Haskell: Language Rascal

By Gage Swenson,

Car codin
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PokitDok is a cutting-edge product, powered by engineers with a knack for stringing together cutting-edge tech. It's one of many reasons why PokitDok is such a great company. If you talk to any of our scientists, you will quickly find that all of them are an expert at something state of the art. Continue reading…

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  Tags: Dev

PokitDok's List of Upcoming Events

By Nicole Fletcher,

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From code-a-thons and healthcare design, to health IT events, telehealth meetings and beyond, we're excited to be attending a number of events over the next few weeks. If you plan to be at any of the following and are interested in meeting with a member of the PokitDok team, let us know!

Health 2.0 Code-A-Thon: March 28-29 - Boston
IHC Private Exchange Forum: March 31 - April 1 - Dallas
HxRefactored: April 1-2 - Boston
HIMSS15: April 13-15 - Chicago
Hx360: April 13-15 - Chicago
LendIt USA: April 13-15 - NYC
DigSouth: April 28- May 2 - Charleston
Health Evolution Partners: April 29 - May 1 - Laguna Niguel
American Telemedicine Association Annual Meeting: May 2-5 - Los Angeles

SONY DSC

Interested in following our events? They're posted here on our Press Page. Simply click the 'Event's tab for a full list.

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  Tags: Dev, Enterprise

AccelAPX Recap

By John Riney,

Accel APX Conference
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Spring is here, and that means two things are coming -

  1. Allergy flareups!
  2. PokitDok's conference season!

Yesterday, I had the privilege of attending the Accel APX Conference, put on by Accel Partners. Featuring platform and evangelism experts from Twitter, Facebook, Uber, and Amazon Web Services, this was a good opportunity to see how strongly Accel and the industry in general are embracing the API economy. Continue reading…

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  Tags: Dev, Enterprise

What Our Customers Are Saying

By Nicole Fletcher,

iStock_000043260972Small
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At PokitDok, we continually hear how great our service is and how genuine and helpful our technical support can be. In fact, we are so proud of our best-in-class Customer Success team, that we decided to let the customer feedback speak for itself.

Our team works diligently to ensure that all of our customers - be it enterprise, developer, provider or consumer -  are well taken care of and have the best experience possible. In that vein, here’s a taste of just a few of the great pieces of customer feedback we've received in the past few weeks.

Enterprise Customers:

"PokitDok's suite of APIs allows us to [check] the patient's eligibility and then [submit] a claim for their visit directly to the insurance provider."

- Adam Jackson, Co-founder and CEO, Doctor On Demand

“PokitDok's extensive database of localized prices for healthcare procedures, appointment booking, and procedure and provider specialty search is a natural extension of our mission to change the way healthcare is delivered….”

- Jim Prendergast, CEO Healthiest You

"I haven't seen anything else out there like this and while I appreciate all the 'I'm going to make you feel better apps' I really like that you've fixed the important but unsexy side of healthcare.  I really like this."

- VC & Prospective Customer

"If others knew [what PokitDok is doing], you could change the world."

- Silicon Valley Influencer

API Customers:

"Thank you so much. Your API works like a charm. You guys have my business and I couldn't be happier with my account manager."

- Kevin B., Developer - San Francisco

"Very cool! Lots of potential - just the tip of the iceberg of what's to come in helping patients aka consumers of healthcare make better and more informed decisions around their health needs. It's like Amazon met Facebook and decided to create PokitDok!"

- Brandon F.

“All I can say is this is SWEET. Now my clients won’t need to call the insurance companies or use the clearinghouse portals. Where are you located? If you’re close I want to come buy you a cup of coffee.”

- Frank G.

"Wanted to let you all know that we've successfully made calls to your application...[and are in a ] testing phase ... as we integrate new functionality that is reliant upon PokitDok. Your team has a great product here, and we are happy to have it as a tool to augment our platform."

- Anon., Healthcare Startup - Silicon Valley

"Customer service: A+++++++++ 10/10. Would definitely email again!"

- Kyle S., Healthcare Startup - San Francisco

"PokitDok is superb!"

