Startup to Watch: CoPatient – for patients, by patients

careinnovators  | January 25, 2012  -  Leave a Comment

Location - Waltham, MA

Website – www.copatient.com

Description – CoPatient audits and appeals medical bills on behalf of patients. We see a large and growing addressable market as employers continue to shift healthcare costs to their employees and providers continue to struggle to collect on self-pay accounts. However, few tools currently exist to help individuals know if the bills they receive are accurate and fair. This service can be scaled by bringing the experience online and applying a continuously evolving set of business logic and rules (sourced through the broader experience of the community) to guide the process.

Target clients – 1. Middle-class, employed consumers with chronic diseases who are likely underinsured 2. Employer groups who elect to self-insure and structure their healthcare benefits with various cost sharing strategies (co-pays, deductibles, coinsurance

Innovation – Truth be told, this patient advocacy service already exists; however, it is currently delivered in a very fragmented and isolated way, which makes it economically feasible only for patients with very large amounts of medical debt. As we scale the service offering, CoPatient will bring a higher quality service to a wider audience experiencing medical bills by: (1) bringing the experience online to aggregate and share data, (2) enforcing a standard nomenclature across disparate data sets, (3) leveraging electronic transactions with payers and providers, (4) codifying outcomes of audits into business rules and logic, and finally (5) applying best practices when it comes to appealing and negotiating bills. Our unique approach of applying technology, intelligence and consistency to medical bill advocacy will enable us to significantly scale and grow this historically low-margin service business.

CoPatient is seeking . . . We are looking for a technology expert who will be instrumental in building the platform and tools needed to efficiently and effectively audit and appeal medical bills. We are also looking for early adopters of our service – any individual faced with medical bills as well as employer groups looking for innovative ways to more efficiently manage their employee benefits and curb their spend on healthcare. We also love to partner with insurance brokerage agencies who see the value in bringing CoPatient’s audit and appeal services to their employer group clients.