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Self-Funded With Spencer

Latest episodes

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Jun 20, 2023 • 51min

How AI Could Repair our Healthcare System - Meet Healthee

How AI Could Repair our Healthcare System - Meet Healthee Join Spencer Smith in his latest episode of Self-Funded with Spencer as he delves into the world of artificial intelligence with Healthee and their co-founder/co-CEO - Guy Benjamin. Guy shares the story behind "Zoe", Healthee's AI-based personal health assistant. The podcast also discusses biases and inefficiencies in the healthcare industry and how Healthee's platform uses AI to improve the health coverage services and experience for employees. Spencer and Guy discuss how Healthee's mission is to provide accessible and transparent healthcare options for individuals, particularly in the United States where the costs for healthcare can be overwhelming. They cover different features of the platform that include Telehealth services, personalized healthcare information, and appointments management. Spencer and Guy also talk about the potential in health coaching, nutrition, and fitness, and how the platform integrates wearable technology data. Finally, they share how the younger generation, who grew up with technology, will drive innovation in healthcare and demand more transparency and accessibility in healthcare pricing. Spencer and Guy wrap up by discussing how much value there is in Healthee's platform and why everyone should check it out. Don't miss out on this engaging conversation that invites you to rethink the healthcare industry and discover how you can take control of your own health journey. Listen now to the latest episode of Self-Funded with Spencer, available on all platforms. Links: Healthee's Website - https://healthee.co/ Healthee on LinkedIn - https://www.linkedin.com/company/get-... Healthee on Instagram - https://www.instagram.com/get.healthee/ Healthee on Facebook - https://www.facebook.com/gethealthee Healthee on YouTube -    / @gethealthee   Timestamps: [00:03:04] Introducing Zoe: Virtual Assistant for Healthcare [00:05:53] From Infantry to Fighter Pilot: One Israeli Veteran's Journey [00:08:47] Air Force, Entrepreneurship, and Life Lessons [00:11:34] Innovating Healthcare with Technology [00:14:18] Comparing Healthcare Systems: Israel vs The US [00:19:59] Personalized healthcare search tool [00:22:42] Smart Consumerism in Healthcare [00:25:26] Streamlining employee healthcare with Healthee platform [00:28:08] Choosing Healthcare Plans Made Easy [00:30:51] Employee Benefit Tracking and Analysis [00:33:35] Role of AI in Healthcare Coverage [00:36:28] Revolutionizing Healthcare with AI and User-Friendly Platforms [00:39:17] Opportunities for Wearable Technology in Health Coaching [00:42:00] Employer-Based Healthcare Solution [00:44:38] Cost-saving benefits of platform-directed healthcare [00:47:09] Adapting to Workforce Change for Health Care Success [00:49:51] Healthee's Mission to Improve Healthcare #healthcare #employeebenefits #selffunding #healthtech #AI #personalhealthassistant #entrepeneurship #healthcaresystem #medicalaudit #provider #smarterconsumerism #healthcareplanning #wearabletech #biases #ROI #transparency #healthcareexperience #customerexperience #innovation #Healthee #zoe
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Jun 13, 2023 • 47min

