By Maggie Habib on November 14, 2022
The platform shrinks payment cycles from months to minutes to drive down rising healthcare costs and reduce administrative friction between payers, patients, and providers
Orem, UT - November 14, 2022 -- Nomi Health — the direct healthcare company making it easy to access high-quality, affordable care across the U.S.— today announced the launch of its Connect fintech platform to power real-time healthcare payments. The platform, which allows healthcare to function at the same speed as fintech, directly connects providers, patients and buyers of care services to power provider payments in real time, while also allowing for claims adjudication and billing workflows, all in a single, paperless and frictionless system – a category first.
By closing the loop to integrate these services, the system enables health plans and third-party administrators (TPAs) to administer claims faster, reduce the administrative costs and overhead that are often a key driver of rising health insurance premiums, and improve patient experiences. The platform also substantially reduces the administrative barriers and cost for providers who have to spend weeks or months chasing down reimbursement for services. Networks, health plans, TPAs, and point solutions in healthcare that can benefit from modern fintech solutions can deploy the platform.
“Traditional, antiquated healthcare workflows have created an ugly reality where patients are a commodity, providers are bill collectors, and those who buy healthcare for their communities are blind participants in a process that is crippling the U.S. healthcare system and driving healthcare costs above $4 trillion,” said Boe Hartman, co-founder, and chief technology officer at Nomi Health. “By simplifying the entire payment process and making it more transparent, we can provide tangible, meaningful benefits for providers, patients and buyers of healthcare. Providers get paid faster, patients get the care they need, and buyers can make their dollars go further.”
Hartman knows firsthand how real-time payments can transform industries based on his more than 25 years of experience leading client service and technology innovation at some of the world’s largest financial institutions, including Goldman Sachs, Barclays, and Capital One. While fintech has long embraced real-time payments based on consumer demand for a more user-friendly way to process transactions, until now the healthcare industry has lagged behind with the traditional claims decisioning and payment workflows deeply connected to the business models of the largest payers.
“The system used to manage healthcare payments for decades is unwieldy and inneficient, suffering from fragmentation, outdated technology, and complexities from market forces. This status quo is no longer sustainable in the face of spiking healthcare costs and a substantial decline in the number of doctors,” said Melissa Guzy, co-founder and managing partner of Arbor Ventures. “Real-time payments and information are no longer optional. Fintech accelerated the massive leap to real-time, and now it is time for healthcare to catch up. Nomi’s solution addresses this problem more comprehensively than any other to date.”
Provider payments delivered instantly
Nomi’s provider portal introduces the ability for a provider to check eligibility, document services, submit a claim, and track payment history. Directly connecting both the plan sponsors and providers’ bank accounts via Nomi’s proprietary payment and virtual ledger technology, the movement of financial funds for the full balance that a provider is due can occur alongside claims adjudication in real time. Compare this to the traditional industry realities that only 60% of what buyers pay the insurance carrier ever reaches the doctor, while providers typically wait 2-9 months to get reimbursed by health plans. In fact, according to the Annals of Internal Medicine, doctors spend nearly twice as much time doing administrative work (49%) as actually seeing patients (27%).
More transparency for patients
Real-time payments for providers also benefit the patients, who will immediately understand what they owe after receiving care. Using the Nomi patient portal, patients create a digital wallet where they can save a payment method to be used at checkout, receive bill notifications, pay their bills, and check the current status of their remaining benefits. By saving a payment method, the checkout and payment process becomes quick and efficient, eliminating the need for waiting on confusing bills mailed months after service in the fragmented payment experience that people experience today.
The launch of the fintech platform is the next step in Nomi Health’s years-long mission to create easier access to lower-cost, high quality care by rebuilding how care is paid for and delivered. As one the nation’s leading Covid-19 care providers, Nomi Health understands the challenges providers face firsthand, as it deployed a direct care delivery model to serve 15 million Americans throughout the pandemic. The platform also builds on the company’s work running analytics on more than $100 billion in healthcare spend for some of the nation’s leading employers via Artemis Health, a Nomi Health company.