Cody Simmons is the CEO of DermaSensor. I met him when he won the Digital Health Hub Foundation award for diagnostic tools last year. DermaSensor is a device designed to detect early skin cancer using Spectroscopy. Right now only 8% of those with potential skin cancer get the recommended screening. It’s another area where technology can potentially democratize medicine. DermaSensor is aiming for the primary care market. Cody shows how the tool works and explains how the PCP can both improve screening for their patients, and also make money from doing that–otherwise of course they wouldn’t do it! As you can imagine both the technology, the FDA approval process and the roll-out is pretty complicated. Cody explains all–Matthew Holt
Massively Better Healthcare, a review
By MATTHEW HOLT
This is a very brief review of Rock Health founder Halle Tecco’s Massively Better Healthcare. Halle is trying to do something quite complicated in this book. It’s really a three-part attempt to help somebody who is relatively new to health care entrepreneurship understand what the hell they are getting into.
The first part is a brief assessment of the current US healthcare system. If you’ve been working in health care for a long time you can probably skip this but if you’re an entrepreneur coming into American healthcare for the first time, it’s a good introduction. It may though not be enough given how messed up and complex the American system is. There are of course plenty of other great books to read about that. It’s not really Halle’s aim to do more than warn you about the mess the system is here.
The second part is essentially a guide to how to do innovation and how to build a company. This is very valuable. I wish Halle had written more in this part and included more of the work she’s done with the many companies she has stewarded and invested in because there’s another book to be dragged out of her about this. ( I’m sure she would hate me for saying this having just finished this one!). But I wanted to know more about all the boardrooms and strategy sessions she’d been in and the conversation she had about company building. For me this was the best part of the book because it has a lot of great nuggets about innovation. I just wish there’d been more here and that the examples were longer and deeper.
The last section of the book is four good rules for what works and what doesn’t and that’s a lot of useful stuff in there as well. She ends the book with an impassioned plea for people to come and fix the health care system, by working on individual problems within it by taking what she calls Smart Shots.
To me this appeal is overly optimistic but it’s also probably the only way that people can actually fix anything in health care given the current state of the system. She actually references the cranky old guard (which I think I include myself in) but I think she’s specifically talking about people who have spent a long time in big hospital systems or health plans and feel that nothing can be changed from within. Because those organizations are so rich and powerful I personally think the only way to really change health care is to have a “meteor hitting the Earth” extinction event for them, but I’ve written enough about that elsewhere.
So all in all I think Massively Better Healthcare is a very valuable read especially for somebody coming into healthcare with intention to fix the system. But I think it will help those people make health care better incrementally rather than massively.
I think I will actually prefer the sequel, so long as what happens in that is that we get more out of Halle about the experiences she’s had and the companies she’s worked with. There is probably nobody better to deliver a real tell-all about the “warts and all” of building health tech startup companies and although we got a good flavor from her in this first book, I think that there is actually a lot more to come from her.
Matthew Holt is the publisher of THCB
7th and possibly final update on the $39.94 lab test bill
By MATTHEW HOLT
I know you all care, so I am giving a 7th update on the telenovela about my Labcorp bill for $34.95.
The very TL:DR summary of where we are so far is that in May 2025 I had a lab test to go with the free preventative visit that the ACA guarantees, but I was charged for the lab tests and I was trying to find out why, because according to CMS I should not have been.
For those of you who have missed it so far the entire now 7 part series is on The Health Care Blog (1, 2, 3, 4, 5 & 6). Feel free to back and read up.
Where we left it last, Brown and Toland (the IPA between my plan Blue Shield of California and Labcorp) told me that on 8/29/2025 their benefits department had finished their review and reported that the original lab test wasn’t coded as preventative lab services by One Medical, so that the co-pay of $34.95 was correct. ($34.95 was the total agreed payment for all the tests, charged at a total of $322.28. And as it was less than my $50 copay, LabCorp only charges the patient for the total, not the $50!). That call was on December 18 and resulted in update 6.
I next (well about a week later later because life, etc) requested One Medical to resubmit the bill coding it as preventative. That happened on Dec 24, 2025 and someone called Alexis working for One Medical, while exhibiting terrible life skills, replied on Dec 25 and sent it on to their billing department asking them to recode it. I followed up on Jan 15 and Alexis at One Medical confirmed that the billing department had faxed the updated codes to Labcorp. I presumed that Labcorp would resubmit the claim to Brown and Toland and I would eventually get a $0 bill from them.
However, today (4/9/26) I called Brown and Toland about a different telenova — a coinsurance I had received for a dermatology office visit. While I had the rep on the phone, I asked about the Labcorp bill from May 2025. She told me that the benefits team at Brown and Toland had decided on December 18 — that’s right, before I contacted One Medical to ask them to resubmit the claim — that the codes should have been classified as preventative and that I don’t owe the $39.94. Of course Dec 18 was the last time I called Brown and Toland when they said that I had to have One Medical resubmit the claim to Labcorp. Sounds a little coincidental that very same day their benefits team re-reviewed the claim and decided that it should change to being preventative. But who am I to complain or raise a fuss!
Just to add to the complication, on Dec 29 someone within Brown and Toland (customer service?) received that message from the Benefits team and sent it over to the “Epic team” which I assume deals with outliers, with a request to reprocess it. As of today (April 9, 2026), that reprocessing had not happened.
As it happens they may not bother. Labcorp way back when agreed not to send me to collections, and I don’t know if they care enough to go after Brown and Toland for the $39.94, or have just given up on it. More likely if the claim is reprocessed, it will probably be tossed into the capitated amount they already got paid. Which is why the “payment” for my two subsequent lab tests was $0.
So I think we may be at the end of this series. (OK, if you read part 6 there are a couple of other tests Brown and Toland think I should be paying for but no one has sent me a bill for those yet and I may just let sleeping dogs lie).
