In this episode of the Sandwich Generation Survival Guide, host Candace Dellacona of Offit Kurman is joined by Neal K. Shah and Sydney Rosbury from CareYaya, an innovative platform transforming the elder care industry. Neal shares his journey from Wall Street to full-time caregiver to founder of CareYaya.
The CareYaya on-line platform connects university students with seniors in need of companion-level care, offering a cost-effective and reliable alternative to traditional home care. Sydney, a pre-med senior at the University of Michigan, discusses the intergenerational experiences and the invaluable skills she gained as a caregiver with CareYaya. Additionally, Neal introduces Counterforce Health, a new project utilizing AI to assist families in appealing denied health insurance claims, aiming to alleviate caregiver stress. The episode highlights the importance of personalized, affordable care and the growing need for innovative solutions in the aging population. Featured in JD Supra: "CareYaya: A Revolutionary Approach to Elder Care".
00:00 Introduction to the Sandwich Generation Survival Guide
01:19 Meet Neal Shah: From Finance to Caregiving
03:58 The Birth of CareYaya
05:24 Sydney Rosbury's Journey with CareYaya
07:10 What is CareYaya?
08:39 Innovations and Impact of CareYaya
12:49 Challenges in the Care Industry
19:30 CareYaya's Expansion and Future Plans
29:19 Exciting New Projects: Counterforce Health
32:47 Conclusion and Final Thoughts
For more information about CareYaya and Counterforce Health, visit:
https://www.careyaya.org
https://www.counterforcehealth.org
https://insuredtodeath.org
Follow CareYaya on social media:
LinkedIn @careyaya
Facebook @wearecareyaya
Instagram @wearecareyaya
Transcript
Introduction to the Sandwich Generation Survival Guide
[Music] welcome to the sandwich generation
survival guide i am your host Candace Delicona and I am super excited to
welcome today Neil Shaw and Sydney Rosbury from Care Yaya welcome guys
thanks Candace yeah thank you for having us oh gosh I am beyond excited to have
you so just to give everyone a little bit of background Sydney one of our guests reached out to me recently on
LinkedIn because of my background in doing estate planning and elder law and
saw the Sandwich Generation Survival Guide podcast and thought that I should know about an entity called Caraya and
candidly I hadn't heard of it before and Sydney and I had the most amazing discussion about this alternative to
traditional home care and I am really excited to share with our listeners guys
all about karaa what it is and how it's this really incredible remarkable social
experiment which is missiondriven that I love so much created by Neil so I'm
going to let you guys go ahead and introduce yourselves and tell us a little bit about you so Neil why don't you tell us a little bit about you and
Meet Neal Shah: From Finance to Caregiving
how we got here and then we'll go to Sydney sure yeah thanks Candace for the opportunity a quick background myself i
grew up in North China which is where we started Kaya but I actually spent most of my 20s and 30s living in New York
City i have a nontraditional background for caregiving i actually was in finance i started my career doing investment
banking in my early 20s by my mid20s I went into the hedge fund industry and I was good at the work and generating very
high returns so I became a partner at a multi-billion dollar hedge fund when I was 27 and actually drove really high
returns on investments across healthcare and technology and by my early 30s one of those investors backed me to start my
own fund so I started that with 10 million and by the time I was 35 I got it up to 250 million and I was managing
money for university endowments charitable foundations pension funds etc so it's really rewarding experience and
I was good at it and I used to work really hard at it and then kind of out of left field I became a caregiver and
starting in my early 30s it was secondary whereas for my grandfather through dementia and kidney failure and
end of life care and really I saw I was the person that family helping a lot of the care navigation side because I'm the
researchy person and but my mother bore the brunt of the direct care and it was my first eye openening experience in how
broken the care industry is just how difficult it is to get care help the reliability the quality of the care kind
of industry structure where the caregivers aren't getting paid much as a result they're often burned out i I became like somewhat obsessed with the
care industry through that experience and after he passed I was looking into okay how can I invest in this industry
through my fund and back people who were doing good things in it but it was really hard to find and then unexpectedly at the peak of my fund
