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Will this partnership of startups help telehealth seekers know what their insurance will cover?

Silicon Valley startups PokitDok and Doctor on Demand announced a strategic alliance that they said will help users of Doctor on Demand’s telemedicine services more quickly determine what’s covered, thereby streamlining both the visit and payment process. Doctor on Demand CEO Adam Jackson said the effort will eliminate the often-slow or burdensome process of connecting […]

Silicon Valley startups PokitDok and Doctor on Demand announced a strategic alliance that they said will help users of Doctor on Demand’s telemedicine services more quickly determine what’s covered, thereby streamlining both the visit and payment process.

Doctor on Demand CEO Adam Jackson said the effort will eliminate the often-slow or burdensome process of connecting insurance for the user.

“Before PokitDok, we manually integrated with health plans,” he told MedCity News. “This will allow us to rapidly onboard employers and health plans, giving access to their employees and members at a much faster rate.”

Essentially, PokitDok‘s suite of APIs lets the company identify much sooner a patient’s eligibility and then submits the claim for the visit directly to the insurance carrier, Jackson said.

It’s the second alignment with a telemedicine company in as many months for PokitDok, having struck a similar deal last month with Healthiest You. PokitDok CEO Lisa Maki said its API, particularly for telemedicine, helps make the process more consumer-friendly than healthcare is accustomed to as an industry.

“They really wanted to seamlessly connect to insurance eligibility to submit a claim for cost,” she said of Doctor on Demand.

PokitDok, which also makes APIs for pricing transparency and for scheduling, views the growing telemedicine space as a natural segue for its APIs. The market is expected to reach $43 billion by 2019, the result of Medicare and Medicaid, and an increasing number of insurers paying for it.

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

PokitDok has partnered with 177 insurers throughout the country, representing 79 percent of covered lives across the U.S. The APIs enable consumers and self-insured employers to use telehealth services through their insurance plan.

Doctor On Demand has a network of more than 1400 Board Certified physicians and 300 psychologists overseen by Chief Medical Officer Dr. Pat Basu, M.D., a former Stanford physician and White House fellow.

The collaboration, Maki said, will be particularly helpful in the direct-to-consumer realm, where Doctor on Demand previously relied on cash payments, which consumer would either pay for out of pocket or get reimbursed later by insurance.

“We now connect them to insurance companies nationwide, so no matter what employer or customer they’re serving, they can seamlessly check that patients and see if they’re eligible and submit a claim,” Maki said.