SM: You essentially act as a translator between physicians’ offices and all of the various insurance companies because you can present insurance forms in each company’s preferred format. Is that a fair assessment?
BB: Yes, that is accurate.
SM: Is that all automated, or are there manual processes in there as well?
BB: It is entirely automated. It would not be feasible with manual processes in the mix.
SM: Let’s put this in perspective in terms of the competitive landscape. How does your service compare with companies such as athenahealth?
BB: athenahealth, in the future, should be a partner of ours. It would make a lot of sense because right now we do not have a practice management system, and athenahealth is the practice management side of it.
SM: My understanding is that their core value proposition is managing collections. They get paid a percentage of the money they collect on behalf of doctors’ offices.
BB: The data that the doctors put into the collection systems are athenahealth systems. They track the payments out of that process. Our role could be to transport that data and format it for insurance. Getting more doctors on an athenahealth-type system where the doctors use that product to put the claims into the system would help us.
athenahealth still has to send those claims on behalf of the doctors to the insurance companies. They could be using an MD On-Line service to do that. Today they are partnered with different companies. I am convinced that we would be a logical partner, and one of the companies we have targeted to talk to is athenahealth. We want to explain what we are doing today to see if there is an opportunity there in the future. When you look at the electronic health records work that athenahealth is doing, it just makes a ton of sense.
SM: What are some of the other companies out there?
BB: Emdeon is a claims clearinghouse in our industry. They would be deemed a friendly competitor because we send them transactions as well. Gateway EDI is another company. The differentiating factor between MD On-Line and any other company out there today is that we have the endorsement of 35 insurance companies. For example, we just became the claims solution for CIGNA Healthcare. We are already the solution for Aetna, United Healthcare, and a whole list of companies.
SM: Who is your target market?
BB: Our target market is the small doctor’s office. We do have some large offices with several hundred doctors, but the target is paper-submitting doctors. They are the forgotten people today. I just presented to the World Health Care Congress that there are still 3 billion paper claims submitted to insurance companies every year. That is a waste of $11 billion.
We work specifically with those insurance companies to get those doctors’ offices off paper. We show these offices the advantages of going paperless. It streamlines their processes and they get paid faster.