Streamlining Pre-Approvals in Telehealth with Mel van Londen, founder and CEO of Develop Health

[00:00:02] [SPEAKER_01]: Hey everybody, welcome back to the Outcomes Rocket. So excited you tuned in once again this

[00:00:09] [SPEAKER_01]: time for the HFMA 2024 Insights series at the national level. The conference was amazing.

[00:00:16] [SPEAKER_01]: And here with us, I've got the pleasure of having Mel van Londen with us. He is the

[00:00:22] [SPEAKER_01]: founder and CEO of Develop Health. Mel, welcome to the series, my friend.

[00:00:27] [SPEAKER_00]: Yeah. Thanks for having me. Saul thrilled to be here.

[00:00:30] [SPEAKER_01]: Hey, pleasure to have you here. We're going to be unpacking the work that you do at Develop Health

[00:00:36] [SPEAKER_01]: specific to pre-approvals and prior authorization. Prior to that though, tell us a little bit about

[00:00:42] [SPEAKER_01]: you. What got you into the business? What inspires you to do what you do?

[00:00:47] [SPEAKER_00]: Yeah. So long history here. I was pre-med in undergrad and as I was interviewing at MedSchools,

[00:00:53] [SPEAKER_00]: I was learning how to code and fell in love with the idea of impacting healthcare at scale

[00:00:57] [SPEAKER_00]: through code. Took a bit of a detour, went into fintech afterwards and went into design

[00:01:02] [SPEAKER_00]: consultancy after that, but then ultimately ended up in the health tech startup scene with

[00:01:06] [SPEAKER_00]: Canvas Medical. Started there early, built a lot of the early tech, built RCEM, population health,

[00:01:12] [SPEAKER_00]: charting experience, and then grew with the company to as VP of product shortly after

[00:01:17] [SPEAKER_00]: the series B left to start Develop Health met my incredible co-founder Ben Easton who

[00:01:22] [SPEAKER_00]: co-founded Rupa Health and we set out to find a problem. We spent six months going through the

[00:01:28] [SPEAKER_00]: process of figuring out what to do in healthcare. And as we were interviewing primary care providers

[00:01:33] [SPEAKER_00]: about a different concept, we were continually getting redirected into Medicaid through firewalls.

[00:01:38] [SPEAKER_00]: That's a bigger pain point. So we decided to double click into the opportunity and found

[00:01:42] [SPEAKER_00]: it to be a huge pain point for providers and patients alike. So we're excited. We've

[00:01:47] [SPEAKER_00]: been focused on this problem for the past year or so and very excited to make a dent in the

[00:01:51] [SPEAKER_01]: industry. Love it, Mel. Well look, congratulations on getting started. That's half the battle and

[00:01:58] [SPEAKER_01]: then it continues. So talk to us about the work that you're doing in prior off and any particular

[00:02:04] [SPEAKER_01]: news or insights that you want to share with our listeners and viewers today?

[00:02:08] [SPEAKER_00]: Yeah. So today we primarily service telehealth companies in the metabolic health space. So

[00:02:14] [SPEAKER_00]: prescribing GLP-1s. And so we've learned alongside the best and brightest and what it

[00:02:19] [SPEAKER_00]: takes to deliver care at scale and how to streamline these processes effectively.

[00:02:24] [SPEAKER_00]: We offer two products, benefit verification and prior authorization. Our benefit verification

[00:02:28] [SPEAKER_00]: takes the list of drugs that you might consider for a patient and we help qualify it against

[00:02:33] [SPEAKER_00]: that insurance plan using an AI phone call. So we figure out for those drugs which ones are

[00:02:37] [SPEAKER_00]: covered, which ones require prior off, what the estimated financial responsibility for the

[00:02:41] [SPEAKER_00]: patient is. And then from there, we present that information back to the prescriber. They

[00:02:46] [SPEAKER_00]: make an informed treatment decision and then we automate the prior authorization process. So we

[00:02:50] [SPEAKER_00]: take in the patient medical records, the patient's insurance information and the prescription

[00:02:55] [SPEAKER_00]: information to auto fill, to select the right form, auto fill it and then send that off

[00:03:00] [SPEAKER_00]: to the insurer. We have a quick review step in the process where the prescriber delegate

