Our Founders
Locations
Who we work with
Our Eligibility response
{
"summary": {
"deductible": {
"individual": {
"in_network": {
"applied": {
"currency": "USD",
"amount": "16.43"
},
"limit": {
"currency": "USD",
"amount": "3000"
},
"remaining": {
"currency": "USD",
"amount": "2983.57"
}
},
"out_of_network": {
"applied": {
"currency": "USD",
"amount": "16.43"
},
"limit": {
"currency": "USD",
"amount": "6000"
},
"remaining": {
"currency": "USD",
"amount": "5983.57"
}
}
},
"family": {
"in_network": {
"applied": {
"currency": "USD",
"amount": "43.91"
},
"limit": {
"currency": "USD",
"amount": "6000"
},
"remaining": {
"currency": "USD",
"amount": "5956.09"
}
},
"out_of_network": {
"applied": {
"currency": "USD",
"amount": "43.91"
},
"limit": {
"currency": "USD",
"amount": "12000"
},
"remaining": {
"currency": "USD",
"amount": "11956.09"
}
}
}
},
"out_of_pocket": {
"individual": {
"in_network": {
"applied": {
"currency": "USD",
"amount": "16.43"
},
"limit": {
"currency": "USD",
"amount": "3000"
},
"remaining": {
"currency": "USD",
"amount": "2983.57"
}
},
"out_of_network": {
"applied": {
"currency": "USD",
"amount": "16.43"
},
"limit": {
"currency": "USD",
"amount": "12500"
},
"remaining": {
"currency": "USD",
"amount": "12483.57"
}
}
},
"family": {
"in_network": {
"applied": {
"currency": "USD",
"amount": "43.91"
},
"limit": {
"currency": "USD",
"amount": "6000"
},
"remaining": {
"currency": "USD",
"amount": "5956.09"
}
},
"out_of_network": {
"applied": {
"currency": "USD",
"amount": "43.91"
},
"limit": {
"currency": "USD",
"amount": "25000"
},
"remaining": {
"currency": "USD",
"amount": "24956.09"
}
}
}
}
},
"coverage": {
"coinsurance": [
{
"benefit_percent": 0.0,
"authorization_required": "yes",
"coverage_level": "employee_and_spouse",
"in_plan_network": "yes",
"messages": [],
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
]
},
{
"benefit_percent": 0.5,
"coverage_level": "employee_and_spouse",
"in_plan_network": "no",
"messages": [],
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
]
}
],
"copay": [
{
"authorization_required": "yes",
"copayment": {
"amount": "0",
"currency": "USD"
},
"coverage_level": "employee_and_spouse",
"in_plan_network": "yes",
"messages": [
{
"message": "PRIMARY OFFICE"
}
],
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
]
},
{
"copayment": {
"amount": "0",
"currency": "USD"
},
"coverage_level": "employee_and_spouse",
"in_plan_network": "not_applicable",
"messages": [
{
"message": "GYN OFFICE VS"
},
{
"message": "GYN VISIT"
},
{
"message": "SPEC OFFICE"
},
{
"message": "SPEC VISIT"
},
{
"message": "PRIME CARE VST"
},
{
"message": "Plan Requires PreCert"
},
{
"message": "Commercial"
},
{
"message": "Plan includes NAP"
},
{
"message": "Pre-Existing may apply"
}
],
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
]
}
],
"benefit_related_entities": [
{
"address": {
"address_lines": [
"123 TEST ROAD"
],
"city": "LITTLE TOWN",
"state": "CA",
"zipcode": "12345"
},
"contacts": [
{
"phone": "8001234567"
}
],
"entity_identifier_code": "primary_care_provider",
"entity_type": "organization",
"first_name": "JANET",
"middle_name": "E",
"organization_name": "DOE",
"provider_code": "admitting"
},
{
"contacts": [
{
"name": "PAYERC BENEFITS HOTLINE",
"phone": "8006762583"
}
],
"entity_identifier_code": "plan_sponsor",
"entity_type": "organization",
"organization_name": "PAYERC"
}
],
"deductibles": [
{
"benefit_amount": {
"amount": "6000",
"currency": "USD"
},
"coverage_level": "family",
"eligibility_date": "2013-01-25",
"in_plan_network": "yes",
"messages": [],
"time_period": "calendar_year"
},
{
"benefit_amount": {
"amount": "5956.09",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "yes",
"messages": [],
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "3000",
"currency": "USD"
},
"coverage_level": "individual",
"eligibility_date": "2013-01-25",
"in_plan_network": "yes",
"messages": [],
"time_period": "calendar_year"
},
{
"benefit_amount": {
"amount": "2983.57",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "yes",
"messages": [],
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "12000",
"currency": "USD"
},
"coverage_level": "family",
"eligibility_date": "2013-01-25",
"in_plan_network": "no",
"messages": [],
"time_period": "calendar_year"
},
{
"benefit_amount": {
"amount": "11956.09",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "no",
"messages": [],
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "6000",
"currency": "USD"
},
"coverage_level": "individual",
"eligibility_date": "2013-01-25",
"in_plan_network": "no",
"messages": [],
"time_period": "calendar_year"
},
{
"benefit_amount": {
"amount": "5983.57",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "no",
"messages": [],
"time_period": "remaining"
}
],
"eligibility_begin_date": "2012-02-25",
