AI Beyond Insights: Nataly Youssef on Helping Employees Reclaim Healthcare Dollars

Russ Fordyce 🏆 (00:01.359) Welcome back to the winner's circle, everybody. I am here with Natalie from Reclaim Health. They are a second year AI Excellence Award winner for the work they're doing in healthcare. Now you might think this is your typical healthcare AI of helping us look around and see what's wrong or do something, but no, we're actually making healthcare useful for the members. So Natalie, welcome to the winner's circle and congratulations again on the award. Nataly Youssef (00:25.599) thank you, Ross. It's such a pleasure to be recognized for the second year in a row. Thank you. Russ Fordyce 🏆 (00:31.215) So before we get into the guts of what you're doing, give us a little bit of background on reclaim and kind of what you guys are kind of really, it's around a single conviction, right? It's making that money that we already spend on healthcare better for us, right? So walk us through a little bit of the elevator pitch. Nataly Youssef (00:46.026) Exactly. Reclaim helps employers and employees recover healthcare dollars that are already, they are already entitled to, but often never realize or they never get access to it. And we use AI and healthcare claims data to be able to detect any billing errors, missed reimbursements, benefit payments and benefit opportunities. And we turn that from insights. into action and actually recover dollars both for the employer back into their budget and for employees back into their wallets. Russ Fordyce 🏆 (01:22.779) And for employees with W-2s, you don't really understand the full cost of healthcare. You pay a very small fraction of what that healthcare actually costs your employer. And it's really not insignificant. I've worked for a lot of companies, they actually give you a benefit statement at end of the year showing you exactly what they spent versus what you spent. And if you're a small business owner, you know exactly how much you spend. It's a small fortune. Nataly Youssef (01:31.159) Yes. Russ Fordyce 🏆 (01:50.967) What gave you the idea for this and where did that come from? Nataly Youssef (01:55.316) I mean, you're probably referencing when you're talking about W-2, you're probably referencing our premiums that we are paying, you know, pre-tax. Probably some HSA dollars we're setting aside or FSA dollars we're setting aside. And those could be smaller. But the average household in this country is paying far more. on healthcare, once you count also the out-of-pocket expenses that they are paying, especially with the rise of high deductible health plans, right? Deductibles are $3,000 right now before insurance kicks in. And so the dollar amount that a household is paying far outweighs the premiums that they are setting aside for that. At the same time, We're talking about employers that have been chasing this cost trend on healthcare, especially larger employers that self-insure their employee population. They're practically the health insurance for their population. From an out-of-pocket expenses, think about it as I pay 20 % and they pay 80%, right? And so they are on the hook for. the majority of the out-of-pocket expenses that their employees and their family members are incurring and needing to pay the providers. And that trend has been on the rise. In the past three years, that cost trend has been above 8%. This is way above the inflation rate. And it is both creating a health care affordability crisis for both employees and employers, how far can you shift costs towards the employees and the households when they are dealing with massive dollars compared to their take-home pay in terms of healthcare, not just premiums, but out-of-pocket costs. And on the employer's side, I mean, these are businesses. These are not health insurance companies. They are health insurance companies, but primarily they're businesses and, you know, to... Nataly Youssef (04:04.846) to have to manage the second largest cost on their P &L is a massive endeavor, especially when these costs are rising year over year, way over the growth rates and inflation rates. Russ Fordyce 🏆 (04:20.291) Now I can see your sales people kind of walking into either a CFO or an HR leader or maybe the CEO's office and telling them we can make your health care better, we can make your employees happier. What is it specifically that kind of makes them lean in and go, wait a minute, what? Nataly Youssef (04:37.898) Yes. Look, it's a simple idea of reclaim. There are dollars in the system that should be going back to you, the employer, and to you, the employees, without having to change your plan, add more benefits, narrow the network of availability for the healthcare services and the provider choice for your employees. And that can be resolved by just minimizing the wastes and the inefficiencies. of your current benefits and the current plan. And you could do that without employee action, without changing behaviors, so we're not asking people to eat less, exercise more. These are owed dollars that are brought back to both you and the employee. And we're not doing this based on reports. We're not providing insights so that you and or your employees go after chasing these dollars. We're doing that completely on behalf of both the employees and the employer. And what it generates really, it just generates actual dollars back, no ROI methodology, no hoops and, you know, gigantic math formulas to come up with an ROI. There's actual dollars. It's zero or one. Did we recover the dollars? Did