[00:03:05] [SPEAKER_00]: reviews the form before it goes out the door, but then we handle it from there. So we follow

[00:03:09] [SPEAKER_00]: up with the insurance company and then we parse the determination and notify the patient

[00:03:13] [SPEAKER_00]: provider once we get paid results. We help tens of thousands of patients each year and we're

[00:03:19] [SPEAKER_00]: growing quickly. So we work with customers like Roe and Found and Fella and the big names in

[00:03:25] [SPEAKER_01]: Tella Health to name a few. That's great. Well, Mel, that's fantastic. You've honed in on a really

[00:03:31] [SPEAKER_01]: specific niche, one that causes a lot of pain points for a lot of people in this country

[00:03:37] [SPEAKER_01]: and around the world, but specifically this country. We're honed in on some of the issues

[00:03:42] [SPEAKER_01]: affecting patients, but also providers. This is affecting providers and their ability to care.

[00:03:49] [SPEAKER_01]: There was a lot of topics at HFMA, the discussion of AI, the discussion of the different segments

[00:03:55] [SPEAKER_01]: of the revenue cycle. What stood out to you as something that our listeners and viewers

[00:04:00] [SPEAKER_01]: should have top of mind that they couldn't attend? What can we share with them?

[00:04:03] [SPEAKER_00]: Yeah, it became readily apparent to me how many options CFOs or the reports have for

[00:04:10] [SPEAKER_00]: improving their practice. As a vendor selling into this space, it's important for us to make

[00:04:16] [SPEAKER_00]: implementation as seamless as possible. You only have so much implementation bandwidth each year.

[00:04:21] [SPEAKER_00]: The more we can promote an ROI within that health system while mitigating the cost required

[00:04:26] [SPEAKER_00]: in terms of personnel and time on our customers front, the more compelling the offering is.

[00:04:32] [SPEAKER_00]: I think just kind of an interesting takeaway for me is how many options there are for CFOs

[00:04:36] [SPEAKER_00]: to move their bottom line or their top line. For a solution like develop, really focusing on how easy

[00:04:43] [SPEAKER_00]: we can make the implementation process for them. That's great. No, that's a really great call out

[00:04:47] [SPEAKER_01]: Mel. On the one hand, you go to these conferences. There's a lot you could pick up, but I love

[00:04:52] [SPEAKER_01]: that you did a market focused insight versus an industry focused insight. The market is noisy.

[00:04:59] [SPEAKER_01]: To your point, what can we do to make it easier for the CFOs and the organizations that need

[00:05:05] [SPEAKER_01]: these resources, make it turn key, make it frictionless as possible? This implementation piece is, I

[00:05:12] [SPEAKER_01]: think, a big nugget for everybody to think about. Look, man, this has been great. These are just

[00:05:17] [SPEAKER_01]: short snippet insights from the conference. As we close out today, Mel, what call to action

[00:05:23] [SPEAKER_01]: would you leave our listeners with? What's the best place if they're interested in

[00:05:28] [SPEAKER_01]: the things that you and your team do, they can get in touch with you and develop health?

[00:05:32] [SPEAKER_00]: Yeah. Please feel free to visit our website develophealth.io or shoot me an email at Mel

[00:05:38] [SPEAKER_00]: at develophealth.io or find me on LinkedIn. Mel Van London would love to connect and share more

[00:05:43] [SPEAKER_00]: about our offering and how we can make it easy for you to realize this ROI.

[00:05:47] [SPEAKER_01]: Upstanding. Mel, thanks again for joining us. This has been a real pleasure.

[00:05:52] [SPEAKER_00]: Awesome. Thank you so much for having me, Saul. Great to see you.

[00:05:55] [SPEAKER_01]: Likewise, man. Likewise. Listeners, viewers, by the way, make sure you check out the show

[00:05:59] [SPEAKER_01]: notes right there. We'll leave a summary of our discussion with Mel Van London, founder and CEO

[00:06:05] [SPEAKER_01]: of develop health, as well as links to get in touch with them if something that he discussed

[00:06:10] [SPEAKER_01]: resonated with you. Appreciate y'all tuning in and stay tuned until the next time. Thank you all.