career at 35 my wife became severely ill and went through years of a difficult cancer battle and I was the primary
caregiver because we were living in New York City and our family her family's from Michigan my family's from North Carolina it was we were dealing with on
our own and I kept taking sobaticals for my work to manage your care and at that point it was a firsthand experience
where when you can't get good care help and you can't get respit you feel guilty and you end up doing a lot of it yourself and I over time realized that
might influence the outcome so after several sobaticals I made difficult decision to wind down my fund which was
like a very heartbreaking and painful experience when you've dedicated almost 15 years of her career to doing something and you've gotten to near the
top of the field to just walk away but I thought it would make a big impact on the outcome she became her full-time
caregiver for a couple of years pleased to say knock on wood she finally had a successful outcome and has now been in remission for a few years so it's been a
positive journey from that perspective and then we actually even more positive we actually had our first child after the whole experience so we have a happy
and healthy four-year-old baby daughter so that's been really cool and then as as part of that journey I relocated back
home to North Carolina just to be near family and once my wife recovered I started Kerrya i was like I've
The Birth of CareYaya
experienced the problem now secondhand i've experienced it firsthand i've looked at it from an investment standpoint this is a half a trillion to
a trillion dollar industry depending on how big you count as like caregiving for someone with serious illness or that's
aging or if you count just homebased care but the industry is growing it's going to double in the next 10 years with our aging population like I can't
believe there aren't good quality reliable solutions there's a huge workforce shortage there's minimal technology the industry operates in like
the 1980s 1990s so I thought there was a huge opportunity for innovation and social impact and I was like okay I'm a
smart person but I finally now in the middle of my life found something that gives me meaning and purpose and I've
talked to so many family caregivers who are just burning at both ends trying to make things and that was the genesis of
starting Kaya yeah you've said so much Neil and I think while you were talking what I was thinking about is that that
old adage where necessity is the mother of invention right and you combine those things with as you point out a passion
and a talent right here you are a person who is really in the finance world and
entrenched in that world but none of us are immune to the human condition and
caring for our loved ones and that's the genesis of Keraya and I think that's a
perfect segway to talk about who Sydney is and what her role is with Keraya as a
student sydney you are a brilliant University of Michigan student in the healthc care field looking to establish
Sydney Rosbury's Journey with CareYaya
yourself one day so obviously a very intelligent young woman and tell us how
you came to Kerrya and what your role is with Kerrya yeah thank you Candace so I
am currently a senior at the University of Michigan last year particularly around the summer time I was looking for
a summer job and I had known that I wanted to do something caregiving related but I wasn't really sure which
population of people I wanted to work with previously I had mostly worked with neurodeiverse children and I had a lot
of fun doing that but I was hoping to expand my age range that I've worked with and there was no better opportunity
than Karaa which I actually found out about through my neuroscience major adviser he sent an email trying to
recruit students in the health related fields to join so I joined there and all
summer long I got experience with different elderly people in the community some of them were couples some
of them were like retired professors retired just all kinds of professions and it was really really interesting to
work with them and I myself do have octogenarian grandparents so I not to
say I didn't have some experience caregiving for the elderly but it's really it's been a really cool and
fulfilling experience to see all of these people from different walks of life and how they have very different
perspectives on the world which is really I wasn't expecting that at all diversity that they have and how they
see the world and how they think the world should run i think what's really important to point out is that what Neil
has created is really a connection so for our listeners Kerry Yaya isn't a
What is CareYaya?
