This article is a transcription of an episode of the RateFast podcast, which you can listen to by searching “RateFast” in iTunes or the iOS podcast store.
If you’re a workers’ compensation provider, adjuster, or case manager check out RateFast Express: the service that writes your impairment reports for you!
RateFast is an original web application that streamlines and simplifies the workers’ compensation process for doctors. All the physician has to do is enter in information and the program will tell them which data, if any, is missing. This reduces any confusion on behalf of both the physicians and doctors; a doctor’s version of TurboTax, if you will.
But inventing such revolutionary software isn’t all sunshine and roses. Programmers have invested, and continue to invest, a great deal of time to ensure that everything runs smoothly and there aren’t any unexpected hiccups. Join Josh Moore in a discussion with Claire Williams about what goes behind the scenes at RateFast and what goes into a typical programming session.
Terms
CPA (noun) – (Certified Public Accountant) a member of an officially accredited professional body of accountants.
Validator (noun) – a computer program used to check the validity or syntactical correctness of a fragment of code or document.
VTAC (noun) – variable thread analytic computation. A logic decision system that filters information through a series of checks and balances.
WPI (noun) – whole person impairment. It is a final value that communicates to the reader what the final measurement loss is in the claim. 0% means that there’s no measurable loss, and 100% means that the individual is nearing requiring support for everything that they do.
Interview Transcription
Claire Williams: Hello, and welcome to the California Workers’ Comp Report. Today is January 24th, and I am here with Josh Moore. Hi, Josh.
Josh Moore: Hi, how are you, Claire?
Claire Williams: I’m doing well, how about yourself?
Josh Moore: Doing good.
Claire Williams: Great. So today on the Work Comp Report, we are talking about our own start-up, RateFast, and particularly this idea of inside the RateFast engine room. So, before we get ahead of ourselves — Josh, what’s your background? Who are you? What are you doing here?
Josh Moore: Sure. So, I grew up here in Sonoma County in a teeny little town called Kenwood, and I’ve stayed in Sonoma County, for the most part, ever since. I graduated from Sonoma State University, and immediately thereafter joined the fun public accounting career. So I’ve been working in public accounting and I’ve been a CPA since about 2000, and never looked back.
Claire Williams: Great. And you know, you used this word, a “fun” CPA career. What makes you a numbers guy? What draws you to work with numbers?
Josh Moore: You know, it’s interesting. Though I don’t remember ever having a whole lot of work discussions with my grandfather, my grandfather was an accountant, so I think there’s some DNA in there. I took an accounting class in high school, Montgomery High School, and it just felt like a fit. I’ve always enjoyed numbers, math to an extent, analytical analysis, things like that that normally most people don’t like to touch. My brain’s always been drawn to those things, so the organization, the neatness, the categories, all that stuff spoke to me. Although the career is nothing at all like what I thought it would be, it’s been a great, great career and I wouldn’t do anything else.
Claire Williams: Awesome. I like that, math in the DNA. So, how did you get involved with RateFast? Where’d you hook up with John Alchemy?
Josh Moore: Totally random – we both were chaperoning our daughters’ field trip, back several years ago, and started chatting. At one of the walks or one of the archery sessions or something like that, I’m trying to remember the specifics, Dr. Alchemy started asking me questions about my career, and vice versa, and before I knew it he was hitting me up to get together to talk a little bit more about RateFast. And over the years, it’s just evolved from there.
Claire Williams: Great. And he said that there was some wonderful Starbucks days, and I’ve been requested to ask your favorite Starbucks beverage.
Josh Moore: [laughs] It’s going to be rather disappointing. I’m a black iced tea guy with no sweetener.
Claire Williams: [laughs] Okay.
Josh Moore: But having a full-time job, and he was busy, oftentimes we would meet either on my lunch break or late afternoon or something like that. We had a quirky little office that we would meet at when I was working downtown inside the mall, you know how they had a little lobby set up with lounge chairs and things of that nature, so that was the home office in the early days. [laughs] It’s morphed a little bit over the years, but it was a fun beginning.
Claire Williams: Yeah, and they do make a mean iced tea.
Josh Moore: [laughs] Right.
Claire Williams: [laughs] What is your part in this idea of the engine in RateFast, the idea that we are taking the American Medical Association Guides to impairment rating and turning them into software? What was your piece of the design of that?
Josh Moore: My section revolved around upper and lower extremities, specifically chapters 16 and 17, so what I helped them do is integrating the user inputs within the boundaries of the AMA Guides, and trying to return the correct results, both mathematically and statistically correct in respect to the Guides, trying to make sure that things round to the correct decimal, combining formulas, and then just incorporating the user experience.
Claire Williams: Wow, very cool. And can you tell us a little bit about the other engine designers on the RateFast project?
Josh Moore: We’ve got Professor Jerry Artz, PhD, Hamline University Department of Physics — he was a college professor of John’s, he’s a stakeholder in the company. And there’s Marten Thompson, a now-graduate of Hamline University as well, with a double-major in Math and Physics. Jerry does Chapter 15 (Spine), and Marten does statistical research for RateFast, he does more research and design of the special projects, things like proof of concept before things go into production. So we’ve got a good group of talented people that work together in an integrated way built on trust and cooperation.
