The notoriously inefficient and disconnected operations of the healthcare sector increase the cost, concern, and time associated with already stressful medical problems. It is vulnerable to disruption and yet lags behind the rate of the digital revolution that is redefining other aspects of our lives.
With platforms and application programming interface (API) interfaces that make sense of the medical billing and payments tumult, several FinTechs are confronting the fragmented structure of healthcare payments. They could be rather direct when describing how much modernization is needed in this industry.
Ken Abel, a co-founder of Lynx and the company’s chief information officer, claimed that when it comes to change, “Healthcare is certainly lagging in that transition” because more responsibility lies with the patient-consumer who queries why healthcare payments can’t be more like other types of consumer spending.
Abel claims that the fundamental force behind the current situation is the growing need among consumers for more real-time, transparent experiences like those offered by Venmo and Cash App. The traditional healthcare providers “have kind of lagged behind in that, but Lynx is putting forward services to really help bridge the gap.”
A great example of the malingering misunderstanding in healthcare is the dreaded explanation of benefits (EOB), which commonly contains the term “you may owe,” which is a warning sign for consumers.
Abel claims that Lynx wants the phrase “you may owe” eliminated from medical vocabulary.
He stated that in order to do this, “You must provide programmatic APIs that the organizations supporting those claims processes may include into their workflows. This will enable them to update those transactions, get access to the payment loop, and provide the user with more seamless assistance and an improved experience.”
Traditional Flows Have Problems
When it comes to basic concepts like shifting one’s care to another system and how data is utilized — or not used — in invoicing and payments, the healthcare sector is lagging behind. This is true despite considerable modifications to the healthcare system and an increase in the types of locations and modes of delivery of services throughout the pandemic era.
Given that healthcare benefits are not transferable should a person leave their employment, for example, Abel highlighted this as “an ongoing difficulty in terms of offering a seamless experience that the customer can utilize as they transition from employer to employer.” We can only conclude that if Lynx supports both the old and new organizations, a resolution will be reached. However, we are conscious that we only make up a very small percentage of the
The Following Interaction Level
The rigorous HIPAA regulations and the sensitive nature of the data make this improbable, even if patients would want healthcare to function more like Venmo. However, there is an opportunity for improvement, and everything, including the incentive, are already moving in that direction.
Although previous incentive programs may have entailed getting a one-time gift card in return for completing a health challenge, Abel continued, it is a straightforward fix that may increase participation and improve outcomes.
We’re saying you can be more deliberate than that, he said, adding, “You can give a reloadable card that enables you to genuinely create a long-term connection with the consumer while employing these incentives on the front end to drive these activities.”