Sramana Mitra: When you were actually processing claims, what did you see that triggered this idea? Ernie Bray: What I saw was that claims technology systems were outdated. They were just green screen technologies at that time. I’ll give you an example. When I was looking at AAA, appraisers would go out and take photographs of
Sramana Mitra: How many insurance companies are there in the United States? Jason Beans: I don’t know. There are about 150 licensed insurance companies doing workers’ compensation. But that’s only in the States. A lot of the insurance companies are forming captives or off-shores in tax havens like the Cayman Islands or Bermuda. There are
Sramana Mitra: How many physicians do you have in your system right now? Jason Beans: We have, according to our database, more than 500,000 physician locations. Now that’s inflated in my mind, because if a doctor treats at four different locations, each location will be registered. If she is an individual doctor in our group and also practices as a part
Sramana Mitra: I guess, what I’m trying to understand is – one of the case studies I know inside out is the Athenahealth story. Their business model is actually very simple. They work on behalf of the physicians, and they have all these rules engines for coding and everything, and they do collections on behalf
Sramana Mitra: What do you think is the core differentiated value in what you do? Is it more the rules engine that helps you determine what is to be approved and what is not to be approved? Jason Beans: That is a differentiator. I wouldn’t say it was the number one, just because if people
SM: Tell me more about how you deliver that service. What do you need in terms of your workforce? What do you tackle in technology? What do you tackle in human resources? JB: It’s a very hybrid model. It’s a half technology, half service model. We have a team of, say, 40 or 50 technology
Health care costs can be prohibitive, not only for the average citizen but for employers and insurance providers, too. Rising Medical Solutions, a Chicago, Illinois-based company, works with insurance providers to help keep health care costs down without sacrificing the quality that patients receive. Their specialities include medical bill review, hospital bill review, care management
By guest author Simon Walker of Blue Cod Technologies The technology world loves its buzzwords. Attaching a catchy term can help grab attention and define a broad technical evolution in a simple way. It can also overcomplicate a new process or technology, put its evolution at risk, and drive buyers to focus on the mechanics