HATCX
HATCX is an innovation lab that develops ideas to help people navigate healthcare, save money on it and get access to care. It is backed by a major healthcare industry player, which brings financial support and a deep understanding of how the industry works.
The challenge
Out-of-pocket costs for medical services are hard for consumers to understand, and most people only see the real number when the bill arrives. What a CT scan or an MRI will cost depends on three things at once: the service, the place that performs it and the person's own insurance plan.
HATCX wanted to take what is overly complicated about health insurance and make it simple, so that insurance becomes more transparent and customer friendly.
What Megsoft built
Megsoft's team built HATCX cost, a mobile app that answered one question in plain terms: what will this treatment cost me, here, on my plan?
It turned the service, the provider and the plan into one number a person could read, before the appointment instead of after the bill.
The experience followed the way people actually decide on care: look up the service, compare the places nearby, see the estimate on their own plan and keep it for when the decision is made.
What the app brought together
Common imaging services
Treatments like CT scans, x-rays and MRIs, priced in the app.
The person's own plan
Every estimate was based on the person's actual insurance plan.
Nearby providers
Costs shown for the facilities and doctors near the person.
Saved results
Estimates saved to review later, when the decision was made.
Why it matters
Federal rules later made this kind of tool a requirement. Under the Transparency in Coverage rule, most health plans must give members personalized out-of-pocket estimates online: for 500 shoppable services from 2023, and for all covered services from 2024. HATCX cost was built around the same idea: show people the price of their care, on their own plan, before they choose.