A health IT company out of Cambridge, Massachusetts thinks providers spend way too much time responding to queries for updated enrollment information from the payers they work with. Madaket Health has produced a way to automate that process with the promise of saving doctors time. The idea is that rather than responding to one query for updated information, one payer at a time, there would be one form to update them all and most of all, speed up payments.
Makadet Health is just coming out of stealth mode after three years. It spent much of that time finding out from providers what their needs were, a spokesman for the company said. It views itself as the first health IT company focusing on this issue from a physician’s perspective. Providers pay for the service on a monthly basis.
To date it has raised $5 million from angel and venture capital investors in New York and Boston.
CEO and co-founder Jim Dougherty noted in a statement that there were more than 7 million enrollments in the US last year. Typically, providers work with 25 payers. Any changes to their information, such as a new address, requires providers to complete a new enrollment.
On top of that, providers have to enroll separately in the electronic service of a payer, such as electronic funds transfer, electronic remittance advice, or electronic data interchange for claims. Each payer has unique forms, data requirements and processes for their services. When complete, payers have to fax, email, or mail forms.The company estimates that 20 percent of forms have errors and are rejected by payers.
The upshot is that doctors wait months to get paid after seeing patients and for payers, they waste a lot of time chasing these queries up.
Madaket’s approach sounds like a great idea, but user interface is key. Automated information is great so long as you don’t make mistakes. All the time that gets saved by using one form to update several provider enrollments could easily unravel if there isn’t an easy way to let relevant payers know when a provider has updated their information.
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Ted Achtem, Madaket chief product officer and co-founder took on that question in an email:
“A lot of errors come from two sources: the complexity of the payer forms and illegibility of responses. We’ve dramatically simplified and standardized data entry from a user perspective and are able to intelligently map this data to forms and fields. Providers no longer need to remember the same field could be called “billing address” by Payer X and “pay-to address” by Payer Y. For payers, we’ve been able to virtually eliminate handwritten responses, reducing errors in processing. Madaket also allows users enter and submit information once and then store the data until it needs to be submitted to a new payer or otherwise modified. Afterward, the information is saved, so each time it is transmitted it maintains accuracy. Updating changes to provider information are also a easy one-time process.”
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