Most defined contribution plans do not permit an award to be expressed as "marital coverture formula", such as: "50% of the amount accrued from the date of marriage to the date of separation or divorce". In most cases, the Alternate Payee’s portion must be expressed as either a specific dollar amount, or as a percentage of the account. When dividing a defined contribution plan, the Alternate Payee is typically awarded a portion of the Participant's account balance as of a specific date (the "Valuation Date" or "Assignment Date"). A division of this type of account must be done by way of a Qualified Domestic Relations Order (QDRO). Examples of this plan type are Employee Stock Ownership Plan (ESOP), Profit-Sharing Plans, 401(a), Savings Plans and 401(k). Regular contributions are then made by the Employer, the Participant, or both. Typically, a Company Sponsor (Employer) of this type of plan creates an account for every individual Participant. Meanwhile, she’s busy hiring in the data science and engineering departments and, following a strong trend in the health tech field, the company just released an AI bot named Ellie to make it easier for customers to ask questions about their bills.IVINCI HEALTH 401(K) PLAN is a DEFINED CONTRIBUTION PLAN. Gleason also says Eligible is on a growth trajectory with about 14 million transactions per month currently and an expected 50 million transactions per month by the end of the year. Legacy clearinghouses like Change Healthcare (formerly Emdeon) also serve more or less the same purpose but run on more ancient technology to create a billing workflow.Įligible, which Gleason tells us has been profitable in the past but is now focused on scaling, makes its money on each of those payments, taking in five cents per transaction, with most of the revenue coming from insurance companies. Other startups like Simplee and iVinci are also working to modernize medical billing, but Eligible actually built the backbone for a lot of these consumer-facing startups and lets them use its API to unlock pricing data for patients in the same way e-commerce companies might use Stripe for payment processing. ![]() According to Gleason, doctors routinely collect 50 percent more revenue per month using Eligible, since they’re not stuck trying to collect bills after patients leave the office. You’re basically in the dark and it leaves the doctor potentially not getting all the money owed and patients left with staggering medical debt.Įligible integrates with medical systems like the Cleveland Clinic or One Medical and Quest Labs to tell you not only how much the procedure costs but what your co-pay will be and offers you a way to pay without waiting months for the bill total. There’s also no way to find out if there’s a more cost-effective treatment option covered within the same insurance plan. That means when a patient is at the doctor’s office and a doctor recommends a certain specialist, there’s no way to know if the patient’s healthcare covers the recommended specialist or what the final bill will be. While electronic medical claims processing is nothing new, the system has been stuck in a cloudless, pre-data sharing era. Gleason soon wound up working 90+ hour weeks as the top sales rep for DrChrono when the electronic health records company first came onto the tech scene in 2010.Ĭhaotic as it was in those early days, Gleason wanted to launch something of her own and saw the need to reform medical billing. Instead, she was a New York City stage actor who put herself through state university working as a sales rep and waiting tables. But, unlike many founders in the health startup field, she didn’t start out in medicine and never went to business school. Gleason has been through Y Combinator twice (once for DrChrono and once for Eligible) and raised $25 million from a syndicate of investors like Angellist’s Naval Ravikant, Reddit’s Steve Huffman, Dropbox founder Drew Houston and others so far. Founder Katelyn Gleason wants to make it easier to know what and how much you are paying for before you step into the doctor’s office with her new medical billing startup Eligible. But its inner workings are still very murky - most of the time it’s not clear how much something will cost and sometimes you don’t even get the (possibly whopping) bill until months down the road. Medical billing is a largely untapped and lucrative industry, potentially pulling in $55 billion globally by 2020.
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