"group_description": "MOCK INDIVIDUAL ADVANTAGE PLAN",
"group_number": "000000000000013",
"level": "employee_and_spouse",
"out_of_pocket": [
{
"benefit_amount": {
"amount": "3000",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "yes"
},
{
"benefit_amount": {
"amount": "2983.57",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "yes",
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "6000",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "yes"
},
{
"benefit_amount": {
"amount": "5956.09",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "yes",
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "12500",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "no"
},
{
"benefit_amount": {
"amount": "12483.57",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "no",
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "25000",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "no"
},
{
"benefit_amount": {
"amount": "24956.09",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "no",
"messages": [],
"time_period": "remaining"
}
],
"plan_begin_date": "2013-02-25",
"plan_number": "0000000",
"service_date": "2013-08-25",
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
]
},
"payer": {
"id": "MOCKPAYER",
"name": "MOCK PAYER INC"
},
"provider": {
"first_name": "JEROME",
"last_name": "JEROME AYA-AY",
"npi": "1467560003"
},
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
],
"subscriber": {
"address": {
"address_lines": [
"123 MAIN ST"
],
"city": "SAN MATEO",
"state": "CA",
"zipcode": "94401"
},
"birth_date": "1970-01-25",
"first_name": "Jane",
"id": "W000000000",
"last_name": "Doe"
},
"trading_partner_id": "MOCKPAYER",
"valid_request": true
}
Some Data Science
Medicare Referral Network
From the Miami Herald
Top Providers
LDA
Unsupervised machine learning fordocument topic discovery
LDA
Unsupervised machine learning fordocument topic discovery
- I like broccoli and bananas.
- My sister adopted a hampster.
- Look at this hampster munching on a banana.
Our Eligibility response to bag of words
{
"summary": {
"deductible": {
"individual": {
"in_network": {
"applied": {
"currency": "USD",
"amount": "16.43"
},
"limit": {
"currency": "USD",
"amount": "3000"
},
"remaining": {
"currency": "USD",
"amount": "2983.57"
}
},
"out_of_network": {
"applied": {
"currency": "USD",
"amount": "16.43"
},
"limit": {
"currency": "USD",
"amount": "6000"
},
"remaining": {
"currency": "USD",
"amount": "5983.57"
}
}
},
"family": {
"in_network": {
"applied": {
"currency": "USD",
"amount": "43.91"
},
"limit": {
"currency": "USD",
"amount": "6000"
},
"remaining": {
"currency": "USD",
"amount": "5956.09"
}
},
"out_of_network": {
"applied": {
"currency": "USD",
"amount": "43.91"
},
"limit": {
"currency": "USD",
"amount": "12000"
},
"remaining": {
"currency": "USD",
"amount": "11956.09"
}
}
}
},
"out_of_pocket": {
"individual": {
"in_network": {
"applied": {
"currency": "USD",
"amount": "16.43"
},
"limit": {
"currency": "USD",
"amount": "3000"
},
"remaining": {
"currency": "USD",
"amount": "2983.57"
}
},
"out_of_network": {
"applied": {
"currency": "USD",
"amount": "16.43"
},
"limit": {
"currency": "USD",
"amount": "12500"
},
"remaining": {
"currency": "USD",
"amount": "12483.57"
}
}
},
"family": {
"in_network": {
"applied": {
"currency": "USD",
"amount": "43.91"
},
"limit": {
"currency": "USD",
"amount": "6000"
},
"remaining": {
"currency": "USD",
"amount": "5956.09"
}
},
"out_of_network": {
"applied": {
"currency": "USD",
"amount": "43.91"
},
"limit": {
"currency": "USD",
"amount": "25000"
},
"remaining": {
"currency": "USD",
"amount": "24956.09"
}
}
}
}
},
"coverage": {
"coinsurance": [
{
"benefit_percent": 0.0,
"authorization_required": "yes",
"coverage_level": "employee_and_spouse",
"in_plan_network": "yes",
"messages": [],
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
]
},
{
"benefit_percent": 0.5,
"coverage_level": "employee_and_spouse",
"in_plan_network": "no",
"messages": [],
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
]
}
],
"copay": [
{
"authorization_required": "yes",
"copayment": {
"amount": "0",
"currency": "USD"
},
"coverage_level": "employee_and_spouse",
"in_plan_network": "yes",
"messages": [
{
"message": "PRIMARY OFFICE"
}
],
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
]
},
{
"copayment": {
"amount": "0",
"currency": "USD"
},
"coverage_level": "employee_and_spouse",
"in_plan_network": "not_applicable",
"messages": [
{
"message": "GYN OFFICE VS"
},
{
"message": "GYN VISIT"
},
{
"message": "SPEC OFFICE"
},
{
"message": "SPEC VISIT"
},
{
"message": "PRIME CARE VST"
},
{
"message": "Plan Requires PreCert"
},
{
"message": "Commercial"
},
{
"message": "Plan includes NAP"
},
{
"message": "Pre-Existing may apply"
}
],
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
