Why we started Finestra
When the COVID-19 pandemic broke out in the US in March 2020, our founder Tae Young was laid off from his job in New York City and was frantically looking for a new job on Glassdoor. He was also looking to get a COVID test after a potential exposure, but was scared to get one because he couldn’t find out how much it would cost (this was before COVID tests were offered for free). Seeing how Glassdoor displayed salaries posted by employees, he thought, "Why isn't there a website where patients can share how much they were charged for medical bills, so that people can know beforehand how much procedures will cost them?" Tae Young formed a team and began diving into creating a search engine for medical bills.
The search engine was to be simple: anyone should be able to search a medical procedure with their insurance plan to find out how much they may be charged at a hospital or doctor’s office near them.
Starting with publicly-available data either published directly by hospitals or released online by journalists or patient advocacy groups, the Finestra team has parsed through millions of lines of data and connected prices with the relevant insurance coverage and hospital to make sure that the search results are accurate. We first revealed the prices of hospitals in New York City, and are quickly expanding to major cities across the US.
We believe that people should be in control of their health care, and that control begins with the ability to know how much a procedure or service would cost.
How we acquire our data
On Jan 1, 2021, the Centers for Medicare and Medicaid Services (CMS) issued a new Hospital Price Transparency Rule that required all hospitals in the United States to publish their price lists. Despite legal pushback from some hospitals as well as a delay in publishing the data (some still not complying today), many hospitals across the country are publishing the prices that they charge patients and insurers.
However, these lists are difficult to find and almost impossible to understand; we go through an extensive data analysis process where we compile all the data published by the hospitals, match the prices with the relevant insurance coverage, and republish the numbers so that they are easily readable on our website. We decoded the prices according to their price type, so we can distinguish the cash prices charged to patients without insurance from the negotiated prices charged to insurance companies. The raw data published directly by hospitals serve as the foundation for our database.
We started in the greater New York City region with over 3.5 million price data points from 100+ hospitals.
On July 1, 2022, the Transparency in Coverage Final Rule went into effect, requiring health insurance issuers to publish pricing information for covered items and services. This rule will allow us more knowledge on what prices insurance companies and employers have negotiated, therefore making our search engine more accurate.
We are actively creating a secure system where real patient bills can be stored and managed, from which the prices will be anonymized and incorporated into our price database. A combination of prices directly published by hospitals and real bills received by patients will continue to make our results more accurate and reliable.
Why we think this technology is important for you
Medical bills are often confusing messes of charts and graphs, fine print text, and insurance company jargon. Reading these bills is not easy. But given that one study found 80% of health insurance bills contain some sort of error, it is important for you–and your wallet–to give it a shot.
When you go to the doctor or dentist, you are typically not billed on the spot. This is because your specific care needs to be sent to your health insurance company in order to figure out how much money you will owe.
Once the insurance company figures this out based on what services or products you received, you will receive an explanation of benefits (EOB). There are three important numbers to look for: the amount of money the services or products billed to your insurance, the amount of money you saved by going to an in-network provider, and the amount of money you are expected to pay.
However, the explanation of benefits is not a bill. The bill will be sent by the health care provider. Once you receive the bill, you will be able to pay. On the bill, you will be able to see a more detailed breakdown of what services or products you are being billed for.
Each service or product has its own unique code. This is where errors are most likely to be found. Sometimes medical coders–people whose job it is to translate a medical service or product into a code–make mistakes. In rare instances, untrustworthy providers may intentionally attempt to overbill patients.
Given that one survey found that nearly 80 million people in the United States have problems with medical bills, one can fairly point out that more needs to be done to help individuals to better understand health care costs.