Here’s a little quiz. Can you define the terms above?

Great. Now, what if you asked your employees to do the same? In a survey conducted at the end of last year, only 49% of insured Americans were confident that they understood the nine most basic health insurance terms. What can be said when fewer than half of us understand how our insurance works? When there are such fundamental gaps in patient knowledge, it becomes difficult to get them to use their insurance for treatment, and then for lack of care, it’s hard to make them healthy.

We know that this basic misunderstanding is a significant burden on HR teams, who most employees will defer to for answers, or worse yet, they might not defer to anyone. It’s also a huge hassle for employees themselves, who are often misusing or not getting the most of their plans.

In the last month at Sherpaa, 39% of our client interactions were insurance-related. Sometimes, we answered questions as simple as “What’s my copay on my birth control?” and “How many times can I see a physical therapist under my insurance plan?” Just a small investigation on our part prevents the first client from overpaying and the second from exhausting their coverage.

We did more elaborate work, too. When one of our clients turned 26 and had to leave his parents’ insurance plan, he was at a loss for finding the best option. It’s important to us that all of our clients fully understand what they’re signing up for, and more important that they sign up for a plan that’s valuable to them. So we put together a plan and benefits comparison for his unique needs. When he’d chosen his plan, we walked him through his forms, and helped him enroll.

In one case, a client of ours needed the HPV vaccine and found it almost impossible to get prior authorization because he was male. Our different departments put their heads together and figured out a way to coordinate care between his pharmacy, doctor’s office, and insurance carrier. Because we were able to engage both the healthcare industry and the insurance industry at once, our client received prior authorization, saving him quite a bit of his salary (the vaccine, minus the cost of the doctor who administers it, can be upwards of $500!)

What all these cases have in common are the potential for the client to spend much more than necessary, or to spend hours sleuthing only to end up with a feeble answer. We at Sherpaa know there’s a smarter way. Sherpaa’s Insurance Guides have dealt solely with these sorts of problems for years, so they’re able to answer these questions and resolve billing problems much quicker than an HR team with other duties to fulfill. Our Guides also work closely with doctors to ensure everything is not only cost effective and without hassle, but quality, necessary care.

So if you did poorly on our quiz, don’t fret. When your business, HR department, or employees need help navigating health insurance and the healthcare it covers, you can always ask Sherpaa for help.

Getting help when you’re feeling sick isn’t always easy. Sherpaa’s Doctors are able to solve 70% of problems without a visit to the office. See how we were able to help our client out when he was feeling his worst in the video above.

Sherpaa is the smart way to keep your business healthy. Our physicians offer your employees unprecedented care around the clock, and our HR experts use smart data about your company’s health to make sure you save. We take care of your company’s health so you can focus on what your business does best.

We’re making healthcare work for business— now that’s revolutionary.

The New York Times recently wrote a story about what it means to be a “Top Doctor”:

The official letter is sitting on my desk, announcing that a relative of mine has just been named one of the world’s top physicians in his area of expertise. Once he confirms his biographical details, he is guaranteed inclusion in online and print directories of similarly honored peers (“not only a tribute to your success, but also a valuable resource for potential patients”).

I can clearly imagine his reaction had he opened the letter himself: a combination of amusement, dismay and just a small hint of pleasure. However, since he has been dead for 16 years, his widow passed the envelope over to me, and I got to experience all those emotions myself.

The amusement and dismay speak for themselves. The pleasure lay in this really superb demonstration that skepticism should attend all interactions with services promising to lead you through the thickets of subpar and merely average doctors directly to best of breed.

I can understand this perfectly well. Town and Country magazine rated me one of the nation’s top concierge doctors a few years ago. They sent me a copy of the magazine congratulating me on my success. They even ran a small story on me and my practice. The problem was, I hadn’t practiced medicine in the 4 years leading up to the publication.

So what does it mean to be a top doctor? Here’s what we think it means. 

What is a Sherpaa Insurance Guide?

Here at Sherpaa, we have a few unique job titles. It’s not just the titles that are different — changing the way healthcare works requires new roles in the industry. And we’d like you to know exactly what our folks do.

So meet Chrissa, Sherpaa’s Insurance Guide Manager.

Can you tell me a little bit about your background? How did you get into insurance?