home care agency it's a really revolutionary organization if you will
that connects college students like Sydney with for me as someone who is
advising families every day on long-term care and being able to what we call age
in place with your own surroundings in your own home something like this is
truly remarkable and unique in the marketplace neil tell us how you came up with the moniker Keraya sure and also
thanks Candace for explaining what Kara is because I totally realized I forgot to explain it but yeah a couple of
things i think came up with the name because we wanted something positive and just like playful and fun and techy
because we realize a lot of the care industry has names that allude to the later stages of life or potentially death and we're like okay we want to
make aging and just caregiving more fun as it can be so it was just the word yah twice but it also yaya means grandmother
in Greek yaya also means caregiver in Hindi and Swahili and Thai so it has
like this double meaning and then we thought ya ya is a great acronym for you are your advocate which would be like
the future of self-directed care we thought that the care industry just has several break points where there's multiple opportunities for innovation
where booking care is very inconvenient a lot of the local care agencies don't have price transparency you have to call
and get quotes you have to have somebody do a home visit and sign contracts it hasn't really caught up to 2025 that
we're in now meanwhile you look at things like food delivery like Door Dash or getting a ride like Uber it's so
Innovations and Impact of CareYaya
convenient and streamlined so in our case the innovation was really multiffold of could we deliver a online
booking experience that you can spend less than two minutes to go online fill out a few basic things about yourself and your loved one and schedule and book
caregivers right away then could we do something that's much better than care.com or other online players where
all the vetting and background checking and interviewing of the caregivers is done for you and you just simply put the
days and times you need and you're like given someone and then could we do something where the caregivers are all
of a niche population that is much better than what I think is in the traditional care industry which are wonderful college students across
America who are not only in top universities but who are aspiring to future clinical careers and graduate
programs so they have a really wested interest in doing a good job so think about premeds nursing preysition
assistant prehysical therapy these are students that yes they can get paid through the program but they're not just doing it for the money they're doing it
for the career experience and like career development and then the final thing is we do it for no fees so we
absorb all the cost on the technology and the bookings which has been like an interesting innovation initially was just bootstrapping and funding it but
over time we've had social impact funders but pleased to say that when a family books care through Kyi and on
average they're paying 20 bucks an hour the full 20 goes to the student we're not even in the middle of the transaction so it's unbelievably
streamlined for students earning good income and families paying what in most markets is 30 to 40% lower than
prevailing home gyear rates which is awesome because a lot of people can't afford an industry that does a lot of markups so yeah there's multiple kind of
innovations to that point Neil and and for our listeners I think what's really important to note is that as people age
and particularly they need help with what we call the activities of daily living those
activities are not skilled services so traditional insuranceances don't cover
assistance that one might need to stay independent whether it's bringing food
or help preparing food or that companionship that can sometimes be missing from a senior's life and because
of that families as you point out Neil are spending a huge amount of money paying privately because traditional
insuranceances do not cover this type of care which is companionship care
and enter in someone like Sydney who I may be a little biased having gotten to know her a little bit but as you point
out Neil you have these brilliant college students who have a zest for life and they're coming in and you're
making this connection across generations which is really so remarkable and kind of beautiful
experience for both generations sydney already has a fondness for her grandparents so why not expand that yes
so Sydney from your perspective what do you see can you without obviously revealing any any information about your
your particular assignments but share with us a great example of what you
might do with one of your seniors on a daily basis yeah so there's actually there's a
decent amount of freedom you can balance the things that need to get done and then also the things that they want to
do that bring them joy within their activities of daily living for example if someone were to be visually impaired
or hearing impaired I can help be that extra set of ears extra set of eyes to
help them navigate tasks around the house sometimes it's as simple as putting socks and shoes on helping guide
them to the bathroom to brush their teeth and do their personal hygiene things in the morning but I can also
help with meal prep light cleaning taking out the trash in Michigan in particular in the winter I do not want
any of my clients going outside in the ice so I'm always like I will take your trash out i will do anything that needs
to be done outside i'll salt your porch anything like that just to make sure that they're living in a safe
environment and that they're able to do the things that they love whether that's watching TV reading knitting i have some