we not? And that is something that is really important. The second piece is as you're realizing the value of benefits that you've already paid for. And that is massive in terms of trying to gain an actual realized ROI and impact from the plethora of benefits and plan designs that you've already put in place as an employer. Russ Fordyce 🏆 (06:31.611) Now, most employers, I bet, think that they've got a handle on all the benefit costs. I mean, they've put out the plan, people are using it, they're doing the transactions. I know from spending time in management, they know what percentage of the population is using it, and they look at all that data. When they get into reclaim, what do they typically discover that's in their claims data that they just had no idea about? Nataly Youssef (06:57.518) I must say something. Benefit leaders and benefit managers at larger organization do suspect that their benefit spend is not optimized. So they do come with a lens of, let's find out, let's discover the areas where I can optimize. Basically, the problem that there are inefficiencies of the healthcare system is a problem that is very well felt by benefit leaders. It's also felt by employees, by all of us. I mean, how many times, do you pay for a healthcare bill in Wonder? Do I owe all this amount? Russ Fordyce 🏆 (07:44.303) every month. Nataly Youssef (07:45.292) Every month. And so I think the idea that there's waste in the system and there's inefficiencies is something that is well known. Now, how do you come across and can help, right, an employer identify those pieces? So it's really interesting. We call that the day one reporting at reclaims. So you ingest the benefit data, the enrollment, the eligibility data of the population. And you collect the claims data. What claims data are is think about them as the billing transaction data across the healthcare system. It's the 360 view of whatever you have gotten in terms of healthcare using your insurance card. That's what really it stands for. And so once you bring that all to the system, the AI goes to work and we have a set of algorithms, some of them supervised, some of them pattern detection, unsupervised, some of them decision rule based that goes and analyzes every single claim, 100 % of the claims data, 100 % of the covered lives, employees and their dependents, not just the employees. And it basically looks and provides back opportunities for resolving billing errors. This is think about it as duplicate billing, wrong billing. billing a higher level complexity for a service than warranted given the health encounter and what it entailed, adjudication errors, copay errors, et cetera, that may be resulting from the adjudication of these claims. But also, it will start generating this report of how many benefit dollars are owed to the membership. FSA dollars that could have gone forfeited and we could minimize that forfeiture. You've got accident reimbursement, critical illness reimbursement, hospital indemnity reimbursement. These are really valuable products that employers are making available to their employees to help alleviate the healthcare affordability that is normally tied to these qualifying major events and making that available. Nataly Youssef (10:10.903) from day one. But also you could, know, employers are able to see how much of their population is overinsured, underinsured, and well-insured. Are they in the right plans? This is practically what it means, right? What else in your benefits that you're offering could it be made, you know, communicated to your membership? Because you mentioned engagement. It's not that easy to engage employees in the plethora of benefits. They're very complex. right, for them to engage with them. And then you've got certainly all of this from day one and then you can start basically having that report becoming sort of your, it starts as your roadmap for the dollars to be hunted after and then it becomes basically our ROI measure of the dollars that actually we recovered as you, you know, start hunting the dollars. Russ Fordyce 🏆 (11:06.011) Well, you've said a couple of things I want to dive into a little bit. One is in billionaires. Let's get there in a second. But the one you just mentioned are all these kind of voluntary and ancillary benefits that we might sign up for. And I remember signing up for tons of them because they were largely inexpensive. And you kind of looked at them and you're like, I might as well get that for five bucks a month or $20 a month or whatever. And I imagined that, you know, those two pools have to be where tons of this money is. Nataly Youssef (11:20.823) Yes. Russ Fordyce 🏆 (11:35.063) is kind of sitting. How widespread is the problem of these kind of voluntary? You're not at the register ringing out with your HSA. You're not with your doctor. And it's all connected. It's all these kind of ancillary things that you have to, I imagine, go back and start claiming. Nataly Youssef (11:45.102) Yes. Nataly Youssef (11:51.258) They're siloed. So your medical is for the most part siloed from these additional insurance products that you have enrolled in. And so there's not an easy mechanism where they would just trigger a claim on your behalf because of what you have already done. The industry has tried to do what they call nudging. So where they are connecting some level of healthcare data or sometimes disability. claims information and they wire a notification to an employee that says you may be eligible for a reimbursement. Here's a button, file for your