Growing up, I felt a natural affinity for the healthcare industry whether it was volunteering at nursing homes or conducting research at the Albert Einstein College of Medicine in high school. I attended the Bronx High School of Science in NYC, so with an intense science curriculum and my love of people, I decided on a career in medicine and was pre-med in undergrad. After graduating from Cornell University I started working for United Health Care as a Health Insurance Agent. I also directed a start-up project between The Mental Health Association in Tompkins County and Cayuga Medical Center in Ithaca, which made me more aware of the challenges of healthcare in our country. After that my focus was being an agent of positive change, so I decided to consult for non-profit and healthcare companies. 

What exactly is an insurance guide and why are they needed?

A Sherpaa Insurance Guide is well-versed in every health insurance company’s policies and procedures for clients that we handle. They handle a range of queries such as what plan an employee should enroll in, verify and explain benefits, submit pre-authorizations, find network providers and rectify premiums and billing issues– which can be the most burdensome for plan holders. They fill the need in educating and solving complex health insurance problems for the normal everyday working individual.

What about the relationship between the insurance industry and the healthcare industry needs the most work?

One of the main issues within the healthcare industry is access, which has a great effect on how it’s delivered. Even though we expect enrollment in health insurance to increase in the US, this does not mean that people know exactly what they are entitled to, where they are accepted and how to go about submitting paperwork to insurance companies. There is a disconnect between healthcare facilities and providers and the insurance companies in educating the patient on how each system works. They go in to see the doctor hoping that their doctor’s billing office verified that everything is covered by their insurance and then weeks later, they’re mailed an exorbitant charge balance that they’re responsible for. 

What is Sherpaa doing differently than other healthcare start-ups in regards to making insurance work better for its clients?

We work with every major and new insurance company that our clients use instead of trying to sell them another policy. We provide our clients with a service that guarantees they are making the best use of the health insurance they have provided to them, something that currently does not exist in America. Essentially, it is similar to the Apple Genius Bar, but for healthcare. 

Also there is an average 19.5 day wait period to see primary care physicians in major cities across the US. The time spent on hold with an insurance company does not guarantee the person on the other end has the correct answer to your question. This discourages and frustrates the person seeking medical attention. By offering the patient a system for support and autonomy to ask questions and receive help is the first step in providing a more effective and dynamic healthcare experience all while decreasing insurance premiums.

Sherpaa has an internal team devoted exclusively to building and optimizing a group of specialists our full-time doctors here at Sherpaa refer to when you need to be seen in person. This only happens about 30% of the time, but when you need to be physically examined, our mission is to send you to the highest quality doctor where you’ll have the best experience. Essentially, out of the 880,000 doctors in America, we’re curating doctors so we can send you to the best doctors who will provide you with the best experience. These doctors are rare. We look for the upper echelon of exceptional— the probably less than 5% that meet our definition of a doctor we’d trust with our own lives. So how do we choose our specialists? And how do we define an exceptional doctor? 

Our candidates must meet the standards of a proprietary 30-point weighted system before they’re considered. Next, we look at credentials. Are they board-certified in their specialty? How prestigious was their education? What have they published and do they have a professorship? Are they members and/or leaders of professional organizations? Most of all, we prize clinicians, as we believe that the more time spent with patients, the better.

Credentials are only the beginning. Sherpaa next performs an exhaustive search of  a candidate’s online presence, of how a doctor presents herself and of how patients perceive her. We’re likely to refer to someone with great Yelp reviews, for instance, but that’s only one piece of the puzzle. We then investigate all available quality metrics. For example, we’ll consider outcome rates for procedure-based specialists or preventive care efforts for primary care doctors.

Part of our commitment to a great patient experience is ensuring that the medical treatment as well as financial obligations make sense. Our doctors take patients’ insurance nearly every time. We also ensure our doctors aren’t part of the sliver of doctors receiving a large amount of payouts from insurance companies. We want to avoid, at all costs, doctors who overbill insurance companies and patients.

If a prospective specialist passes this test, we move the conversation offline and into their practice. We choose physicians and practitioners with great personalities; who enjoy their profession and nurture their interests; whose offices are orderly and comforting; and who appreciate timeliness, kindness, and efficacy. 