clients who I've done woodworking with and doing those activities that they really like with them and they enjoy
teaching a younger person too as somebody who is getting older and being a member of the sandwich generation Neil
Challenges in the Care Industry
we're always in search of finding the way to make sure that we age with grace
and our loved ones age with grace with dignity and not to disparage
institutions and long-term care facilities because certainly there are examples where they are absolutely
necessary but you point out as somebody who studied the market if you will
finding this der this real sort of vast emptiness where there weren't these
options can you tell us maybe what the difference would be between hiring let's
say a homeare dependent versus a student and why it almost can be the same thing
and inform everybody yeah sure yeah and great question Candace i think that there's like a spectrum of care needs
and I think people have to make the decision that's right for them but I I think that so we did we're backed by the
AP we've received funding from the ARP innovation labs and age tech collaborative from ARP and as a result
of that they've brought us under their fold and given us a lot of access to their research and one interesting research that they have internally is
that cumulatively of the amount of hours cared for people above 65 61% is people
with companion level care needs so 39% have a higher ACU or subclinical needs and those we cannot address with college
students right but 61% is a large portion of the $500 billion current homeare market and that is something
that I think is ripe for innovation because the costs are just too high so for those people Kerry can serve as a
wonderful alternative because in the traditional homeare industry currently the cost of care let's just say if
you're booking traditional 40 hours a week because the sandwich generation son or daughter might be working and you
want somebody around mom or dad current cost of home care right now is pushing $65,000 per year for that so if you
think about it that's affordable for a vast majority of the middle class even the upper middle class right because most people don't have 100k plus of
pre-tax income just to spend on that or tons of savings so there we find Keraya
delivers a similar thing for half the price because all the money is going to the students and there's no fees or markups and even better the money is
circulating in the local economy you you are literally directly paying somebody's future med school tuition or physician
assistant school tuition so it's cool you're almost getting care for yourself or your loved one while enabling
somebody to be set up for a pathway towards becoming a future healthcare worker so I think that's pretty cool i
think for people who have more clinical care needs I do think that a lot of the homeare agencies are a good viable option because many of them have
certified nurse aids and people that can do medication administration insulin injections things like that those are
things that students can't do and shouldn't be doing so I do think that makes sense to your point about institutional facility based care I
think there's a need for that in the market because many people don't have the luxury of aging at home unfortunately no matter how good the facility is so much research has come
out like near us Duke University put out a research report about six months ago and it was the statistics adjusted for
every other factor if you move an older person into any institutional care life expectancy goes down by three years and
that's adjusted for like race income level you name it right gender anything so it's just that's a reality that
people really thrive on their independence and living in their home and of course as they lose some
abilities they would like to get help in the home rather than move out somewhere and when you move them out somewhere into an unfamiliar setting no matter how
good the care is just like life expectancy declines so I think that we're going to have this interesting thing in America where the cumulative
care market is now 1 trillion which is about 500 billion in home 500 billion in facilities it's expected to more than
double with their aging population so by 2035 it'll be two trillion but I think market share shift is going to be
significant that I think the home care part is going to more than double because facility based care is becoming
out of favor and my kind of final point on that is that today's baby boomers they were the generation that their
parents they saw moving into these facilities because if you think about assisted living facility as a concept it's like a very 1980s 1990s type of
innovation where these facilities spread all over the country during that time period so the boomers had their parents go through it and then they realized
like hey this isn't a great place I want to go to and then I think COVID kind of destroyed whatever remaining shred of
reputation there was because the just some of the outcomes at these nursing homes and assisted living facilities were horrible so I think now there's a
fear in many of today's 75 and 80 year olds that do not put me there at all costs like I'd rather die at home and
then the final thing is a lot of these places are dealing with unbelievable staffing shortages i think for a variety of reasons like the workers have burned
out during COVID i think they can get better opportunities elsewhere there's been regulatory pressure from government
so like in our area in Raleigh Durham we often hear from people where okay mom fell and broke her hip or is
recuperating at a skilled nursing home and literally I hear horror stories where it's like the staffing is like 25
to one and it's just like somebody hits the button to get a glass of water and it takes them 40 minutes to respond so