- CEO, 2nd.MD

Provider:

"I can reduce overall spend by keeping costs down and workers (patients) happy & healthy through PokitDok"

- Devon, CEO of COHO Medical Group

Consumer:

"PokitDok just saved me $5K! I sent a Request for Quote for an MRI at a hospital in Georgia and I continued to search for a private practice because Hospital prices are always higher...come to find out just across the street from Cartersville Hospital at Reed Imaging, I could have the same MRI for only $479!! Thank you, PokitDok.”

- Brad M., Georgia

Have feedback for us? We'd love to hear it.

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  Tags: Consumer, Dev, Enterprise, Provider

Understanding Insurance Benefits: Cracking the X12 Eligibility Request And Response Code

By Samir Bakhshi,

json
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With healthcare records going digital, common healthcare transactions — be it claims, authorization for a service, referrals to a specialist, eligibility verification, status of a claim, or new plan enrollment — can be performed electronically. This means your healthcare providers can spend less time and resources filing paperwork and making calls, and spend more time on what is most important — YOU, the patient!

We are going to explore an in-depth healthcare transaction that provides you or your provider with your coverage information — this transaction is also known as the eligibility request and response (270/271). These transactions can now be done in real-time — meaning that once a request for eligibility information is sent, the response from the payer is returned immediately (within a few seconds).
Continue reading…

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  Tags: Dev, Enterprise

PokitDok Partners with Doctor on Demand

By Natalie Cann,

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DOD_PD

The PokitDok team is thrilled to announce a partnership with Doctor on Demand, a telehealth company offering patients Video Visits with Board Certified physicians. Co-founded by CEO Adam Jackson, Chairman of the Board, Jay McGraw, and the one and only Dr. Phil McGraw, Doctor on Demand aims to streamline and simplify the operations side of healthcare delivery, thereby making the whole healthcare system easier for all parties involved.

With the help of PokitDok’s application programming interfaces (APIs), Doctor On Demand will be able to accelerate the eligibility, claims, and claims status checks process across PokitDok’s near 200 insurance trading partners, which represent 79% of covered lives nationwide.

The API's allow patients and self-insured employers to use telehealth services directly through their insurance plan. The service is currently available across 47 states with more than 1400 Board Certified physicians.

Read the full press release here.

 

 

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  Tags: Consumer, Dev, Enterprise, Provider

The gremlin-python library

By Brian Corbin,

python logo
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Our data science team uses many components in the TinkerPop stack, along with the Titan graph database. As you may know from our previous post on namedtuples, we're a pretty serious Python shop - in fact, both our Marketplace and APIs are built with Python. So, there was a desire to continue to use Python syntax when defining graph schema using the management system, performing graph traversals, and so on. Today, we open sourced the work we've been doing to help our engineers and data scientists use Python when working with the PokitDok HealthGraph. Get the code at

github.com/pokitdok/gremlin-python

It's still an early version so you may find things not quite working as expected. We'll continue to send up pull requests as we uncover things. Please create issues if you discover things that are not working or not yet implemented, and we'll see if we can help get that fixed up.

Here's a quick usage example:

Here's what Denise Gosnell, PokitDok Data Scientist has to say about using gremthon:

"It was super easy to create a graph schema using python, and I am forever grateful for all of the time BC gave this week to make this for us!!"

We hope this (small) contribution back to the community can help some folks just like the TinkerPop stack has helped us.

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  Tags: Dev

What is X12 Anyway?

By Nicole Fletcher,

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At PokitDok, we talk the X12 talk all day, every day. From the water cooler and the coffee pot, to the conference room and beyond, we chat about data sets and payer integrations til the cows come home. We realize we’re different though- so in the spirit of education and live application, we thought we’d take a minute to break down the specifics of this much beloved communication standard- and more importantly, why you should care.

First things first, what is X12?

X12 is an exchange standard (more on what this means later) for real data that is used by many industries - from finance and government, to transportation, healthcare and beyond. When we talk about X12 of course, we’re talking about healthcare. When it comes to data type and uniformity, one might assume the data well - woke up like this - when in fact, it’s a bit of a mess before its morning routine.

Before:

Screen Shot 2015-02-18 at 12.02.39 PM

#mess

After:

Screen Shot 2015-02-18 at 12.03.16 PM

#flawless

It takes some work to look this good.

