Self-Funded With Spencer

How to Find Money in Medical Bill Errors - Zoe Holderness - Co-Founder of Slingshot Zoe Holderness, the CTO and co-founder of Slingshot, recently appeared on the podcast, Self-Funded with Spencer featuring host Spencer Smith. Slingshot is a software company that specializes in auditing medical bills. They automatically monitor every claim that comes through for an employer, finding savings and overcharges both for the plan and member. Zoe grew up in Charlotte, North Carolina, and later attended Georgia Tech, where she studied mechanical engineering and computer science. She then moved to California and worked at Tesla as a firmware integration engineer. She then moved on to work for Lyft, working in their E-Bikes division. She got to test out her own work, by riding the bikes everywhere after firmware updates, causing it to be referred to as a "dream job" for her. She also got the chance to work with a lot of women engineers while at Lyft, which is not typical in engineering jobs. Ultimately, an overcharge on a gynecology appointment led her down the path of creating her company - Slingshot. She received an itemized bill and she started reviewing CPT codes and calling the billing office to request audits. Eventually, she was able to get her bill reduced! Along with her co-founder Pranov Duggasani, they started to discuss the prevalence of these medical bill errors with friends of theirs and realized how common this issue was. They discovered that they were able to help their friends reduce their medical bills as well, by about 30% on average! Once they grasped the severity of the problem, they started to develop software to scale the solution instead of just supporting people manually. This led them to Y Combinator, where they received funding and learned the basics of how to start a business. Here are three key takeaways from Zoe's interview: 1. Strive for clarity and transparency- Zoe and her team at Slingshot aim to provide clarity and transparency by uncovering any errors, overcharges, and incorrect coding in medical bills. This can save patients and their families a significant amount of money. 2. Build a strong team- According to Zoe, Slingshot values teamwork, and each member of the team brings a unique skill set that together helps them to achieve success. Slingshot has a transparent, open culture that values input from all employees. 3. Be passionate about your work- Zoe is passionate about technology and healthcare, which has led her to her current role at Slingshot. Her passion and enthusiasm for her work are contagious and serve to motivate the team to give their best. Listen to the podcast to learn more about Slingshot Medical Bill Audits and Zoe Holderness's journey in the tech industry. [00:00:00] Starting a Career in Tech [00:03:01] Working for Lyft [00:05:40] Intro to the Healthcare System [00:08:41] Streamlining Medical Billing with Software Engineering [00:14:20] Y Combinator program and Slingshot's benefits [00:17:17] How to Save on Healthcare Expenses [00:20:11] Slingshot's Role in Employer Plan Error Correction [00:23:04] Improving Hospital Billing Through Coding Changes [00:26:10] Improving Healthcare Billing Accuracy with Machine Learning [00:28:59] Benefits of Healthcare Claims Auditing [00:31:54] The Risks of Denial or Delay in Healthcare [00:34:54] Underutilized Nonprofit Hospital Financial Assistance Policy [00:37:59] Financial Assistance for Healthcare Access [00:40:49] Transparency and Tools Advancing Healthcare If you are someone who has struggled with medical bills and navigating the administrative side of healthcare, Slingshot's expertise in auditing medical bills is worth listening to. #healthcare #medicalbilling #codingerror #SlingshotHealth #YCombinator #startup #MedicalBillAudits #employerbenefits#transparency #innovators #AIgorithms #healthcarecosts #telehealth #primarycare #healthtech #insurancebroker #claimdata #podcast #podcasting #ai #software