believe it or not people are using Kerry in the facility completely never would have imagined that but a son or daughter
will say "My mom's in this place we're paying eight grand a month and there's no one paying attention so I'm gonna
book students a few hours a day to be one-on-one and same whether it's skilled nursing assisted living etc so I think
it's crazy the staffing shortages is impacting people's agree and you just said so much Neil to unpack right so I
want to point out to our listeners that all of the statistics and the research that Neil just referenced there's
something coming called a gray tsunami which is our population is aging and
staying alive much longer than our prior generation so we have a huge part of the
population that is going to need this level of care and to Neil's point I think it's important to note that we
want choices as we get older and right now there are less choices so what you found in Carrie Aayat was providing an
option for people to make sure that they can age in place and for our listeners
out there this is not just Neil's opinion he is very humble as is Sydney they are backed by John's Hopkins and
Harvard and really legitimate and cutting edge organizations including the
ARP that advocates for aging in place because the level of uh lifestyle and
care you get one-on-one clearly is better than any institution could hope to provide and Neil I want to say also
that we're in the New York area and so you talk about $8,000 a month that is probably a third of what it costs here
in New York City wow so I think that is something worth noting yeah so what I'd
CareYaya's Expansion and Future Plans
like to know is and I'm sure a lot of families would want to know when a student gets started to sign up with
Keraya what sort of training or information are they provided about being a caregiver can you share a little
bit about that process yeah sure great question and that's been something we've continued to add to our offering so
initially when we started we had collaborations with UCLA public health so we were offering their Alzheimer's
and dementia training videos just because online YouTube based videos and curriculum that students could do self-directed we were also finding many
of the students themselves had come in with a CNA or an EMT lensure and Sydney
can talk about that as well where they've done that on their own or they've volunteered at a hospital or they've worked at a hospital those students were already equipped and then
we approached the National Institute on Aging because they had heard about our program and John Hoff considered about the program and there was this
collaboration between them where they wanted to increase workforce development so we went through this whole process
with them where they gave us a grant to build what it's called guide but it's basically what they call the duo lingo
of caregiving which is kind of byite-size training modules to meet Gen Z where they're at we've been working on
that grant funded innovation which is the first AI powered dementia care training program right now we're like
been prototyping with students and it'll be broadly rolled out over the next few months but it's been pretty cool where there's an ability and an opportunity to
upskill the students while they're doing it and to upskill them through bite-siz modules where they don't want to
necessarily all go through a 100 hours of coursework before they go out in the field you kind of give them lower acuity
companion level care and then say watch these one minute two minute five minute videos where you get that tutorial from
a geriatric physician at Johns Hopkins or a geriatrician at Duke etc and then you learn that way so that's been pretty
cool and then the final thing is a lot of them learn from the families as well so there's like real practical field experience i was just going to say too
and and then I want to hear sorry Sydney's perspective i think it's important to know I think families have a false sense of security that when they
go through an agency if they hire a companion there is not training beyond what you're talking about and candidly
the resources that you're talking about are top of the top and again another shout out for your being very humble and
earnest about how remarkable Kerry Aaya is in that regard that it has been
received so many accolades um from the National Institutes of Health and organizations like that that see the
need and recognize this is a viable option everyone so Sydney talk about a
little bit about maybe what your training is or what you've learned and I would like to know if you do something different now since you've been in Ker
Yaya for a while and if you are giving those tips to your your peers who have
joined Yaya yeah absolutely so like Neil said there is the certifications list on
the app i believe the families can see it on my profile too it's at least on my profile when I click on it where there's
options where you can select if you're CPR trained CNA EMT or medtech in my
case I'm basic life support certified so that encompasses CPR and first aid and
those were qualifications that I needed for my previous job working with special needs children so a lot of those initial
certifications can carry over but the memory care modules and the dementia
modules are really helpful and especially for people like me who might not have worked with older adults that
much before and then I would say that a lot of kara students have majors where
we are learning about these things too so as a neuroscience major I'm constantly learning about the new
cutting edge things in memory care and Alzheimer's research dement research so I can keep those things in mind too as I
am delivering care to people in real life amazing and I can't as a sandwich
