What is Kumba Health?
Kumba Health is an online marketplace and payment platform that connects pre-paying patients with quality providers such as doctors, imaging centers and labs. At Kumba, patients can search, book, pay and save on medical services.
What does the name Kumba mean?
The name Kumba was inspired by the idea of Kumba-ya, as our goal is to bring patients and providers together, "holding hands" as a community to create a better healthcare experience for all!
Who is a Kumba Health patient?
Kumba Health is a good option if you prefer the no-hassle simplicity of self (or direct) pay, if you have a high deductible that you are unlikely to meet, if you’re uninsured, if you want to see a quality doctor who doesn't take insurance, or if your insurance does not cover the services you require.
Kumba Health could also be a good option for you if you are a foreigner or traveling in the U.S. and do not have medical insurance coverage in the U.S. Kumba Health enables people to carry insurance for unforeseen catastrophic events (similar to home or auto insurance) while being free to pay reasonable fees for regular checkups, sinus infections, preventative medicine, or even a broken arm, for example.
Kumba patients generally benefit by saving money, the peace of mind that comes with knowing what their medical services will cost up front (no surprise bills), expedited appointments and the absence of navigating the world of insurance mumbo-jumbo.
What is the Refund Policy?
The short answer is that we do not provide refunds. Now for the longer answer:
If you complete your service and are unsatisfied, you are welcome to take it up with your provider and for our part, we will do whatever we can to ensure that you have a great experience. If you do not complete your appointment due to (cancellation or rescheduling) and you comply with the providers cancellation policy (each provider has their own policy) we can provide you with a full refund.
If you have any further questions regarding this topic, please email us at firstname.lastname@example.org.
How do physician members and other healthcare providers determine their fees?
Kumba Health encourages physician members to look at the typical insurance reimbursement for the healthcare services they offer when deciding on a fair direct-pay fee structure. Physicians are encouraged to take into consideration that Kumba Health patients would be their preferred patients, since they are paying in full at the time of service, without the administrative burden that comes with insurance.
Does Kumba Health comply with HIPAA?
You bet. We have covered all of our bases when it comes to patient privacy. All PHI (Personal Health Information) managed by Kumba adheres to HIPAA regulations. Moreover, we do not pass on or sell your personal information to any third parties (except of course the information that must be shared with the healthcare provider for which you scheduled an appointment via KumbaHealth.com).
Is Kumba free?
Yes, consumers do not pay any subscription or membership fee to schedule appointments with providers via KumbaHealth.com. Kumba offers a free trial to providers. Doctors and other healthcare providers such as labs, imaging centers and clinics may join Kumba Health at no cost. Once we prove the value of our service by virtue of sending you patients on a monthly basis, we activate a nominal monthly subscription fee, which is cancelable at any time.
Who is behind Kumba Health?
Kumba is comprised of a group of seasoned medical professionals, entrepreneurs and technologists. We have all our bases covered. The company is currently seeking capital to expand nationwide great news for patients and providers! Our investment thesis centers around:
- Once a valuable lead-gen source for providers, the benefits of being in-network with insurance no longer outweighs the cost (for many doctors). For consumers, insurance also no longer guarantees more affordable everyday care and convenient access.
- Historically, medical practices fail to collect the majority of the patient responsibility (they are much better at billing insurance than capturing payment from patients, such as co-pays or fees for services and procedures that aren’t covered by insurance).
- High deductible insurance is here to stay. That means that more and more consumers are going out of pocket for healthcare covereage without knowing the costs up-front. To enable patients to become better healthcare consumers -- with the money that's now coming out of their pocket -- Kumba gives its users transparent, up-front pricing. By creating a better marketplace Kumba can enable consumers and providers to tackle the problems facing the traditional healthcare marketplace while moving the whole system forward. Now patients can get the transparent pricing they need to comparison shop, and providers get the payment assurance they want!
Kumba Health is poised to address all three of these issues, in one fell swoop! For investor inquiries please send an email to email@example.com.
How much will Kumba Health save me?
That's our favorite question! There are 3 ways that Kumba Health helps you save:
- Kumba Health saves you money on the services you book. Many Kumba Health providers are reducing their typical fees 10% to 30% for Kumba Health patients. Sometimes even more, for example our prepay lab prices are typically discounted by over 50%. Each participating provider determines their fee structure, so savings will vary by provider. As another example, we had a patient book the latest technology, Fusion Biopsy, and he saved over $5,000 on the single procedure alone by booking with one of our Cedars Sinai Urologists on Kumbahealth.com!
By using Kumba Health instead of your insurance, your cost for services should be lower, especially when for many, it’s unlikely you’ll reach your out-of-pocket deductible anyway. And you can use your HSA (Health Savings Account) to pay for Kumba Health medical expenses just as you normally would.
