Simplee’s payment portal for for health care gets boost from Medicare support

Since its launch last year, health tech startup Simplee has been described as a for health information because, much like Mint, it gives consumers an easy-to-use dashboard for tracking and managing medical expenses and insurance claims. But as the site grows and adds new partnerships and features, it’s becoming clear that its goal is to go beyond being a Mint-like service to offering consumers a comprehensive payment portal for healthcare.

“Think of our vision as becoming a PayPal for the out of pocket [health] market,” CEO and co-founder Tomer Shoval told me.

From the beginning, Simplee offered users the option to pay bills directly from the site, but, over the past few months, it’s rolled out new partnerships that are bringing the company closer to Shoval’s broader vision.

Last month, for example, Simplee announced an integration with Silicon Valley’s El Camino Hospital to match a patient’s hospital bill with their insurer’s explanation of benefits (EOB) to resolve charges, explain claims, scan for billing errors and pay bills online. Earlier this year, it partnered with ACS|The HSA Solution, one of the largest HSAs (health savings accounts) in the country.

And on Thursday, the company introduced support for Medicare, giving the millions of Americans who qualify for Medicare benefits (according to the U.S. Census Bureau, there were 48 million beneficiaries in 2010) the ability to use the site to manage and pay their medical bills.

Navigating the health landscape is even more complicated for Medicare patients because their claims may be routed through two separate insurance companies. That means an even greater chance that they’ll miss benefits or make late payments.

With Simplee, Shoval said, patients (as well as the loved ones that might be taking care of them) can track their claims and bills as they are processed by both insurance companies, then see if they need to pay and, if so, do it through the site.

“The value that Simplee brings to Medicare patients is even greater than the value it brings anyone else,” he said.

And, with its Medicare integration, the company is bringing its services to a population that is not only growing steadily – 10,000 people turn 65 and become eligible for Medicare each day – but likely has a higher volume of medical bills and claims to sift through.

More startups bringing transparency to healthcare

Simplee is one of several new startups trying to bring more transparency into medical billing and health insurance process. CakeHealth, a San Francisco startup that has also been dubbed a “Mint for health insurance” and is part of Startup Health Academy’s latest class, similarly provides an online platform for tracking and managing health expenses.

But Shoval’s goal is to make Simplee the trusted destination for patients to make all of their out-of-pocket health payments, from hospitalization to dentist visits to primary care appointments. Between 2006 and 2010, Shoval said, the yearly amount that an average family pays out of pocket climbed nearly 80 percent, from $2,000 to $3,600.  As the consumer-driven healthcare movement makes consumers even more responsible for their medical spending, he believes there is an opportunity for Simplee to be the central hub for all of their transactions.

For consumers, he said, the platform will always remain free – Shoval launched Simplee after his family experienced its own confounding moment with the healthcare system and said helping others better understand their health expenses was a major motivation for the site. It plans to make money through a software-as-a-service model targeting employers, HSA banks and other partners.

By providing a single checkout platform, hospitals and insurance companies can receive payments that might be delayed or go through a collection agency because of patient confusion. And Simplee offers the added benefit of saving them money on paper (which can cost 70 cents to $1 per bill, Shoval said).

Simplee does not share the number of people currently using the site, but has said that it currently manages about half a billion dollars in member medical visits and that 60 percent of the members use the site at least once every three months.

One concern I’ve raised before is that consumers might not feel totally comfortable sharing sensitive health information with a new third-party platform. Data breaches aren’t an atypical occurrence and the procedures and care people receive from healthcare providers are very personal.  But Simplee said that it is very careful and strict about privacy and doesn’t sell user information. And, as people start using the site and realizing its advantages, the privacy tradeoff is one they might increasingly be willing to make.

Image from Andy Dean Photography via Shutterstock.