benefit claim. But file for your benefit claim means going and getting all the documentation, getting an itemized hospital bill, getting an injury report, getting a physician statement, getting an explanation of benefit, et cetera. the medical claims information that we have contains all these elements that provide the evidence in the first place. So we're not only notifying people, but we're going the length of filing on their behalf, then substantiating the claim on their behalf to show the evidence that that reimbursement is owed to them, and then monitoring all the way until we register the dollars, the check, you know, amount that was dispersed over to the member. And so. That I think is really interesting because then you are practically creating a end-to-end connection between two sides of the healthcare system that normally don't talk to each other or for those that have invested in having somewhat of a conversation, they stop really short at what looks like just a nudge that says, maybe owed some money. And then having the burden on the employee. to be able to do this. you know, just think about a typical employee in the workforce. mean, all of those work that you need to do to be able to get back $1,500 from a hospital insurance that you have. I mean, think about it. If you are dealing with filing for a hospital reimbursement, this means you're recovering from a hospitalization. This means that you're Russ Fordyce 🏆 (14:09.337) Right. Nataly Youssef (14:11.446) Attending to your life, to your job, probably you are on disability and you're making less money than you normally would, etc. It's not like we're sitting on a huge amount of time to be able to do this, right? So really the funnel breaks in the awareness and in taking action. And then if you are aware and you take action, then it breaks documentation, which could take months for people to be able to complete. Russ Fordyce 🏆 (14:38.523) Oh yeah, and if you get months into those, I've been in those situations where you think you're owed $1,000 and it gets seven months beyond where you were and now it's harder to get that information, maybe stuff's been archived. Do I really feel like spending the time now? Am I really gonna get it back? Is it worth it? Am I gonna get a fraction of that back? Is it worth $200? And all those questions just kinda depress you and then you end up not doing it. What you've done is really. is really genius, which is taking the human out of that loop. For all the AI that's putting human in the loop, you've taken that human submitting forms out of the loop, which it never should have been in there in the first place. You know where that stuff lives. kudos to you guys for kind of changing that model. On the billing errors perspective, I've always thought that there's definitely errors in billing. I think as Nataly Youssef (15:23.576) Yes, exactly. Yes. Russ Fordyce 🏆 (15:33.573) people got into this digitized and digital world that all of sudden this didn't happen anymore. But I imagine you guys see a lot of it. How common do you see billing errors in all of this data? Nataly Youssef (15:45.933) Yes. Look, I want to preface this by saying, yes, errors do happen. They do not happen at a gigantic amount that is, you know, the, so let me backtrack. So claims submitted contain quite a bit of errors when the providers submit the claims. But the claims at administrators think about the Aetna's, the Optum's, et cetera. quite a bit of work in terms of adjudicating and administering these claims to the point that then now when you're getting to what the errors could be, you're looking at basically a little, the residue of that. It could be from the standpoint of coming down from 60 % down to the smaller percentage. At that point, this is where their resources become. you know, it becomes difficult to resource down to 0%, right? 0 % errors. So I want to just commend them for the incredible work that they have done that includes a lot of automations, includes a lot of first come, first serve claims adjudication so that they could pay the providers faster. Now, on the other side, there is also AI and automations that is being used in terms of submitting the claims and what codes are used to submit the claims, et cetera. There's also this complexity in the benefit design that we have created where there is bundled payments that are value based care, there's reference based pricing, there is custom networks and all of that good stuff. And it's not like you go to the hospital and only one provider sees you. There is, you know, nine, 12 different entities that probably touch you and are belonging to different billing entities. So it's really difficult and some errors do get... you know, overlooked, but probably not resolved. By the time the employer pays the provider, and by the time a bill is generated that hits the mailbox of the patient, you know, the member, the employee, their dependents. And so there's this part of it that is, you know, errors that are just left over from this. The other part is, Nataly Youssef (18:11.395) AI and pricing on revenue cycle management side is also correlated with a higher up coding of charges where there is higher complexity services being charged in the ER as an example and the urgent care setting. And so there is some interesting new patterns that are being seen in these billing errors. So these are. Errors that when you look at them for both the plan and the employee could result in serious amounts of money for someone that is chasing keeping that cost trend in check. I