Assertion Contradicted
Perry: Most Surprise Medical Bills Stem From Provider Submission Errors
“In most of those cases, the provider submitted the claim wrong.”
Assertion Not checkable as stated
Perry: Major US Health Insurer Manually Processes One in Eight Claims
“Yeah, actually, I know there's a large payer, ah, that I know manually processes one in eight claims because their adjudication system doesn't do it. It's a large payer. We'd all know the name of it.”
Assertion Not checkable as stated
Perry: Candid Was First to Catch a Major Health Payer's Bug
“We were the first company in the country to identify that this very large payer had put a bug into their rule system. And they fixed the bug based on, like, us pointing out, hey, you guys, something seems to have happened here.”
Assertion Not checkable as stated
Perry: Most Medical Billing Companies Ignore Touchless Claim Rates and Automation
“Most billing companies do not do that number because they don't care about automation. They care about first pass resolution, but we wanted first pass resolution where no manual steps were taken.”
Insight
Perry: US Healthcare Standardized Forms but Not Field Requirements
“They didn't, they standardized the form. But they did not standardize the field, what you put in each field in the form.”
Opinion
Perry: Medical Billing Remains Manual Because Industry Lacks Good Software
“Why this is so expensive, so manual is because there's no good software today. People have to do this by memory or they're like, Creating their own rules or they're like doing things. They're hand jamming. There's a lot of manual work to actually try to do all…”
Prediction Not checkable as stated
Perry: Candid Health Can Sell Its Pre-Adjudication Engine Back to Payers
“I 100% think we could because if you think about what we're doing, we're pre-adjudicating the claim. We know how the payer's, we know what the payer wants on their claims. We know, like, what their rules are for how to submit a claim. And there's a bunch of no…”
Opinion
Perry: Healthcare Billing Costs Could Be Cut in Half via Software
“Easily. At the end of the day, there's no software. They're throwing bodies at the problem. The last innovative thing we did in this industry was offshore it.”
Insight
Perry: Effective AI in Healthcare Billing Requires Massive Underlying Infrastructure
“The actual useful application of machine learning is the tip of a very large iceberg, and we're building the infrastructure under the ocean right now of, like, the infrastructure for how do you do all that automation correctly and the machine learning correctl…”
Assertion Not checkable as stated
Perry: Candid Health Submits Up to 99% of Claims Correctly First Time
“The rules engine, I think is probably the brain of what we're doing is probably the most valuable part of what we're building, and it's how we can submit, in some cases, 99% of claims correctly the first time.”
Insight
Perry: Value-Based Care Struggles Under Legacy Fee-for-Service Claims Rails
“That actually opened up a can of worms on the move to value base of how do you actually pay for that? You actually, they, the way they implemented that in many cases is actually they like put that on the claims rails. So they actually submit these claims and i…”
Assertion Supported
Perry: Over 1,000 US Health Insurers Have Different Claim Rules
“And all of, all those thousand, over a thousand insurance companies literally have different rules for how to submit the claim.”
Insight
Perry: Cluster Denied Claims to Extract Rules Instead of Calling Payers
“Cluster your claims. Find which ones were denied for the same reason. Make one call. Don't call for all thousand of the ones were denied. That's smart. Take that rule, put it in the rules engine, and don't make that mistake anymore.”
Assertion Not checkable as stated
Perry: Candid Health Grew Revenue 6x in 2023 to 100 Customers
“We grew six X this year and the team is around 50 people and have about a hundred customers now.”