What that means is that data comes in all shapes, sizes and languages - and in order to easily access and understand it, a metaphorical tunnel has to be dug beneath the surface from the patient - to the provider - to your insurance company. Surprised it’s not already? Like we said, it takes a LOT of work to look this good. X12 takes the MANY data fields required to process a request - be that determining your healthcare eligibility or processing a claim - and connects them in a real time - readable manner.
To paint a clearer picture, a real life application seems fitting. It should be noted that X12 can be used not only for eligibility or claims (as noted above) but also claims status, enrollment, referrals and authorizations.
When Barb from the front office of Dr. Smith’s practice is looking to process eligibility requests at 11am on a Tuesday in March, she has a few choices - one without access to X12 and one with.

Without X12:

  • Barb finds patient file>
  • Barb picks up phone>
  • Barb dials insurance company>
  • Barb waits on hold for 13 minutes>
  • Barb finally talks to support operator Glen>
  • Barb gives patient info to Glen>
  • Glen puts Barb on hold again, this time for 8 minutes>
  • Glen comes back and asks for a piece of information he missed the first time>
  • Glen puts Barb on hold once again>
  • Barb waits on hold for 7 minutes>
  • Glen comes back and gives Barb her patient’s coverage plan>
  • Glen and Barb exchange pleasantries and hang up

 

This interaction for one patient took no less than 30 minutes.

With X12:

  • Barb inputs patient information in computer>
  • Barb receives immediate, complete output from patient’s insurance company with benefit information including eligibility (if they have current coverage with the provider), deductible information/status, out of pocket maximum and beyond.

 

This interaction for one patient took no more than 1 minute (including time for Barb to refill her coffee) and produced much more complete and rich information. Wouldn't it be nice if Barb could also tell you how much a particular service will count against your deductible? #transparency #thefuture

 

Hopefully this gives you a sense not only of what X12 is - but really, what it means for patients, providers, insurers - and of course, the future of health. Stay tuned for more X12 posts to come and remember, #sharethehealth.

 

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  Tags: Consumer, Dev, Enterprise, Provider

New Features - API Application Data

By John Riney,

doctor_tablet
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Today, I'm checking in with a neat new feature of our PokitDok Platform APIs. If you're not familiar with them, our APIs provide a clean, easy way to do eligibility checks, file claims with insurance companies, search for providers, and much more. Have a look at our platform site to learn more and sign up for free.

We recently had a customer ask if they could pass a bit of metadata along with their eligibility requests, and have it returned with the response. They could then pick this metadata off and use it to route the response to the correct place in their existing system. Well, we thought that was a great suggestion, so we have implemented this across our entire suite of API endpoints.

We've updated our developer documentation to demonstrate this functionality. Here's a quote from there:

API client applications may include custom application data in requests to help support scenarios where an application is unable to store the activity id and wishes to include application specific data in their API requests so that the information will be stored on the request's activity and returned to the application in asynchronous callbacks. This can be useful for scenarios where you want to directly associate a PokitDok Platform API request with some identifier(s) in your system so that you can do direct lookups to associate responses with the appropriate information. For example, suppose you wish to fire off a number of eligibility or claims requests and want to include some identifiers specific to your application. By including the identifier(s) you need in the request's application_data section, you can easily do direct lookups using those identifiers when you receive the API response.

Here's an example of how to craft a request payload containing application data:

The application_data block comes back to you, unchanged, in the data section of both synchronous and asynchronous responses, and it's also stored on the corresponding Activity for the transaction, viewable in the Platform Dashboard.

This has turned out to be a useful little feature for at least one of our clients. Hopefully it'll help you too. If you have questions concerning this, or anything to do with our health data APIs, feel free to contact our Platform team using our Contact Us page.

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  Tags: Dev, Enterprise

5 Ways Healthcare Could Take You From Riches to Rags

By Natalie Cann,

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According to a recent article on Huffington Post, even rich women fear they could become bag ladies, often as a result of a health related incident.  It’s a growing trend and concern even among the well-heeled, with many outrageous hospital claims and bills going viral like the surprise $117K bill covered recently by the NYTimes - a bill from a doctor the patient didn’t even remember meeting!

