March 05, 2015
Dealing with an illness or injury is stressful enough. The last thing someone in that situation wants to do is comb through a stack of medical bills to make sure their charges are accurate.
A Philadelphia startup, TrueClaim, will do it for you.
A recent report from the U.S. Department of Health and Human Services found that 42 percent of Medicare claims for routine office visits contain a coding error, costing the U.S. healthcare system as much as $700 billion per year, according to Fortune magazine
Backed by DreamIt Health Philadelphia, the soon-to-launch company is basically a health-focused adaptation of the system credit card companies use to review suspicious transactions, Fortune reported.
We saw it working in the credit card industry and thought, ‘[Health] is a much bigger pool of money,” co-founder and CEO Kasey Sousa told Fortune.
The TrueClaim system plugs directly into an insurance provider’s claims feed. After a doctor submits a claim, the TrueClaim engine, which is hosted on a HIPAA-compliant server in the cloud, analyzes it for potential billing errors. If it sees a suspicious bill or charge, the system will contact the patient with an email, phone call, or text message and ask him a series of up to four “yes-or-no” questions.
They might be simple (“Did you see Dr. Smith last Tuesday?”) or detailed (“Did you make this appointment to get care for your shoulder?”). If the answers don’t match the bill, the system signals the insurer to rectify the error with the doctor.
TrueClaim received $50,000 through DreamIt Health in the summer of 2014, with a second round of funding expected when the company readies to launch a pilot program with Independence Blue Cross within the next few months.
Read a full article on TrueClaim here.
