Pacific Northwest providers and health plans are taking notice of a new app that aggregates a patient's insurance information in the doctor's office while also allowing the patient to pay on the spot.
The mobile platform developed by Wellero, a Portland, Ore.-based affiliate of Cambia Health Solutions, is being marketed as a two-way app, says co-founder Hanny Freiwat. On one side, it gives patients all the eligibility information they need at the point of care; on the other hand, it gives providers a portal in the office to connect the patient with his or her health plan and improve the billing process.
Wellero is part of a growing trend in the mHealth industry to target healthcare payments at the point of care – in particular, out-of-pocket charges, which typically account for 30 percent to 35 percent of a patient's bill. Other vendors bringing similar tools to market include CareCloud, DocuTap, Iconic Data, and Kareo.
The shift in healthcare to a more patient-centered, risk-based approach is spurring an increase in high-deductible health plans, giving patients the option – and the opportunity – to assume more of the costs and to pay them up front.
That's where the developers of online, cloud-based revenue cycle management platforms come in. They're the bridge between the payers, the providers and the ever-more-involved consumers.
Healthcare analysts see this move as simply aligning the market with other industries, like banking and retail, even transportation and entertainment. If a consumer can pay for a cab or a concert with a credit card at the point of purchase, why shouldn't they be able to do the same in the doctor's office or clinic?
Just as important, these types of platforms help consumers manage medical costs at a time when many are having difficulty paying medical bills. A recent Kaiser Family Foundation study, in fact, found that one in three consumers is having difficulty paying medical bills – with more than half of those having employer-sponsored private insurance plans.
Freiwat said Wellero launched its platform last June, and added the online bill pay feature in April. He added that the platform gives providers a front-end office management solution that integrates with existing claims and bill payment solutions, cuts down billing charges and enables them to receive payments within 48 hours, rather than the standard 60 to 90 days. That improves the physician's consumer engagement strategy and reduces costs incurred tracking down late payments.
"Even the best medical care in the world begins to lose value a few weeks after you're feeling better," he said.
Wellero is gaining traction in the Pacific Northwest, where it's been adopted by Regence BlueCross BlueShield of Oregon and Regence BlueShield of Idaho. The Wellero platform now supports close to 500 health plans, and Freiwat expects to take it national in the near future, along with adding capabilities to address hospitalizations and other complex medical processes.
Freiwat continued the mobile aspect of Wellero fits right in with prevailing trends. Both consumers and providers are relying on mobile devices, especially smartphones, to get real-time information and make business transactions. And anything that improves access is going to gain approval from physicians, who are looking for ways to streamline their workflows and reduce waste.
"With this platform you're getting the exact determination of a bill at the point of care," said Freiwat. "That's pretty much the definition of the Holy Grail of Healthcare."