How Artificial Intelligence is Powering the Future of Risk with Matt Weaver of Gradient AI In this episode of "Self-Funded with Spencer," host Spencer Smith chats with Matt Weaver, Director of Sales for Gradient AI, about Artificial Intelligence in underwriting tools for self-funding and other stop-loss initiatives. Gradient AI helps underwriters make better assessments of risk, especially when limited loss and claims history exists, or even in the potential absence of claims data altogether. This solution can be helpful in the world of self-funding when it comes to underwriting stop-loss insurance, especially for smaller employers. Matt, who brings his expertise in the legal and sales domains, shares his experience working at large insurance defense firms after law school, selling insurance despite no prior knowledge of the industry, and eventually finding himself working with Gradient AI. He explains how the Gradient AI tool uses advanced data analytics and Artificial Intelligence to accurately assess risk profiles for small and mid-sized business groups. Their platform has revolutionized the underwriting process, making it faster, and much more efficient. They also discuss the challenges of predicting outcomes for the "messy middle" groups and how the pricing model can lead to a rollercoaster ride for employers. Listeners will learn the importance of data to support the recommendation of self-funding and how Gradient AI is using AI to make more informed decisions in the insurance industry. Join Spencer and guest Matt Weaver, as they share their insights into how AI is changing the future of employee benefits and A and H space. Timestamps [00:00:09] Artificial Intelligence in Self-Funding Underwriting Tools [00:03:04] Experience working at an insurance defense firm [00:06:06] Transitioning from Insurance Defense to Benefits Consulting [00:09:01] Starting in Insurance Sales [00:14:42] Transitioning from traditional brokering to consulting [00:17:53] From PEO Consulting to Joining Gradient AI [00:21:04] Gradient AI's Role in Predicting Risk for Insurance [00:27:37] Challenges in Underwriting Self-Funded Businesses [00:30:45] Distinguishing Factors in Predictive Analytics [00:37:14] Risk Scores and Cost Estimates for Health Insurance [00:40:30] Success of Data-Driven Underwriting Tool [00:43:35] Revolutionizing Underwriting in Insurance Industry [00:46:33] Innovative Pricing Model & AI in Health Benefits [00:52:56] The Power of Claims Data in Insurance Consulting [00:55:47] Maximizing Benefits of Self-funded Healthcare Plans [00:59:02] Challenges of Self-Funding for Employers [01:01:59] Procurement processes for clients and use of data [01:05:26] The Future of Artificial Intelligence in Insurance [01:11:47] Risk Analytics and Artificial Intelligence in Insurance

A Professional's Guide to Bespoke Fashion in 2023 - Will Russ - R6 Clothier Get ready to elevate your fashion game with Spencer Smith and his guest, the founder of R6 Clothier, Will Russ. In this exciting episode, they discuss men's fashion in a professional setting, sharing insights from Will's experience in door-to-door sales and the importance of relationships and credibility in starting a successful clothing business. They delve into the mechanics of setting up a custom clothing business, discuss current fashion trends, and emphasize the value of investing in high-quality, custom-made attire. They even announce a new business venture of Will's called "Tailored Gents, which simplifies the process of purchasing custom outfits. Here are three takeaways from Will's journey as an entrepreneur: 1. Embrace your failures: Will admits that he was initially bad at selling clothing because he lacked context, having grown up with a perception of clothing through the limited scope of brands like Tommy Hilfiger and Polo. However, he didn't let this deter him, and with help, he persisted and learned the ropes of the clothing business. 2. Opportunities come in unexpected ways: Will's journey from being a door-to-door book salesman to a professional men's fashion brand owner might not seem linear, but it's not uncommon for entrepreneurial journeys to have twists and turns. 3. Passion for the product: Will's interest in sales stemmed from an interest in the product. He enjoyed being around people and found enjoyment in selling clothing over other products. It's critical to have passion for what you're selling, and it's often what sets entrepreneurs apart. Don't miss this enlightening conversation that will boost your confidence and respect level both inside and outside the office. Tune in now to Self-Funded with Spencer! Timestamps [00:00:09] Interview with Will Russ on Men's Professional Wear [00:03:44] Door-to-Door Sales: Challenges and Triumphs [00:07:03] Mastering Salesmanship with a Steady Mindset [00:10:30] Experience in Fashion Industry and Building Client Trust [00:13:56] Career transition struggles and realization [00:17:36] Starting a Clothing Business from Scratch [00:21:12] Leveraging Relationships to Start a Business [00:24:13] Metrics & Scaling for Small Businesses [00:27:13] Cost-effective Clothing Business Marketing Strategies and Professional Attire Trends [00:30:30] Efficient RFP Management and Fashion for Business [00:33:46] Custom-made clothing features and options [00:36:37] The Benefits of Custom-Made Clothes [00:39:56] The Popularity of Sneakers with Formal Attire [00:43:06] The Importance of Professional Dressing [00:46:21] Taylor Jent - A Simplified Custom Clothing Experience [00:49:34] Revolutionizing Online Clothing Subscriptions [00:52:56] The Future of Professional Fashion [00:56:07] Impact of Appearance on Confidence and Perception #mensfashion #professionalwear #entrepreneurialjourney #sales #customclothing #door2doorsales #coaching #startup #custommade #tailormade #businessattire #casualwear #sneakerswithsuits #investing #selfconfidence #clientrelationships #fashiontrends #podcast #TailoredGents #R6Clothier #bespoke #bespokemenswear #fashion #fashionblogger