Claire Williams: I have to say I agree. [laughs] So, the RateFast engine runs on something called a validator, as opposed to a calculator. Can you tell us about the difference?
Josh Moore: So the calculator, you simply put something in and it turns something out, whereas a validator is more like a money exchange machine. So if you put in a piece of paper and it’s the same size as a dollar bill, you’re not going to get any change back because of the multiple validation checks that are being done to ensure that that paper that you put into that machine is indeed money. So, same thing with the RateFast engines. They’re validators, and the entry is checked against logic tests for validity, reproducibility, probability and accuracy. So a validator will take a piece of data and analyze it to a specification and take it out or move it forward in the direction of the administrative rule set. For example: If you took a knee rating, if the rating is to be provided on a loss of motion, it has to contain three measurements, and it must be within ten percent to even be considered before moving to the next phase of the impairment rating. So a calculator doesn’t do that, it’ll just provide you a fixed response without that dynamic ability to check the other parameters for accuracy and consistency in the clinical data set.
Claire Williams: Wow. I feel like that wizard behind the curtain moment. That’s pretty impressive. [laughs]
Josh Moore: Yeah, it’s good stuff.
Claire Williams: Yeah. So, RateFast also runs logic called variable thread analytic computation. What is that?
Josh Moore: Sure. So, VTAC for short, it’s a logic decision system that promotes the movement of the data through the rating process. So variable thread means we can consider multiple body part logic rule sets in a parallel, and then ensure the movement is compliant with the administrative rule set. It takes a complex web of checks and balances, more than can be expected for a provider manually to catch all potential errors that would occur if a person were just trying to do it.
Claire Williams: Sure. And kind of on that note, do you see some parallels between doing tax returns and doing impairment rating?
Josh Moore: Yeah, I do. You’ve got to have all your receipts lined up, just like collecting the data inputs in the exam room, you have to know what’s allowed and what isn’t allowed within different ranges of data. You could compare that to different income levels within a tax return, when it comes to deductions or the alternative minimum tax, stuff that will put you to sleep talking taxes. Basically, figuring out if the data set does or doesn’t qualify using an example of say, an extra half a percent WPI if the limitation of motion is below a sixth minimum value. That would be similar to certain credits or deductions in the tax world.
Claire Williams: Sure. And I love that moment in TurboTax when I enter in the numbers and they’re like “You’ve earned this much.” It’s very satisfying. [laughs]
Josh Moore: Mhm, and hopefully your refund is large, right?
Claire Williams: Yes, exactly. [laughs] So, what’s the challenge in creating this kind of engine? Some people might just think that you look at the AMA Guides, 5th Edition, and just like that, it works in the Cloud. Is it that simple? Or, what’s missing there?
Josh Moore: No, I think the fact that there’s nothing like RateFast that’s commercially available in the marketplace just speaks to the enormity of the project. It’s a massive undertaking. Basically, we’re taking a platform that takes the current system of a medical provider’s interpretation of an injured worker’s subjective and objective complaints, which vary greatly from provider to provider, and moving the industry to a new and better place based on the medical facts, and then when we take this task and scale across all possible body parts of the human condition, you know, that’s a tall order. So unfortunately, it’s not magic, despite Dr. Alchemy’s last name being Alchemy.
Claire Williams: [laughs] So, what does a typical programming layout session look like? Who’s at the table, and how does it flow?
Josh Moore: Yeah, so it’s evolved quite a bit since the early days that started out in the mall, but you know, our sessions are normally a couple weeks apart, where we do about four to six hours of programming. We’ve got the whiteboard, and we’re drawing from input or experience, we focus on the logic conflicts and how to make some of the granular details usable in a meaningful way for the stakeholders, you know. We ask ourselves how people ask questions, how they do exams, how they should take measurements, and how the measurements are actually taken or not, we have meetings about consensus on statistical rounding, we consult the AMA Guides, 5th Edition, and then repeatedly consult one another. My role is that I take notes and then my part of the creative process is to make this work and bridge the math with the reality, or sometimes the other way around.
Claire Williams: Wow. Very, very fascinating, and I think that, I can imagine it like the engine room. You know, down there with the coals. [laughs]
Josh Moore: [laughs]
Claire Williams: So, does this project have a direction, a bigger picture? Does programming of the engines contribute to the vision of the company?
Josh Moore: So, RateFast is a company founded on a core set of beliefs. The target customer isn’t any particular individual in the stakeholder’s community of workers’ comp, but rather the relationship that exists between the employer and the employee. You know, that’s why workers’ comp was created in the beginning, and we believe the process of calculating an injury value is a high privilege, and that protecting the integrity of the data set is the priority of everything we do, period.
Claire Williams: Great. Okay, that concludes my questions. Do you have any closing thoughts for our listeners today?
Josh Moore: Just that it’s been an incredible ride, and I look forward to seeing where things go next. Great people, obviously a great product, and it’s been a pleasure to be associated with it.
Claire Williams: Great, well thanks so much for joining us for this episode, and we hope you’ll tune in to some more from here on out.
Josh Moore: Sounds good, thank you.
Claire Williams: Bye.
Narrator: Thank you for joining us for this episode of the California Workers’ Comp Report. You can follow RateFast on Twitter at @ratefast, or visit www.rate-fast.com to learn more.