generation member I can't imagine anything better than having this young bright student who is in the medical
field who wants to be there who really sees it more as a vocation a calling as
opposed to a job and Neil to your point about the burnout and the caregiver industry we've seen a shortage here in
New York City so tell us a little maybe from the university perspective you you've been able to get these amazing
universities on board and what should a university do to become part of Kerry or
are there students that can get that started in certain cities like New York that maybe you don't have as great of a
presence and how would one go about that yeah great question Candace pleased to say we are as of the last two to three
months starting out in New York so we started at Columbia University where prehealth career adviserss usually our
like main opening point is when prehealth career adviserss biology professors reach out to us because they
realize and I think this is like an interesting point philosophically like even with Sydney's career trajectory and many of the students career trajectory
it has become harder and harder now to get into medical school to get into physician assistant school to get into nurse practitioner programs than let's
say 20 years ago when I was in college so as a result of that many of the students are trying to get a lot of
field experience sometimes graduate and then take one to three years after college to accumulate a lot of care
experience and then apply so the career adviserss know that and they're always like looking for how can I help this
student who really wants to apply to medical school who applies to physician assistant school by the way physician assistant is a fast growing field over
the last 20 years right and many of those schools require you to have 1,000 to 3,000 care hours to have a
competitive application sometimes people the students prefer I need to get to 3,000 as fast as possible so I can show
I'm serious now mathematically there's no way to get that stuff during undergrad unless you can do part-time
flexible hours geek economy work which no one in the care industry is set up for except Kerry whenever the University
of Michigan pre-health career advising hears that hey here's a way that my students can actually get field
experience in what they want to go to and if they start on KI as a sophomore as a junior yes by the time they
graduate they will have 2,000 3,000 plus hours and they can apply straight and the grad school will be impressed that
they'll be like "Wow this student is so passionate that they want out of their way to do that." And then for the students perspective it's like why not
do this instead of working at the local coffee shop or doing Door Dash food delivery right it's like in line with what I want to do in my future so the
schools are very welcoming of the program and they're continually telling students about it and they love the
feedback so I think that's been an easy way to expand for us but of course we're like a relatively small team so I think
when we expanded to New York we went to Colombia first because they reached out we now have a couple hundred Colombia students on actively doing it that's
been really awesome one of them was featured on CNBC which was really cool like they actually followed her into a
care session that was really cool and then we're also active at Form and I believe Hunter College we just started
but of course if you guys know anyone at NYU or any of the other great universities we'd love to expand because like you said New York is a huge market
and sometimes and running this in North County we're always surprised when we go to new markets to realize what the cost of home care is and I was stunned i
think in New York it's averaging like 42 or $45 per hour it's something unbelievably high and absolutely true
Emil and it prices people out of the market almost immediately and Sydney I
would love to know you have all of these hours under your belt and you are a healthcare major what is next for you
and what experiences from Keraya will you take in your future profession
yeah so I am hoping I'm in the process right now of applying to several different premed gap year programs i
would really like to get into one of those because most of them allow a research component as well as a clinical
care job and I think that would be a really cool combination to have and it's a combination that's pretty difficult to
balance if you don't have a specific program designed for it because if you
have a research job that's going to be a full-time job and if you have a clinical care job that will be but some of these
allow for both so that is my goal right now and I will say that Keraya has had
such an impact on me and I think it's really shown me the importance of treating patients as an individual and
as a person and not generalizing care to an entire population because the reality
is each person has really specific needs and it's really important to listen to
their advocates whether that be their son their daughter their spouse brother or sister because those people truly do
know know the patient best and I have so many examples of that that I've just been really thankful that the Kerry Off
families are also so helpful and they are really just hoping for the best for
their loved one and they give me that information that I need so it's taught me a lot about care advocacy and just
how to approach a care situation too to make sure that the patients needs are
fully met but you've almost created a runway for yourself in becoming the best
caregiver in a professional setting that you can and Ker Yaya has brought you to that place and I think one of the things
that you said that is so important is the advocacy piece right that's what we're trying to do with the sandwich
