blastbking

super cool post!!

paging luigi

Sonnet 3.5 as of today is superior to Opus, curious if sonnet could have solved your problem

it is generally well understood that plant protein is less bioavailable than animal protein

reddit! consumer healthcare website

the 'data' used is pretty suspicious in this article obviously, international founders moving to america will have a better time raising money and if you're selling B2B SaaS and 90% of your customers are physically headquartered in SF, you're handicapping yourself living elsewhere.. at some level people will just ignore your sales motion if they don't see a san francisco headquarters on the website

i've lived in both SF and NYC and worked on my own startup in both

NYC has a pretty vibrant startup ecosystem but doesn't compare with SF, except for some reason there's way more healthcare founders in NYC (prob bc bay area healthcare scene is dominated by large hospital systems that are impossible to sell to)

but SF is such a disgusting city overrun with homeless people and crime NYC isn't exactly the prettiest either but pick your poison i guess

i personally prefer south bay over SF hope SF gets its act together since I don't feel safe living there

surely this was planned!!

awesome!!!! love it

Seems like the author is a slow metabolizer like me. Interestingly enough, it seems that the caffeine half life can be shortened by eating broccoli (https://pubmed.ncbi.nlm.nih.gov/17266520/) - by having coffee in the mornings and broccoli with dinner I've been able to enjoy the mood boosting effects of caffeine during the day and still be able to sleep fine.

Sleep quality aside though, I thought my anxiety was due to stressful job, but maybe it's due to all the caffeine I have in an attempt to be productive.. perhaps something to experiment with myself.

amazing, we need more housing supply

I had this experience making an iOS game. After a few years of making the game, I went back to it, and found that I was unable to get it to compile. I guess iOS games are very warm blooded. Perhaps if I had stuck with a desktop platform or web it would have remained fine? Not entirely sure.

I think they're celebrating a little too soon. A few years ago I lived in a roach infested apartment in Seattle and we used every form of pesticide imaginable, essentially to no effect. We were finding them in our food, inside kettles, etc. It maybe wasn't as bad as the waves the post described.

I guess this quote from the article even admits that roaches have become wiser and are on the rise again:

So, roach numbers are slowly going up again. And if you read publications of the Pest Management Association newsletter, which maybe I’ve done recently, you can see that there’s, you know, there’s some chatter about how roach calls are increasing.

Okay, so I pulled some numbers. I went to the American Housing Survey from the federal government. In 2011, 13.1 million estimated households had signs of cockroaches in the last 12 months. In 2021, 14.5 million.

Agree with the sentiment of this article but the disturbing ai generated images every paragraph were definitely not necessary - do people actually need to see these?

Finally... should have been done decades ago.

This reads like someone who think startups are structurally dependent on infinite VC money or loose spending due to low interest rates, perhaps because the writer's business is impacted. Nothing about rising interest rates prevents the formation of new businesses. Many great internet businesses were founded in 2008 (Airbnb, Uber, Whatsapp, etc). Let's not forget that businesses are supposed to make money, and it doesn't require that much capital to start a software business.r

Actually, technically, it's possible that she was dead in the sense that her heart stopped at 11:59AM, and then she was revived via CPR. So maybe GPT4 is right here :)

That's a great idea / suggestion! Due to the licensing rule we avoid showing CPT codes to patients and write our own descriptions. I think we might open source that as I hate that AMA tries to charge so much for this - they don't do any work and just make healthcare more expensive for everyone.

Yep, since the pricing data is publicly available, we list mostly non-partnered providers. Eventually we would want to convert all of them to partners, but that's a years long journey.

That's a great suggestion, we are planning on adding cash prices! It's a bit harder to collect them as we have to manually call all these places (not covered by the regulation).

Yeah, it's really hard to go head up against companies with 100B+ revenue (united healthcare etc) who essentially write the laws.

I think this is a good space for the government to step in with progressive policies, and there are a lot of supporters that aren't as easily influenced by lobbying and under the table bribery.

Our approach is to make something that makes the existing system easier to use for patients, under the assumption that that system continues to exist as-is. We do think there is bipartisan support for price transparency. Something like single payer healthcare is much less likely to get passed and health insurance companies would fight for their lives to prevent it from happening.

There is a ridiculous amount of overhead that the whole insurance dance adds to providers and I think it's unfortunate how much that inflates pricing for everyone.

