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It's great to see innovation in this space! Spent some time working on similar solutions both for patients and employers so I understand how big of an undertaki

It's great to see innovation in this space! Spent some time working on similar solutions both for patients and employers so I understand how big of an undertaking it is. Patients that I've interviewed generally want a completely abstracted process - send or upload a picture of their bill and their insurance, and then hand it off. This would be similar to the cushion.ai experience. Employers on the other hand want to ensure that they aren't being overcharged by their current stack. They are always looking for solutions for reducing costs and better understanding the drivers of those costs, which tools like springbuk.com address. I have less familiarity with the provider side, but the cost of maintaining an insurance billing program has always seemed manual and inefficient. At the SMB scale, I suspect something like Square or Stripe would have a great shot at solving these problems, but I can see data and billing teams at health systems using this to help with negotiations on specific cases and baseline pricing for different CPT codes. API endpoints that provide clean, abstracted negotiated rates data could be a great infrastructural product for both traditional providers and digital health companies.

kunle 4y ago
Few things > API endpoints that provide clean, abstracted negotiated rates data could be a great infrastructural product for both traditional providers and digital health companies. Cascade Health (who I've been working with) have this API on the roadmap >Patients that I've interviewed generally want a completely abstracted process - send or upload a picture of their bill and their insurance, and then hand it off. This would be similar to the cushion.ai experience. Mixed on this. I think a way to select your insurance and know what you'd pay out of pocket, and to compare your out of pocket costs between multiple providers, is SUPER valuable. By the time you have a bill, you already owe money. Before the visit, you actually have a shot at making a decision that costs you less. > Employers on the other hand want to ensure that they aren't being overcharged by their current stack. They are always looking for solutions for reducing costs and better understanding the drivers of those costs, which tools like springbuk.com address. Cascade is also doing this. > I have less familiarity with the provider side, but the cost of maintaining an insurance billing program has always seemed manual and inefficient. Have a writeup coming about this one actually. I believe there's room for "Contract Streaming" which allows you to use the published data to a) ingest your contracted rates with every payor and b)know in advance what the out of network rates are for any payor, so you can tell a patient in advance exactly what their visit will cost them before they walk out the door. (There's also a bunch of other benefits around forecasting and stuff, but this is the start).

kunle 4y ago

Few things > API endpoints that provide clean, abstracted negotiated rates data could be a great infrastructural product for both traditional providers and digital health companies. Cascade Health (who I've been working with) have this API on the roadmap >Patients that I've interviewed generally want a completely abstracted process - send or upload a picture of their bill and their insurance, and then hand it off. This would be similar to the cushion.ai experience. Mixed on this. I think a way to select your insurance and know what you'd pay out of pocket, and to compare your out of pocket costs between multiple providers, is SUPER valuable. By the time you have a bill, you already owe money. Before the visit, you actually have a shot at making a decision that costs you less. > Employers on the other hand want to ensure that they aren't being overcharged by their current stack. They are always looking for solutions for reducing costs and better understanding the drivers of those costs, which tools like springbuk.com address. Cascade is also doing this. > I have less familiarity with the provider side, but the cost of maintaining an insurance billing program has always seemed manual and inefficient. Have a writeup coming about this one actually. I believe there's room for "Contract Streaming" which allows you to use the published data to a) ingest your contracted rates with every payor and b)know in advance what the out of network rates are for any payor, so you can tell a patient in advance exactly what their visit will cost them before they walk out the door. (There's also a bunch of other benefits around forecasting and stuff, but this is the start).