Andrew: Hey there, freedom fighters. My name is Andrew Warner. I’m the founder of Mixergy, where I interview entrepreneurs about how they built their businesses for an audience of real entrepreneurs.
And you guys might have over the years heard me say that I’ve been having trouble breathing, runny nose, stuffy nose basically my whole life. And every time I went to see a doctor about it, they would say, “Well, what have we tried? Did you try this medication? Did you try this approach? Did you try that thing?” And I would say, “I don’t know.”
I remember one time saying to the doctor, “I have no idea what I took, like, six months ago. I don’t remember.” And he’d say, “Okay, then what we’re going to do is try you again on this medication. Maybe you took it, maybe you didn’t, but we’re going to try.” And I go, “All right, fine, can I take a moment to just write down in Evernote everything you told me that you think is going wrong, that’s leading you to prescribe this medication?” And he said, “Okay, take a moment.” And I started typing it into my phone and I’m just . . . with my two thumbs. I can’t type it fast enough. The guy is ready to move on to something else, and I say, “Wait, hang on, can I record you?” “No, you’re not allowed to do audio recording of a doctor.” I said, “Fine, all right, give me the medication, I’ll try it.”
This has been going on for 10 years. That’s one of the problems that today’s guest is solving. She understands . . . her name is Lauren Cascio. She understands that health records are obviously important not just to patients, but to the doctors and to the insurers and everyone else who’s involved in our medical care, but it’s disorganized, and it shouldn’t be that way. And so she’s working to organize it. Her name is Lauren Cascio. She is the co-founder of Abartys Health. I don’t know why, Lauren, I’m pausing on that. I want to make sure that I get right. Abartys Health is a centralized data hub that allows medical record portability and universal patient identification. It’s one of those things where why didn’t anyone do this sooner?
This interview we find out how she started this business from Puerto Rico, about the personal challenges that she had in her life that I’m shocked and appreciative that she’s willing to talk about here. And so much more is sponsored by two great companies. The first is Regus. That’s whose company I use. That’s a company I use to rent office space. And the second is HostGator. I signed up with them to host my website. I’ll tell you more about them later. Lauren, welcome.
Lauren: Thank you so much, Andrew, for having me.
Andrew: Lauren, I was doing research on you, and the one thing I couldn’t confirm but I saw here in my notes from our pre-interviewer is your revenue. How much revenue are you guys producing at Abartys?
Lauren: So we have signed over $9 million in annualized revenue. And we are an insurance technology company, so [signed 00:02:32] revenue, booked revenue and billed revenue are all different things. Signed revenue, if you want the excruciating detail, so signed revenue means that you have contracts that when fully actualized, meaning you’ve enrolled their entire population, have a specific value. Booked revenue is revenue that is on the book, just like its own, and then billed revenue is revenue that you will expect to bill in a specific year. We use calendar years.
Andrew: How about cash flow over the last say 12 months or this year? What can you tell me about cash flow?
Lauren: Our expected cash flow from clients for 2018 is about $1.2 million.
Andrew: So is it fair to say that you’ve done over half a million in booked revenue? Sorry in cash flow, in cash in the door?
Lauren: Yes. That’s [to date 00:03:27].
Andrew: Okay. All right, that gives me a sense of it.
Lauren: To date.
Andrew: Were you going to say something? Sorry?
Lauren: Like, January to date. Yes.
Andrew: January to August, which is when we’re doing it. All right, that gives me a sense of where you are. That’s impressive considering that you’re going after the insurance industry, which has long sales cycles and is not really eager to talk to new entrepreneurs with their great new ideas. It’s really impressive that you did it.
I told you before we started this interview that I was looking on your site to get a sense of everything you do, and as I scrolled around to see is this real, is this not, something stood out for me, and that is, on the very bottom of your site, the copyright says 2016 even though we’re clearly in 2018. And then I looked over to the left of the number and I saw the “copyright” is spelled with an “I” not a “Y.” What’s going on? That made me think, “Is she real or not?” And then I looked at who introduced us, I looked at your investors, I said, “Okay, it seems legitimate.” But what’s the deal with the “I”? What’s the deal with some of the typos I see on your site?
Lauren: Oh, I’m laughing a little bit. It is a second language for our developers, and so I give them a lot of flak. And I didn’t catch it myself before we released it. We did hire a copywriter, and we released all four of our sites in a deployment at once. That is the marketing site, the one you were scrolling through, InsureLynk, PatientLynk, and ProviderLynk. But we did a staging deployment on Friday that contains the updated copy, and it failed, numerous tests, critical bugs. So it did not go live yet. And it will. And we are aware of them, but it’s kind of the process.
