I’m assisting an adventure capital group called Pul 63, which focuses on the Philippine market. It was started by an engineer based in the Philippines who exclusively invests in healthcare startups. I asked to see their startups, and he had about 30 companies under his umbrella. One that caught my eye was a claims system, which is a very simple solution. It learned the rules of the Philippine Health Insurance Corporation, but he didn’t know how to sell it to them. So, I became their business development advisor.
I said, “Look, I think I can help you generate revenue from your product.” I structured it so that PhilHealth uses the platform as their claims management system. All claims from every provider in the Philippines are checked at the provider's site before they are sent out electronically or physically. The claims are validated by AI using PDF files, images, and data related to the procedures. The billings are all scanned PDFs that are easily fed into our cloud-based system.
Our AI Swift Claims ensures that every line item in a claim is met according to PhilHealth standards. We verify whether the claim is covered and to what percentage. For instance, do we cover 30% of a heart surgery or 20% of dialysis? We also conduct fraud checks to confirm that the person exists and that they were in the emergency ward for the reported issue.
This system is still growing, and we are expanding our fraud detection technology. We're implementing a secure ID card system outside of the cloud to prevent hacking. This way, we can store the resident's medical data on an ID card that they carry, ensuring that their information is secure.
The claims system is making a significant impact by reducing 99% of all return-to-hospital claims. As you know, hospital claims often get returned if there’s one mistake, causing significant delays in payments. In the Philippines, hospitals could wait anywhere from 90 days to two years to receive payments, leading to backlogs. Our system reduces that 90-day cycle to just 15 days. I asked PhilHealth why it couldn't be done within a day, and they explained that the banking system takes a week to a week and a half. We are currently working on automating the banking approval process to expedite fund transfers into provider accounts.
This is a huge project for us, and I refer to it as Project 28.8. The goal is to create a sustainable primary care solution to ensure that our 28.8 million public school children receive their annual check-ups and have access to primary care 24/7 in their home villages. In many rural areas, schools serve as community centers—places for voting, playgrounds, and gatherings—so we believe we can establish what we call Life Clinics or LabEx Digital Clinics in these schools.
The Life Clinic is essentially a clinic in a box, equipped with complete diagnostics. For example, we can conduct a complete CBC using AI imaging. One drop of blood goes into a reader that takes a picture, which is then sent to the cloud. We can provide a comprehensive 20-parameter CBC report, including platelet counts. I found a manufacturer in Brazil that developed an AI-enabled digital microscope to accurately read platelet counts.
The project is in its infancy; we're currently in the 100,000 range, but with approval from the Department of Education, we hope to scale up to a million children every quarter. We need the Secretary's support to ensure that all schools in the Philippines sign up.
AI is not a disruptor; it represents good medicine. I believe healthcare is one sector where AI will enable improvements—hundredfold, even thousandfold. From genetics to new medicines, AI will enhance how we monitor patients, and ultimately how we feed ourselves.
AI should be viewed as a tool for improvement, much like electricity transformed our lives without disrupting older technologies like candles. AI will enhance our education, communication, work, and healthcare. In the coming years, we will likely sequence many human genomes and match them with clinical data, revolutionizing healthcare and potentially curing diseases like cancer.
Currently, the cost of genetic sequencing is around $300 per person. I’m involved in liquid biopsy initiatives that focus on early cancer detection, using AI to assess risk levels. The future of AI, genetics, and clinical data is promising, and I firmly believe that, like electricity, AI will ultimately save more lives than it risks.
I’m assisting an adventure capital group called Pul 63, which focuses on the Philippine market. It was started by an engineer based in the Philippines who exclusively invests in healthcare startups. I asked to see their startups, and he had about 30 companies under his umbrella. One that caught my eye was a claims system, which is a very simple solution. It learned the rules of the Philippine Health Insurance Corporation, but he didn’t know how to sell it to them. So, I became their business development advisor.
I said, “Look, I think I can help you generate revenue from your product.” I structured it so that PhilHealth uses the platform as their claims management system. All claims from every provider in the Philippines are checked at the provider's site before they are sent out electronically or physically. The claims are validated by AI using PDF files, images, and data related to the procedures. The billings are all scanned PDFs that are easily fed into our cloud-based system.
Our AI Swift Claims ensures that every line item in a claim is met according to PhilHealth standards. We verify whether the claim is covered and to what percentage. For instance, do we cover 30% of a heart surgery or 20% of dialysis? We also conduct fraud checks to confirm that the person exists and that they were in the emergency ward for the reported issue.
This system is still growing, and we are expanding our fraud detection technology. We're implementing a secure ID card system outside of the cloud to prevent hacking. This way, we can store the resident's medical data on an ID card that they carry, ensuring that their information is secure.
The claims system is making a significant impact by reducing 99% of all return-to-hospital claims. As you know, hospital claims often get returned if there’s one mistake, causing significant delays in payments. In the Philippines, hospitals could wait anywhere from 90 days to two years to receive payments, leading to backlogs. Our system reduces that 90-day cycle to just 15 days. I asked PhilHealth why it couldn't be done within a day, and they explained that the banking system takes a week to a week and a half. We are currently working on automating the banking approval process to expedite fund transfers into provider accounts.
This is a huge project for us, and I refer to it as Project 28.8. The goal is to create a sustainable primary care solution to ensure that our 28.8 million public school children receive their annual check-ups and have access to primary care 24/7 in their home villages. In many rural areas, schools serve as community centers—places for voting, playgrounds, and gatherings—so we believe we can establish what we call Life Clinics or LabEx Digital Clinics in these schools.
The Life Clinic is essentially a clinic in a box, equipped with complete diagnostics. For example, we can conduct a complete CBC using AI imaging. One drop of blood goes into a reader that takes a picture, which is then sent to the cloud. We can provide a comprehensive 20-parameter CBC report, including platelet counts. I found a manufacturer in Brazil that developed an AI-enabled digital microscope to accurately read platelet counts.
The project is in its infancy; we're currently in the 100,000 range, but with approval from the Department of Education, we hope to scale up to a million children every quarter. We need the Secretary's support to ensure that all schools in the Philippines sign up.
AI is not a disruptor; it represents good medicine. I believe healthcare is one sector where AI will enable improvements—hundredfold, even thousandfold. From genetics to new medicines, AI will enhance how we monitor patients, and ultimately how we feed ourselves.
AI should be viewed as a tool for improvement, much like electricity transformed our lives without disrupting older technologies like candles. AI will enhance our education, communication, work, and healthcare. In the coming years, we will likely sequence many human genomes and match them with clinical data, revolutionizing healthcare and potentially curing diseases like cancer.
Currently, the cost of genetic sequencing is around $300 per person. I’m involved in liquid biopsy initiatives that focus on early cancer detection, using AI to assess risk levels. The future of AI, genetics, and clinical data is promising, and I firmly believe that, like electricity, AI will ultimately save more lives than it risks.