The Connective Tissue of a Health Plan - Planned Administrators Inc

he Connective Tissue of a Health Plan - Planned Administrators Inc In the latest episode of "Self-Funded with Spencer," host Spencer Smith invites George Stiles, the President and COO of Planned Administrators Inc (PAI), to discuss the transformation of the TPA industry and what makes a good TPA partner. George shares his journey from claims processor at Blue Cross Blue Shield to his current role at PAI. The conversation covers topics from data analytics, and direct primary care, to how to navigate the new regulations in transparency. Hear about PAI's reliable data center with top-notch security and where over a billion claims run through every year. Listen in as Spencer and George provide insight and knowledge on the ever-changing healthcare industry. Listeners will also gain insights into data analytics, the trends in the stop-loss market, and the optimism surrounding the future of healthcare The dynamic conversation also includes discussions on transparency in healthcare pricing, attracting the next generation of superstars in the industry, and the importance of collaboration between TPAs and brokers Visit their website, paisc.com, to connect and discover inbound activities as a proof of their successful podcast. You won't want to miss this engaging episode filled with valuable information and expert insights! [00:00:09] George Styles' Journey to Providing TPA Services [00:03:12] The Guest's Journey in Healthcare and Public Policy [00:06:28] Blue Cross Technical Support and Data Center [00:09:35] The Benefits of Corporate Entrepreneurship and Third-Party Administrators [00:15:36] Level funding as a stepping stone [00:18:32] Challenges and Benefits of Direct Primary Care Expansion [00:21:46] Quality Healthcare and Medical Expenses Correlation [00:24:48] The Value of Data Analytics in Employee Benefits Management [00:27:52] Data Analytics in Self-Funded Healthcare Plans [00:30:56] The Value of a Trusted TPA Partner [00:33:48] Stop Loss Marketing Shift [00:40:06] Advantages of healthcare transparency [00:43:05] Nurturing Young Talent and Industry Innovation #healthcareindustry #TPAservices #dataanalytics #healthpolicy #selffunding #directprimarycare #employeefinancialhealth #transparency #insuranceindustry #innovation #longtermpartnerships #healthcareconsulting #TPApartnerships #insuranceconsultants #employeebenefits #healthcarereform #entrepreneurmindset #healthcaredata #stoplosscarriers #futureofhealthcare #TPAadvantages #employeehealth #healthcareauditing #employeetransparency #healthcaretechnology #healthcareaccessibility #insurancedata #healthcareanalytics #healthcarequality #medicare #healthcare
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Jun 6, 2023 • 53min

Create Better Wealth with The AND Asset - Caleb Guilliams

How to Create Better Wealth with The AND Asset - Caleb Guilliams Welcome to the Self-Funded with Spencer podcast! In this episode, we are thrilled to have Caleb Guilliams, founder of Better Wealth and author of "The And Asset." Spencer and Caleb discuss the power of life insurance as an investment tool, and how it can help people achieve their dreams while building wealth. Caleb shares his inspiring story of overcoming his insecurities and using his fear of failure to become a successful business owner focused on helping people with money. He explains how he used life insurance as a tool to improve his financial standing and how he founded Better Wealth Solutions, a company specializing in maximizing the benefits of life insurance. Caleb emphasizes the importance of education and mentorship, and how these principles have been instrumental in his success. He also discusses the multidimensional aspect of money and the power of giving your money more than one job. Throughout this podcast, you will learn about the benefits of overfunded life insurance, how to use life insurance in your investment portfolio, and the importance of creating content across multiple platforms to scale awareness of your business. Caleb and Spencer also discuss their experience with public speaking and the role of video content in building momentum and credibility, as well as the impact of creating "Value Leverage" Don't miss out on this exciting episode of Self-Funded with Spencer! Chapters: [00:00:09] Introduction of Caleb Williams and Personal Story [00:03:01] Overcoming External Factors and Pursuing Personal Growth [00:05:47] Early Career Success through Connection & Mentors [00:08:47] Overcoming Impostor Syndrome in Investment Banking [00:11:27] Caleb's journey out of banking [00:14:05] Maximizing Wealth with Overfunded Life Insurance [00:16:57] Wealthy Investors and Life Insurance [00:20:05] Importance of Intentional Investing and Life Insurance [00:22:50] Effects of over-funding on insurance contracts [00:25:37] Intentional living and using life insurance for financial gain [00:28:40] Teaching Entrepreneurs Financial Strategies & Value Leveraging [00:31:57] Maximizing Product/Service Value and Leverage [00:34:54] Leveraging Personal Experience for a Wider Audience [00:37:32] Multiplying Your Money: Combining Assets for Greater Returns [00:40:10] The Benefits of Public Speaking and Video Content [00:43:12] Repurposing Content for Maximum Reach [00:45:59] Content Creation and Frameworks [00:48:47] Creating a Living Legacy [00:51:25] Business as a platform for serving others Caleb Websites: Better Wealth - https://www.betterwealth.com/?r_done=1 The And Asset - https://www.andasset.com/ Buy the Book - https://www.amazon.com/Asset-Secret-Save-Your-Money/dp/1732724903
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May 31, 2023 • 53min

