ph#2. Changing that alone proved to be a bigger headache than building the technology. Not to mention the education part of people. lol.. I think the movie Idiocracy was onto something ;-)