Andrew: And the insurance company clients that you have, they’re okay buying from you, they trust you despite some of these typos.
Lauren: None of our existing clients or prospects have brought it up, but I guess it’s potential. If somebody visited the marketing site and said, “These people can’t even spell ‘copyright,’ I’m not giving them medical data.” So we’ll fix it. And, you know, it happens.
Andrew: All right, I want to get into how you built this business, but first, let’s talk about how you became who you are, the person who can feel confident with this business despite the fact that it’s new and there’s some clear issues with it. I wonder how much of this goes back to your parents and watching them take risks. Your parents were in what business?
Lauren: My parents are restaurateurs.
Lauren: In Florida and then also in Georgia.
Andrew: And you remember when they opened up the first restaurant and the risks involved, right?
Lauren: That is one of my clearest childhood memories is a few days before the opening of their very first restaurant, they were, now what I can see in hindsight, clearly overbudget and overtime, and so we spent the night in the restaurant painting, like, the baseboards and the walls. And I ate pizza on, like, one of those painter mats, and I fell asleep there and woke up there the next morning and . . . I mean, that became the norm in my life. I had no siblings. I was very close to my parents and their work. I waited tables and I was a hostess and a dishwasher. So I got to see it.
Andrew: You told our producer that you watched them in uncomfortably stressful situations. What’s one of them?
Lauren: You know, one that I remember . . . well, you know, so when I was growing up, when they first started the restaurant, it took I think like four or five years for them to make money. And so we had a very obvious lifestyle change once the restaurant started making money, and so I got to see the rewards. We moved into a bigger house. I was able to go to private school. We went on vacation. But before that, you know, I was not living that way. And so, you know, the happiness and the level of stress that, you know, was between them and in our family kind of was a constant. They were never much happier with more. You know, they managed their stress really well.
A more recent one was during the recession actually. They kept their restaurant open in Florida while opening a new one in Georgia and lost a lot of what they had saved, but I watched them weather that with grace. They didn’t lose the house. They cut back on spending and knew that they would make it through. It’s the confidence, you know, that I watched them gain.
Andrew: I remember for my dad, I’m looking for like . . . I wonder if there’s something that stood out for you. Like for me with my dad, when he was going through financial issues, I remember he had to go buy a suit for a wedding, and he asked the person how much a suit cost, which he never did before. And then when the man went to look to see how much a suit cost, he said to me, “Look at me, I have to watch a budget.” I never heard my dad use the word “budget” before in his life. It just wasn’t in him, but now he had to, like, live within a budget. And that was a challenge. That’s a way that you identify yourself is tied in to how you make little decisions like that. Did you have an example like that?
Lauren: I mean, I remember how . . . I mean, I just can remember when they couldn’t come see me in college because they couldn’t afford to leave the restaurant they were opening to travel. They needed to spend their time there. You know, I mean, they just couldn’t afford things anymore, but they handled it really well. I actually, when I was in college, they helped me for my first couple of years, and then when they went through this most recent, you know, financial crisis, they couldn’t help me. So I used my scholarships, and I had to finish school by myself. I had to make it work. You know, and of course, they wanted to help me like they had my entire life, but it just wasn’t possible. But, you know, I watched them maintain themselves through all of that.
Andrew: And then they ended up selling it to a hotel company. Things worked out well for them in the end. You were studying physiology. I’m impressed that you graduated from college because of what happened with you and your boyfriend. Do you feel comfortable talking about it?
Lauren: Sure. Yeah.
Andrew: What happened?
Lauren: It was part of [the story 00:09:40]. So I was in my third year of college, set to graduate a semester early, also I could go travel, and . . . well, first, I was studying physiology, so, you know, my interest in health essentially began then. I studied health trends, and I was training to be an athletic trainer for football players, professional football players. Well, I became pregnant right before my last . . . at the very end of my third year of college, and I ended up marrying my boyfriend. He was a football player in college turned WWE wrestler. This is where my life really began. So I had two kids with him. It was awful. Everything that you can imagine that went on, I mean, like just domestic violence and abuse and screaming, and, you know, he would disappear. It was a terrible, terrible marriage. And then I followed him to Puerto Rico.
