Blueprint For Saving 11 Billion Dollars In Healthcare Costs: MD On-Line CEO Bill Bartzak (Part 2)

SM: In 1995, when you were starting MD On-Line, you were on your own. Who did you have to actually build the technology, and how did you find them?

BB: The first programmer I hired was Alan Sagan. I met him through a mutual friend. He is the nephew of Carl Sagan. He owned a company called Bottom Line Software Developers in San Francisco. He has since passed away.

When we started, our application as a DOS-based product that was dial-up based. We were using 2,400-band modems trying to get files across in the fastest manner possible. It was groundbreaking at the time, yet today we look back and laugh at what we were dealing with. As time went on, we developed a special niche of converting paper claims to electronic without ever going to paper in the first place.

SM: Could you explain how your process works?

BB: The doctor’s office would generate a claim form in their computer system and typically print it out. Initially, and we still do it to some extent today, we would have them create a print image of that form. We would map that form. The cutting-edge technology was the mapping process.

We make our doctors live within 15 to 20 minutes of submitting their first batch of claims. The nearest competitor is really three or four days. A lot of it has to do with our initial mapping process technology, which remains the groundwork for what we do. Today we accept every format available, and it works with virtually every practice management system out there. Today we have more than 35,000 doctors working with our system.

Our breakthrough happened in 1997 when the Oxford Health Plan system would not work anymore. It suffered complete failure. What was a disaster for them presented the opportunity for MD On-Line to step up and start getting these claims again from the doctors’ offices. We went to the individual offices and got the claim files back out of their systems. A lot of times they were not able to do that by themselves or  re-create the claims. We would re-create them with the doctor’s office and help Oxford Health Plan get back on their feet and start paying doctors again.

SM: Can you delve deeper into your image-mapping technology? What exactly does that do? That sounds like your secret sauce.

BB: A lot of our success has been driven by customer service, but you are right, the mapping processes and the processing of the claims is the secret sauce. The way we are doing it is not very different from other mapping technologies, with the exception that it is very specialized to the data that is on the claims forms tied to healthcare. We take the initial print image and put it into a secondary format, which is our proprietary MD On-Line format. We then validate the data before processing it into any format the insurance company wants it in.

This segment is part 2 in the series : Blueprint For Saving 11 Billion Dollars In Healthcare Costs: MD On-Line CEO Bill Bartzak
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