[blastbking]

Yeah, it's definitely based on probabilities. I will definitely check out careignition as this is a problem we've been struggling with for sure! For orthopedics we're aware that the range of care and CPT codes are super complex and we're holding off on adding complex procedures for now until we get a better handle on the data side.

We are taking the approach, as you suggested, of limiting procedures in the search engine to ones that patients know what they're getting. Our initial focus is actually Dermatology for this reason, from a combination of popular demand and us seeing that the procedures billed are often very simple and easy for us to model / predict.

For us, our goal is to guarantee the rates that we show on the site, and we're building a model that figures out what the correct rates are as claims get adjudicated. At scale, internally we will have the most accurate model of what costs will be, figuring out which of the carrier rates is real. This part is definitely challenging as well and we expect to lose money on the guarantee (paying out to patients) for some time until we figure it out, but we're limiting the losses by not listing the more complex high variance stuff.

RE in advance EOBs, we think that we can help providers comply if/when that regulation goes into effect!

[alecst]

Thanks for the reply, and great work on making a cool product. It's really impressive, and I hope it does well.