Andrew: Before we get to Puerto Rico, what would set him off for domestic violence? Where would that come up? And what do you mean by domestic violence?
Lauren: He was arrested for domestic violence.
Andrew: So you would get into an argument and suddenly whack? You’d get hit?
Lauren: I remember the first time that he hit me, I was about six months pregnant with my second child, and I slept on the floor of my daughter’s room, she was about a year old, my kids are, like, 15 months apart, you know, for safety. I’m not sure what switched in him. It was definitely . . . you know, he wasn’t like that when we were dating and when we got married. I’m sure it was never a great relationship, but I was 20, so I knew nothing. But yeah, it became more a commonplace, and it got worse as the years went on. It would go through cycles of better. I read about it after I got out and kind of learned what I had gone through.
Andrew: I see you as someone who’s strong, self-possessed, who can obviously handle herself really well, why do you think that you allowed that to go on? Help me understand what you were going through.
Lauren: Well, I don’t like to say it like a . . . you know, I don’t like to call myself a victim. I don’t like to victimize myself, but the mindset that you have when you’re in a relationship like that is that it’s going to get better. I was doing it for the kids. I thought keeping this family together is going to be better for them because of the family that I had. My parents are still together today, and they went through stressful times in their lives, and so I could do it too. And so you just say that to yourself. And it’s always a cycle. So you go through a really bad phase and it might end in violence and then, you know, there’s an apology and things get better and you think that they’re ready to change.
Andrew: I see. All right. And then you were in Puerto Rico. You decided after you got divorced to stay in Puerto Rico. What was it about Puerto Rico that attracted you?
Lauren: A lot of things. So I moved to Puerto Rico because his work moved him here. He was no longer working with the WWE, and so he was wrestling on a circuit in Puerto Rico, so I followed him to keep the family together. I started working as a personal trainer. And I knew that I couldn’t . . . so once we got divorced, you know, I was done. We separated and got divorced. I was left completely alone with two little kids. They were two and three at the time. I was a very good trainer but working, like, 11, 12 hours a day. I couldn’t afford to pay tuition. I couldn’t afford to pay for childcare. I was spending no time with my kids. And so I started just to read a lot. I latched onto tech, and I started to teach myself PHP late at night. It never really, you know, evolved into anything except a really bad website, our first Abartys website, but that is what I focused on.
And so I kind of changed my mindset about where my life was going, and I decided that I wanted to work in corporate wellness, which is what I had learned about in college, and combined technology. I wanted to start automating a lot of the processes in healthcare. I didn’t know how I would do it. I had no clue at that time.
Andrew: You saw that there wasn’t much automation for it.
Lauren: Yeah, specifically in corporate wellness.
Andrew: Give me an example of what you saw . . . well, what was the job that you had?
Lauren: I was working as a personal trainer, and then I actually transitioned into corporate wellness at the facility of the gym.
Andrew: What does corporate wellness mean?
Lauren: Well, there’s a lot of meanings, but essentially, it is wellness programs that corporations build in, and a lot of times the insurance company will offer incentive or provide specific wellness services, preventative services for their employees. And this is [inaudible 00:15:13] the ACA, so dating back like 2012. ACA is the Affordable Care Act. I try not to use the acronym.
Andrew: That’s known as Obamacare.
Lauren: Yes, also aka Obamacare. And so I started to just develop this program and seeing that if we could automate, you know, some of the processes that insurance companies were dealing with, we could incentivize the, you know, populations to be healthier, and the insurance companies would be able to see that was happening, and it was a win-win for both sides.
Andrew: Okay. Let me take a moment to talk about my first sponsor, and then we’ll come back and see what you did with this combination of corporate wellness understanding and a little bit of development chops. My first sponsor is a company called Regus. Are you familiar with Regus, Lauren?
Lauren: I’m not. No.
Andrew: Great. I’m about to open your mind to it. Here’s what happened to me. My wife and I, when we were dating, moved into same apartment. I invited her to move into my place. Actually, I basically brought her cat to my house, and then I started bringing her stuff in, and she had no choice. And it was great, except it kind of became hard to work at night or random times if she was home because it felt awkward for me to be in the office at home when she was in the house. It felt like I was being antisocial. And frankly, because I was in the house, there’s a lot of snacks, a lot of distractions, I wasn’t getting enough done. I said, “You know, let’s look for office space.” And I looked at lots of different types of office spaces. I looked at the kinds of places that were super cool, the kinds of places that would have parties, the kind of places that had the laid-back attitude. That’s basically what most co-working spaces are like. I didn’t need a big space. I just needed a desk for myself, a quiet area to work.