Ross Conner, CIC, CRM is a Partner at Hotchkiss Insurance in Fort Worth, TX, where he focuses on helping middle market and franchise businesses grow through a compliant, consistent, and streamlined risk management program. Oh, and Ross is in Property and Casualty, not Employee Benefits. Now you might ask what is a P&C guy doing on a self-funded benefits podcast?! Well besides being hilarious (follow him on LinkedIn here ----> https://www.linkedin.com/in/ross-conner-cic-crm-9b1189a/ ) and having a truly remarkable life story, Ross also created a unique insurance captive to help manage risk at a very large children’s activity franchise. Ross started his career as a general contractor building high-end homes, but an unfortunate downturn in the economy coupled with being overleveraged with inventory he couldn't sell ultimately led him down the path of bankruptcy. Ross was then in a position where he had to reinvent himself and eventually found his way into the world of insurance. In this episode, Ross emphasizes the power of Networking. He says networking played a crucial role in helping him turn his career around and how your network can create opportunities, generate leads, and open doors that can help you grow your business. Here are three tips to make the most of your network: 1. Attend events and conferences: One of the best ways to meet like-minded people and expand your network is by attending industry-specific events and conferences. These events bring together professionals from different backgrounds who share similar interests and can create opportunities for business collaborations. 2. Build genuine relationships: It's important to approach networking as an opportunity to build relationships rather than simply sell yourself or your business. Take the time to listen to others, understand their needs, and offer support and assistance where possible. 3. Follow-up: After connecting with someone, take the initiative to follow up with them. Send an email or set up a phone call to check in and keep the lines of communication open. This is a great episode for anyone who likes risk management, property and casualty discussions, insurance captives, personal growth, and a great redemption story! #contentcreation #insuranceindustry #careerjourney #entrepreneur #finance #bankruptcy #familylife #captives #propertyandcasualty #insurancecompliance #crossselling #technology #cybersecurity #emergingrisks #AI #podcastdiscussion #ChatGPT #businessstrategy #LinkedInmarketing #takingrisks #experiencedsharing #podcastingtips

ICHRA Explained - Everything You Need to Know About Individual Coverage HRA's with Kyle Estep Self-Funded with Spencer, hosted by Spencer Smith, is a podcast for those looking to strategically navigate the complex landscape of health insurance. In this episode, Spencer speaks with guest Kyle Estep from Take Command Health. Kyle Estep is the VP of Growth for Take Command Health. Kyle spent 8 years of his career early on consulting for Deloitte, one of the top consulting firms in the world. He also spent a year in South Africa for Awethu, focused on identifying, developing, and investing in world-class entrepreneurs. He worked alongside the CEO & COO to launch the incubator in Johannesburg, South Africa. His insurance-specific career began at Oscar Health, which was based in New York, and he was hired to help launch their Texas business unit. Kyle built out the sales and distribution team there, helping them scale across the country. His time at Oscar initially led to meeting Jack Hooper, the CEO and Founder of Take Command Health, which offers HRAs for small business health insurance. Specifically, for this episode, we focused on the value of an ICHRA, also known as an Individual Coverage Health Reimbursement Account. An ICHRA is a way for an employer to give tax-free money to its employees so that they can find the health insurance plan that best suits their needs. ICHRAs allow an off-ramp for employers who no longer want to be tasked with