“Don’t bother doing something unless you’re radically different from the competition” – Richard Branson
By Leon Winsiewski
When Thomas Edison invented the light bulb people stopped using candles and lanterns. AI now makes the impossible possible. Feed the models enough information and it will learn what is the right answer.
Medical bills are a disaster. Its hard to find the billing codes and the prices on the bill don’t even reflect the amount the hospital expects to receive. Did I say medical bills are a disaster?
But now AI can read the medical bills and pull out the procedure codes. Bounce that against the price transparency data and you have your answer. Now you don’t need to pay a TPA $25 to $35 PEPM for a service most hardly use. Just take a picture of the medical bill and let AI do the work. Pay the hospital directly.
The new normal.
Want to cut the admin waste out of healthcare? You can start by cutting out the TPA.
With medical bills, price transparency, cash cards and ai we can lift the codes from the medical bills, reprice it, send the machine readable file to the employer, and pay the clinician.
Why pay $25 to $35 PEPM when you can spend 70 cents using ai to scan the medical bills. And many people don’t go to the doctor or hospital so we’re only talking about a few people who will actually use this.
Is paying a monthly fee for people who don’t even use insurance worth it? I say no
Related Blog Posting – Wisniewski
John was a former city manager who survived local politics in the twenty plus years he was city manager. Early on he wondered why the city was purchasing health insurance from a third party vendor, paying someone else for work they could do themselves.
“We are big enough to self-fund, and we can process claims right here in our offices. This is not rocket science. We don’t need a TPA or a BUCA and we certainly don’t need stop loss insurance. And, we don’t need a network either” was the message to staff.