And then because of this guy, Maneesh Sethi, who saw me on Facebook say, “I’m looking for office space, what do you recommend?” he said, “Check out Regus.” I said, “I’ve never heard of them. Let’s go check them out.” I walked into Regus, one of the first things they do is they offer you coffee. You look around and it feels like what, the 37signals or what are they called now, Basecamp people, Jason Fried, David Heinemeier Hansson call Library Rules. It’s quiet enough that you can talk if you need to someone, but it’s also a low enough level volume that you can work. I looked around and I said, “This is like Library Rules, people are quietly working. And that’s all I want out of office. I’m not looking for a hangout. I get to hang out everywhere else.” And so I thought, “This could feel like home.” And I signed up, and I worked for them.
And I remember one time since the place that I signed up for was in Argentina, the internet went out. Most places you say the internet goes out, including if you call Comcast, they’ll say, “Give it a moment, we’ll get it back up.” They said, “Don’t worry, we have another location a few blocks down.” I said, “Okay, I don’t know where it is because I’m new here.” They said, “We wrote the address on a Post-It Note so you can communicate it to the Spanish-speaking taxi driver, and we called ahead to tell them that you need an office space, a desk, and internet connection, and quiet because you record.”
I walked in there like I was a billionaire or founder of I don’t know how many companies. I give the slip to the cab driver, the cab driver takes me there. I open the door to the next Regus, they say, “Andrew Warner?” I said, “Yeah.” “We’ve been expecting you. Right here to your office. Would you like some coffee?” Boom, I get coffee. I got so much more productive in the Regus office because of these niceties, because they take care of everything you need to get worked on. And it’s been fantastic.
And if I happen to be in Puerto Rico, I could get office space because they have offices all over the world. I checked it out, they have one in San Juan. And so why would I want to be in San Juan? I’ll give you an example. I was in South by Southwest, which I know that you won a contest for, at South by Southwest, I was in there. You know this about Southwest, Lauren, South by Southwest, it’s chaotic. And I needed to talk to one of my potential course leaders from Mixergy. I need a quiet place. I said, “Oh, there’s Regus.” We pop into Regus, I say, “I’m with the other office. Can I use space here?” They say, “Absolutely, Mr. Warner. Can we get you and your guests coffee?” They got me and my guests coffee. We had a great conversation. We nailed everything down and we went back down to party.
If you’re out there and you want to be productive, Regus is the best place I’ve found, and I’ve looked around, where you can be productive, high-speed internet, coffee that you don’t have to pay for, no distractions. Get work done. If you’re looking to get involved with them, go check them out at regus.com/mixergy. They’ll know you came from me. And if you want me and my team to introduce you to the person who we work with at Regus to get office space like I do, just email us, firstname.lastname@example.org and we’ll introduce you. That’s Regus or in Spanish, where you are Lauren, they call it Regus, I don’t know why they have roll that “R.” Right?
Lauren: Roll the R, Regus.
Andrew: Regus. They’re everywhere in the world. Guys, if you want to be productive, go check them out, Regus or regus.com/mixergy. And of course, contact my people. They’ll tell you how much we love it. I even do Scotch night over here. That beautiful space I invite people over for Scotch. It feels like it’s my office because it is. Go check them out. One person, two people. I could talk about them all day. I’ve got to stop.
All right. You were seeing this isn’t advanced enough. You thought you could create something more advanced, and then did you just start working on it, or is that when you met your co-founder and the two of you decided, “Let’s work on this as one of our experiments”?
Lauren: So actually, it was a co-worker/friend that said . . . it was right around December of 2014, and I had brought him this presentation, and it had, like, a bunch of statistics on health trends and diabetes and just the global . . . I mean, literally, the U.S. health care crisis, which is, it’s trending towards 20% of our GDP. And so he showed it to somebody he knew, who’s my business partner now, and she said like, “Have whoever made this make an appointment with me in January, and I want to meet them.” So preface to Dolmarie, she was and had worked in insurance, so she was an insurance executive for 12 years prior, 15 now. And so I met with her, and that was January of 2015, and we hit it off. She had been working on, like, claims but in Excel sheets, everything very manual. She had come to the conclusion of some of the same issues that I did, and we were gung-ho about preventive medicine.
