Simplee Demystifies Medical Billing for Hospitals and Consumers

September 03 01:00 2013 by ushadmin

After a terrible vacation, Simplee CEO Tomer Shoval quit a big corporate job to create the Mint-style medical bill payment platform.

In September of 2009, Shoval was traveling in Mexico with his wife and three kids when they all got violently ill. Three months later, back in the states, the Shovals started receiving complicated invoices and explanations of benefits. “We tried to figure out what they were about,” he says. “We couldn’t remember if we had paid at the time or not. Why did we need to pay X vs. Y when insurance should cover it? That was pretty much the moment it struck me that this was really broken and we needed to solve that.”

As Shoval dealt with his own bills, he started looking into trends in the industry and found that consumer-driven healthcare was on the rise. As more people opt for high-deductible plans, they find themselves paying more and more money out of pocket. “Today the average family spends almost $4,000 on top of paying for insurance,” Shoval says. “The motivation has really changed for patients.”

Shoval and two cofounders started the company in the summer of 2010, with the aim of making the medical billing process easier for both patients and health care systems. Even as consumers deal with the increasing out-of-pocket costs of health care, hospitals and practices have the bigger job of collecting payments from patients instead of insurance companies and government programs. “If you connect the dots that patients are confused, you figure out that there’s a growing challenge of collecting patient payments,” he says. “We solve that problem.”

On the consumer side, the company has created a free Mint-like platform called SimpleeWallet that shows members a breakdown of their medical bills, including the difference between what they owe and what their insurers pay, as well as expenditures by family member. It also works as a payment platform, allowing users to pay their bills directly through the app, and link their Healthcare Spending Accounts as well. The app also has a function that allows it to detect errors in billing, like getting charged for a mammogram, a free preventative service under Obamacare.