mean, just to give you an idea, like employers would like to be able to minimize the cost trend to 4%, 8 % to 4%. And so the inefficiencies that we look at at reclaim is equivalent to about 3.5%. I mean, right there, no changes. No changes to the plan design, no changes to how you are underwriting your population. It's just make what you have work. And so it is a good amount of money once you put in the owed benefits, once you put in these billing errors, even if as a percentage of the total medical spend, the number seems small to someone that is not. really familiar with the healthcare space. But there's a lot of dollars there that are being left over. Yeah. Russ Fordyce 🏆 (19:41.273) Well, yeah, mean, not to put a fine point on it, but I believe health care costs are the number two cost of an employer. It's literally salary and then the health care for that person. Nataly Youssef (19:51.707) Yes. Nataly Youssef (19:55.25) And then literally as the two largest P &L costs, salary and compensation followed by healthcare. And your revenues are based on the growth of the company, the growth of the economy, which are not increasing at 8 % year over year. And so it dents into the profits, it dents into, you know, the growth of the organization. And then for households, it is a big consideration. Russ Fordyce 🏆 (20:11.993) Right. Right. Nataly Youssef (20:24.465) as well, mean, just thinking about the level of bankruptcies due to medical errors, medical bills, denial rates as complexity and investigational therapies. You've got increasing costs with new types of drugs hitting the market. You've got the disassociation of pharmacy deductibles and benefits from the medical that deals with new surprises for. for employees, think both entities are really hitting a crisis when it comes to what, you know, they call healthcare affordability. And, you know, there's really a lot that you could do to help by not just providing them insights because they are swimming in insights. They're swimming in to-do lists and checklists and. to dues, et cetera, but you want to build a system that actually takes that burden out of them and that have the ability to actually resolve things. And back to the billing errors just for a second. You know, could create a report, send it out to the employer. You could create a report, send it out to the carrier. But you're creating undue burden on both entities to be able to resolve these issues. What we have done at Reclaim is that we use the member advocacy channel to be able to resolve it. And if you think about it, it's the patient who has a relationship with all of the above. They're insured by their employer. They have plan member support with the carrier. And they have a patient relationship with the provider. So they really unlock all of that without giving them the to-do list for them, we do it on their behalf, but that's a massive piece of putting the AI detection into recover basically for them. And that's, think, is the really interesting nugget. In addition to all the detection work is actually the ability to take action. Russ Fordyce 🏆 (22:37.423) Well, one of the things I liked about your nomination too was that if an employer is going into kind of this change and they're looking to save costs, they're looking to improve benefits, whatever they're trying to do with their plan, they can actually use your system to kind of model it out and kind of see what it's going to look like. How does that change the annual plan review for a team that's been historically flying blind and trusting their broker? Nataly Youssef (22:48.561) Thank Nataly Youssef (22:54.202) Yes. Nataly Youssef (23:03.535) Yes, the interesting part about reclaim is that it gives a benefit leader an insight as to what fits the needs of their employees from an employee lens. Because at the end of the day, if you just strip out things of reclaim, you take a step back, reclaim as a financial concierge for employees. We make sure that your bills are accurate. We make sure that any money that is owed to you is paid back to you. And we make sure that you are able to make good financial decisions for the future so that now you're also saving, know, prospectively by being on the right insurance package, by putting the right amount of dollars aside for healthcare, all of that good stuff. So with that in mind, when you predicated on the fact that reclaim, this is what it does, It's for the betterment of the employee, the member, right? Member focused. Now the employer can align to what really works well for their employees. And the fact that Reclaim talks to the employees in the context of bills, not in the context of engaging you to be a healthier you, you can now start looking at cost containment strategies that the employer is doing and really factor them as cost containment for the employee too. And so now you can start simulating these strategies and how often will it be recommended to an employee, that a good fit for an employee and their family, and the likely adoption and movements, if you will, for employees into these new different plans that you're creating, et cetera. And it really helps with change management. You can. take a look at the network disruption. You can take a look at what it means to a likely adoption of a new plan, what it means in terms of disruption, in terms of canceling a plan that is already existing. So that's one piece. The other piece that is really interesting is what is the actual value? Nataly Youssef (25:16.562) of the benefit and the plan that you're