Joe Lonsdale: American Optimist Ep 73: How Candid Health Is Fixing the $280B Healthcare Billing Fiasco, With Lessons from Palantir
Dec 7, 2023
Nick Perry and Doug Proctor, co-founders of Candid Health, discuss how they are fixing the $280B healthcare billing fiasco. They highlight the complexities of medical billing, the importance of technology and AI in streamlining the process, and their goal of automating claims and improving the US healthcare system. They also talk about the challenges of revenue cycle management and the potential for opening up opportunities for new healthcare companies.
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Pick A Narrow, High-Impact Focus
- Focus narrowly on a high-impact problem rather than trying to be everything for everyone when building a company.
- Hire exceptional people and apply first-principles thinking to tackle hard, ambitious problems.
Why Billing Costs $280B
- US medical billing is extremely fragmented with thousands of payers and procedures creating bespoke rules for each claim field.
- This fragmentation forces manual work and is the core reason the industry spends roughly $280B annually on billing.
Cluster Denials, Fix The Root Cause
- Cluster denied claims and call the payer once to learn the underlying rule instead of calling per claim.
- Capture that rule in the engine to prevent repeating the same denial across thousands of claims.