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Mar 29, 2016 11:48 AM ET

Decisive Health: Health insurance eligibility and upfront billing made easy

iCrowdNewswire - Mar 29, 2016

Decisive Health

Health insurance eligibility and upfront billing made easy


Decisive Health provides tools to help providers collect medical bills upfront and reduce patient billing complaints. We provide upfront billing and health insurance eligibility checks, by analyzing the patient’s health insurance coverage with the provider’s contracted negotiated rates.

Our mission is to empower patients by enabling them to understand their medical bills and health insurance coverage, while helping providers collect medical bills at the time of service.

Currently, both providers and patients cannot determine their medical bills and health insurance coverage without calling the insurance carrier, often taking upwards to an hour. We solve this problem by helping patients and providers determine insurance eligibility instantly and medical bills at discharge.

We are able to provide tremendous benefit to all parties involved: patients, providers, and healthcare facilities.

Medical service providers, such as urgent care facilities, face problems with patient complaints due to billing. Right now, providers cannot provide patients with an accurate bill when they leave the medical facility. Bills go through the provider’s billing department, then to the patient’s insurance carrier, before the bill is mailed to the patient 6 months after they visited the doctor. In addition, most patients do not understand their health insurance coverage, making bills difficult to understand.

As bad as this is for patients, it is just as bad for medical providers. Historically, this convoluted billing process means that hospitals only manage to recoup 10-20% of what patients owe on their bills.

In short, no easy way exists to instantly provide patients with a medical bill and explanation of their health insurance coverage.

Shouldn’t there be a better way? At Decisive Health, we think so, which is why we’ve set up a platform that connects to all major insurance carriers and to the provider’s contracted negotiated rates, allowing bills to be instantly generated.

It started with a simple truth: Providers can instantly provide their patients with a bill and information about their health insurance benefits, thereby eliminating billing frustrations for both parties. We decided to bring this idea to scale and provide a platform that connects providers to all major insurance carriers for instant information retrevial.

We’re taking an industry that is currently fragmented between insurance carriers, billers, and providers, and connecting them together to provide upfront billing and health insurance eligibility information.

Decisive Health is a web platform where providers can eliminate billing frustrations by providing an accurate bill and explanation of health insurance benefits.

Provider facilities make money capturing revenue at the time of patient discharge, not six months later, and increasing patient satisfaction by eliminating patient billing frustrations.

Decisive Health connects you to both the insurance carriers and your billing department so that you can provide your patients with up-to-date information about pricing and health insurance benefits.

We show you the price you would pay if you go through your insurance company or if you choose to self-pay.

We provide you with an explanation of the patient’s health insurance benefits: co-pay, remaining deductible, co-insurance, and out-of-pocket maximum.

By connecting to both the insurance carriers and provider’s contracted negotiated rates, we can determine what portion of the bill is covered by the insurance carrier and what portion will need to be covered by the patient.

Accurate bills means that you can collect payments from the patient at the time of discharge, not six months later.

Decisive Health was launched on August 1st, 2015.

Within 2 weeks, we signed-up 8 urgent care facilities in the San Francisco, CA, including the largest chain of urgent care facilities in the Bay Area.

We handle over 3000 patients a month and are growing. Since our launch, our usage has been increasing at an average rate of +49% month-over-month. Our revenues have been growing at +63% month-over-month.

We have received investments from Johns Hopkins Medicine, 500 Startups, the CEO of NerdWallet, Dreamit Ventures, and Launchpad Digital Health.

Physicians aren’t the only people taking notice of Decisive Health — we’ve been featured in several leading publications, including:


Up Next: Expand! We are moving beyond San Francisco and are rapidly expanding into cities across the U.S.

In 2016, we plan to expand into other specialties such as primary care and Ob/Gyn practices.

Contact Information:

Jonathan Shih
Nathanael Rosidi

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