[ryanianian]

1. If there's ML and a "guarantee" involved, what actually happens if the bill is larger than predicted?

2. I've been to medical appointments where doctors have clearly ordered tests to pad the bill. E.g. a lung capacity test to prescribe stimulant medication. Or doing many blood panels "just in case" (conveniently when they have an in-house blood scanner and phlebotomist). Some practices offer dozens of such tests and procedures. They are judgment calls but doctors are perversely incentivized to order them. What is the patient/doctor experience in these situations? Having the menu of services+prices readily visible and available and the doctor walking through the options and risk/reward?

3. Will you publish the pricing information over time? Perhaps comparing the transparency/hospital-published data versus your experiential and predicted data?

[blastbking]

If the bill is larger than predicted, we end up covering the difference (assuming that the services we showed the user are the ones the user ended up getting). We match the prices shown in the table of 'All Covered Services' that we show to the user, so if you go to a derm to have a mole looked at, it might be $150 for a consultation, and we'll tell you it'll be $70 to have a biopsy done, and if you get the biopsy, we'll guarantee all you owe is $220, and if you don't we guarantee it's $150.

In terms of padding the bill, we think that doctors tend to pad it in order to get reimbursed more by insurance, but they're pretty soft on holding patients liable to these padded things, and also they will get in trouble if they do it too much. We do need to figure out the patient experience though, our goal is that patients know the cost of procedures a doctor is recommending (for ex if my doctor says I should get an arthroscopy and an x ray, I want to know ahead of time how much it costs), and can make an educated decision on whether they want to get the procedure done or want to see a different doctor.

The pricing information, we're likely to publish broad analytics level information, but from a business perspective we're thinking that the discrepancies between the published data and our experiential data are really our 'data moat' for the business, so that's likely to be our IP (as it's what prevents someone from easily copying us by scraping our site). We want consumers to have to go through our site in order to get the pricing info, otherwise if it's just an informational site and people use us to look up pricing then end up going to competitors, we wouldn't be able to financially support the site existing long term.

[darkclouds]

So an insurance hedge for insurance schemes, with an AI as the hook?

[FireBeyond]

Diagnostic Imaging is one of these areas. All of the big imaging manufacturers (Siemens, GE, Philips, Toshiba) have physician-specific financing assistance to help doctors buy CT, MRI, etc. They also offer consulting to assist obtaining Certificates of Need (generally required when opening certain new practices/facilities). They discuss break-even numbers of a couple of years, if not less.

Studies show that physicians who own/part-own a DI facility tend to refer their patients for imaging substantially more than their peers who do not.