offering. Because all of the designs are looking for an actuarial value. We as the employer pay X percent, the employee pay Y percent or 1 minus X percent, right? In this case here, reclaim can really showcase. Is it truly 84 % actuarial value? Right? it really brings, think about the best way to think about it is it brings the needs of down to every member and then aggregates it up to the employer so that now they have a nice experimentation as they're thinking about the benefits they're designing with the lens of is it a fit to my employees? And when it's a fit to their employees, do I have what it takes to make sure that they will? If your plan differences have only $200 of benefit to your employees, you will not move as many people to that new plan that you're offering, because there's not enough dollars to have people move over. But if there's a $1,500 difference, and people understand it very simply, that if I stay on this plan, I pay $1,500 more versus this other plan, you will get a lot more people actually migrating. That is so powerful for benefit leaders as they are thinking about their next benefit plan year. Russ Fordyce 🏆 (26:38.615) What impresses me most of you guys have done this in this highly regulated environment. This is not an easy data exercise that you're doing just without regulation. And then you're also talking about probably one of the most fragmented industries as well. There's data everywhere and everything's proprietary. Everything is privacy focused. Nataly Youssef (26:54.95) Yes. Nataly Youssef (27:02.394) Yes. Russ Fordyce 🏆 (27:02.543) And so what did it take technically to build these pipelines robust enough to power this real time automated decision making? Nataly Youssef (27:10.214) you know, I would love to have said, and Anthem opened an API, you know, like we see in other industries. It's, you know, good old flat files and the good old normalization that you have to do in standardization. Russ Fordyce 🏆 (27:19.707) All right. Nataly Youssef (27:35.097) encryptions at rest and in motion, all of that good stuff, high level of risk assessment questionnaires, you know, both at the employer level but also at the carrier level and at whomever is sending you data is very important. So creating a culture but also a system that completely is predicated on what we do with your data, how we protect the data and most importantly, continuing to improve. I think that is very key in terms of a lot of the security compliance standards that we follow. And so it's a bottoms up approach because you create it from the very base and then you keep on building on top of it. It's the best way to really describe this at the highest of levels, but it's ingrained in everything we do. little data packet that gets moved to reclaim or that reclaim moves to others is, you know, impeccably studied in terms of the data security, the privacy policy. The other thing too, you're building a tool that is predicated on the trust of the employee and the member. You can't sell their data. You can't use their data for any other. purpose other than their betterment. And you've got to stick your guns to it, right? And I think this is just at the highest of levels, this is where is, you know, our biggest banner. We are not interested in making money or making headway by using people's data other than getting dollars back into their pockets. and ensuring that they are better off. So I think this is a big part because you are dealing with very sensitive information. Russ Fordyce 🏆 (29:38.703) Well, it seems like a no-brainer for an employer and an employee relationship. A lot of these benefits are actually managed through other people. There's consultants galore, there's brokers, there's entire organizations set up that are deeply embedded inside of these corporations, so much so they have people on staff effectively. How do you position Reclaim relative to those existing relationships rather than against them? How are you getting embedded inside of them? Nataly Youssef (29:48.178) Yes. Nataly Youssef (29:55.804) Yes. Nataly Youssef (30:06.653) yeah. So first of all, the beauty of what we do is we are not here to displace anybody. We are here to make actually all the broken pieces work nicely together. And we believe in the value of every one of these vendors and consultants that the employer has brought into their ecosystem. What we are resolving is communication, right, instead of tying everything together for the employee and then as a result to the employer. So from consultants' perspective, consultants are really intrigued and actually are the best partners of Reclaim because they are influencers, they are great at doing the diligence, they are the right arm of benefit leaders. But they're also, these are sophisticated organizations that they may be sitting on a claims data warehouse of their own. They have large functions of putting voluntary benefits towards employers and employees and really want the value out of their, you know, the voluntary benefits paying employees what they're owed. Some of them have decision support tools. Some of them have benefit enrollment tools, et cetera. So their ecosystem is actually very interesting and reclaims the plugs in various different functions that they are doing. The reports that we hand over to the employers are also accessible to their consultants because that gives them some of the insights. It's, I always call it, it's the. combination of the actuarial work that is impressive that they do, which is top down, with a bottoms up approach that