As I've noted in the past, there are lots of companies seeking to find one or another Holy Grail in the health care world. After all, when this sector comprises almost 20% of the US economy, who wouldn't want a piece of it? But to be successful, you need to offer a product or service that actually enhances the day-to-day lives of clinicians or others in the sector.
This brings us to Madaket, founded by my buddy Jim Dougherty and friends. (Note: I have no financial interest in the venture.) They noticed a very serious hole in the health care marketplace--the enrollment of doctors with the variety of insurance companies with which they must deal--and have developed an elegant solution to fix it. Short version:
The average healthcare provider works with 25 payers. Providers must be enrolled with payers to receive payments. Each payer requires a unique set of forms, procedures, and data to be submitted in order to enroll for Electronic Funds Transfer (EFT), Electronic Remittance Advice (ERA), Electronic Data Interchange for Claims (EDI) and other common provider-payer transactions. When providers make minor changes to their enrollment information, they must submit these forms again.
It takes months for payers to fully process provider enrollments – and months before providers start receiving correct payments. Time is wasted dealing with paper forms, correcting manual errors, and tracking down the status of enrollments. Madaket automates the enrollment process. Providers fill out a simple online form once, and Madaket sends the right information each applicable payer. The result? Less paperwork, faster payment.
Here's the video:
Note the design: All web-based, user friendly, and infinitely scalable. In addition, the existence of Madaket will pull those insurers who currently rely on paper and faxes into the same web-based environment, further enhancing its (Madaket's) deliverablity and efficiency over time.
This is a winner. Let's go back to that beach on Nantucket and contemplate the good that will come from this!
Paul - Having been involved with provider credentialing at a large primary care physician group I can see the value that Madaket would bring to a busy office. I also know that at a primary care office the expression "free isn't cheap enough" is usually true so I am curious if it is the providers or the payers that pick up the cost for this service and at what cost? Also, provider credentialing includes a lot of other paperwork such as getting NPI numbers, hospital credentialing, DEA numbers and state license information. If the offices still have to do all of this work they can't really cut as much overhead as they could if Madaket did everything. Having seen first hand how messy and timely the credentialing process is I agree that this is a big opportunity but it seems like healthcare is SO messy these days it is difficult to truly streamline anything.
ReplyDeleteTo be clear, this is enrollment, not credentialing. My understanding is that the providers are already choosing to pay for it, as it brings them value quite quickly.
ReplyDeleteI don't know the fee schedule. I'm sure the company would happily provide it.
I congratulate them - and, I sure wish I'd seen the word "patients" in here.
ReplyDeleteAnd I sure long for the day when an exactly similar aggregation service exists for patients' needs!