The pain was unrelenting. I couldn’t sit, stand, walk, or sleep. I had two severely herniated discs, and I needed back surgery. But it was the middle of the COVID-19 pandemic, and all procedures for non-life-threatening conditions were on hold. I was stuck.
I’d spent a decade working as a data scientist in the tech industry. I loved partnering with the most innovative companies to solve real-life problems. It felt important. At the time, I was working on cloud products, developing a next-generation automated machine learning platform for a big-name organization. Outside of work, I was a competitive USATT-rated table tennis player. I had energy, enthusiasm, and suddenly, severe back pain that made it impossible to enjoy anything. My life came to an abrupt halt.
Those three months were the hardest period of my life. Not knowing the date of my surgery—of when I would be able to resume my regular life—combined with the constant pain, drove me into a deep depression. I felt helpless. I’d tried physical therapy. I’d tried rest. The only thing that would make the pain go away, according to my care team, was a surgical procedure. So, when elective surgeries resumed, I secured the earliest available slot with my provider—ten days away in late April. For the first time in months, I felt genuine relief. I was in the final countdown to my freedom from pain. Little did I know, the path to healing was about to become even more complicated.
A week later, I discovered that my surgery hadn’t been approved by my health insurance. Even with complete documentation including my medical history, MRI results, physical therapy notes, and the diagnosis from my treating physician, authorization had not been granted for my procedure. I wondered if I would ever get the surgery I so desperately needed, if I would ever feel better. My provider and I called the insurer every day but made little progress. I felt unseen by the company meant to protect me. I’d resigned to the fact that I might have to pay out of pocket—a debt I wasn’t prepared to face—if I ever wanted to feel healthy again. But my care team wasn’t about to give up.
On the morning of my surgery, I waited outside the operating room while my nurse and doctor advocated for me on the phone with the insurance company. Finally, just five minutes before my scheduled operation, the procedure was approved. I was on the path to health, and it would be covered.
The surgery was successful, and I’m deeply grateful to the clinical team who would not give up in the face of administrative complexity. But the experience changed my life. To my insurer, my procedure was a number on the screen. A single entry that rolled into a larger metric of claims and authorization requests. To me, it was a fight to hold on to hope in the darkest time of my life. And I’m not alone. About $266 billion is lost to administrative inefficiency in healthcare each year, and that statistic doesn’t address the human impact. Behind every claim, behind every authorization is a person fighting for their life in a complex maze of administrative processes.
As a data scientist, I knew I had to do something to change the system. My ordeal shifted my career focus from innovating with the most forward-thinking tech companies to investing my experience and knowledge to solve administrative inefficiencies in healthcare that cost patients their peace and, too often, their lives. Not everyone is as lucky as I was to have a team that persisted until we got the necessary authorization. It became my mission to make sure that no one else would ever need that.
I joined Machinify because I share in their mission to reimagine what’s possible in the healthcare industry. Like me, Machinify keeps the people behind the numbers at the forefront of everything we do. Today, I work with the Machinify Pay team to build intelligent models that automatically find and fix claims and coding errors so that patients get the treatment they need, providers and payers are compensated appropriately, and the healthcare system runs faster and more efficiently for everyone.
My wife sold my table tennis paddle to prevent further injuries, but that’s okay. I am smashing inefficiencies in healthcare these days, and I’m proud to do it with Machinify. Care to join me? Visit our Careers page to find your fit.
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