Starting any company isn’t easy, but Goodbill CEO and co-founder Patrick Haig will tell you that’s especially true when you’re innovating in a slow-moving industry like healthcare.
Haig and co-founder Ian Sefferman launched Goodbill in early 2022 after raising $3.4 million seed funding, with a vision of leveraging technology and data to help patients negotiate their hospital bills at scale. Goodbill has since expanded nationally and can help patients with bills from more than 6,000 hospitals across the country.
The Goodbill blog team sat down with Haig to reflect on the company’s first year, and what he’s found surprising, frustrating and fulfilling.
Back in 2020, my wife and I had our first child, and my co-founder Ian just had his second. It was our first real interaction with the hospital system as adults. I got these bills months after the actual birth, and they were $4,000 to $5,000, and the first thing I thought was, "This is a lot of money."
We wanted to understand how it could be possible to get a $4,000 bill after insurance. Being the data nerds we are, we started asking: What data goes into this bill? Who owns it, and how do we get that information? And as we started digging into that, we started learning more about things like the medical record, the codes that go into it, and negotiated rates with insurers.
We wanted to understand how it could be possible to get a $4,000 bill after insurance. What data goes into this bill? Who owns it, and how do we get that information?
We also came across new regulations. First, the CURES Act gives patients access to their medical records by requiring electronic health record providers to provide API access. It went into effect in 2020, but 2022 was when it really hit, so we were right in the middle of it. So now, all of a sudden patients have access to their medical record, which is the source of truth for everything on their bill.
Then, the second key regulation was the Hospital Price Transparency Rule, which went live in 2020 and required all hospitals to publish their rates for every service they provide: what they’ve negotiated with insurers, their cash rates. It must be in a machine-readable file, so now we have structured data we can ingest. Third, there was a regulation called Transparency in Coverage, which is like the price transparency rule for insurance companies and plans.
So now, you have all this data that is being made digitally native so that patients can consume it. So we thought: Now’s the time to reverse-engineer the data to help patients understand whether their bills are right and fair, and to help reduce prices on consumers’ behalf.
We thought: Now's the time to reverse-engineer the data to help patients understand whether their bills are right and fair.
Harder. I mean, I don’t ever think I thought it would be easy. But true to healthcare form, it’s really hard, and it will remain hard.
What surprised me the most is that you can be a patient standing there asking for records you’re legally entitled to, and there are hospitals who will look you in the eye and say "no" or "we’ll only give it to insurers." It’s surprising how many hospitals are willing to do that to patients, when all patients want to do is understand their bill.
I don’t think it necessarily always comes from a nefarious place where they’re doing something sketchy or hiding things. But it’s paternalistic. It’s very much mainstream healthcare to put patients at the bottom and say, "Why should we provide this?" or "You take this," or "Just because you want to poke your nose in things, doesn’t mean we want to explain things to you."
Here’s another surprising thing: Even if you’re armed to the teeth with all the information, or if you find some issues with your bill, some hospitals will come back a few weeks later and say: Your bill is correct, your deductible stands, and you have to pay it. And you’ll ask: Why is it correct? Where is the proof? Did you review it? And you won’t get an answer. The message is, "Stay out of it, patient." If you question it, they don’t want to explain how it works.
It’s very much mainstream healthcare to put patients at the bottom and say, “Why should we provide this?”
You would never go to a car mechanic, get the bill, and then say "Wait you said you replaced my alternator. I don’t think that’s true, can you show me?" The mechanic can’t just say, "No, I did." You want to see the proof.
By default, everyone would get an itemized bill. And by itemized bill, I mean it has industry-standard coding, and makes clear how their insurance company reimburses the provider. Read more about itemized bills here.
Every bill you get should say exactly how the provider is being reimbursed by the payer — whether it’s a negotiated rate, a flat fee, or a daily rate that changes with more days. And second, it should include all relevant coding and itemization out of the gate. You shouldn’t have to ask for it.
Getting the itemized bill allows the patient to start on square five, versus square one, when it comes to understanding their bill. It literally cuts out one month of work, waiting, stress, anxiety, phone calls, and being worried about collections.
Getting your itemized bill literally cuts out one month of work, waiting, stress, anxiety, phone calls, and being worried about collections.
Building a product that’s well on its way to automating a lot of this junk. Saving people money and countless hours of frustration and banging their heads against the wall.
I think we give people hope. So many times, we get thanked by people who say "I’m so glad you’re building this. Because it’s about damn time." When people come to us, they tell us how many times they’ve tried and couldn’t get anywhere, but Goodbill was able to crack through.
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Guides, news, and articles to help you tackle hospital bills.
Read our expert tips on how to negotiate your hospital bill to save up to thousands of dollars.
Itemized bills provide key details that can help you negotiate your hospital bill.
You have time before your bill can go to collections or affect your credit.