Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Show HN: Eligible API for 700+ Health Insurance Companies

eligibleapi.com

Post reply on HN
Print view View original

51–60 of 95 posts

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#51

Post by kategleason »

samstave wrote: post #48
dfc wrote: post #15

Earlier quoted context omitted.

Insurance covers teeth whitening? I thought elective/cosmetic procedures were not covered.

Not all do - but this is why I ask - I would like to see an API that lets me search for procedures I want, and ultimately have a market that makes the providers of that service compete for MY business. As it stands, the insurance market is inverted that it makes the insured compete for coverage.

Agreed. Castlight health is doing this for employees of certain companies http://www.castlighthealth.com/.

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#52

Post by kategleason »

obituary_latte wrote: post #8
kategleason wrote: post #4

Earlier quoted context omitted.

Thanks for your comment. We handle the connections to the insurance companies and the EDI to JSON transformation. I respect your point about 5 cents being high. We, of course, will evaluate that as time goes on. To start, you as a developer can make an app for the medical industry that checks patient's health insurance eligibility. Details you can call include: health spending accounts, deductibles remaining, coinsur…

Maybe I'm misunderstanding, but this post makes it sound like you've created an efficient API to find whether or not a person can "afford" treatment. Again, maybe (hopefully) I've misunderstood. And not to be the the tree-hugging idealist of the post, but as a fellow human, how does this make life better for the rest of us? Sorry if I seem confrontational about the whole thing; progress usually is a good thing. That…

I think it's better for patients to know if they can afford (have coverage) for a treatment before it occurs rather than get a $3000 bill in the mail after it occurs. I know it still sucks ;-/

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#53

Post by kategleason »

6ren wrote: post #45

The deeply nested JSON (9 levels) seems difficult to understand without some kind of schema/detailed docs - though maybe domain users are already familiar with the underlying data's schema? Part of the problem is intrinsic data complexity, aside from EDI format. https://eligibleapi.com/restful-json-api/response Also, it's simulating JSON [] lists as objects with fields named "Item #1", "Item #2", ... Seems an odd cho…

We want to make the JSON as simple as possible to parse. I'll be posting full data sets to the documentation shortly. Feel free to email me with how you would prefer to see it handled.

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#54

Post by kategleason »

buss wrote: post #24

I've been using Eligible API for just over a week and I must say that I'm loving it so far. Kate & Patrice have been extremely responsive and improving incredibly fast.

Your team has helped us improve 100% over past week alone. Thanks again.

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#55

Post by foxhop »

kategleason wrote: post #4
chime wrote: post #2

If I understand it correctly, this is an EDI to JSON API? At 5c/call, it seems like one of the most expensive APIs out there but I'm guessing it does something that is very difficult to setup on your own. Reading the front-page, did not make it clear what is it that it really simplifies. And how can I as a developer (who might want to make a mobile app for the medical industry) make use of this service?

Thanks for your comment. We handle the connections to the insurance companies and the EDI to JSON transformation. I respect your point about 5 cents being high. We, of course, will evaluate that as time goes on. To start, you as a developer can make an app for the medical industry that checks patient's health insurance eligibility. Details you can call include: health spending accounts, deductibles remaining, coinsur…

I think .05 cents per request is too expensive. If generating a response is a computationally intensive task, then I understand. But your current pricing model reminds me of the pay-per-minute phone calls of yester-year.

Pricing has to make sense. Pulling from my experience building and marketing LinkPeek.com, I have found the best results by providing different tiers or plans for different target markets. I try to use the different tiers to show value for different types of customers. It should be a no-brainer for your customers which plan to choose.

I feel you should review your current pricing model so that you don't scare people off when they do the math.

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#56

Post by daigoba66 »

chime wrote: post #2

If I understand it correctly, this is an EDI to JSON API? At 5c/call, it seems like one of the most expensive APIs out there but I'm guessing it does something that is very difficult to setup on your own. Reading the front-page, did not make it clear what is it that it really simplifies. And how can I as a developer (who might want to make a mobile app for the medical industry) make use of this service?

The big companies all charge crazy expensive transaction fees: Emdeon, ENS (now Ingenix), ACS (now Xerox), Ability, Relay Health (formally HTP), and Meddata/Transunion. They all charge upwards for 25-35 cents per eligibility transaction.