Andrew: Wait, when she was working with spreadsheets, what was she doing in spreadsheets?
Lauren: Claims auditing.
Andrew: For who? For an insurance company?
Lauren: Yes, for insurance companies and employers, large employers.
Andrew: Because insurance companies want to make sure that if somebody is filing a claim, that it’s legitimate, that they’re not just what?
Lauren: Yeah, correct. They want to legitimize claims that are coming in. You have to remember that the data is . . . it’s really poor, the data that gets passed through the healthcare system because there’s very little validation and verification on [inaudible 00:22:05].
Andrew: Wait, so what’s the danger? That I might go in to the doctor and say, “I can’t breathe very clearly,” but really I can breathe and I’m just trying to get medicine or something else?
Lauren: I can give you an example of it. So Dolmarie, so because of lack of data validation, Dolmarie, my business partner, was actually misdiagnosed in 2013, and she spent four months in the hospital because she, like, the issue that she was having, the lab results were passed to somebody else. So because of a lack of transparent, clean data, they misdiagnosed her. And she ended up losing all of her hair and becoming really sick.
Andrew: Wow. And the reason that is is because what’s being passed back and forth? Is it like a, not a screenshot but a scan of the paperwork? How are the doctors passing information from one doctor to the other and to the insurance companies?
Lauren: So in different markets, it’s different. So in Latin America, you have a lot of PDFs, a lot of receipts, a lot of scans. No OCR, optical character recognition, pulling data off of that. In the U.S., you have a lot of internal patient identification, meaning you have a number in your insurance company or with your doctor but actually doesn’t mean anything. You know, it’s not your Social Security number, or it’s not a number that is linked to your Social Security number. And so it oftentimes they’re not matching that data back against a database that has the rest of the information.
So I’ll give you an example with our first case study into data validation. We were working with a huge lab, and we ran clinics almost 2,000 people. Over 30% of the data that we processed, now mind you, this went through a clearinghouse, and a clearinghouse, their job is to take a clinical dataset and turn it into a claim for an insurance company to pay. That’s what they do. Well, we took that same dataset, we matched the identification of the messages against our database through a couple of algorithms and found over 30% inaccuracy in the name versus patient IDs versus other metrics that we were looking for in the data. So whether it was a misspelling, wrong date of birth, or a completely wrong person, yielded over 30% error. It was incredible, incredibly high.
Andrew: So let’s talk about how you got then this. Is it a client that gave you access to all these clinics?
Lauren: That was a client. That was our second client.
Andrew: So let’s talk about the first client. The PHP first version website that you created, that was just a way for the world to know what you did. That’s not the software that took care of the clients, right? So you put that up, impressive. You then needed to go and make an offer to a client, a potential client. The first client was somebody who you guys had been working with somehow, right?
Lauren: Yes. So the first client was one of Dolmarie’s clients previously.
Andrew: And what she was doing was just working for insurance companies, putting all the data of what people’s . . . the data into spreadsheets and checking to make sure that what people said that they got was actually what they got.
Lauren: So she was working for a third-party administration, that is they resell insurance products, and she’s a U.S. compliance officer. So after she went through all of that stuff where she was hospitalized, that was part of her initiative was to become a U.S. compliance officer. And she started running benefits. So she was doing benefits management for a large employer, essentially through a CPA for the insurance company.
Andrew: And what benefits management means is they have employees, employees say that they want certain health insurance, they sign up for it, and she’s supposed to make sure that they get the health insurance that they deserve.
Lauren: Yeah, she’s managing at large scale the population.
Andrew: At large scale.
Andrew: And I’m imagining too if a doctor is trying to get certain kind of treatment for a patient, the patient can’t get it because the insurance company is not helping, she’s the in-between person too.
Lauren: Her agency. Her department was.
Andrew: And she was working for a company that did this.
Lauren: She was one of the owners in the company. Yes.
Andrew: Got it. And then you and she teamed up, and you went to that company and said, “Would you like us to do this for you?” And you knew that you were going to create better software than she had access to. Is that right?
Lauren: Well, we didn’t. I don’t think at that time we realized that we were going to create this entire software system. We went to a few people. We went to them, to that client, and we went to also an insurance company who is still our client today. And we said, “We want to run your preventative clinic.” And that is what we did.
Andrew: And what do you “run them”?