If the bill is larger than predicted, we end up covering the difference (assuming that the services we showed the user are the ones the user ended up getting). We match the prices shown in the table of 'All Covered Services' that we show to the user, so if you go to a derm to have a mole looked at, it might be $150 for a consultation, and we'll tell you it'll be $70 to have a biopsy done, and if you get the biopsy, we'll guarantee all you owe is $220, and if you don't we guarantee it's $150.

In terms of padding the bill, we think that doctors tend to pad it in order to get reimbursed more by insurance, but they're pretty soft on holding patients liable to these padded things, and also they will get in trouble if they do it too much. We do need to figure out the patient experience though, our goal is that patients know the cost of procedures a doctor is recommending (for ex if my doctor says I should get an arthroscopy and an x ray, I want to know ahead of time how much it costs), and can make an educated decision on whether they want to get the procedure done or want to see a different doctor.

The pricing information, we're likely to publish broad analytics level information, but from a business perspective we're thinking that the discrepancies between the published data and our experiential data are really our 'data moat' for the business, so that's likely to be our IP (as it's what prevents someone from easily copying us by scraping our site). We want consumers to have to go through our site in order to get the pricing info, otherwise if it's just an informational site and people use us to look up pricing then end up going to competitors, we wouldn't be able to financially support the site existing long term.

Thx for the encouragement! Right now we don't have relationships with a lot of these providers, but we do use the only charge when a patient shows up thing as a selling point when selling to providers - providers HATE getting charged for no shows. We wanted to list more providers (even those we don't have relationships with) because with only a handful of providers the shopping experience doesn't really work.

Yeah, it's definitely based on probabilities. I will definitely check out careignition as this is a problem we've been struggling with for sure! For orthopedics we're aware that the range of care and CPT codes are super complex and we're holding off on adding complex procedures for now until we get a better handle on the data side.

We are taking the approach, as you suggested, of limiting procedures in the search engine to ones that patients know what they're getting. Our initial focus is actually Dermatology for this reason, from a combination of popular demand and us seeing that the procedures billed are often very simple and easy for us to model / predict.

For us, our goal is to guarantee the rates that we show on the site, and we're building a model that figures out what the correct rates are as claims get adjudicated. At scale, internally we will have the most accurate model of what costs will be, figuring out which of the carrier rates is real. This part is definitely challenging as well and we expect to lose money on the guarantee (paying out to patients) for some time until we figure it out, but we're limiting the losses by not listing the more complex high variance stuff.

RE in advance EOBs, we think that we can help providers comply if/when that regulation goes into effect!

Sure! This is something we're still figuring out as we're quire early. Would say that the APIs don't guarantee a lot, so it's up to us to piece together the story for a patient and figure out these edge cases.

Oo that's a good domain name! I think this space is pretty challenging. We actually wanted to work on this before the regulation came out and ran into similar issues - however thanks to the transparency in coverage rule, we have access to their pricing info without having to speak to a single doctor! Although we still need to make relationships with doctors in order to get the business part to work.

We did hear from some dentists that their insurance company forbids them from sharing their rates, which makes it tough to add dentists to our platform.

Good to hear from you. I hope that we can offer you peace of mind on pricing! We want people to not have to worry about surprise bills. We are working on sorting out the in-network/out-of-network lab situation soon as that's been a common complaint we hear from patients.

Thank you for the support! I think it is a challenging product to build for sure. We're focusing with simpler procedures that involve a few CPT codes and a single provider to make the problem easier but definitely want to figure out a way to make those complex procedures shoppable.

I didn't know that they weren't allowed to offer cash rates to insured patients! Definitely a bummer from the patient's perspective (why pay for insurance if it will just cost you more...).

Have heard a lot about the book, will check it out!

When patients enter their insurance, we have an API we use to retrieve their deductible remaining info, and then we use that to calculate their out of pocket cost that we show. And yes, we guarantee the patient responsibility!

Definitely a challenge timing wise if a patient does other services with other doctors off platform between when we quote them and they see the doctor though.

Would love to trade notes on the pricing data!

Just pushed up the fix! Let me know if it works? Although we're not yet operating in 19103 - so it won't be particularly exciting - but thanks! Excited to expand to your ZIP soon.

Ooo, seems we have a caching issue. Working on a fix...