Health Payment Accounts (HPA) with Paytient CEO - Brian Whorley

Health Payment Accounts (HPA) with Paytient CEO - Brian Whorley Welcome to Self-Funded with Spencer, where we dive into the world of healthcare and explore ways to make healthcare coverage more accessible and effortless for everyone. In this episode, Spencer Smith welcomes Brian Whorley, CEO and founder of Paytient. Brian is creating a new category for health payment accounts that helps remove the impediment of out-of-pocket costs for patients. Together they discuss the importance of creating a feeling of security, peace of mind, and confidence in the form of a Visa card for health plan members. Throughout the podcast, Spencer and Brian cover a range of topics, from the importance of empathy and considering patient needs to the impact of removing barriers to healthcare consumption. They delve into Paytient's product experience that allows employers to offer medical, dental, vision, pharmacy, and veterinary expense repayment options to employees, enabling them to make tax-advantaged payments for eligible transactions. In this episode, you'll also hear about Brian's previous venture, "Big Tree," and the journey that led to the creation of Paytient. Spencer and Brian discuss the various decisions and policies that shape a patient's healthcare journey, and how Paytient is working to make healthcare accessible and affordable through a frictionless and effortless system. Get ready to be inspired by a team focused on creating real-world solutions to a real-world problem. Tune in to Self-Funded with Spencer to learn more about how Paytient is making healthcare better for everyone, regardless of their situation. Timestamps: [00:00:09] Pareto Health and Paytient's Benefit Solutions [00:03:13] Guest's Work Experience & Passion in Healthcare Industry [00:06:55] The Importance of Empathy in Patient Care [00:10:33] Innovative Food Platform and Entrepreneurial Lessons [00:13:23] Name badge payments for workplace expenses [00:16:17] Paying for healthcare challenges and credit card solution [00:19:52] Introducing Patient: An Innovative Payment Card Solution [00:23:29] Flexible Employee Benefits Platform [00:26:55] Equitable Health Plan ROI [00:30:24] Accessible Healthcare Payments for Better Outcomes [00:33:35] Improving healthcare accessibility and quality [00:37:24] Improving Future Healthcare through Innovation [00:41:11] The Future of Frictionless Healthcare [00:44:32] The Future of Retirement and Healthcare [00:47:59] Public Catastrophic Plan for Healthcare [00:51:34] Working with consultants and brokers in healthcare Quotes: "And so that's what motivated me, like, every single day of of how do we serve others?" " I love building things or creating things and kinda going from 0 to 1...Or trying to make things that exist a little bit better. And so that's kind of core to my DNA, what I enjoy doing." #employeebenefits #selffunded #healthpaymentaccount #healthcareaccess #healthoutcomes #healthplans #ROI #catastrophicinsurance #healthcareplatform #universalcoverage #healthinsurance #consultants #brokers #affordablehealthcare #podcastinterview
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May 23, 2023 • 42min

