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Medical Billing is ripe for disruption, but of note, I don't know of any startup that has made significant inroads into this market. Anyone know why its so toug

Medical Billing is ripe for disruption, but of note, I don't know of any startup that has made significant inroads into this market. Anyone know why its so tough to break?

senectus1 3y ago
oh yes, lets apply gig economy thinking here. demand scaling prices and share doctoring.
miguelazo 3y ago
Seriously? Barriers to entry are massive. The insurance lobby is not going to just let their cash cow get "disrupted." Unlike those middle class taxi drivers that got obliterated by Uber, the healthcare industrial complex has a massive war chest and plenty of political clout.
TuringNYC 3y ago
>> I don't know of any startup that has made significant inroads into this market. Anyone know why its so tough to break? Because multiple parties in the system are both making money and control the standards of practice. This makes real competition incredibly difficult.
zeruch 3y ago
Complexity across providers and regulatory compliance are my most likely guesses.
pc86 3y ago
1. Good luck finding a startup, especially a VC-backed one (which for this kind of market I would expect is a borderline necessity), that isn't going to charge at least this much if not more per transaction. 2. Would their customer be the insurer or the doctor? If it's the doctor, I can't see insurers wanting to reimburse anyone other than the doctor. If it's the insurer, why would they farm out their billing to this third party when they already have the capability, and it's clearly lucrative? 3. Medicine in general is ripe for disruption, but it's so heavily regulated that eats into a lot of the potential profits from any service provider. Everything is an enterprise contract negotiation and the technical talent leaves pretty quickly when they see how slow everything moves. I've worked with large hospital systems that were still running Windows 7. Recently.
anonuser123456 3y ago
Because Epic is deeply integrated everywhere. It’s like trying to dislodge SAP; good luck with that.
codegeek 3y ago
Medical Billing issues are a symptom. The real cause is Middle Man Mafia Insurance companies dictating everything that happens b/w a Doctor and Patient.

Medical Billing is ripe for disruption, but of note, I don't know of any startup that has made significant inroads into this market. Anyone know why its so tough to break?

senectus1 3y ago

oh yes, lets apply gig economy thinking here. demand scaling prices and share doctoring.

miguelazo 3y ago

Seriously? Barriers to entry are massive. The insurance lobby is not going to just let their cash cow get "disrupted." Unlike those middle class taxi drivers that got obliterated by Uber, the healthcare industrial complex has a massive war chest and plenty of political clout.

TuringNYC 3y ago

>> I don't know of any startup that has made significant inroads into this market. Anyone know why its so tough to break? Because multiple parties in the system are both making money and control the standards of practice. This makes real competition incredibly difficult.

zeruch 3y ago

Complexity across providers and regulatory compliance are my most likely guesses.

pc86 3y ago

1. Good luck finding a startup, especially a VC-backed one (which for this kind of market I would expect is a borderline necessity), that isn't going to charge at least this much if not more per transaction. 2. Would their customer be the insurer or the doctor? If it's the doctor, I can't see insurers wanting to reimburse anyone other than the doctor. If it's the insurer, why would they farm out their billing to this third party when they already have the capability, and it's clearly lucrative? 3. Medicine in general is ripe for disruption, but it's so heavily regulated that eats into a lot of the potential profits from any service provider. Everything is an enterprise contract negotiation and the technical talent leaves pretty quickly when they see how slow everything moves. I've worked with large hospital systems that were still running Windows 7. Recently.

anonuser123456 3y ago

Because Epic is deeply integrated everywhere. It’s like trying to dislodge SAP; good luck with that.

codegeek 3y ago

Medical Billing issues are a symptom. The real cause is Middle Man Mafia Insurance companies dictating everything that happens b/w a Doctor and Patient.