generation survival guide is provide these resources like karaa so that those of us stuck in the middle trying to
advocate for our loved ones whether it's our spouse and mele in your circumstance thank goodness your wife is okay having
the sort of inside view of the limited options and knowing it's not one-sizefits-all and that everyone is
entitled to have the care customized for them and it really should be something that is the norm as opposed to the Amaly
so I really can't thank you both enough for taking the time to share with us
this incredible mission of Keraya neil do you have any sort of maybe inside
scoop of what's coming next other than this amazing technology that you've obviously developed yeah actually I have
Exciting New Projects: Counterforce Health
a very exciting project that's coming next that's rolling out quietly across the country right now which is regarding
people's troubling experiences with health insurance so as we've all learned I think it's been a national conversation where health insurance
claims denials have been skyrocketing in the last two to three years and we see of course like with the United
Healthcare event it highlighted in the national attention but we had been seeing it one I've experienced it myself
like during my wife's cancer a lot of claims were denied and I was fighting it for hours and hours on the phone and writing all these letters but then we
started seeing it in our caregiving population where as Medicare now has been shifted to being administered by
Medicare Advantage plans like over half of the country's Medicare is going through Medicare Advantage you know these are for-profit plans and they have
absurdly high rates of denying claims so we're seeing it across populations with such as dementia such as terminal cancer
where routine medications we're seeing procedures checkups are being denied and it's creating a financial problem for
people so we basically rolled out a new project through Kerry called Counterforce Health which is a suite of
AI tools which we're just giving away for free to people like we built it as a passion project to automate the creation
of well-crafted appeals to the insurance companies and and the statistic there was we did a lot of research on this and
really the problem is of the 49 million people that have had a denied claim within the last year less than 1% of
people appealed because most people don't know their rights or most people think it's too intimidating how am I going to write an eight-page letter with
medical necessity citations fixing incorrect billing codes things like that they're overwhelmed they're like I don't
have a brother or sister who's a doctor who can do this for me so I'll just eat the cost if I'm denied my meds I'll pay
whatever a few hundred bucks or I'll let it go to collections so or in many cases if it's a prior off people will just not
get the care so we thought okay this is an outrage and then when we started talking to a lot of the clinicians they were like I don't have the time to do
this because it cost my staff time and money and an average appeal cost a clinic about $45 to process so they're
like I can only write a few appeal letters once in a while but not all of them so we thought this is a great use case for AI so we trained AI models
using thousands and thousands of examples and case studies of appeals that have successfully worked um and now
we've gotten it down to the point where you can upload your denial letter you can upload your coverage policy any
other backup information and within 2 minutes it crafts a very well-g engineered detailed appeal letter with
real citations of okay you had XYZ hospitalization this is why it should be
covered you're on this XYZ medication for cancer this is why it should be covered so you give full citations and
then we are able to send the appeal letter for you and then we built a voice AI agent that can actually call and deal
with the insurance company's claim and billing department on your behalf so these are all like the pain points that people don't want to deal with or when
they're sick they find it extremely stressful to deal with or their family caregiver has to deal with so these are
ways to reduce caregiver stress so we're rolling that out now and that's going to be like that's probably the most exciting thing for 2025 is want to
improve care advocacy work and I think our healthcare system is just so broken like that's my takeaway it's like
screwing over all these people who cannot afford any extra time or financial stress and the I'd say
technology has been asymmetrically weaponized by the large insurance companies and this is a good time to
give people the tools to fight back neil if you needed any more proof that you're such a good egg using your skills and
your passion and your experience trying to help the rest of us muddle through
being advocates from the bottom of my heart thank you so much and we are going to put all of these resources online and
Conclusion and Final Thoughts
Sydney I just want to wish you the best of luck as you graduate and as you put forth your applications any med school
or graduate school would be so lucky to have you and I am sure that your path
has been enriched by so many of the seniors that you've helped i just knowing you the little bit that I do I
know that you've enriched their lives and I'm sure they've enriched yours and for all of those who are listening to
this who's saying "Hey one way university student would be a great fit for this." We'll make sure to have those
resources for you any university administrators as well I'll put you in touch with Neil i can't thank you both
enough for spending such time and sharing your passion and your mission with us thank you so much guys thank you
so much for this opportunity yeah thanks for the opportunity this was awesome
[Music]