Healthcare Orchestration with Curus - Jared Mort

Revolutionizing Healthcare Coordination and Advocacy with Curus Get ready to dive into the world of healthcare benefits and savings with Spencer Smith's Self-Funded podcast, sponsored by Pareto Health. In this episode, COO Jared Mort from Curus Health shares his expertise on clinical care coordination, or as he refers to it "Care Orchestration", and how to help mid-sized employers reduce their healthcare costs. Jared also discusses Curus Health's approach to total life concierge services, which assists people with chronic illness and clinical conditions in navigating the healthcare system. The conversation is both informative and emotional as Jared and Spencer discuss real-life examples of how Curus Health has helped patients get the necessary care they need while maintaining the quality of their life. Throughout the podcast, Jared emphasizes the importance of coaching patients and encouraging them to be active participants in their care. He discusses the adverse selection and how Curus Health helps reduce costs while mitigating the risk of expensive medical bills. The podcast also explores the team's approach to managing end-of-life care for patients and their families, even after the contract has expired. Jared & Spencer also discuss the challenges of marketing healthcare services to employers and brokers. Jared talks about the cultural apathy that has developed as a result of the bureaucracy and the overwhelming nature of the industry. The hosts emphasize the immense value their services provide to members and the need for more employers to take advantage of them. If you're interested in learning more about healthcare benefits and saving money on your healthcare costs, then the Self-Funded podcast with Spencer Smith is for you. Tune in now to learn more! Timestamps: [00:03:27] Career in Air Force and Transition to Civilian World [00:09:11] Fortnite and Curus: Gaming and Healthcare Mix [00:12:21] Managing Rising Drug Costs in Healthcare [00:15:25] Curus: Revolutionizing Medical Treatment and Patient Care [00:18:30] Virtual healthcare coordination and patient empowerment [00:21:35] Humanity in healthcare [00:24:37] Importance of Patient Advocacy in Healthcare [00:27:45] How medical SWAT teams assist with ongoing medical costs [00:30:32] Marketing Strategies for a Health Product [00:33:43] Challenges in Healthcare Sector and Innovative Solutions [00:36:45] Scalability and Solutions for Healthcare Providers [00:40:02] Curus Health's support for all businesses Hashtags #healthbenefits #employeebenefits #healthcare #selffunding #clinicalcarecoorination #airforceveteran #virtualhealthcare #patientadvocacy #medicalcosts #healthoutcomes #healthcareproviders #malpractice #adverseselect #chroniccare #curishealth #paretohealth #podcasts #healthpodcasts #healthcarepodcasts #smallbusinesshealthcare #healthcarecosts #insurance #healthinsurance #virtualcare #virtualmedicine #patientcare
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May 16, 2023 • 1h 4min

Data Analytics for the Modern Benefits Broker - Mike Pattengale - Springbuk

Data Analytics for the Modern Benefits Broker - Mike Pattengale - Springbuk Looking to learn about the future of data analytics in healthcare? Look no further than Self-Funded with Spencer! Host Spencer Smith welcomes guest Mike Pattengale from Springbuk to discuss their innovative approach to data analytics and how it helps drive informed decisions. The two discuss the impact of COVID-19 on the healthcare industry and how data analytics can help employers make better decisions regarding the well-being of their employees. Mike and Spencer reflect on their experience of navigating the pandemic and the challenges it brought with it, along with its unexpected benefits, such as exploring new avenues like podcasting. As they transition to talking about healthcare analytics, Mike, emphasizes the platform's ability to collect and normalize data from various sources, highlighting the collaborative nature of Springbuk's platform. They discuss the value of data analytics, how it can be used to make informed decisions, and the importance of sharing data and embracing technology in the consulting industry. Mike also discusses the capabilities of their system, including the use of artificial intelligence to identify actionable insights and its clinical and financial impact. They also emphasize the importance of an intentional approach to presenting software features to clients to help them focus on the issues that matter most to them. Overall, the episode provides a wealth of information about the healthcare industry, data analytics, and empowering employers to better manage their claims cost. The hosts and guest make compelling arguments about the benefits of using analytics, embrace of technology, and the importance of forging lasting relationships. This is an episode you won't want to miss, and it's a fantastic introduction to the world of healthcare analytics. Tune in to Self-Funded with Spencer and get ready to learn something new! Timestamps [00:00:09] Navigating Zoom during the pandemic [00:03:19] Mike's Career Pivot during COVID [00:09:47] Mastering sales skills through storytelling and connecting [00:19:24] The Downside of Entrepreneurship [00:22:19] Mike's sales career journey [00:25:25] The Growth and Innovation of Springbuck [00:28:21] Integrating Data Sources for Health Plan Management [00:31:42] Turning Data into Action with Springbuck's Solutions [00:34:53] Data Analysis in Healthcare Spending [00:38:14] Post-COVID Tech Sales Advancements [00:41:27] Benefits and Target Market for the Solution [00:44:44] Data Analytics for Managing Healthcare Costs [00:47:39] The Future of Data Analytics in Business [00:51:00] Balancing Technology and Skilled Professionals in the Industry [00:53:58] AI and Actionable Insights [00:57:01] Future of Healthcare Data Analytics [01:00:07] Challenging Industry Status Quo with Younger Workforce Best Quotes: "I realized everything that I was confident in and my ability to sell was winning people over in person. And I took every strength that I thought I had and it was removed..." "Coming out of the pandemic, and when people go back to real world, you'll either become a hunk, a chunk, or a punk..." [00:05:52] Obviously, brokers need to be talking about this with their employers nowadays, or you're gonna be in a losing position" #virtualcommunication #COVIDpivot #skillsdevelopment #selfdiscovery #contentcreation #dataanalytics #healthcareplan #employeecare #dataenrichment #technologyinhealthcare #transparency #diverseworkforce #gratitude #podcastguest #musicanddrumming #podcastsponsor #Springbuk
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May 9, 2023 • 1h 9min

