Adonis' journey into healthcare payments and patient finance
At Adonis, our mission is to simplify payments for healthcare providers and patients. We are proud to announce our launch and first venture round today. You can read more on Forbes.
It’s no secret that healthcare spending is higher in the United States than any other country in the world. What’s surprising is that even as healthcare spending continues to rise, the patient experience hasn’t gotten any better, and by some measures, has even worsened. The question we set out to answer is, why are costs rising while the patient and provider experience has not improved?
Following the money in healthcare billing and payments
Of course, there isn't a single answer that explains why healthcare spending continues to balloon in the absence of improved healthcare outcomes, but it turns out that a lot can be learned by simply following the money.
Here’s how it works in most cases today:
As patients, when we seek care, we book an appointment with a primary care provider or specialist, often without knowing with absolute certainty whether that doctor is in or out of network. Upon arrival we share our relevant health insurance details with the administrative staff. We then leave without knowing how much we’ll owe or when we’ll need to pay it.
After a visit, providers and their teams embark on a long and convoluted process involving multiple systems of record, numerous specialized workers, and complex insurance data exchanges – costing providers anywhere from 3-12% of revenue in overhead costs.
Today, medical billing and other insurance related activities account for nearly $1 in every $7 spent on healthcare in the United States.
At best, this process takes 30 days from start to finish, and at worst, claims can get rejected or denied by insurance companies for unknown reasons. In fact, nearly 15% of claimable revenue is written off by providers each year. This game of cat and mouse between providers and insurance companies can kick-off months of back and forth, creating unnecessary waste along the way. The complex, manual, and human intensive process between the visit, and before we receive a bill, is known as medical billing.
100 million Americans are saddled with medical debt
Unfortunately, the longer it takes providers to receive reimbursement from insurance companies, the less likely it becomes for patients to pay their portion of the medical bill. As insurance deductibles continue to rise, the problem is going to get worse before it gets better. This results in undue financial stress for American households seeking care and challenging business dynamics for the healthcare system. All told the administrative costs of the healthcare system amounts to nearly 35% of total expenditure.
The Adonis approach: intelligence first, automation second
In order to create a more seamless, efficient, and dependable system of collecting revenue for providers, we built infrastructure that enables our platform to connect into any healthcare system of record to exchange relevant clinical and financial data - including Electronic Health Records (EHRs), patient portals, and clearinghouses . Once extracted, this data is cleaned and normalized, enabling real-time and actionable intelligence that practice leaders can use to make data driven decisions.
Through this intelligence, Adonis is able to help practice leaders identify the biggest drivers of claims denials by leveraging machine learning and insights from lookalike practices. Equipped with better information, practice leaders then partner with Adonis to deploy flexible automation that interoperates across systems and throughout the healthcare payments and patient finance journey.
This process of using practice level intelligence to drive automation decisions has a meaningful impact on the provider and the patient’s bottom line. On average, practices using Adonis are submitting claims faster, cheaper, and with greater success – leading to a 50% reduction in billing fees and a 40% increase in reimbursement rates. This improved process means that patients receive their bills in a more timely manner with greater explainability.
How we got here
Adonis is founded by two brothers, Akash and Aman Magoon, who have spent their careers building software in healthcare, data infrastructure, and fintech. When running their previous company and in their experiences working with insurers and healthcare organizations throughout the country, we saw firsthand how connected data has advanced a few care domains - like drug discovery - but has failed to make its way to others. Adonis is a group of software engineers, data scientists, machine learning enthusiasts, and healthcare experts that is bent on partnering with every healthcare organization across the care continuum to drive intelligence and better decisions.
The time to change the healthcare payments and patient financial journey is now. Today, nearly 90% of healthcare organizations in the United States have digitized how clinical data is stored, EHR adoption is at an all time high, and healthcare interoperability is on the rise. Adonis has made it easier than ever before to connect data across systems, enabling the support of healthcare organizations of different sizes and specialties.
The journey won’t be easy, but we are determined now more than ever before to tackle these challenges head-on with pragmatism, frugality, honesty, and optimism.
If you’re interested in learning more about our vision, please reach out at founders@adonis.io.
