PokitDok said it would end the practice of charging fees for essential transactions with payers such as insurance enrollment, eligibility checks, claims processing, authorizations and medical referrals. The condition is that they use PokitDok’s X12-compliant Application Programming Interfaces.
In an interview with CEO Lisa Maki at Health 2.0, she said PokitDok previously charged 1 cent to 2 cents for these transactions. She noted that the practice of charging a fee for essential transactions is an outdated concept that began with the rise of clearinghouses to serve as intermediaries between insurers and providers for basic Electronic Data Interchange associated with medical billing and to assist in driving digital adoption across health systems.
PokitDok’s move isn’t likely to have a huge impact in the short term given its size compared with, say, Change Healthcare, which just spent $126 million simply to change its name from Emdeon. The company had $522 million in revenues last year. PokitDok, by comparison, has raised more than $39 million to date. But dropping the negligible charge wins it a little love from providers and signals to the information clearinghouses to watch out. It will be interesting to see how they respond, if at all.
When Investment Rhymes with Canada
Canada has a proud history of achievement in the areas of science and technology, and the field of biomanufacturing and life sciences is no exception.
Maki likened PokitDok’s approach to using APIs to what Amazon and Uber have done — using a collection of APIs to create a seamless way to integrate disparate tasks and services.
“Once we put effort into building connections between providers and insurance companies, the cost of getting data from the insurer to the provider is close to zero. The value is on the IP we put around data, such as interoperability and analytics.”