Reclaim does that goes basically down to the single member need and then aggregates it up. And those two, when they come together, it produces a really good outcome for all of the above, right? Because then you've got the top level taken care of, but you've got every single member to be also taken care of. Nataly Youssef (32:21.511) So this is on the consultant side. I enjoy these conversations quite a bit with them because they are really experts and they have seen so much of employers that they are serving and they're looking always for innovations in this space. Now, other ancillary vendors, I mean, for benefit enrollment. companies for voluntary benefit carriers. mean, think about Reclaim as a really interesting collaborator in terms of making sure that people get the financial value of the benefits that they're enrolling people in, right? Or being a data connector that allows them to actually produce the value of the benefits they're offering or also being able to engage people. in those benefits on their platform in the very context of their actual care needs. And so there's a really nice symbiosis that happens there as well with those entities. For other vendors such as condition management vendors, et cetera, think about us as a side of their ability to talk to people and to access people for whom their programs are designed specifically to. And the way Reclaim communicates these programs is in the context of we reviewed your claims and your bills and we have something to tell you about them. And by the way, did you know that you have access to this program free of charge or at a much cheaper rate and people who have used it save on average X percent and then move them over to these programs. Of course, you know, We could help, but there are other organizations that do this, which can compare a cohort that is engaged with a cohort that is yet to be engaged and be able to truly prove out an ROI of the program. But at the very least, what Reclaim does is think about this channel of introducing warmly people to these programs. it's really a symbiosis of all of the above that we experience that Reclaim. And we found a little. Nataly Youssef (34:40.644) niche for ourselves where we have a great, you know, great relationship with the benefit ecosystem and are here to make sure that whatever entails as dollar amounts for employees and employers that we're able to just get to them, whether retrospectively in correcting the past or prospectively in terms of using efficiently what's available for the employees. Russ Fordyce 🏆 (35:06.031) Well, as an employee, imagine it's very heartening to kind of get that message or maybe you see it in your statement somewhere that, we've recollected $142 for you or you get a check or however that operates. mean, as an employee, I'd be like, you know. Nataly Youssef (35:19.335) Yes. Russ Fordyce 🏆 (35:25.465) Now, but you guys work with the employers and these consultants to help them kind of do that work better. Is there a path where reclaims capabilities reach individuals that don't have an employer as the access point? Nataly Youssef (35:38.443) my gosh, I would love that. think reclaim should be in the hands of all Americans, insured or non-insured, frankly, in terms of helping them navigate both the past, you know, recent bills, but also in terms of helping them navigate their insurance packages for the future to make sure. People buy insurance because they just want to have the peace of mind and be able to access care. without bankrupting themselves and their families. I mean, that's at the end of the day. The important piece is access to the billing side of healthcare that really has us prioritize the employer market in partnership with large employers. The access to the claims data is really key because the last thing we want to have people is upload bills. you know, log in to their health insurance portal, et cetera. That created a frictionless system. Yes, I think with some of the new innovative ways that people are able to get access to data, et cetera, I do see a future where this would be in the hands of everybody, people that are on Medicare, people that are on the ACA, or people that are uninsured that are navigating negotiations. with the providers directly. I would love for this to be in the hands of every single person. Russ Fordyce 🏆 (37:10.905) Well, now if I'm a benefits director or an HR leader out there and I, you know, I probably suspect that there's some unclaimed value in my plans. But I wouldn't, you know, other than doing an annual review with my consultant or my team or my partners, you wouldn't really know where to start. What do you think they should be asking first? Nataly Youssef (37:19.772) yes. Nataly Youssef (37:30.996) I mean, look, Ross, just a couple examples. I'm just going to share with you from literally recent employee conversations. One of them is as it relates to claims audits, and then the other one is as it relates to VB, okay? Question is simple. Let me start with the VB. Question is simple. How many voluntary benefit claims that are not related to wellness, the $50 because you've gotten your screening done, how many? accident, hospital, and major diagnosis or critical illness claims have been paid out. They don't know. They know a loss ratio, which includes so many different things like reserves, et cetera. They have to wait for an annual review with their voluntary benefit carrier. we don't know it. it's moved up. Now it's this month versus this month. And then you just don't get a view of, you