Our system for assigning potential specialists a weighted score includes the following:

  • Their personal website must be high quality and value beauty and clarity
  • They take more than 5 major health insurance plans
  • Their practice size is less than 10 physicians
  • They graduated from a well-regarded American medical school
  • They have a professorship
  • They’ve published academic journal articles
  • They are members of their respective professional affiliation
  • They’ve been in practice between 5 and 15 years
  • Yelp must have above 4 stars and 20 yearly reviews
  • Healthgrades must have over 4 stars and over 10 yearly reviews
  • ZocDoc must have over 4 stars and over 20 yearly reviews
  • They speak English and Spanish
  • Their bedside manner is top notch
  • Their office is well designed, with exceptional staff, and minimal wait times
  • They are one of the top 10 specialties to which we refer

Our team is constantly researching new doctors, looking for the 5% of doctors that meet our criteria, adding them to our referral network, engaging with them on a regular basis, and ensuring the reviews our patients leave within Sherpaa sustain our decision to include them.

We’re curating doctors to add meaning to the list of 880,000 doctors in America we all have access to on the internet or on our health insurance company’s website. Massive lists are meaningless. We’re doing all the work for you so you have access to a curated group of specialists who meet our definition of an exceptional doctor.

When Adrian, a client of ours, contacted Sherpaa with swelling and a sharp pain in his right foot, he wasn’t sure if it was something to worry about. He was moving around well enough, continuing with his exercise regimen, and already knew a podiatrist. But instead of scheduling, waiting, and paying for a doctor’s appointment, he contacted Sherpaa first.

Our doctors responded right away with a number of diagnostic questions, a few are listed below:

And what followed was simple:

  • Based on Adrian’s answers, Dr. Santana ordered an X-ray, no appointment necessary.
  • Adrian walked in the same day, got his X-ray and a copy of the films.
  • Within a half hour, Dr. Santana had the results: a fracture at the base of his fourth toe.
  • Adrian went to his podiatrist the next day, and his toe was set to heal in four to eight weeks.

One of our Sherpaa Doctors reminded us recently that pain is your body telling you to slow down. All Adrian had to do was listen, send us a message, and allow us to handle the rest.

We’re really glad Adrian had the x-ray taken, too. Stress fractures, if left untreated, can cause the bone to break apart completely.

Though our doctor-client interactions rarely stray from the phone or our messaging app, we strive for quick and comprehensive care. Just by spending a few minutes in contact with Sherpaa and an hour or so with a doctor and radiologist, Adrian identified a potentially harmful injury that at first seemed benign, then had it taken care of in no time.

CNBC’s Nightly Business Report featured us in their Bright Idea segment on last night’s show. Click above to watch!

Here’s a real life Sherpaa story that we think is truly amazing. In his own words below, Joey describes how we were able to prevent his soccer injury from turning his night into a catastrophe:

I was playing soccer late one evening and I got kicked really hard in the face. There was a lot of blood and I had a deep cut over my left eye. It was a pretty bad situation. My two biggest concerns were: do I need stitches for this, and if so, do I need to go to the hospital right away to get that done? It was already 10:30pm as all of this was running through my head, and the idea of a 4-hour visit to the emergency room sounded like a complete nightmare.

Since I wasn’t sure what to do, I used my Sherpaa account to get in touch with a doctor. Dr. Santana replied within a few minutes and I told her what happened. She asked me to take a picture of my eye. I sent her the first photo above and she let me know I definitely needed to get stitches. She also mentioned that with lacerations to the face, it’s preferable to get the stitches done by a plastic surgeon to make sure the scarring is very minimal. She immediately gave me a referral to a plastic surgeon, Dr. Adam Kolker.

To my surprise, I was able to get in touch with Dr. Kolker - it was already 11pm at night at that point. He was very thoughtful and reassuring over the phone, and explained that it would be perfectly OK for me to wait until the morning to get stitched up. He gave me instructions on how to take care of the wound in the meantime and set up an appointment for me to see him at 8am the next morning.

This was amazing to me: not only did I have the comfort of knowing that I would receive amazing care in the morning, but I also avoided the emergency room completely. Instead, I went home and was in bed before midnight.

Dr. Kolker was fantastic the next morning - I was in and out of his office in less than 30 minutes. I didn’t have to miss any time at work or lose a bunch of sleep waiting in the ER to be seen.

