A third of French people feel that they do not know their health coverage rights well, and 42% think that the French health system is too complicated. To meet the challenges of this study it conducted, the mySofie application offers individuals follow their reimbursements more easilyof better understand their dependents, and even, recently, to take out an additional supplement. To explain these many features that aim to make life easier for households, we met Philippe Baransky, co-founder of mySofie.
How was the mySofie project born?
With Aymeric Méhu, we created mySofie in 2017, after having worked for twenty years in a social protection group. We realized there that no one understood anything about health insurance. We have therefore developed this project to make this subject accessible and understandable by all. Our solution, which we consider disruptive, is housed in a free mobile app which makes it possible to concentrate and analyze all the medical and administrative information of our policyholders in the same place. We are the only ones to address this issue today in Europe, and we deliver a highly rated customer experience on the stores. After three years of R&D to build this solution, we are currently connected with 375 mutuals, insurance companies, provident institutions, and social security schemes. We are able to analyze 147,000 contracts daily, and 4.8 million treatments. In total, these are 315 million euros which have been optimized by our application.
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How many users trust you today?
The app counts today 185,000 members. Beyond the number, we are particularly proud of the fact that our users consult mySofie on average 8 times a month, i.e. a little more than 3 million cumulative visits in 2021. This is 100 times more connections than on the customer area or the application of a traditional insurer. It must be said that we wanted to offer a real revolution, insofar as we are able to reconstitute the entire care pathway of the user, to tell him how he will be reimbursed, if he is well reimbursedand, ultimatelyhow he can optimize his mutual reimbursement.
The application therefore also makes it possible to clearly identify the remainder to be paid.
Absolutely. Optimization is a structural issue in the consideration of care in France. Out of all French health expenditure, which amounts to 207 billion in 2019165 are covered by social security, 28 by complementary health insurance, and the French therefore have an outstanding balance of 14 billion euros. We analyzed this amount, to see how we could reduce it. We offer through the application a supercomplementary, which is called myBooster and which tackles the rest of our users’ burden on city care, excluding optical and dental care: alternative medicine, specialist, medical auxiliaries, laboratory analysis, radiology, etc. On these treatments, we offer the possibility of being reimbursed for 35%, 50% or 75% of the remaining charge after intervention by health insurance and complementary health insurance.
How does the subscription to this offer take place?
All this is done automatically: if we detect a treatment with a more or less significant remaining charge (greater than 10 euros) we will alert you that it can be reduced thanks to myBooster. Then, you have the possibility of subscribing in 90 seconds to this offer, and take advantage of automatic reimbursement on your bank account. We launched this first top-up offer in October, and we are now analyzing new opportunities that could allow us to tackle the rests to be paid in optics, dental and hospitalization.
You also promise to simplify the administrative life of families
The particularity of mySofie is that you can connect as many contracts as you wish, and constitute your tribe of insured persons: you, your spouse, your children, your parents, a loved one so you would need to follow the health , etc. The idea was to be able to offer a great simplification to caregivers, and to be able to save time for all of our users. Anyone who has ever tried to call their mutual health insurance company knows that it can be particularly tedious, just like trying to find a refund.
” Anyone who has ever tried to call their mutual health insurance company knows that it can be particularly tedious, as can trying to find a reimbursement. “.
And how does in-app registration work?
Quite simply, you download the application, you create your account by communicating name, first name, email address, and telephone number. We then suggest that you connect your complementary and your Ameli account. From the moment you are logged in, theon boarding is complete, you live the user experience. For the time being, the application does not allow you to manage a health diary, even though we offer a teleconsultation service to our premium users, and the transfer of the prescription to the pharmacy. In fact, the application automatically detects all upcoming refunds. After passing your vital card to the doctor, the information goes to the Sécu and the complementary. We collect this information and we simply recompose the course of care, then we break down the reimbursement: the part taken by Social Security, the part reimbursed by the first complementary, and we analyze whether there is any remaining charge. It is the latter that we propose to reimburse automatically.
You also want to tackle the problem of missing refunds
There are indeed today on all mutuals, provident institutions, insurers and brokers, management errors, or computer processing that does not pass. If you do not check your Ameli account on the one hand, and your mutual insurance account at the same time, you cannot know what has gone wrong, because insurers do not check if there is a rate of Error Among Refunds. In the application we have developed a number of services that allow us toalert the user to the fact that his complementary has not yet reimbursed him, and even to recover a refund not made due to computer or human error on the part of the complementary. We do this work on behalf of the user: from the moment we receive a Social Security flow, we wait for the complementary flow, and if we notice that after 21 days the reimbursement flow does not happen, we alert our user to the possibility of an error. At the same time, we look at its guarantees and so we know what reimbursement must be made.
Is it also possible to find old missing refunds?
Yes, as we typically retrieve between 12 and 18 months of history. Our algorithms go through the entire flow, so we can immediately see if there have been any missed refunds in the past. On average, we are around 205 euros recovered per year and per tribe on average.
Do you consider yourself an insurtech? How do you perceive this ecosystem in France?
We have been clearly an insurtech for five years, registered with Orias as such. Our partners see us as such too. Over the past five years, online insurance has expanded into many insurance products, including health. Many work in B2B directly with companies; but none has been developed to make the French aware of what they have, what they could have and how to optimize their health budget. On a comparator, or when contacting a broker or an insurance company, a discovery interview is carried out to find out which health product you need. It’s the opposite at mySofie: from the moment you download the app, we analyze your needs in terms of care consumption, and we try to determine which ones you will need tomorrow. Of course, we do not consider ourselves owners of the data we have, since the GDPR has reminded us: it belongs to the user, who entrusts it to us only. Our job is to make the best of it.
mySofie in figures: find your missing refunds
- Three quarters of users declare having recovered missing refunds thanks to mySofie,
- In half of the cases, the sums are greater than 50 euros per user,
- The maximum amount mySofie has helped recover is 3,480 euros for a tribe,
- 15 tribes recovered between 2,875 euros and 4,432 euros,
- 120 tribes recovered more than 1,000 euros each.