health 2.0 code-a-thon: power to the patient: wtf! denied wins for the financial and explanation of...

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What does it mean? Problem: Explanation of Benefits OMG WTF EOB! Unnecessary procedures or invalid diagnoses Incorrect codes Unresponsive insurance providers Understanding billing explana6ons Finding errors and inconsistencies What can I do about it?

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Post on 29-Nov-2014

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Code-a-thon winning team, including CareSync's Amy Gleason (@thepatientsside) took first place in Health 2.0's Financial and Explanation of Benefits Track in San Francisco, California, September 28 and 29, 2013. The result of their two-day, non-stop, caffeine-filled session is WTF! Denied, which extracts data from the patient’s Explanation of Benefits and presents it to patients in a redesigned, easy to understand layout, and allows patients to interact with each other in an online forum dedicated to resolving EOB issues.

TRANSCRIPT

Page 1: Health 2.0 Code-a-thon: Power to the Patient:  WTF! Denied Wins for the Financial and Explanation of Benefits Track!

What  does  it  mean?  

Problem: Explanation of Benefits OMG WTF EOB!

•  Unnecessary  procedures  or  invalid  diagnoses  •  Incorrect  codes  •  Unresponsive  insurance  providers  

•  Understanding  billing  explana6ons  •  Finding  errors  and  inconsistencies  

What  can  I  do  about  it?  

Page 2: Health 2.0 Code-a-thon: Power to the Patient:  WTF! Denied Wins for the Financial and Explanation of Benefits Track!

Frequency  of  Problem  

Audience

Targeted  Users  

1  Na6onal  Vital  Sta6s6cs  Report  –  CDC  2  Global  Genes  Project  

•  1.2B  visits  to  the  doctor  annually  with  each  resul6ng  in  an  EOB  

•  Average  of  15.5%  of  claims  are  denied  

•  Chronic  diseases  (133M)1  •  Rare  Disease  Pa6ents  (30M)2  •  LiUle  understanding  of  medical  billing  

Page 3: Health 2.0 Code-a-thon: Power to the Patient:  WTF! Denied Wins for the Financial and Explanation of Benefits Track!

Convert  your  EOBs  to  BB+  

Solution: WTF! Denied? (.com) Outsmar6ng  EOBs  Together  

Draw  on  the  experience  of  others  

http://bit.ly/wtfdenied

Page 4: Health 2.0 Code-a-thon: Power to the Patient:  WTF! Denied Wins for the Financial and Explanation of Benefits Track!

Redesigned  EOB  

EOB: Redesigned

Shamelessly adapted from @mjacksonw's Blue Button EHR redesign.

Readable  benefits  summary  

Relevant  totals  

Details  that  make  sense  

bbClear compatible

Page 5: Health 2.0 Code-a-thon: Power to the Patient:  WTF! Denied Wins for the Financial and Explanation of Benefits Track!

Upload  &  Convert  EOBs  Pool  your  collecJve  knowledge  

Track  EOBs  in  one  place  

Frustration: Crowdsourced

Redesigned  EOB  

http://bit.ly/wtfdenied