Leadership & Legacy with Scott Smith - President/CEO of TRUE Network Advisors

Join podcast host Spencer Smith as he sits down with guest Scott Smith from TRUE Network Advisors to discuss topics ranging from leadership to personal growth in the latest episode of Self-Funded with Spencer. Scott and Spencer delve into the concept of authentic leadership, exploring what it means to be "authentic" (a buzzword that makes them cringe) and striving to be the best version of oneself. The discussion also touches on the challenges of providing mentorship and guidance to others and feeling a sense of responsibility for the advice given. Impostor syndrome is also explored in detail, and both speakers reveal their experience with the phenomenon and how it can affect even the most successful individuals. The speakers also ruminate on the importance of taking care of oneself through self-care, delegating tasks, and intentionally spending time in activities that energize and fulfill oneself. Toward the end of the episode, the speakers discuss the importance of legacy and the impact that one has on others beyond just accomplishments. With topics ranging from personal growth to leadership and legacy, this episode of Self-Funded with Spencer is a must-listen for anyone looking for inspiration and practical advice on becoming the best version of oneself. Tune in now for a great discussion of leadership, mentorship, and creating a living legacy with Scott Smith! Timestamps [00:00:09] The Pressure of Podcasting for Influential Listeners [00:03:19] Guest's Public Persona and Use of Humor [00:06:41] Challenging the Notion of "Authenticity" [00:13:16] Evolving as a leader [00:20:09] Overcoming Adversity and Impostor Syndrome [00:26:55] The Importance of Investing in Personal Development [00:30:26] Finding Inspiration in Team Members [00:33:24] Building Connections [00:36:49] Building an intentional legacy [00:40:01] Creating a Legacy through Giving [00:43:11] Working with an Executive Coach [00:46:28] The Importance of Direct Communication in Leadership [00:49:29] The Importance of Self-Care for Work-Life Balance [00:56:09] Delegating and prioritizing tasks for productivity [00:59:10] Challenges of Helping Everyone and Time Management [01:02:10] The Importance of Joy, Legacy, and Authenticity [01:05:17] The Legacy of Parenthood Great Quotes: "Leadership really is caring about people. First and foremost. And if you really mean it and you show it, you demonstrate it, you put others before you, that's the very the foundation of leadership is caring about the people that you're working with" - Scott Smith "If you don't know yourself, and you're not attempting to know yourself, it's gonna be very hard for other people to trust you" - Scott Smith "It became less and less about me and more about what's possible with these organizations". - Scott Smith Hashtags: #podcastpressure #leadershiplegacy #mentorship #employeebenefits #TrueNetworkAdvisers #authenticity #carefirst #selfimprovement #impostorsyndrome #legacybuilding #intentionallegacy #givingback #selfcare #delegation #relationshipbuilding #parentinglegacy #futureplans #podcastbeach #thankyouforlistening
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May 2, 2023 • 58min