- As health insurance premiums continue to rise, many patients (and employers) may be forced to increase their deductibles in order to afford health insurance. However, many healthy, savvy consumers may self-elect to move to a higher deductible health insurance plan in order to save money, and use services like Kumba Health, providing better level of value and care. We have received personal testimonials from people saving thousands of dollars per year by raising their deductibles and saving tons of money on their monthly premiums, then using Kumba for their regular care. Even when hundreds or even thousands come out of their pockets by paying for services directly on Kumba they are still coming out way ahead because of the enormous savings from their reduced monthly premiums. And in a year when you are completely healthy, these savings are even bigger.
- Kumba saves you time and frustration. Instead of having to call around to find out how much a particular service will cost you if you pay direct without insurance, Kumba does the hard work for you. We list the prices right on our site for the services you need. If there's a particular service your looking for that you can't find on our site, just drop us a note to firstname.lastname@example.org and we'll get right back to you.
By using Kumba Health, your cost for services should be lower, especially when for many, it’s unlikely you’ll reach your out-of-pocket deductible anyway. You can use your HSA (Health Savings Account) to pay for Kumba Health medical expenses just as you normally would.
That's what Kumba Health is all about! Please send us your savings stories to email@example.com.
How do I find participating healthcare providers?
The Kumba Health website includes a continually updated searchable database of Kumba Health physicians and other healthcare providers. Kumba Health is expanding; please check back as additional physicians join in your area. Today, most of our providers are in in the Los Angeles area. In addition to physicians, you can also search for participating imaging centers, labs, and urgent care facilities.
How do I cancel or re-schedule an appointment I booked through Kumba Health?
Please contact your healthcare provider directly. At this point, the site does not handle modification or cancellation of an appointment. Out of courtesy, please contact your provider at least 24 hours in advance of your appointment if you need to make a change or cancel it.
Can I apply the cost of a medical service I receive via a Kumba Health appointment to my deductible?
Kumba Health was created with the end goal of eliminating the insurance hassle for both you and your healthcare provider. The basic premise of our service is that you are paying direct at the time of service, and are not running it through your insurance (usually because you have a high deductible and aren't likely to meet it anyway).
Every insurance carrier has their own policy regarding acceptance of direct-pay receipts to be applied toward an existing deductible. Please check with your insurance company on a case by case basis as these policies are continually evolving. We recommend asking your provider for a copy of the superbill (or at least listing the CPT codes for the services provided on your receipt) at the time of your appointment, this will be very helpful in processing with your insurance carrier, to either be applied toward your deductible for in the case of self-pay patient reimbursement.
What if my physicians are not registered on Kumba Health or there are no physician members in my area?
Let them know about Kumba Health or let us know about them by clicking on the FOR PROVIDERS tab at the top of our home page, and we'll contact them for you.
Should I schedule follow up appointments via Kumba?
For sure. You'll likely save money, and you'll likely get an expedited appointment. Plus it's easy!
What if I move or need medical care while traveling?
At this time, Kumba Health is primarily available in the Los Angeles area, however, in time you will be able to visit Kumba Health providers anywhere in the United States. As far as emergency or after-hour services, we anticipate many urgent care clinics becoming members of Kumba Health, however we are still working to expand this segment of our marketplace. Unfortunately, Kumba Health is not available outside of the U.S. at this time.
What if I need a specialist or alternative care?
There are medical specialists of most major areas of healthcare available through Kumba Health. There is no limit on the type or number of licensed healthcare providers you can choose or request to join, however they must meet our criteria in order to participate. We realize your medical needs may change, and you are free to change physicians, or request other providers join anytime. If you are looking for a specific doctor or specialty that you can't find then please request for us to add them here.
Do imaging centers, labs, and urgent care facilities offer Kumba Health pricing?
Yes. Imaging centers, labs, and urgent care clinics are joining Kumba Health and offering their best direct-pay prices.
Will my insurance company mind that I'm using Kumba?
Not at all. You are saving them paperwork too!
Do you credential or monitor your providers?
Kumba Health providers are licensed and regulated by their appropriate professional and governmental organizations. These organizations are responsible for review and enforcement of provider credentials. Kumba Health is proud to be a by-invitation, peer-referred network, which means a provider must be referred or approved by a participating physician in order to participate. Kumba eligible providers should have above average composite consumer ratings, and be recognized as quality providers. Kumba Health does not make any representations or verify information provided by its participants. It is the responsibility of each patient to research and make their own choices of who they would like to engage for services.
What if I can’t afford to pay my provider for services at the time of my appointment?
Financing options will be available in the near future for those patients who cannot pay at the point of service. Please email us at firstname.lastname@example.org if this is something you are interested in.
Can patients also be involved in making others aware of this “movement”?
Definitely. We are counting on it. The more physicians and patients participate, the stronger this movement becomes. We hope people will tell others about Kumba Health because it just flat out makes sense. Kumba Health’s goal is to help patients and providers build a common-sense, patient-focused, fair, and no-hassle healthcare marketplace. The more active users there are, the more powerful and efficient the marketplace becomes.
