Lumedic started with an $800 wellness visit and a misguided patient. Today, we’re on a bold course to improve the financial experience of healthcare for patients. But to get there it starts with streamlining how the industry translates patient services into payment.
Today, we’re working with caregivers, patients, and administrators to modernize financial healthcare experiences to be easier to understand for patients. We want patients to know their healthcare costs before getting a bill in the mail, and we want caregivers to have the freedom to focus on patients, not administration.
These goals are challenging today because the industry is incredibly complex. Despite technology’s advances in other industries, healthcare remains in the dark ages when it comes to infrastructure and interoperability. Encumbered with decades of legacy systems and processes, today’s IT landscape creates administrative costs that are largely hidden from the average patient. And that complexity exacts a painful cost on physicians, insurance administrators, and patients alike, both cognitively and literally.
According to a National Institutes of Health workshop, over $315 billion is projected to be spent in 2018 on healthcare administration tied to billing and insurance related processes alone. These functions fall within the domain of healthcare responsible for translating your medical visit into payment to your doctor, better known as revenue cycle management.
Unlike going to the grocery store and buying a gallon of milk, there are dozens of transactions that need to take place throughout the revenue cycle from scheduling a visit to confirming insurance eligibility to filing a claim and sending the bill. While critical to keeping the healthcare financial system running, many of these processes remain manually intensive, relying on armies of personnel to enter accurate, timely data each day.
Today’s processes still rely on physical correspondence and fax machines for sending medical records, and caregivers can spend hours each week waiting on hold to check the status of claims. To monitor changes in insurance company policies, health systems use tools to screen scrape payer websites for new information. A patient’s insurance information can be mistyped, authorization numbers incorrectly copied between unconnected systems, and sometimes information is just lost — all resulting in a denied claim and often a surprise bill to the patient.
These are the processes that drive the underlying financial experiences that we’re served as patients. To fix how patients consume care related financial information, we first need to fix how administrators and caregivers interact with the revenue cycle. And this starts with addressing how organizations and systems exchange information.
To do this, Lumedic builds on a core of distributed ledgers, smart contracts, and data science as the key to enabling a more efficient, trusted, and intelligent revenue cycle.
We’re excited at what’s to come, and look forward to sharing what we learn along the way!
We’re just getting started.