In 2013, the concept for Madaket started on a whiteboard. Two years later, the platform went live. Ever since, we’ve been navigating the maze of archaic systems and risk aversion holding healthcare administration back. It all boils down to unautomated, organization-specific, and frankly illogical processes making non-clinical functions more cumbersome than they should be. After two years of research in stealth mode between concept and launch of our platform, we learned the only way to truly move the whole industry forward is to work with the entire healthcare ecosystem.
Gaining the trust of the whole industry has been a progression. To simplify functions like enrollments, onboarding, credentialing, licensing, and more, we had to start with clearinghouses — the gatekeepers and liaisons between providers and payers exchanging paperwork and data. All the while, we’ve been aggressively building more spokes on our Provider Data Exchange platform (PDX) so that we could become the neutral, third-party hub of provider data that we always envisioned.
Why? Because no one’s gotten it right yet. Every organization we’ve encountered was spun up by one industry group at the expense of another. Not us — we came in from the outside with no agenda other than removing waste from healthcare administration.
That’s why we don’t believe in competitors. Yours or ours.
This belief doesn’t come from naiveite, but instead, optimism grounded in practicality. The goal for all of us should be to cut out waste in healthcare, ensure we don’t all overpay to give or receive care, and stop being embarrassed internationally for how our healthcare system functions (how’s that for a Triple AIM?).
All of that takes a community effort. And we’re prepared to be the ones driving it forward. Here’s how.
On the Ground: Providers and Their Staff
Healthcare administration has not kept pace with the many seismic shifts in healthcare that are collectively crushing providers on the frontlines.
Our healthcare system has become more strained with patient needs as the pool of providers has shrunk over time. On top of that, the industry has recognized a need for reform across payment structures and care delivery to help right the healthcare ship. For providers, this means they have more work, new programs and ways of providing care to learn, and lots of paperwork and documentation that comes with that. Looking closer at trends of burnout, mergers, consolidation, and COVID, we see additional layers of strain landing on providers.
In this overworked, understaffed, and highly strenuous environment, providers and their staff definitely don’t have time for things like claims denials due to a payer not reading a staff member’s handwriting correctly. These sorts of activities are due to the manual, ad-hoc processes that exist in provider organizations. In our work with providers, what we often see at Madaket is Joe and Sally working in a back-office downloading, filling, faxing, and mailing forms—processes that were right for healthcare two decades ago, but now no longer serve us.
What Madaket does is cut out the human error by empowering the Joes and Sallies to do more with less. Using our portal, providers can enter data into Madaket once and click a few buttons to apply that data across the 20-plus payers they likely work with.
With Madaket, providers can free administrative staff to assist with things like value-based care documentation or other tasks that add more value than chasing checks that should be automatic. To slice this another way: we can 3D print body parts in healthcare now. Shouldn’t we be able to eliminate fax machines and snail mail for simple paperwork?
In the Middle: Clearinghouses, MSOs, Practice Management, and RCM Partners
At the intersection of delivering care and reimbursement, clearinghouses are the backbone of healthcare administration holding it all together. In our years of working with clearinghouses, we’ve demonstrated that we can help them be better partners to their provider customers and be better liaisons to payers by automating steps on both sides.
Take for example PNC Healthcare, the clearinghouse arm of PNC bank. PNC Healthcare recognized that its provider clients spent a disproportionate amount of time and resources on enrollments and re-enrollments, and jumped at the chance to ease their burdens. Using Madaket’s provider portal and PDX platform, PNC Healthcare eliminated manual steps and static spreadsheets and saw drastic results: turnaround time dropped from 32 days to 4.5 days and the rejection rate from 20% to 5%.
Beyond clearinghouses, there are MSOs, practice management groups, RCM partners, and other facilitators between providers and payers that can transform their provider data management with Madaket — some of whom could even be considered our competitors. Most recently, we teamed up with ExpandMD, an organization focused on helping health practices run more efficiently. We’re powering their new credentialing solution that simplifies this basic yet reoccurring task for providers by implementing digitized steps, structured data storage, automated payer connections, and regular status updates.
Though we’re helping ExpandMD differentiate itself among its competitors, our true hope is that every organization like ExpandMD will follow suit in bringing healthcare administration into the 21st century. Because at this point, automation should be the standard, not the innovation.
We’ve got data on more than 75% of provider groups nationwide, enabling us to provide an ecosystem of accurate, timely, use-agnostic provider data that partners can easily plug into. Plus, our PDX platform for task automation provides insights to help them design more sophisticated offerings. Essentially, we give any organization better data, smarter ways to store that data, and faster tools for using that data.
For now, a synchronized, all-in-one solution is an innovative leg up for companies like PNC Healthcare and ExpandMD. Eventually, it’ll be the norm, and working with Madaket will be a given, just like Kleenex is synonymous with tissues.
Behind the Scenes: Payers
Payers often get a bad rap for being the cause of headaches in administrative waste. Health plans often have bureaucratic, unique processes for getting the same basic tasks done. This means that providers and partners jump through a variety of hoops to reach the same destination.
Though the impact may be a hassle, the intentions are good. Payers struggle with provider data management too. In a given week, they have tens of thousands of data points flying in and out of their systems. That’s why they need tight structures to wrangle and manage it all. Yet there are opportunities for these systems to be simplified and more uniform from payer to payer.
In our work with a top-ten national payer, we’ve helped streamline the provider data coming in by bulk-sending forms to them in a structured, automated fashion. With this simplified method, they can digest the information and respond to providers faster. Their cooperation doesn’t just benefit providers. It makes the payer more efficient too. Payers working with us experience more efficient interactions with providers and fewer status inquiries. Plus, those that take advantage of our vast provider database and intelligent insights discover benefits for network and directory improvement.
Our endeavor to build trust across all facets of healthcare is just beginning. We approach each relationship with the fundamental belief that every payer, provider, and those that work with them should have the same larger aim: to enable the lowest cost and best quality of care. Less administrative work across the industry is a winning combination that gets us all closer to that goal. So that’s why we don’t believe in competitors, yours or ours.
It’s been said that the rising tide lifts all ships. But those who catch the waves earliest ride them longer. So, the sooner you can automate your healthcare administration, the better off your organization — and healthcare at large — will be.
Learn about the Madaket PDX platform with task completion, a single source of truth for provider data, and industrywide insights that drive ROI and move organizations forward.