The software company I work for sells a healthcare product which includes automatic real-time eligibility verification. We don't charge per transaction. We can afford to do for two reasons 1) we put a lot of effort into finding cheap/free/redundant real-time connections to payers and 2) we can simply eat the cost as part of the margin for our product. Our philosophy is that you should check eligibility often and always, at every point of the patient's encounter from scheduling to check-in. Per transaction costs scare away customers which is part of why we don't charge per transaction.

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#57

Post by gvnonor »

kategleason wrote: post #49
ammmir wrote: post #47

I applaud the initiative, but I think the JSON needs to be friendlier. * Use REST. * Use HTTP Basic auth instead of cluttering the URL query string with the API key. * Use ISO 8601 for dates, no exceptions. * Use lower_case or lowerCamelCased keys. * Don't use spaces or other non-alphanumeric/underscore characters in keys, otherwise you can't easily index child objects with dot notation in many languages. * Instead o…

can we hire you? I love your feedback, we know this is still raw (early beta) but its great hearing constructive suggestions. Please email when you have a chance k@eligibleapi.com so that I can provide you with a full data set of JSON response.

In case ammmir decides takes you up on your offer, I'd advise him to ensure that a contract is in place before committing to do any work.

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#58

Post by kategleason »

gvnonor wrote: post #57
kategleason wrote: post #49

Earlier quoted context omitted.

can we hire you? I love your feedback, we know this is still raw (early beta) but its great hearing constructive suggestions. Please email when you have a chance k@eligibleapi.com so that I can provide you with a full data set of JSON response.

In case ammmir decides takes you up on your offer, I'd advise him to ensure that a contract is in place before committing to do any work.

Waiting for that bad boy. In case anyone is curious of what gman is referring to you can read my response here katgleason.tumblr.com

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#59

Post by aamar »

samstave wrote: post #7
kategleason wrote: post #4

Earlier quoted context omitted.

Thanks for your comment. We handle the connections to the insurance companies and the EDI to JSON transformation. I respect your point about 5 cents being high. We, of course, will evaluate that as time goes on. To start, you as a developer can make an app for the medical industry that checks patient's health insurance eligibility. Details you can call include: health spending accounts, deductibles remaining, coinsur…

While I think this is awesome (I work in the healthcare space - on the infrastructure side (design, build and implement systems for new hospitals)) though I would LOVE to see the following, if this API allows: I as a user would like to tell you my insurance info and tell you what procedure I want and you tell me the best/cheapest location to get that done. Then - here is where the groupon model farking failed: (I hav…

I as a user would like to tell you my insurance info and tell you what procedure I want and you tell me the best/cheapest location to get that done.

This is offered by Castlight Health (www.castlighthealth.com), where I used to work. Though it is currently only sold to employers & offered free to their employees.

Re the groupon model: I think you'd need to adjust the model a lot to sell services which are frequently covered by insurance. Teeth whitening generally isn't insured, which is why it is in fact a very frequent groupon offer.

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#60

Post by DennisP »

daigoba66 wrote: post #56
chime wrote: post #2

If I understand it correctly, this is an EDI to JSON API? At 5c/call, it seems like one of the most expensive APIs out there but I'm guessing it does something that is very difficult to setup on your own. Reading the front-page, did not make it clear what is it that it really simplifies. And how can I as a developer (who might want to make a mobile app for the medical industry) make use of this service?

The big companies all charge crazy expensive transaction fees: Emdeon, ENS (now Ingenix), ACS (now Xerox), Ability, Relay Health (formally HTP), and Meddata/Transunion. They all charge upwards for 25-35 cents per eligibility transaction. The software company I work for sells a healthcare product which includes automatic real-time eligibility verification. We don't charge per transaction. We can afford to do for two r…

Wow. It's so weird seeing Meddata mentioned and described as one of the "big companies."

I was Meddata's second programmer, and built their eligibility system. I wrote their edi parser in five pages of C# code. Two of us built an entire eligibility and referral system, and took the company from nothing to profitability in five years. Then I moved on.

I still visit them from time to time, and although Transunion owns them now, the Meddata team is still pretty small.

Post reply on HN