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Location: 1 West Old State Capitol Plaza, Suite 505, Springfield, Illinois, United States United States
Founded in: 2015
Stage: Revenue generating
Number of employees: 1-5
Funding history:
- Date: 05/2015, Seed: undisclosed amount (post valuation: undisclosed amount).
Short URL: vator.co/benefit-defender-llc
Followers (1)
Vatorx1

Benefit Defender LLC

We Make Health Insurance Payments Happen
Startup/business
Springfield, Illinois, United States United States
https://www.benefitdefender.com

Benefit Defender is a cloud-based, HIPAA compliant healthcare platform that connects patients with chronic medical conditions to health clinicians. Clinicians assist patients in obtaining reimbursement for healthcare treatment denied under their health insurance policy.

  • About
Company description

Benefit Defender is a subscription HIPAA compliant, cloud-based platform that allows consumers to obtain assistance for health insurance reimbursement issues. By using Benefit Defender, consumers are able to manage health insurance and health care documents of their entire household from anywhere. The Benefit Defender platform allows consumers to communicate with qualified medical and legal professionals who understand health insurance reimbursement. Consumers can track insurance receipts (EOBs), receive appointment reminders, and learn about their health insurance plans such as out-of-pocket amounts. Benefit Defender allows consumers to message health professionals day or night without leaving their home or business.



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Team
  • Etim Fisk
    Etim Fisk | Founder
    I have 20 years of experience working with IT solutions within the insurance industry. This founder has an extensive knowledge of working with mainframe applications and was involved in the setup of a MVS IBM mainframe operating system.
  • Matthew Haden
    Matthew Haden | Advisor
    I am a Mayo Clinic trained physician and entrepreneur with special interest in health care innovation. Outside of my own startup, I am also an advisor to Benefit Defender, LLC.
Business model

Three Ways Benefit Defender Makes Money:

1. Subscription:

Consumers enroll in a subscription plan. Based on the type of plan, the consumer receives services at a discounted rate or for free.  All plans receive services such as insurance receipt review, calendar reminders, medical document storage, HIPAA compliant message center, integrated invoicing system, etc.

 2. “On demand” model which includes fee-for-services:

Fee-for-services available through Benefit Defender include medical appeal services, ask a nurse, medical record review, prior authorization assistance, prescription appeals, etc.

 3. Broker fees from service providers:

The Benefit Defender telehealth system allows providers to educate, treat, triage and provide services to their clients. Benefit Defender charges a fee to the providers for the use of the Benefit Defender telehealth system.

 

Competitive advantage

A death of a love one was the main motivator in starting Benefit Defender. My father was denied healthcare treatment due to a clerical error in the insurance payment codes and he could not afford paying out of pocket for treatment. He fought a hard battle and his heart finally gave out on him and died very young. This problem happens to millions of consumers everyday and I vow for Benefit Defender to be a preemptive solution to denied health insurance payments and healthcare treatments.

 Knowledge of what providers needs to document in the telehealth system. Seamless integration for providers and their clients.

We took part in writing a proposed amendment to a state statute involving health care coverage.