know. doesn't need to be a daily view, even though we do give a daily view, a 24-7 view of how much is owed, how much has been paid. I can't believe that they don't know that. And I'll touch on the fiduciary landscape in a moment, but that is a struggle. That's number one. Russ Fordyce 🏆 (38:49.819) As somebody who's run budgets, like not having that data, you do not want to be caught off guard when the CEO calls you in and says, how about our voluntary benefits? Nataly Youssef (39:00.917) But also, like, you are hoping, you are, you want to take into account what these dollars are in your medical design, because you're banking on some dollars going back to the employee's pockets when you are, as an employer, you know, in the uncomfortable decision to increase the deductible yet another year by $200 at the individual level. And so it is dollars that employers feel like we don't know how much it is. We don't know how to quantify them. Like the opportunity is unclear how to quantify. And then more importantly is actually what is actually realized so that I can feel like my employees are actually benefiting from these products that are supposed to supplement health. They're called supplemental health products for a reason. They're supposed to supplement your health needs. So there's this angle. The other angle is, you know, employers do, with their consultants do sample claims audits. And they are very useful. I've learned that the consultants, you know, the experts on the consultant side that do this. know, wind up sitting inside of the claims adjudication system of the carrier with a carrier's approval, of course. And they're able to work together on any pattern recognition, et cetera, give an idea to the employer about how this is running. And these are certified audits and they're very useful. The problem is, okay, what about other than the sample claims that we have seen? The other question that is almost always on everybody's mind is, and is it affecting my employees? I know it's affecting me. Is it affecting my employees? And that now gets me back to that fiduciary landscape, which a lot of benefit leaders, their CFOs and companies are having to really consider. Nataly Youssef (41:07.145) The employer group health plan, according to Arisa, has to make sure and ensure that the plan is working to the benefit of the plan participants. Not just to them as the business, but the plan participants. And so it's interesting if you produce a report to an employer and you put it in front of them and you put the onus on them to act when they don't hold. the relationships with all of the providers, et cetera, you're putting them in a worse off position than not having the report in their hands. So the ability to move from insights to action is so important. Otherwise, you're putting them in a more vulnerable position. You've got now also another class action lawsuit. And this is the first time that it's in voluntary benefits, naming the employers and their brokers and consultants. Russ Fordyce 🏆 (41:42.821) Yep. Nataly Youssef (42:01.801) that again now in a supplemental health perspective that is, you know, normally thought differently from the group health plan, you are starting to have that focus of a lot of dollars are being paid, a lot of people are being compensated, but the participant, the covered member, the covered employee, the covered dependent. And so. These are very serious questions that benefit leaders, CFOs, CEOs, business leaders are asking. it is, reports and insights is not enough. The dollars have to flow back. And that's, think, is a big differentiator in how the... from the trend of the market of how they are thinking about. They went past, is there waste in the system? Do I have unrealized benefits? I think more to, I am anxious and eager to make it work because otherwise I am supposed to be the steward of my plan. Russ Fordyce 🏆 (42:55.781) Right. Russ Fordyce 🏆 (43:11.257) Yeah, well, I think you said it best right before we started recording, which was it's AI beyond insights, right? And it's so often today that you put something into AI and you get all of this data back and strategy insights, and then you're forced to put it to work. that alone is not very helpful, right? Unless they... Nataly Youssef (43:17.543) AI beyond insight. Nataly Youssef (43:34.897) Exactly. our stance is simple. AI should do work for people, not create more work for people. Exactly. That's how it's supposed to take a layer of burden off of people. This is how we would have used, know, and would be using AI for good. Russ Fordyce 🏆 (43:42.841) Yeah, well said. Russ Fordyce 🏆 (43:55.641) Natalie, congratulations again. A very interesting conversation. I hope you get down to that individual employee level and let us get there because the small businesses like me out there are dying in healthcare debt too and we need some help out there. Nataly Youssef (44:02.037) Thanks. Nataly Youssef (44:07.317) Well, we need to help you all, not only the employees of large employers, we need to help every American. So I hope to get there soon in the future, really in the short term. Russ Fordyce 🏆 (44:18.297) Well, thank you so much for joining us and congratulations again on the two awards. Nataly Youssef (44:22.606) thank you. Thank you very much, Russ. We are incredibly humbled and grateful for the recognition. And, you know, this recognition matters because it validates that AI can do a lot of work in healthcare, can really be helpful, not just analyzing problems, but actually towards solutions.