]
}
],
"benefit_related_entities": [
{
"address": {
"address_lines": [
"123 TEST ROAD"
],
"city": "LITTLE TOWN",
"state": "CA",
"zipcode": "12345"
},
"contacts": [
{
"phone": "8001234567"
}
],
"entity_identifier_code": "primary_care_provider",
"entity_type": "organization",
"first_name": "JANET",
"middle_name": "E",
"organization_name": "DOE",
"provider_code": "admitting"
},
{
"contacts": [
{
"name": "PAYERC BENEFITS HOTLINE",
"phone": "8006762583"
}
],
"entity_identifier_code": "plan_sponsor",
"entity_type": "organization",
"organization_name": "PAYERC"
}
],
"deductibles": [
{
"benefit_amount": {
"amount": "6000",
"currency": "USD"
},
"coverage_level": "family",
"eligibility_date": "2013-01-25",
"in_plan_network": "yes",
"messages": [],
"time_period": "calendar_year"
},
{
"benefit_amount": {
"amount": "5956.09",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "yes",
"messages": [],
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "3000",
"currency": "USD"
},
"coverage_level": "individual",
"eligibility_date": "2013-01-25",
"in_plan_network": "yes",
"messages": [],
"time_period": "calendar_year"
},
{
"benefit_amount": {
"amount": "2983.57",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "yes",
"messages": [],
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "12000",
"currency": "USD"
},
"coverage_level": "family",
"eligibility_date": "2013-01-25",
"in_plan_network": "no",
"messages": [],
"time_period": "calendar_year"
},
{
"benefit_amount": {
"amount": "11956.09",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "no",
"messages": [],
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "6000",
"currency": "USD"
},
"coverage_level": "individual",
"eligibility_date": "2013-01-25",
"in_plan_network": "no",
"messages": [],
"time_period": "calendar_year"
},
{
"benefit_amount": {
"amount": "5983.57",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "no",
"messages": [],
"time_period": "remaining"
}
],
"eligibility_begin_date": "2012-02-25",
"group_description": "MOCK INDIVIDUAL ADVANTAGE PLAN",
"group_number": "000000000000013",
"level": "employee_and_spouse",
"out_of_pocket": [
{
"benefit_amount": {
"amount": "3000",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "yes"
},
{
"benefit_amount": {
"amount": "2983.57",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "yes",
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "6000",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "yes"
},
{
"benefit_amount": {
"amount": "5956.09",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "yes",
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "12500",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "no"
},
{
"benefit_amount": {
"amount": "12483.57",
"currency": "USD"
},
"coverage_level": "individual",
"in_plan_network": "no",
"time_period": "remaining"
},
{
"benefit_amount": {
"amount": "25000",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "no"
},
{
"benefit_amount": {
"amount": "24956.09",
"currency": "USD"
},
"coverage_level": "family",
"in_plan_network": "no",
"messages": [],
"time_period": "remaining"
}
],
"plan_begin_date": "2013-02-25",
"plan_number": "0000000",
"service_date": "2013-08-25",
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
]
},
"payer": {
"id": "MOCKPAYER",
"name": "MOCK PAYER INC"
},
"provider": {
"first_name": "JEROME",
"last_name": "JEROME AYA-AY",
"npi": "1467560003"
},
"service_type_codes": [
"98"
],
"service_types": [
"professional_physician_visit_office"
],
"subscriber": {
"address": {
"address_lines": [
"123 MAIN ST"
],
"city": "SAN MATEO",
"state": "CA",
"zipcode": "94401"
},
"birth_date": "1970-01-25",
"first_name": "Jane",
"id": "W000000000",
"last_name": "Doe"
},
"trading_partner_id": "MOCKPAYER",
"valid_request": true
}
chiropractic, professional_physician_visit_office, ...
LDA Visualization
The pyLDAvis library rocks
"There is a new technological institution that will
fundamentally change how we exchange value.
And it is called the Blockchain."
-Bettina Warburg
Ted Talk
Blockchain
A decentralized database that stores
a registry of assets and transactions
across a peer to peer network
Identity
Visibility
Reneging
Evolving data exchange
in healthcare
ASC X12
HL*1**20*1~NM1*PR*2*Premium Gold Insurance Co.****
*PI*0123456~HL*2*1*21*1~NM1*1P*1*Back*Has*Your***X
X*9876543210~HL*3*2*22*0~TRN*1*89368DC6A14E4E529AA
876ED416E8A9F*1453915417~NM1*IL*1*A-lot*Lifts****M
I*MEM10001~DMG*D8*19820315*M~EQ*98^33~
JSON
{
"summary": {
"deductible": {
"individual": {
"in_network": {
"applied": {
"currency": "USD",
"amount": "16.43"
},
"limit": {
"currency": "USD",
"amount": "3000"
},
"remaining": {
"currency": "USD",
"amount": "2983.57"
}
},
"out_of_network": {
"applied": {
"currency": "USD",
"amount": "16.43"
},
"limit": {
"currency": "USD"