Startups, Health IT

Startup Vericred wants to do something about those surprise medical bills

Vericred, a healthcare data services startup based in New York City, is now offering a provider-network notification service.

health insurance, Obamacare

Health startup Vericred is seeking to alleviate a problem in the world of healthcare: undisclosed changes in provider networks.

The New York City, New York-based healthcare data services company has launched a new service, called provider-network notifications. With it, carriers can inform patients when specific providers leave or join a network, thereby reducing the possibility of surprise bills after an out-of-network visit.

In a phone interview with MedCity, Vericred CEO Michael Levin explained how troublesome it can be to show up at a physician’s office, only to discover the provider is no longer taking your plan.

“It’s an uncomfortable situation for everybody,” Levin said.

A person in this scenario, Levin stressed, has a few options, none of which are truly positive. “You can stay there and pay out-of-network fees. You can go look for another doctor. Or you can go to an ER, in which case there are significant costs to the payer,” he said.

This issue, he said, was the genesis for provider-network notifications.

Through the service, Vericred detects changes in its provider-network data. The startup then sends these changes to its partner platforms, who can notify their members via whatever method they choose.

Provider-network notifications are beneficial to a number of parties.

Patients are no longer put in awkward situations or given sticker shock by medical bills. For carriers, who were often tasked with solving this notification problem, Vericred’s service makes the process easier, reducing both bad member experiences and administrative burdens. Even human resources platforms can see benefits through the increased value and satisfaction they give employees.

It’s a rare situation where you can create a win for everybody,” Levin said. “It really provides benefits across the spectrum.”

Looking ahead, Levin said he believes provider-network notifications like Vericred’s will eventually become ubiquitous. “It’s kind of a no-brainer,” he said. “This should just become commonplace.”

Vericred has been working in the healthcare field since its founding in 2014. That November, the startup raised $1.125 million in seed funding in an effort to ease the provider credentialing process.

It eventually expanded its scope, looking to assist potential insurance customers in determining whether their physicians participate in specific payer networks. In early 2016, Vericred closed a $3.1 million seed funding round, which it said it would use to expand data services and beef up its sales team.

Last month, the startup brought its total funding to just under $10 million when it closed a $5.5 million Series A funding round led by FCA Venture Partners.

Photo: BrianAJackson, Getty Images