Client Spotlight: Phil Ballyk, CEO of Caddie Health
Caddie Health is helping physicians make more time for patient care by using AI to automate medical billing. Its product analyzes physician chart notes to predict the optimal billing and diagnosis codes, saving time, increasing revenue, and improving billing staff efficiency.
Physicians know spending time with patients is critical to providing the best care possible. Unfortunately, the demands of running a practice can often take physicians away from the examination room. Billing for their services is one of the many time-consuming tasks that result in physicians forgoing time with patients.
AC:Studio client Caddie Health is working to help physicians reduce their administrative work and increase patient care time with its AI-powered software. Caddie Health enables physicians to convert their chart notes into the appropriate billing and diagnosis codes for provincial health insurers.
The med-tech startup was founded by Michael Judd and Akshay Rajaram. Phil Ballyk joined the team as CEO in 2022 after working at a management consulting firm, ZS Associates. He said it was Rajaram's personal experience as a family physician that inspired the Caddie Health solution.
"The genesis of the company came from Akshay's direct experience as a physician. He found the billing process to be incredibly manual and fraught with errors. There's not a lot of support available to get those billings right, which impacts your overall practice financial health," Ballyk said.
During his residency at Queen's University, Rajaram completed a quality improvement project that eventually led to formal research and the creation of an AI model that could predict billing and diagnosis codes for submission to the Ontario Ministry of Health for payment. Rajaram and Judd joined forces in 2021 to start Caddie Health and built a product based on that research.
The problem of wasted time on administrative tasks impacts patient care across the province. According to a recent article in the Globe and Mail, more than 18.5 million hours a year are lost to administrative activity. That is the equivalent of 55.6 million patient visits across Canada.
The article reported that if 10 percent of that administrative workload was eliminated, an additional 5.5 million patient visits could be supported. Ballyk said that reducing the administrative load on physicians is the objective of Caddie Health—and billing is a time-consuming and energy-sapping task for any physician.
"It's a problem, and it's causing a lot of burnout. Saving physicians time so they can focus on patient care is essential," Ballyk said.
Caddie Health can also reduce errors and free up time with office staff by automating manual back-end billing tasks. Ballyk said the platform helps by applying the proper codes so that office staff do not have to deal with returned billing submissions from insurance providers.
"We can save them a ton of time to work on things that are going to drive more impact for the practice," Ballyk said.
Caddie Health's path to market aligned with the launch of the AC:Studio program. Ballyk had heard the Accelerator Centre mentioned in multiple early-investor meetings, and a conversation with Chris Leclerc, manager of Venture Studio Programs at the Accelerator Centre, sealed the deal. The Caddie Health team has participated in a few different accelerator and incubator programs, and Ballyk said the AC:Studio program has stood out from the rest.
"They all provide a different level of support, but the Accelerator Centre has been the best. One of the reasons for that has to do with the mentors that we have access to. The thing that impressed me the most is how committed these individuals are to really understanding our business. They don't just want to talk about our pitch deck," Ballyk said.
Each mentor has provided Ballyk with insights on sales, marketing, and other topics, and Ballyk said that the key is how the mentors at AC:Studio keep each other informed. He added that all the seemingly disparate advice comes together to help the Caddie Health team solve its challenges.
"It's very common to have this experience where you go out to lots of different mentors and advisors, and they all have different perspectives. You then have to weed through and figure out what's actually right. At the Accelerator Centre, I've found the advice you get from all these discipline-specific domain experts fits together," Ballyk said.
As CEO of an early-stage startup, Ballyk said sales and marketing are two areas that AC:Studio mentors have helped him with questions on go-to-market planning, developing a repeatable sales process, and understanding customer success with AC:Studio mentor, Bob Mathers.
"What does it take to roll out software to physicians? They are not your typical user. They operate in a unique environment, and Bob has helped us build a robust onboarding process and navigate the feedback we've received to refine it. He's been really great, and that's critical because we need to have very successful pilots from the outset," Ballyk said.
The platform launch comes at a crucial time in the province, with physicians and other healthcare providers continuing to deal with a backlog of patients due to the COVID-19 pandemic. At the same time, Ontario is losing family physicians to retirement and other provinces.
"There's a net deficit of physicians in the province. In a few years, one out of five patients in Canada will not have a family doctor. You can bring them in from other countries, you can try to increase the capacity of medical schools to train them, but it's hard to add doctors fast enough. Caddie Health takes the administrative load off their plates so they can see more patients without burning themselves out. That's ultimately our company's mission—helping them make critical decisions and offload things so that they can focus on the patients in front of them."
Caddie Health is completing its first pilot project at Queen's Family Health Team in Kingston, and Ballyk said they are seeing success with physicians and their patients.
"It's been a long journey of developing the software, but seeing it live and having an impact on physicians is amazing," Ballyk said.
AC:Studio is funded by the Government of Canada through the Federal Economic Development Agency for Southern Ontario (FedDev Ontario) and is delivered in partnership with WEtech Alliance, Innovate Niagara, Conestoga College, SnapPea, Uvaro, Bereskin & Parr, PWC, and Gowling WLG.