As the San Francisco, New York and other urban housing markets heat up, so, too, it seems, do monthly health insurance premiums and health related expenses. Even for those considered wealthy by the rest of the country’s standard, cutting costs and staving off unforeseen health expenses has become increasingly important. After all, the most financially secure among us could still find themselves in an unpredictable health situation, so here are a few scenarios to be aware of.
Screen Shot 2015-02-11 at 4.48.10 PM

 

1. You’re Involved in an Accident or Suffer an Unexpected Injury

Well-to-do and healthy millennials are increasingly choosing high-deductible health plans, sometimes known as “catastrophic plans”. Many, especially those in San Francisco, are also choosing to ride their bikes to and from work - a healthy, low cost and environmentally friendly choice, but one which carries added risks.  Not long ago, a former colleague was involved in a hit-and-run accident one morning while riding his bike to work. While he lay there unconscious, someone called an ambulance on his behalf. He ended up being fine physically, but financially it was a different story. He spent the next six months negotiating and fighting a $12,000 emergency room and ambulance bill, not realizing that with a catastrophic healthcare plan, he would end up owing a lot if there was indeed a catastrophe. Ask yourself: What health insurance plan do you have and what does that truly mean for your wallet? Is riding your bike to work a financially smart move, or one that could put you in serious financial jeopardy if you end up in an accident?

 

2. You Don’t Understand or Negotiate Costs Up Front

One might not immediately consider Modernluxury.com to be the go-to source for saving a buck, but they recently featured a post about negotiating your healthcare costs up front to save money. Quoting our CEO Lisa Maki,  “High-deductible plans are potentially one of the best things to happen to American healthcare.” With these plans, doctors are processing paperwork only to find that the bill should have gone directly to the patient. According to Maki, that means that they lose around 30 to 50 cents for every billable dollar—and it takes them longer to get paid, which is not in their best interest. But for the first time in healthcare history, the power is increasingly in the hands of the patient. You can now take charge of your financial fate and physical health by talking about price tags before signing on the dotted line.

 

3. Your Provider is Suddenly Out-of-Network

An “in-network” provider is a provider that has a pre-negotiated agreement with your insurance carrier. That means you are ‘approved’ to see them and your carrier will cover some of the cost of your visit less a co-pay. However, network status can change frequently and seems to be doing so more rapidly in recent months. One provider that is in-network today may not be tomorrow. Take, for example, my physical therapist. Last week’s visit only incurred a $30 co-pay, this week I was on the hook for the full $180. Often, you’ll need to be armed not only with current provider network status, but also with the CPT (Current Procedural Terminology) code to ensure the procedure itself is covered. If you find that a provider you must see is out-of-network or a procedure is not covered, it might behoove you to negotiate a same-day “self-pay” discounted price, which in many cases will knock off 25%, just as it did for me during a recent ER visit.

 

4. You Lose Your Job Unexpectedly

With the addition of publicly sponsored state healthcare exchanges, you may think you’ll be fine if you have a gap in employment. However, high income individuals making over $190K (high in most of the U.S. but just enough to squeak by with a family of four in the Bay Area) unfortunately aren’t eligible for state discounts through Medicare or Medi-Cal. Without employer coverage, annual premiums in some areas can top $2K-$3K per month for families of four, a cost unforeseen and unfathomable even 3-5 years ago, leaving those families spending nearly 25% of their take home pay on healthcare premiums alone. It’s also important to consider that parents are paying for those costs for more years than ever before, up to age 26, which is the earliest that most post-college grads are able to secure or pay for their own healthcare. Suddenly having and insuring a family is much more expensive, especially if you lose your lucrative job for a stretch. 

 

5. You’re Taken to the Wrong Hospital

Similar to the scenario above, hospitals also have pre-negotiated agreements with insurance companies. What’s the difference, you ask, if you were taken to the wrong hospital while unconscious in an ambulance? Well, in the case of Megan Rothbauer, the difference between a $50,000 bill and a $1,500 bill was a whopping 3 blocks.  Our Seattle pricing demo further illustrates how prices between hospitals can vary drastically even within the same zip code.

 

What Does it All Mean for You?

The best thing to do to protect yourself financially is to stay covered under a plan that works for you and your family. Know all of the costs before you go in to seek medical care, and stay informed like you would for any other consumer purchase. Make sure your plan includes a maximum allowable out-of-pocket ceiling that you can afford in a given year so you don’t get sticker shock in the case of a catastrophe.

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  Tags: Consumer, Provider