Having spent enough time over the last several weeks trying to prove I’d spent all of the money in my flexible spending account on medical expenses, I immediately grasped the reason Bill Marvin’s business has grown so much.
InstaMed, based in Center City, said last week that it had processed more than $60 billion of health-care payments through its electronic payments network – just one year after having surpassed the $30 billion mark.
Based on the trends InstaMed tracks from the hospitals, doctors’ offices, and insurers who use the network, Marvin said he projects “triple-digit growth” in transactions over the next year.
With all of that growth, InstaMed remains a small company in the enormous health-care system, with a market share Marvin estimated at less than 1 percent of the volume. “We are just scratching the surface,” he said.
InstaMed may be a small business, but it’s a well-capitalized one, having raised $35 million since 2004. Its investors include US Bancorp, one of the 10 largest banks, and Osage Partners, a Bala Cynwyd venture firm.
Since I’d last talked with this health-care entrepreneur four years ago, InstaMed has grown to 100 employees from 60. Two-thirds of those people work in Philadelphia, while the rest work in Newport Beach, Calif.
But the real growth has come in the tens of billions of transactions being handled by InstaMed’s network. Health-care reform is only encouraging more use of electronic records and payments, Marvin said.
According to Marvin’s estimates, there are five billion patient claims per year and each claim may involve at least seven “transactions”:
A doctor’s office checks patient’s eligibility to receive services under his insurance plan.
The office swipes a credit card to accept a co-payment.
The office then submits a claim to the insurer for the services provided.
The office also verifies whether a claim was received by the insurer.
The insurer makes a payment to the doctor.
The insurer sends a statement to the patient on the payment to the doctor.
And the doctor sends a bill to the patient to receive a “back-end payment” for the amount not covered by insurance.
Doing all of that electronically may trim only minutes and a dollar or two from each claim, but multiply that by the billions of claims in the U.S. system and you start saving real time and money. That’s why InstaMed has been adding hardware in its East Coast and West Coast data centers to keep up with the trends in volume.
But my recent experience reminds me of how paperbound health care remains. I was able to use up all of the money I’d contributed in 2012 to my flexible spending account. And I have a manila folder containing explanation of benefits forms, receipts, and doctors’ bills to prove it.