managing the risk of a health plan on behalf of their employees, but who still want to provide them with financial support to purchase their desired plans. It is NOT fit for every situation and sometimes depends on the affordability and diversity of plans being offered on the individual market in that specific geographic location. This is where Take Command comes in, in not only consulting around the employer's goals but also analyzing what individual plans are available to benchmark against group health options the employer is quoting as well. In addition to this analysis, Take Command's special sauce is their service around the seamless transition to an ICHRA so that the members still feel supported by their employer. If you have ever wondered what an ICHRA was, what types of companies it works for, and how an employer goes about switching to this arrangement, then this is the episode for you! #SelfFunded #Deloitte #HealthInsurance #ConsumerProtection #ICHRA #Tax #ACA #IndividualMarket #SmallBusinesses #AffordableCareAct #TakeCommand #PublicPrivatePartnership #AdviserOptions

Welcome to Self-Funded with Spencer, a podcast that explores how employers can most effectively manage their health plan costs by "Self-Funding" their insurance. In this episode, Spencer talks to Kari L. Niblack, Esq. from Blackwell Captive Solutions, a risk attorney with 30+ years of experience in the business. Kari shares how her law career prepared her for sales, and her experience with the obstacles faced by women in the benefits industry, especially those seeking leadership positions.  Personally, Kari comes from a racing family, with her aunt Roxi was a racecar driver back in the 1980s, long before Danica Patrick became a household name.  Kari got to see her start with "quarter midgets", and then before graduating high school, leave for Europe to pursue a professional racing career. Kari herself is an avid backgammon player, learning from Roxi after she brought a board back from Europe.  She is actually highly ranked in the world as a backgammon player, and plays nearly every day online with players all across the world! Kari also talks about the concept of “captives”, and how companies of all sizes can benefit from them.  She also discusses with Spencer why they are becoming increasingly popular.  Finally, Kari touches on the importance of giving back and helping those who have helped you.  Self-Funded with Spencer offers an engaging and informative look into the world of health benefits, risk management, and self-funding. Tune in now and take away valuable advice and experience from our guest Kari L. Niblack, esq., president of Blackwell Captive Solutions! #captives #insurance #riskmanagement #mentor #leadership #women #sales #employeebenefits #SelfFundedWithSpencer #BlackwellCaptiveSolutions #RiskAttorney #DanicaPatrick #Backgammon #Plansight #CaptiveCompanies #CarrieUnderwood #Innovation #Flexibility #Agility #Stability #racecar #racing #indycar #formula1 #nascar

This is a great episode for anyone interested in what it is like to succeed within the largest insurance brokerage in the United States. Travis is EVP at Marsh McLennan Agency (MMA). Travis was an exceptional wrestler in high school but hung up his wrestling singlet in college, where he studied general business at Westminster College in Fulton, Missouri. Like quite a few of my guests in the past, Travis has a thrill-seeking side, being an avid skydiver AND scuba diver, where he jokingly says to me, "I guess I am just not comfortable on the ground"! Travis said that he didn't start skydiving until 2001, and since then is nearing 500 jumps in total.  He did it initially to conquer a fear of heights and eventually fell in love with the sport, turning it into a real passion. Heading under sea level, Travis picked up scuba diving while traveling with his wife, realizing that this was an activity he could share with her and bond over. Travis began his benefits career working for a PPO Network in Atlanta, Georgia.  Early on, his role was to review massive amounts of PPO contracts where he uncovered over $1,000,000 of missing revenue.  Because that company was going through due diligence to be acquired, Travis unknowingly assisted in increasing the valuation of his company.  This helped him personally as well, receiving an offer to join a startup in Athens, GA with one of his mentors. Travis found himself down in Dallas next with MHBT, where he ultimately joined his current firm through an acquisition of MHBT by the Marsh McLennan Agency, also known as "MMA", a subsidiary of the largest insurance brokerage in the United States. Travis found himself gravitating toward self-funding as he started to get exposed to larger prospects and clients.  