Starting a new insurance plan can be time-consuming, expensive and difficult. One of the challenges is to build a system to handle claims, track registration, and manage other administrative tasks.
Although some insurance companies want to build these functions internally, it is costly and time-consuming. Others work with a third-party administrator (TPA) to complete this work.
Flume Health bills itself as a technology-leading TPA, hoping to make this process easier for insurance companies.
This New York-based startup was founded in 2017. Initially cooperated with a self-insurance company, For example, construction companies in Indiana and car dealers in North Carolina. Now, the company is seeking to cooperate with insurance companies.
“Now, making a health plan is like asking people to set up a server farm in the basement,” CEO Cedric Kovacs-Johnson told MedCity News. “…In order to enter the market, you have to build all this infrastructure and raise a lot of money to do this. As an entrepreneur, this is a huge obstacle to overcome.”
His goal is to simplify the process by managing claims processing, registration, compliance, and payments to providers, brokers, and points solutions.
Currently, Flume works with a number of insurance plans.It is working with primary care startup Firefly Health, which Recently launched a virtual priority health plan For small and medium employers.
“Firefly Health provides this very compelling virtual primary care product,” Kovacs-Johnson said. “They realize that their ability to influence downstream behavior is limited because they are inserting health plans that have no background in what they are trying to do.”
Firefly Health CEO FRothenburg In a prepared statement, it said that without Flume, the company would not be able to launch its health plan in less than a year.
Flume also works with Radion Health, a stop-loss insurance company for small and medium-sized businesses.
The health plan is changing. They include more and more single point solutions and applications, and more consideration is given to how members can take advantage of their benefits. But in most cases, the fundamentals remain the same.
“In terms of medical transformation, the administrative level feels like a big elephant in the room,” he said. “We feel that all these solutions serve as a complement to a very old system.”
In the future, he expects to launch more health plans, some of which are tailored to specific communities or patient groups. His goal is to make it easier for them to learn.
Photo credit: eakrin rasadonyindee, Getty Images