But don’t worry, there’s always more stupidity in the way Americans deliver and pay for health care, so I’ll keep talking about it. Until we blow up the system and build one that works.
Mathew Holt is the Founder & Publisher of THCB
Tom Kelly, Heidi Health
Tom Kelly is the CEO of Heidi Health, another of the many ambient AI scribes that is spreading its wings to other roles, including bringing its own AI Open Evidence competitor! He calls it an AI care partner. Heidi started in Australia, and quickly moved to the UK and Canada, but now are in over one hundred countries. More recently they have come to the US and have now four major health systems and a lot of other mid market users. Tom think’s Heidi will soon do all the “work around the work”, and he doesn’t think it has to be deeply integrated with the EMR. He sees that as a superpower as doctors don’t want to be in the record. Is he right? Are scribes and ambient AI going to be separate? Does the scribe have to be a medical device, as it does in the UK? Will patients use it? Lots of questions about the future and Tom has lots of answers. Some might even be right!–Matthew Holt
Today’s April Fool is me in 2011
I randomly found this interview I had completely forgotten about on Youtube from 2011. I was younger and thinner then, even though I didn’t have much hair. And I was very optimistic that tech was going to change health care in 10 years……and that it was going to take a long time. Guess we are still waiting!
Kevin Wang, Suki
Suki is one of the original Ambient scribing, now Ambient intelligence, companies. They’re selling both to providers and to other partners using their tech in their tools and services (think telehealth, other EHR providers like Athena, and more). Kevin Wang is the Chief Medical Officer, and he told me about the evolution of ambient documentation, how it makes doctors happy, and how it’s now moving into improving coding (and billing) but will soon be moving into improving clinical decision support. We haggled a little about the ROI from Ambient and where that comes from (remembering codes), and discussed how the EMR v Ambient plays out. And we talked a little about what the impact of ambient and AI will be on medicine…–Matthew Holt
Adventures in health care billing. My $51.96 zit co-insurance
By MATTHEW HOLT
I know my many fans love me delving into the world of why we get seemingly incorrect trivial bills in health care, and what they all mean. The long telenovella of the $39.94 bill from Labcorp is as yet stalled with One Medical apparently resubmitting the original claim with the new preventative codes on it. But even though I am continuing and expanding my role as a difficult patient this year, there are still some blasts from the past that won’t quite leave.
This particular one concerns some rather unpleasant dermatology issues. For many years I had an nasty small sore/lesion on my leg that never quite healed. Then I started getting a few more that started as zits and never quite left. My wise PCP Andrew Diamond at One Medical told me to use some antibiotic wash and referred me to a dermatologist. Unfortunately the one I was referred to was out of network for the Blue Shield HMO I was in, but one request back to One Medical and I was both sent to a dermatologist in my network and got a pre-auth in the mail from Blue Shield to go see him!
Dr Cristian Gonzalez took a quick look at my leg, decided what the problem was, and proceeded to inject, freeze and attack my various lesions. He then prescribed a cheap topical steroid for me to use, and basically after 4 visits over the summer and Fall, my legs went back to resembling a baby’s bottom–well more or less.
For each specialty visit Blue Shield had a co-pay of $85 per visit, which I handed over using my HSA card. One time the front desk said I had a balance, but when I asked them what it was for they told me it was a mistake. Until this week.
Some 4 months after my last visit I got a bill in the mail for $51.96
Given that I had made a co-pay of $85 each time, this seemed a little odd. So I took a look at my Blue Shield EOBs. (BTW they are back online, you may recall they vanished when Blue Shield cancelled and then changed my plan but the Internet never forgets….)
There a curious anomaly began to play out. Each visit generated three identical claims and three more or less identical EOBs.
Continue reading…Ian Shakil, Commure
Ian Shakil is the Chief Strategy Officer of Commure, the AI platform being used by HCA, Tenet and others. He came to Commure via its acquisition of Ambient AI vendor Augmedix, and there are a lot other other new acquisitions within Commure (Athelas, PatientKeeper, Memora Health, Rx Health etc). We dived in not only about what Commure does but the big question of how does a client like HCA or Tenet decide what Commure does, vs what Meditech does, vs what Google does vs what they do internally. We also (sorta) looked into the various criticisms (basically all from Sergei Polevikov!) of what Commure and its main funder General Catalyst are up to and what is happening at Summa Health the hospital in Ohio that GC bought. He also says the good experience from AI will come to help patients this year, and I’ll be holding him to that!–Matthew Holt
Jason Prestinario, Particle Health
Jason Prestinario is CEO of Particle Health. The company is best known for its current lawsuit against Epic, but behind that there is a real company delivering a set of products as on ramp for clients wanting to access health data. Particle was cut off from access to Carequality & Epic a couple of years back but is now both delivering services to its customers and separately suing Epic for being an abusive monopoly regarding its payer platform. I had written about this a couple of years ago but I used this chance to catch up with Jason, to see what the sate of play was. He explained that Carequality said that Particle was right in the original dispute, and why they were right and Epic was wrong. The court case continues. But it’s interesting to hear from someone in the middle of the new disputes about data. — Matthew Holt
Mario Danek, QNovia
Mario Danek is CEO of QNovia, a behavior change platform focusing on smoking cessation product. Essentially the problem with smoking cessation nicotine products is that they don’t deliver the “hit” of a cigarette as quickly as a cigarette or a vape. Mario’s new vape-like product delivers a nicotine replacement therapy (think like Nicorette gum) just as quickly as the form factor it’s replacing. He is hoping that the device/drug/and forthcoming mental health support will be the engine to reduce the current smoking rate from the stubborn level it’s got stuck at. He told me about its likely time to commercialization–Matthew Holt