He found that through the vehicle of self-funding, these employers were seeking more control over their healthcare spend, and self-funding offered a mechanism in which to do that. Travis taught himself self-funding in about two weeks by picking the brains of his mentors and peers at MHBT, as well as reaching out to trusted stop-loss vendors. Travis is also a very astute salesman, understanding body language, behavioral psychology, and being able to read a prospect's openness to the ideas he's presenting.  Being in the industry for 20 years, he has also built up a great referral network, something he calls a "Center of Influence", which allows him to be more choosy about who he works with, and the ability to sit down with an audience more receptive to his strategies. Chapters: 0:00 Sartain vs SarTAIN 2:00 Intro to Travis 9:20 Sky & Scubadiving 17:00 Enter the Benefits World 28:14 MHBT to Marsh & McLennan 35:00 Self-Funding  48:43 The CAA 54:45 Incentivized Healthcare 57:53 The Big Picture 1:02:39 Closing Thoughts

The Black & White Truth with Kareim Cade and Andy Neary. This episode features the duo of: 1) Kareim Cade - Owner and CEO of the Great Lakes Benefits Group 2) Andy Neary - Founder of Complete Game Consulting Together they make up a partnership called "The Black & White Truth". Their program has 3 pillars: Modernize how Salespeople are Trained Redefining Leadership Encourage Diversity of Thought Black & White Truth combines collaborative coaching, on-site workshops for insurance agencies, and keynote speaking at industry conferences and large employer events. Kareim grew up in a house where his mother was in the insurance business, working for New York Life, even working for her when he was really young, getting paid $.25 for each folder he put together for her! Kareim studied at a historically black college named "The Clark University" in Atlanta, where at first he spent more time partying than learning.  Eventually, his mom told him they were only paying for 4 years, so Kareim knew he had to get his act together right away.  Kareim studied insurance and risk management, and walked away with a degree he had no idea would ultimately catapult him into the life of a successful benefits agency owner. Andy Neary is a former professional baseball player, and a one-time insurance producer himself, who ultimately became a marketing consultant and founder of Complete Game Consulting.  His company focuses on helping insurance producers build their own personal brands using content and modern sales training.  His methods have helped countless producers and agency owners transform their outdated prospecting processes, by leveraging video content and LinkedIn to maximize their visibility with potential buyers. There is a ton more to the story of Any and Kareim individually, which you can hear all about in Episode 84 of the Self-Funded with Spencer Podcast! Chapters: 0:00 Intro to Kareim 10:40 Intro to Andy 15:50 Building an Agency 20:09 The Power of Coaching 24:30 The Black & White Truth 31:55 The 3 Pillars 43:23 Power to the Content Creators 44:55 Updating Training Methods 48:46 Leadership Redefined 50:40 Diversity of Thought 54:22 The Big Picture

Jason Scott is First Vice President for Alliant Insurance Services in Dallas, TX. Jason originally learned the art of sales from his Dad, who taught him how to sell without being "sales-y".  He also taught Jason the power of getting to the yes or the no as fast as possible, because the "maybe's" are career killers.  His Dad was actually instrumental in helping popularize a seasoning in the United States called "Tajin", which is a mixture of lime, chili powder, and salt, and is very popular within the Hispanic community. His first sales role was at Paycom, which inadvertently opened the door for him to enter the insurance world, as one of his payroll prospects was a large regional insurance brokerage in Dallas called MHBT.  They kept calling him back multiple times to present the same thing, but to new people, and he started to realize they were actually interested in hiring him to work for the firm instead! Jason was offered roles within MHBT in both the Employee Benefits and Property & Casualty departments,  but he gravitated toward EB because there were a couple of other young producers in that department he liked, plus he found the subject matter more interesting and creative. Eventually, he found himself at Alliant after the acquisition of his prior firm called Crystal & Company, and there he had the opportunity to help hone best practices within his new, larger employer.  