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.
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
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:
$ ./bin/rexster-console.sh -l python
(_______( 0 0
( (-Y-) <woof>
l l-----l l
l l,, l l,,
opening session [127.0.0.1:8184]
?h for help
rexster[python]> g = rexster.getGraph("graph")
rexster[python]> [v.name for v in g.V]
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.
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.
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.
- 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.
- 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.
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.
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.
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.
At PokitDok, our mission is to provide a better, more efficient and transparent consumer experience in healthcare. That said, the foundation of why we do what we do is inspired by people and helping them to lead healthier lives. From moms and dads, to kids, significant others, grandparents and everyone in between, we stand for supporting healthy habits and preventative health measures for you and those you love most in your life. In celebration of American Heart Month and Valentine's Day, we give you this fun, heart-inspired post. With that, here's seven foods to keep you heart-healthy all February long:
1. Carrots. Did you know that carrots are high in Vitamin A and have been associated with a lower risk of heart attacks in women? Nutrients in these orange, yellow, red, white, and purple beauties may provide protection against heart disease and cancer, while helping to build healthy bones and nervous systems. Some studies have also shown that cooking carrots may help boost their antioxidant levels and overall nutritional value. Share the love this month by adding some heart shaped carrots to a healthy dinner like chicken noodle soup- for the soul and for the heart.
Check out the recipe.
2. Bananas. Not often though of as a 'heart healthy fruit', bananas are high in potassium and fiber and low in sodium, making them an excellent choice for maintaining healthy cholesterol, blood pressure and heart function. This Valentine's Day, doodle a few hearts and a quick middle school-esque message for your cheesy humor appreciating fam. They'll go bananas over it.
3. Eggs. They get a bad rap in heart health with yolks containing ~186 milligrams of cholesterol - more than half of the American Heart Association’s daily recommendation. Eggs, though, are an accessible, inexpensive source of protein and contain essential vitamins and minerals that are excellent for your heart and your brain. While some need to be conscious of their egg consumption, both from a quantity and preparation perspective, eggs are a great way to keep your ticker tickin'. Share the love first thing on Valentine's Day with a heart-shaped egg atop a piece of whole grain toast. #hearthealth #heartshape #loveon
Get the mold.
4. Strawberries. Did you know that strawberries rank #2 among the top 10 fruits in antioxidant capacity? They're also naturally fat, sodium and cholesterol-free with 1 serving (~8 strawberries) weighing in at only 50 kcals! Strawberries help control cholesterol, blood pressure and homocysteine levels, three of the risk factors associated with heart disease. Toss 'em in a pretty pink smoothie, a romantically fresh salad, or heck, redefine a bouquet of roses. They're beautifully delicious (and might save you a penny or two come Feb. 14th).
How to make them.
5. Tomatoes. Rich in lycopene, available all year round and with a deliciously sweet flavor, tomatoes are supremely high in antioxidants. A recent study by scientists at Tufts University in Boston, suggests regularly eating lycopene over many years can have a powerful protective effect on the heart. This time around, cut a pearl or cherry tomato in two, position the two halves as shown and jump on Cupid's bandwagon.
6. Dark Chocolate. We know, we know. You've heard it before - but that doesn't make it any less awesome that dark chocolate is good for your heart. It ranks among the top 10 dietary sources of antioxidants (others include cloves, mint, anise, cacao powder, and berries), according to the European Journal of Clinical Nutrition. Dark chocolate is also rich in bioactive flavonols and theobromine, which reportedly have grand effects on our ticker [heart] cells and blood vessels, which keep our hearts pumping healthily. It should be noted that the chocolate we speak of should be dark, as close to pure as possible and consumed in moderation. So tonight when you're hankering for something sweet, grab a square of the good stuff, give your <3 a quick fist bump and relax.
Make your own dark chocolate hearts.
7. Red Wine. The moment you've all been waiting for - when we validate your nightly glass of vin. Cheers to that #amIright. Research shows that the alcohol and antioxidants in red wine may help prevent heart disease. How, you ask? By increasing levels of high-density lipoprotein (HDL) cholesterol and protecting against artery damage. Those same antioxidants (specifically polyphenols) may also help protect your heart's blood vessel lining. So, the next time you reach for a deep Merlot or a pretty Pinot - give the ol' corazon a quick glass clink and know you're doin' your body good.
Physicians are generally known for earning higher than average incomes. However, with the recent changes in healthcare, they have a growing reason to be concerned about money just like the rest of us. Average physician salaries range from $176,000 for family medicine practitioners, to $413,000 for orthopedic surgeons, according to WebMD’s 2014 Physician Compensation report. But those figures don’t take into account that many doctors entering their practices have as much as $200,000 in outstanding loans or, that payment rates are dropping from both CMS and private insurers.
In an attempt to alleviate these financial pressures, many doctors are seeking supplemental revenue streams in creative ways you might not expect. Here are a few of the many ways that doctors are doing just that:
Retail sales for skincare or spa related items: You may be used to seeing sunscreen and other creams at your dermatologist’s office, but what about at your OB/GYN clinic? Some OBs carry not only breastfeeding supplies, but lubricants, vitamins, and skin care products in addition to offering services like facials and peels.
