By Emma Court
Misunderstanding health cards poses financial risks for patients, so Zocdoc tried something new
Finding an in-network doctor using the online service Zocdoc was supposed to be easy.
That's Zocdoc's whole premise, after all: Users input their health insurance information, and the service returns a list of in-network doctors, along with their availability in the coming days and weeks.
But Zocdoc soon realized that a lot of the time, people were putting their member ID numbers, a crucial piece of information, in wrong. A survey of 1,000 Zocdoc users and non-users revealed a broad-based problem, with 92% of respondents saying they found health insurance cards confusing.
Health insurance is famously complicated. But "it seems like the card should be the easiest part," said Zocdoc Senior Product Manager Ruth Sylvia. "If you can't understand the most physical manifestation of this complex thing you have called insurance, there's probably a lot more you can't understand."
Related: American health care is so messed up that a whole industry has been created to help navigate it (http://www.marketwatch.com/story/american-health-care-is-so-messed-up-that-a-whole-industry-has-been-created-to-help-navigate-it-2017-04-24)
Health insurance cards are used all around the world, a pass patients use to navigate health systems and get treatment and medication.
In the U.S., they carry limited but essential information, such as identity, facts specific to the health insurer and plan and an outline of copayment amounts.
Any confusion initially sounds like, well, a patient problem. Can't people just figure it out on their own? But Sylvia says that health insurance cards really are confusing, and she would know; Zocdoc has collected cards for hundreds of thousands of patients.
Much of the confusion likely stems from one simple fact, she said: Patients may carry the cards, but they're largely geared for use by medical professionals.
And because there are so many health insurers with all kinds of different plans, there's a tremendous amount of variation. Plan names may sound similar, be located on the front or back of the card, or simply be in very small font.
Read: This expensive risk lurks in nearly every medical experience you have (http://www.marketwatch.com/story/the-expensive-risk-lurking-in-nearly-every-medical-experience-you-have-2017-03-31)
And though all the different numbers on the card may look interchangeable, they serve different functions.
The group number, for example, tells a medical professional where to bill a claim, while the Rx bin number is intended for a pharmacist, said Dr. Raffi Terzian, senior vice president of clinical operations at Health Advocate, which helps patients navigate the health care system and resolve insurance problems.
Health insurance cards are "probably more helpful to the person you're presenting it to than the consumer," Terzian said. "But it's good information to have on you, to know which plan you have. The information ultimately smooths the process."
Both on and off Zocdoc's platform, forgetting or misunderstanding a health insurance card creates financial and billing risks (http://www.marketwatch.com/story/forget-iphones-many-americans-cant-pay-a-100-medical-bill-2017-03-21) for patients, especially when starting a new relationship with a provider, Terzian said.
See: Forget iPhones--many Americans can't pay a $100 medical bill (http://www.marketwatch.com/story/forget-iphones-many-americans-cant-pay-a-100-medical-bill-2017-03-21)
Mistakes could result in treatment by an expensive out-of-network provider, while a missed or incorrect digit in a member ID number might hold up claim processing, he said.
Zocdoc tackled the problems with a new feature, Insurance Checker (https://www.zocdoc.com/about/blog/company/introducing-zocdoc-insurance-checker/), which was launched in October. Using user-submitted photos of health insurance cards, Insurance Checker selects the right carrier and plan for them.
Related: Zocdoc CEO Oliver Kharraz on why health-care uncertainty is a good thing (http://www.marketwatch.com/story/zocdoc-ceo-oliver-kharraz-on-why-2017s-health-care-uncertainty-is-a-good-thing-2017-01-04)
Insurance Checker's machine-learning technology is already in use elsewhere, with such products as credit cards. But insurance cards, with no standard template and hundreds of different designs and formats, were harder, Sylvia said.
Zocdoc teamed up with creative agency Office of Baby to reimagine the health insurance card.
The reinterpretation emphasizes consumer-oriented information--think health insurer, plan and member number--while clustering information for doctor's offices and hospitals elsewhere.
Some health insurers have moved to digital health insurance cards via a cellphone app, an America's Health Insurance Plans spokesperson told AAFP News (https://www.aafp.org/news/practice-professional-issues/20160223digitalcards.html), the media arm of the American Academy of Family Physicians.
And Aetna Inc. (AET), for example, has had digital cards as an option for years, AAFP News reported.
There's also a health insurance card app offered by the privately held company Medlio (http://www.medl.io), which allows users to see benefits information in real time, locate doctors and share medical information with them, among other things.
Meanwhile, Zocdoc's Insurance Checker has encountered a new challenge: Photography is hard, too.
"A picture has to be of some level of clarity that we can read," Sylvia said. "Some very tiny pictures, sideways pictures; some very shadowy pictures have definitely been challenging."
-Emma Court; 415-439-6400; AskNewswires@dowjones.com
(END) Dow Jones Newswires