Sherpaa, Dr. Santana and Dr. Kolker were fantastic for me for two major reasons. First, I ended up getting really great care: I didn’t have to research who to go to, while bleeding from a laceration on my face. That was all taken care of by Sherpaa. Second, I was able to get professional, expert medical advice late at night that saved me a whole lot of time and annoyance and a visit to the emergency room. It’s tough to really understand how important both of those things are until you’re in the moment and it’s happening.

Dr. Santana also checked in on me via my Sherpaa account the next day, and I happily sent her the second photo above. It was really nice to have that kind of follow-up. The whole experience could not have been more seamless for me.

  1. Camera: iPhone 5s
  2. Aperture: f/2.4
  3. Exposure: 1/15th
  4. Focal Length: 2mm

Although there is a ton of activity in healthcare right now in terms of new apps, new health data companies, new ways to purchase health insurance, etc…there are very few companies tackling the most profound part of healthcare that’s broken and ripe for disruption— the delivery of healthcare. What does it mean to “go to the doctor?” When do you need to actually see a doctor in person vs. just talk with a doctor?”

Here at Sherpaa, we’re preventing 70% of office visits from happening at all. That is a fundamentally massive change. It’s true healthcare disruption, not incremental change. It’s not an efficiency increase of 5%. It’s an acknowledgement that 70% of doctor office visits simply don’t need to happen.

So, on June 12th, I’m delighted to be on a panel with two of my fellow healthcare delivery innovators:

  • Tom Lee, the CEO of One Medical Group
  • Jason Gorevic, the CEO of TelaDoc

Although Tom, Jason, and I are reimagining the future of healthcare delivery, there are fundamental differences in the strategy and philosophy of our companies. 

Needless to say, it’s going to be a spirited discussion tackling the real issues of healthcare. I’m excited. 

It’s free, located at Softbank’s space in Flatiron on June 12th and 6:30pm, and there will be food and booze. 

Space is limited. RSVP to Saundra ( to secure your spot. 

(Source: jayparkinsonmd)

I’m obviously quite excited about this. Sherpaa started in February of 2102 with one client, tumblr. A little over two years later:

  • We take care of more than 100 companies
  • We’re 18 employees and hiring
  • Our monthly revenue covers our monthly burn
  • We’re now in California and in the process of expanding to 10 other major cities by the end of the year
  • We solve 70% of medical problems without referring you to see a doctor in person…think about that…that means 70% of doctor visits don’t need to happen
  • Our insurance experts recoup money on a daily basis for you from insurance companies and doctors’ billing mistakes
  • Employees absolutely love the service with 98% rating the experience as exceptional
  • Companies are offering this exceptionally-rated service and saving money 

Healthcare absolutely can be better and we’re proof. I’ve seen a lot of healthcare companies come and go and raise too much or too little money. My goal is to create a sustainable service that people absolutely need and love powered by an intelligent business and investment strategy based on a career of studying what works and what doesn’t in healthcare. In the beginning of my career, back in 2007, I often blogged about what’s wrong with healthcare. Around 2011, I decided to stop bitching, and start building something better. Sherpaa is a dream come true, enabled by a good idea and passionate investors who want to change a very important, yet broken, industry and fundamentally make it better. Without our investors’ passion and talents, Sherpaa would be nowhere. Along with the investors in our seed round (O’Reilly Alpha Tech Ventures, First Round Capital, and Collaborative Fund) who followed on in this Series A, Josh Guttman at Softbank led this investment along with David Karp, the CEO and founder of tumblr. I’m thrilled to have such a rock star group of investors enabling Sherpaa to grow bigger and better.

The WSJ article alludes to something I strongly believe. If you haven’t noticed, our investors are not healthcare investors. Their main focus is consumer technology. I’m a huge believer that change in healthcare cannot come from within the confines of traditional healthcare thinking. It must come from fresh-eyed partners and investors outside of the healthcare box who find healthcare way too frustrating and backwards. 

So cheers to the finest team of doctors, sales people, engineers, account experience directors, and insurance experts that power Sherpaa and make a better version of healthcare as awesome as it can be. Cheers to the companies who entrust us to make healthcare better for their company. And cheers to Phase Two of Sherpaa, making it bigger, better, and quickly coming to a city near you.

(Source: jayparkinsonmd)