Big on company culture, Jason stresses the idea of servant leadership and making sure the people that work for you feel valued and supported. Jason isn't all business, though, as he also coaches his young sons in baseball at a very competitive level.  However, it is not all about talent for him, as Jason brings the emphasis of team culture from his work life to the baseball diamond, and won't accept new players onto the roster based on pure ability alone.  They also need to be respectful, and polite to their coaches, and he also manages the expectations and egos of the parents as well. In the big picture of healthcare, Jason is bullish on the private sector to solve the problems we encounter and believes more consumer-driven plans will eventually prevail. He also believes innovation in our space is only going to accelerate, and that the BUCAH's of the world will continue to stay relevant as long as they can, but face stiff competition from new entrants into the market. Chapters 0:00 Intro to Jason 12:15 Bringing "Tajin" to the US 16:42 Developing Sales Skills 20:32 Working for Alliant 32:00 The Importance of Company Culture 36:16 Lessons from Baseball 42:55 Respect from your Peers 47:13 The Future of Healthcare 52:14 Closing Thoughts

Can one app manage pricing, communications, and payments for health plans? In short, YES!  Medxoom "unifies member identity, pricing, communication and payments into one, easy-to-use app". For Episode 82, my guest is James the EVP of Strategy and Growth for MedXoom. His hobbies are triathlons, for which he trains 16-20 hours a week to prepare for events, and scuba diving.  Jame calls himself "a back-of-the-pack triathlete", and recently he had to back out of a full Ironman race in Florida about 36 hours prior to it starting because of a lung infection. James has also performed well over 500+ deep dives, saying it is the most peaceful and exhilarating experience simultaneously.  He even once found a 1-carat diamond ring during his adventures, as well as visited many underwater shipwrecks. James started his career out in the legal world, then moved on to sales with ADP, then PEO sales, before finding himself in SaaS tech centering around human resources with Namely. His current company is MedXoom, which is a technology platform that has the ability to improve the financial outcomes for both plans and members. Medxoom creates a true white-labeled member experience, with clients ranging from Third Party Administrators, Health Plans, Brokers, and many other solution providers selling out to employers directly. Health Plans have nearly an infinite number of combinations of solutions folded together including things like Telehealth, Direct Primary Care, carved-out PBM’s, Reference Based Pricing, etc, and Medxoom allows the administrator to bring all of those components together, white-label in one singular experience, so the member has one place to go. Members can do things like: - Use their Benefits Wallet - Search for Care - Engage with a Care Navigator - Align with a Provider on Price James said one of the reasons they get such good member engagement is that many of their employer clients have gone fully digital, even eliminating plastic ID cards.  “You go fully digital and you get adoption” With plans who have done this, they see 70% + in downloads and enrollment within the first week of launch. They also partner with 3rd-party data providers in order to large ingest machine-readable files with pricing data so members can easily search for cost details of care, which helps employers be compliant with the CAA. In the near future, the app will even be able to recognize if certain procedures are searched for and turn that information over to a case manager to proactively help determine the best course of action. Medxoom is also assisting with improving the provider payment process, using something called a “Single Payment Credential” or SPC card.  This functions as a single-use, virtual credit card loaded with plan dollars allowing for a closed-loop transaction that pays the provider in full.  Medxoom takes it a step beyond and can even float the money for their clients to ensure a frictionless transaction.  All of this has led to 100% acceptance of payments using this method. Best of all, Medxoom’s clients are giving them data that shows on average, using the SPC method of payment, they are realizing a 40% reduction in unit cost versus traditional network arrangements! Chapters: 0:00 Triathlons & Skydiving 11:58 James' Career Path 20:30 Intro to Medxoom 31:20 Medxoom Partners 38:53 Solving the Payment Problem 46:07 Who is it for? 55:00 Future of Healthcare 56:50 Closing Thoughts