Health care is a mess, and the billing is even worse: Simplee is making this process more manageable
Palo Alto-based Fintech solution provider for the health care sector Simplee announced on Tuesday the close of their Series C funding round, pulling in $20 million in new financing.
Leading the round was new investor Social Capital, who joined with existing investors 83North and Heritage Group. Along with Social Capital, American Express Ventures is another newcomer to the team of investors, adding Simplee to their growing portfolio of Fintech and marketplace companies.
Co-founded in 2011 by CEO Tomer Shoval, CTO Tom Tsarfati, and COO Roberto Rabinovich, Simplee works with health care providers like hospitals to help simplify and streamline the billing process with insurance companies and patients.
The company touts their Simplee Financial EngagementTM software platform as the “first patient engagement solution unifying hospital and physician estimates, statements, payments, and credit.”
Their product is aimed at helping to create transparency in the decidedly convoluted world of medical billing. Simplee’s solution helps patients understand what exactly it is that they are being charged for, breaking down which part their insurer is picking up and how much they owe.
Since the platform is integrated into the health care provider’s system, both the patient and provider are able to view the same set of details, hopefully leading to a significantly smoother exchange to resolve payments.
The need for Simplee’s service is derived from the fact that even if a patient has insurance, there are always extra charges that are left for the individual to pay. Beyond the standard co-pay and deductible that comes with most doctors’ visits, undergoing a medical procedure can often incur additional costs. This may include staying in a recovery room or overnight and other details that would not occur to the average patient that they would have to pay out of pocket for, and can be a very unpleasant surprise after returning home.
Health care providers use Simplee’s easy-to-follow system and mobile integrations to work with patients from the point of the initial estimate of costs, all the way through to the end of the billing. This includes a platform similar to PayPal where the patient has a ”wallet” and easy method of making the payments, receiving statements, and hopefully keeping everything above board. Beyond simply making the experience easier for the patient, they are also ensuring that collection is a whole lot easier for the providers.
As mentioned above, hospital billing is one of the darkest of arts, spun of webs that can drive a person insane. Simply cruising around the internet, it is pretty easy to find horror stories from people who had insurance and were still hit with insane and unjustifiably expensive bills.
Hospital billing systems in the United States, for example, are sometimes so messed up that they can get significant portions of the bill wrong. Take a second to read this Business Insider article and see how this guy found himself with a $55,029 bill for treating his appendicitis.
They also include some important tips on how to argue with the hospital and pay for only what you actually owe. Fighting with customers over incorrect bills can be a time consuming process for the provider, leaving them unpaid. Simplee hopes that by using their system, hospitals can greatly reduce this wasted time and resources, leading to better margins.
Having launched their first platform in 2013, Simplee is now being used in almost 900 physician groups and hospitals in the U.S., providing service for some five million patients at a value of over $1 billion in payments annually.
The health care crash is coming
The American health care system, much like that of many other countries, is facing a crisis of overblown costs built on a system where providers ballooned pricing to charge the insurance companies outrageous amounts of money, that in turn get passed on to the patients.
The billing system has turned into a maze exceedingly difficult to navigate at best, and all too often ends with serious frustration. Since this problem is so rooted at the core of the health care system, it will likely take more than one or two startups to resolve the issue.
All that said, Simplee appears to be doing a great job at bringing some semblance of order to the chaos. By making the billing process just a little more manageable and transparent, they stand to have an influence on the lives of a lot of people.
As people continue to live longer, the entire health industry will need to seek out solutions to improve the quality of care while reducing costs. Technology working to catch problems early through at-home monitoring and IoT wearables will likely have a big role to play since they are much cheaper investments than dealing with a full-fledged emergency.
On the bright side, one of their existing investors is the Heritage Group, a strategic investor in the American health care system and represents hundreds of hospitals. Hopefully with their help, they will be able to get Simplee integrated with more health care providers, spreading the good word.