Can Kumba Health reimburse my physician?
No, Kumba Health is not an insurance company. Patients pay their providers directly for services via Kumba Health.com. Participating physicians, imaging centers, labs, etc. voluntarily lower their fees for Kumba Health patients who pay in full at the time of service without using any form of insurance.
Why should I sign up for Kumba?
Can I sign up for Kumba if I still plan to accept insurance?
Yes, Kumba works independently, yet side-by-side with insurance. Kumba may even help to convert your existing insurance patients into cash-pay patients by showing them the potential for savings if they pay you directly instead of having you process their services through insurance. Besides that, we will send you new cash-pay patients so your practice will become less dependant on being part of an insurance network to gain new patients. Hopefully, in time your practice will have a healthier ratio of Kumba cash-paying patients vs. insurance patients, making your practice more profitable even when providing lower prices to your cash-pay patients.
How do I decide on my fee structure?
You establish the Kumba Health fees for your practice per visit and/or based on the service. The more competitive your fees are, the faster your cash-pay practice should grow. A good guideline is to match or beat the typical in-network reimbursements you currently receive from insurance carriers. Providers who are happy with the Medicare reimbursement schedule should be even happier to receive prompt payment from Kumba patients, and may elect to use the Medicare schedule as a guideline. Keep in mind, by eliminating administrative costs associated with activities such as verification of benefits, billing, completing insurance claim forms, coding diagnoses and procedures, referrals, authorizations, payment delays, EOB reviews, claim denials, re-submissions, collection risks, and other "managed care” costs, you can provide patients a fair price for services without the administrative hassle, bureaucracy and time consumption.
Many of our physicians reduce their service prices in comparison to in-network reimbursement schedules by 10% to 30% for Kumba Health patients and still benefit financially, but your Kumba Health fees are your decision. You have the legal right to charge a reduced rate for a particular medical service based on a "prompt pay" discount. You may change your pricing at any time.
How does Kumba Health help me attract new patients?
We employ a state-of-the-art digital marketing team to give your practice better online exposure and presence. Our members pay a monthly subscription fee in return for being a part of our exclusive, growing community.
Kumba Health will not only help you attract new patients, we will help you attract patients who will pay at the point of service. These patients will be your best patients. In addition, participation in Kumba Health includes being featured in our searchable online database as part of our Kumba Health community of providers, including a provider profile page with pertinent information about your practice which each physician controls and updates. Patients can find participating physicians by searching the marketplace. Patients will identify your practice as belonging to Kumba Health and they will know they can receive your "best cash-pay price" when paying in full at the time of service. To strengthen this connection, as a provider member, you may include the Kumba Health insignia in your advertisements and send a press release to the media in your area, specifically mentioning your practice in conjunction with Kumba Health.
How should I “code” services for Kumba Health patients?
The short answer is that we leave any coding or description of services up to you. To distinguish Kumba Health patients from others, we recommend using the acronym KH in your notes. This simple approach will save you time, avoids confusion, and reduces your legal exposure for accidentally mis-coding a service. Kumba Health is simple and does not involve billing third-party insurance, therefore there’s no need to use the CPT or insurance billing coding scheme for Kumba Health patients. With Kumba Health, you are not performing all the billing and administrative services required by your CPT/insurance bills. The CPT code book is a joint venture between the AMA and HCFA that has been adopted by most insurance companies, but is not required for other purposes and is not a legally required directive.
Can I let my patients know about Kumba Health?
Yes, please do! You can let your patients know that you are a member of Kumba Health and encourage them to visit this website. Those with high deductible insurance plans will especially thank you. Kumba Health is a community marketplace that believes in the spirit of patients, physicians, and allied healthcare providers working together to enhance the current healthcare system. We are confident that the simplicity of the process speaks for itself. We encourage you to let your patients know about Kumba Health.
In fact, it is to your benefit to market Kumba Health to your existing patients because the more patients who decide to pay you directly via Kumba, the better it will be for both of you, and the quicker you will streamline your practice and make it more cost efficient while leaving you with more time for patient care and less time for administration of insurance-related paperwork and collections.
How does Kumba Health protect against no-shows?
Kumba patients pre-pay for services when they book an appointment. That means we've secured a credit card payment for the booked service on your behalf which ensures patients are very likely to show up for their pre-paid appointment. As soon as the appointment is completed and your staff sends us notification, we immediately transfer the payment to you.
The added bonus is that Kumba also eliminates the patient financial responsibility issue and collection of fees from patients, which is becoming a bigger and bigger problem as health insurance deductibles continue to increase. This is a major financial issue for private practices as doctors are often having difficulty collecting from their patients.
What about Medicare patients?
Physicians and healthcare providers are often concerned about compliance with Medicare. Based on "prompt pay," you are permitted to offer a special price to Medicare patients. From a practical standpoint, most Kumba Patients do not have medicare.