Thought Leaders in Healthcare IT: Simplifeye CEO Ryan Hungate (Part 4)

Sramana Mitra: What do you see as open problems in your space right now?

Ryan Hungate: There are a few of them. They’re glaring problems. One is insurance. You’ve got a huge opportunity in insurtech. At the same time, you have to be very careful because insurance companies may not say it out loud, but they don’t want to fix that.

Let’s take verifying insurance as an example. When you walk out of a doctor’s office, you think it’s free. Between 30 and 90 days later, you get a bill in the mail for $600. You have to send the check in the mail. This happens because of how insurance works. They make it very ambiguous on how much they’re going to reimburse. If I call in for you, I don’t know how much of your benefits you already used. The insurance companies make it purposely ambiguous because whether they reimburse you or not is completely up to them.

Now what happens is, the front desk staff has to call up, wait on hold for 30 minutes, and verify your benefits over the phone. Then if they’ve the right information, they’ll know how to do the calculation for you. If you don’t do that upfront for the patient, you do it afterwards. There’s literally a person in the practice that is on the phone all day long with these insurance companies and doing manual calculations. Verification of benefits and automation of claims have to be fixed at least in the retail healthcare world.

Sramana Mitra: There are a class of IT companies doing the collections part. Gradually, they’ve morphed more into the electronic health record space that automates the collection process. Are you telling me that they are not active in the space that you’re in?

Ryan Hungate: No, we’re not in insurtech. I don’t want to ever be in there. On the medical side of things, they’ve gotten a little bit better. Those electronic health records have integrated with services that can automate that process. When it comes to the retail healthcare portion, which is where we concentrate on, it’s the fastest-growing piece of medicine.

Retail healthcare is different from hospitals or your primary care physicians. Right now, you don’t have a verification of benefits. There are companies that are trying to tackle this. There’s one called Dentist. They’ll start with a service where they have human beings powering a little bit of that. It’s maybe 80% technology and 20% people. As you start to push these services, you’re going to see more and more of these insurance companies start to be amenable to these interactions. 

Sramana Mitra: Anything else you want to add?

Ryan Hungate: It depends on the way you approach things in healthcare. To entrepreneurs thinking about attacking healthcare IT, I would recommend them to think about the patient journey first. Then think about if the target patient will actually use it. I actually know whether I would have used it or not.

I see so many people create something for a problem that doesn’t exist. You start to see a lot of these things stack up in the office every single day. It gets to be a lot. You’re going to see consolidation. For anybody looking to attack the healthcare IT world, there are a lot of problems but you really have to check if it’s something that needs to be fixed.

Sramana Mitra: Thank you for your time.

This segment is part 4 in the series : Thought Leaders in Healthcare IT: Simplifeye CEO Ryan Hungate
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