ClearPay Health

Inspiration

Patients want the most convenient, affordable, and frictionless experience they can find using information from devices, apps and websites when buying health care benefits for procedures, visits, or appointments. Cost considerations for the buyers is a never ending concern due to budget constraints and continuous rise in health concerns. Whether uninsured and paying cash, paying cash before the deductible kicks in; covered by an employer, state exchange or a government plan, patients recognize they are assuming more financial responsibility. They want to know more about an ever-changing array of care options and coverage. They want easy access, fair or transparent pricing, omnichannel with multiple payment methods, and low-cost medicine.

Similar to banking, health care can be personal. Every patient needs to be provided the tools to discover, choose, consume and engage with the health care system based on personal preferences and needs.

Patients are comfortable with the digitally enabled capabilities that help pinpoint health care opportunities and find value by harnessing the full power of digital. Therefore patients must be placed at the epicenter for controlling their information, payment preference, choices, and channels of engagement. Health plans and providers are working together to provide up-front price transparency for medical and surgical procedures, patient visits, and other clinical services before the patients pick their plan or decide how to pay.

What it does

ClearPay offers the following:

Price transparency - up-front pricing through search and filter capabilities. A user can search for procedures and pricing rates.
Customized payment options - omnichannel and multiple payment methods
Data-driven financial insights around cash flow for the providers
Data analytics for bookings or appointments
Shopping for fair pricing with price comparison like in e-commerce
Scheduling of and payment for appointments via online websites and through chatbots
Discovery of pricing on a Google maps similar to finding homes on Zillow based on prices
Consolidation of multiple plans into a single plan for payment on a mobile device for convenience
Telemedicine and payment for telehealth for risk adjustment and quality visit - this form of engagement has grown in popularity since the advent of the novel coronavirus causing COVID-19 infections
Omnichannel and multiple payment options to collect money from patients by the Back - Office healthcare users and admins (e.g. providers).
Frontend, backend, in-person and video visit payments.
Patient portal - consumer app
Back - Office administration app - backend app Integration with the Square payment gateway, terminal device and other Square services - the Square account is HIPAA compliant.
Text reminders
Replacing stack of paperwork to fill out with digital-first

How we built it

The Turquoise price transparency dataset (Turquoise Health dataset_Datavant Hackathon Sept 2022.csv) was imported into an Azure Database for PostgreSQL via the pgAdmin tool. A backend node js middleware server is communicating with the Azure DB for PostgreSQL service to retrieve the data. The front-end app gets the data from the backend middleware via REST API calls.

For the search capabilities, two approaches have been explored. The first approach involves uploading the dataset to MongoDB database and synchronizing the data between MongoDB and Algolia using the Mongoose Algolia library. Algolia search API client for JavaScript iis then used for the search.

The second approach is already described earlier by uploading the price transparency dataset to Azure Database for PostgreSQL and using the search capability within Vue js.

Challenges we ran into

The price transparency dataset does not contain locations or addresses of the providers and health systems. So, the CMS NPPES NPI registry provided was used to search for some address locations based on the name of the organizations in the price transparency dataset. Some of the address locations are displayed on Google Maps with prices similar to a pricing map from a Zillow home search.

Accomplishments that we're proud of

Increasing understanding of the healthcare space and developing the idea into a working prototype within a very short time frame.

What we learned

I learnt about the pgAdminTool, Azure Postgres, and price transparency for health care benefits.

What's next for ClearPay Health

Integration of ClearPay with the Square’s AfterPay service for medical payment financing. Consumers expect financing options for larger purchases like cars and appliances, so healthcare providers should consider offering the same.

A claims management portal to manage claims between the provider and the payer.

Invoicing and a better mobile app. A web and mobile chabot integration with the Azure bot service and the Cortana channel for booking appointments.

A much better medical services pricing transparency display on Google Maps.