Health Cost Labs

Health Cost Labs is a medical cost transparency company whose mission is to create competition amongst Providers and Facilities. By providing transparent cost to consumers, employer groups, providers and insurance companies, we can bend the cost curve in a meaningful way. We believe data driven decisions will help all players in the health care system manage dollars more wisely. Our backgrounds from Data Science, Provider Reimbursement, and Fraud, Waste & Abuse allow us to understand the claims data from different perspectives. This insight into the claims data allows us to create analytics that deliver actions. The problem with health care stems from the reimbursement method. Fee for Service. Fee for service incents providers to bill more units to increase their revenue. Billing managers market themselves as expert billers because they are measured by the amount of revenue the generate. Some exploit loopholes within the claims processing system to maximize revenue. Consumers are unaware of what they bought until after they receive the processed claim. Consumers are not familiar with billing codes and, therefore, cannot determine if the coding is appropriate which means the claims will likely not be disputed. Providers and hospitals are also acquiring other providers and hospitals. The intent here is to increase network market share. A larger network market share enhances the negotiating leverage with the carrier over reimbursement rates. The larger the market share, the higher the reimbursement rates. With cloud computing and mobile apps we can deliver cutting edge decision making tools to the consumer before health care is purchased. When consumers start migrating to lower cost providers, higher cost providers will have to course correct and become lower cost. This is the essence of competition.

网站

https://www.healthcostlabs.com

Health Cost Labs的外部链接

所属行业

IT 服务与咨询

规模

2-10 人

总部

Audubon，PA

类型

合营企业

创立

2018