Botox parties: Botox parties have impressively transformed injections from private, personal procedures to group social events...with wine. Strange, right? Try brilliant. Considering the steep price point, doctors can, in a one room sweep, easily make extra income off a cheery group of wine drinking pals. Not bad for a happy hour's work.
Concierge fees: To date, 3% of doctors offer a concierge practice and the rate and popularity of such services is growing steadily, especially in affluent urban areas. In return for a monthly or yearly fee, patients may receive additional services including longer visits, quicker access to care, and visits with physicians (versus nurse practitioners).
Cash-only practices: Cash-only practices are becoming more popular. In fact, 6% of practices exclusively accept cash so they don’t have to deal with complications brought on by the insurance process. Without the insurance arm in the equation, patients also have the ability to negotiate lower fees, which is pretty revolutionary in itself. Sites like PokitDok's provider profiles, make it easy for providers to list procedures by price and have their patients schedule and "self-pay" up front.
Side jobs: After their already long hours, willing docs can pick up extra shifts on nights and weekends or even on their practice’s days off. They might also take on side jobs at urgent care clinics, nursing homes, skilled nursing or hospice facilities.
Retail clinics: Retail clinics, like the ones you see at drug stores, are usually staffed by physician assistants and nurse practitioners. However, these health care extensions are legally required to have physician supervision, even though the doc doesn’t physically need to be on site at the time.
Clinical trials: Whether the doctor’s site participates in clinical trials or simply recruits patients for them, with expert knowledge, there’s money to be made on both sides.
Telemedicine: As this space continues to rapidly expand, companies and clinics alike are hiring full and part-time physicians to handle telemedicine calls. According to MDLive, 85% of certain doctors visits can be solved via telemedicine. These ‘visits’ can often be handled from a home office or anywhere with a secure internet connection.
Writing: The advent of blogs, online publications and the need for accurate, forward thinking medical content has increased doctors’ opportunities to use their expertise for content creation. They may be paid for their written content or use this experience to establish themselves as thought leaders in the industry, thereby leading to more, potentially lucrative opportunities.
Become a medical examiner or claims reviewer: Doctors who get qualified by insurance companies can conduct one-off occupational health and other patient evaluations for insurance companies. The work may be monotonous, but worth it for the right price.
Speaking & teaching opportunities: Pharmaceutical and CME companies hire physicians to present educational content to other physicians at conferences and in seminar settings. Similar to content creation, this has the potential for doctors to earn respect and awareness as well as position themselves as experts in their specialties.
Renting office space: Some ways to add income don’t involve medical care at all. Doctors who happen to have extra office space can rent it out to other providers, including ones that can have a beneficial referral relationship, like physical therapy or psychiatry. For example, our fine group of engineers at PokitDok's Charleston location rent office space from a former doctor's office complex.
Just like the rest of us, doctors will continue to deal with the ever-changing economy in creative, ingenious ways. The next time you have to wait 2 months before seeing your doctor, or get shuffled through a rushed 10 minute exam, perhaps you'll maintain compassion and composure with the knowledge that the system is broken for them as well and they're just doing their best to stay profitable. Until a better consumer healthcare experience takes hold and the technological tools to streamline practices becoming more widely adopted, we'll give them a break.
We are building the world's largest health graph
In our last post, we introduced the latest thing the Data Science team is building for PokitDok: the PokitDok HealthGraph. Today, we'd like to tell you why we are excited about this technology and give you a closer look into the connectivity of the PokitDok HealthGraph.
The top 3 things we love most about the PokitDok HealthGraph
1. Healthcare is naturally connected - let’s look at it that way.
Healthcare, at its core, is about people, procedures, and places, and the relationships between them. Modeling these sorts of relationships - or any sort of relationship between entities, really - is where graphs excel. By modeling the data more organically, we spend less time figuring out how to hammer the data into tables, and more time exploring and resolving questions that are important to you, our customers.
Why We Love Healthcare In Graphs
While the front-end team has been busy putting together version 3 of our healthcare marketplace, the data science team has been hard at work on several things that will soon turn into new products. Today, I'd like to give you a sneak peek at one of these projects, one that we think will profoundly change the way you think about health data. We call it the PokitDok HealthGraph. Let's ring in the New Year with some data science!
PokitDok is proud to announce that today, at the J.P. Morgan Healthcare Conference, we introduced the launch of the PokitDok Enterprise Scheduler. This patent-pending calendaring system enables group medical practices, telehealth companies & hospital networks to improve the efficiency of their scheduling programs, thereby making both the patient and administrator side of the equation more seamless.
With this technology, appointment times can be made available on intranets, websites & mobile apps, complete with the option to integrate with a patient's calendar system or send them push notifications via SMS or email. Healthcare is an industry that relies heavily on costly switchboard operators, robust call centers and, well, paper. The PokitDok Enterprise Scheduler drives down those costs, saving admin time, improving patient communication, and potentially lowering user error. The PokitDok Enterprise Scheduler brings unprecedented efficiency and improves the consumer experience.
Interested in the PokitDok Enterprise Scheduler? Contact someone from our team or see the full release on Business Wire.
* Screenshot of the upcoming version of PokitDok Marketplace enhanced with scheduling functionality