Case Study

How One Health Startup Saved 23 Hours Per FTE on Insurance Eligibility Checks

With the pandemic’s spotlight on mental health, one telemedicine startup needed to streamline its revenue cycle and billing to scale its business successfully. Thanks to Gentem’s platform, including its real-time eligibility and estimate tools, the startup could recoup vital employee time and grow its care model.

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A Renewed Focus on Mental Health Leads to Growth

In early 2021, a telemedicine mental health startup was experiencing rapid growth. Starting as a self-pay and self-pay/out-of-network model, the organization wanted to become in-network. With mental health taking center stage during the COVID-19 pandemic, the organization knew going in-network was essential for further growth — but it needed assistance with the technology infrastructure to get there.

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Gentem Boost

Gentem provided an accessible API for its Boost package, which includes real-time eligibility and patient estimates. This API allowed the startup’s developers to plug the Gentem tools into their existing system, making for seamless integration.

Searching for a Health Tech Partner that Could Fill Essential Gaps

As the budding telemedicine company grew, it needed a partner to support its revenue cycle management (RCM) and billing. With 40,000 patients and 1,000 providers, that was no small task. They needed a platform to help streamline the process and provide accurate, timely data.

But the partner couldn’t be a run-of-the-mill RCM or billing vendor. As a health-tech company, the startup required an RCM partner with a tech focus. The RCM partner also needed the resources and experience to create API integrations that fit seamlessly into the startup’s existing workflow.

Finding Success with Seamless Integration

The telemedicine startup partnered with Gentem for its RCM journey. After kicking off the relationship, the startup realized they needed a better way to verify insurance eligibility and patient estimates. 

In addition to providing more transparency and increasing upfront payments from patients, estimates and eligibility tools were essential for determining the best treatment package to offer the patient.

Because of this need, the startup leaned heavily on Gentem’s tech for real-time eligibility (RTE) checks and patient estimates. Gentem provided an accessible API for the RTE and estimate tools, allowing the startup’s developers to plug it into their existing system easily.

More Time, More Upfront Payments

With an eligibility check typically taking three to five minutes, the Gentem RTE and estimate tool cut that process down to 30 seconds or less. And with 40,000 patients, that meant substantial time savings for the startup’s internal teams. The telemedicine startup saved 23 hours per full-time employee (FTE) thanks to Gentem’s real-time eligibility tool. 

The patient estimates for out-of-pocket costs, which the organization could send via HIPAA-compliant text or email, also helped increase upfront payments from patients — essential cash flow for a rapidly growing startup.

See how Gentem Boost can save your team time and improve your bottom line