Goodbill helps self-funded plans save more on hospital claims. Our cost containment solution leverages 501(r) discounts and enhanced claim reviews to protect plans from overpaying for hospital visits.


What is Goodbill?

Thanks, Chris. Goodbill is a member-driven cost containment product that transparently saves self-funded and level-funded plans and members money on hospital claims, really, in two ways. The first way is we screen members and automate the application process for nonprofit hospital financial assistance programs, and the second way is we tap into members' digital medical records to review claims for accuracy.

How is Goodbill different?

We started Goodbill direct-to-consumer. Creating a seamless, delightful member experience is everything to us and drives real savings only members can capture. On the 501r front, most hospitals are required by law to offer income-based financial assistance programs, which are severely underutilized. In fact, according to our data, 4 in 10 claims, on average, qualify - with some plans scaling up to 7 in 10 claims - depending on member demographics, resulting in up to a 100% member cost-share reduction and presenting the plan with a repricing opportunity, which can save up to 80% off of billed charges. We streamline and automate this process, not only on the member experience side, but also on the claim flow. When it comes to claim review, members can connect their patient portal accounts directly to Goodbill in seconds, empowering plans to review claims faster prepayment using the source of truth: the medical record. We see almost half of claims have inflated charges uniquely discoverable with the medical record, and we've integrated directly with thousands of hospitals across the country through their EHR products, such as Epic - or how many people know them, MyChart - Cerner, and Veradigm and Meditech. Combined, these strategies can yield up to 8% in annual plan savings, in addition to significant member savings.

Who is a good fit for Goodbill?

We work with independent TPAs, unbundled plan products, and their brokers and advisors. At a time when it's never been more important to ensure plan sponsors are fulfilling their fiduciary duty by maximizing benefits and minimizing costs, we help empower plans and members alike, and along the way, show members just how much work their plan is doing on their behalf.

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Duration: 02:19

Posted: Thursday, May 9, 2024

Video tags: Under 50 EEs