The Evolution of PBMs with The "PBM Princess", Rachel Strauss of EHIM

Join host Spencer Smith on another episode of Self-Funded with Spencer, as he welcomes the PBM Princess, Rachel Strauss from EHIM. In this engaging and informative podcast episode, Rachel shares valuable insights about the Pharmacy Benefits Management industry and EHIM's merger with ProCare Rx. Rachel and Spencer also take a deep dive into the importance of transparency in PBMs and how it affects the relationship between PBM and clients. Rachel shares her journey of becoming a PBM consultant and how she found her niche as a problem solver, helping clients navigate complex healthcare systems and policies. This episode discusses PBM selection and highlights the challenges of determining which PBM would work best for your company. Rachel shares her thoughts on a pricing model called "Cost Plus", which Mark Cuban has popularized recently in the world pf Pharmacy Benefit Management. Additionally, the podcast highlights the need to align PBM incentives to client goals, the importance of understanding client priorities, and writing RFPs that align with them. In this engaging conversation, Rachel shares her prediction on the reporting mandates that will track dollars and rebates, potentially affecting the earnings of some companies. Another important aspect of Rachel's work is in fixing problems, rather than just identifying them. She explains that her role is not just about diagnosing issues but providing actionable solutions that can make a difference in the lives of patients and providers. Rachel's work is guided by her passion for improving healthcare access and quality, and she encourages others to find their own purpose and drive in their work. Don't miss the fun banter between Spencer and Rachel as they share stories, opinions, and experiences. Tune in now for an engaging and informative conversation on pharmacy benefits management, self-funding, and everything in between! Chapters; [00:00:00] Introducing "PBM Princess" Rachel Strauss [00:02:32] PBM Princess's Impact in Sales & EHIM's Merger [00:05:50] The Rise of Transparent PBMs [00:08:59] EHIM's Integration into ProCare for Advanced Tech [00:11:59] Navigating emotional experience of company acquisition [00:14:46] Navigating the Complex PBM Industry [00:17:44] Pharmacy Benefit Management complexities and Mark Cuban's involvement [00:20:26] Spread Pricing in Pharmacy Benefit Industry and Mark Cuban's Launch [00:23:22] Strategies for Saving Costs in PBM Industry [00:26:14] PBM Tactics and Rebates Issues [00:29:05] The Deceptive Nature of Pharmaceutical Rebates [00:32:04] EHIM's formulary strategy and committed rebate transparency [00:35:00] Private Equity in PBMs [00:40:37] Turning Healthcare Data into Actionable Insights [00:43:30] Customized Services for Diverse Client Goals [00:46:30] Third-party Vendor Blacklisting and PBM Priorities [00:49:30] Debate on Ozempic coverage for weight loss [00:52:27] Insurance Coverage of Bariatric Surgery [00:55:19] Creativity and Collaboration in PBM #PBMs #pharmacybenefits #consultants #EHIM #ProCareRx #specialtydrugs #transparency #rebates #formulary #privateequity #dataanalytics #medicalcompliance #Ozempic #obesity #bariatricsurgery #creativity #partnerships #healthcareindustry #podcasts #podcastingtips #podcastingcommunity #businessstrategies #salesindustry #employersponsoredplans #specialtypharmacy #pharmacycosts
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Apr 25, 2023 • 45min

Medical Bill Audits - Slingshot - Zoe Holderness

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
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Apr 18, 2023 • 1h 16min

Artificial Intelligence in Underwriting with Gradient AI

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

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