Lauren: Oh, we, like, woke up at, like, 3:30 in the morning to get to, like, all of these different satellite locations [inaudible 00:27:25] patients to make sure that, you know, the blood busses were on site at 5 a.m., checking people in in Excel, making sure we had, like, their numbers written down. I mean, we were bare-bones set up on AWS, Amazon Web Services. I was still doing manual data transfers.
Andrew: Opening up the door to the clinics too?
Lauren: I mean, the lab technicians essentially did that, but we would check every single person in. Like, thousands of people we checked in.
Andrew: You would wake up at 3.30 in the morning, you’d go in there, and you’d make sure that if someone said that they were working for the day, that they were in there checked in working for the day.
Lauren: Well, in there, like, getting their lab results taken. So we would meet the employees and they would . . . you know, they come in, “Have you eaten anything? Okay, good, you can have your glucose test.”
Andrew: And then you’d pass them to someone else who would take their blood.
Andrew: Okay. All right, so I can see how this would not be that hard of a leap for a client to make. They basically have somebody who’s managing it. You say, “We can manage it better. We’re willing to get up and do the work.” But it’s a lot of manual work. It’s not new software. It’s none of that. So you’re doing this, is it new software?
Lauren: Yeah. So part of it was that we promised that we would deliver the lab results to the patients electronically, that they would have access to them forever. And any new lab results that came in, we would trend that person’s health which we have delivered.
Andrew: Okay. So they’re taking multiple blood tests. They not only get each blood test delivered to them, but they get to see a trend in the results of the blood tests. Why would your client who . . . was that an insurance company? It is.
Lauren: One was an employer. One was an insurance company.
Andrew: Why would either of them care if the end user got their numbers back? That’s a pain for the end user. It’s not a pain for the laboratory. It’s not a pain for the insurance company. I like that your eyebrows raised when I said that because I’m clearly missing something that’s powerful. Tell me.
Lauren: Well, insurance companies have a huge lack of access to clinical datasets, so they’re just paying out claims, paying out claims, and they don’t really know . . . there’s no rhyme or reason to why they’re paying them because there’s no . . . you know, there’s no validation in the system. So what we deliver to insurance companies, without being promotional, is access to those clinical datasets in an aggregated way that they can understand, you know, what’s happening with their population. Who’s at risk for diabetes? Who’s at risk for arthritis? Who is at risk for a heart attack?
Andrew: And if they can prevent the . . . if they could help the patient prevent the heart attack, they prevent themselves from paying for that patient’s heart attack. And that’s the benefit to them. What’s the benefit to the clinic?
Lauren: So this is part of the reason why health care is so expensive. Something that’s really commonplace now and people don’t know is something called a pay per transaction, a PPT. And that means that every result that a provider has to deliver to a patient or to an insurance company is charged at pennies on the transaction. And now, this is free to them. So this is an insurance company. It’s a totally different model. Giving them a software that they can upload data that will get to the patient so they’re meeting compliance, you know, checkbox, and they’re delivering the clinical datasets to the insurance company, another checkbox. And it’s free. They’re not paying 5 cents, 10 cents per patient. And sometimes it’s not even per patient. Sometimes it can contain, like, 10 messages for 1 lab, that’s a dollar.
Andrew: And this is you now not coding that solution up, but you hired someone to do that, right?
Andrew: Who did you bring in to do it?
Lauren: I was good friends with a professor at the University of Puerto Rico. He’s a physicist and also an economist, he has two PhDs there, and a computer scientist, his master’s is in computer science. And so I went to him and I said, “I’m in over my head, PHP is not going to solve this, and I have no idea what I’m doing. I need help doing, like, very specific tasks.” The first task was making a log of all of the patients’ names that didn’t match their clinical files. So then separating those clinical files so they didn’t accidentally get, you know, transferred to the patients.
So he said, “Listen, I have a graduate student that’s obviously bored with his coursework, but he’s brilliant, and I’m going to give this project to him.” So he comes in the office, “Well, [inaudible 00:32:18], this is Julian.” So Julian is the first one and Jeseuan his student. And they’re still with us today. Julian is our architect and Jeseuan is our VP of Engineering. And so I asked Jeseuan, I’m like, “Have you ever built, like, a website before?” And he’s like, “No, but I can figure it out.” And obviously, I wasn’t asking him to build a website. I was asking him to build software. And so he’s like, “Give me three weeks.”
So they come back three weeks later and they have, like, this whole platform that today looks terrible. Like, if I were to see it today, it was, like, this Jango site, very, like, bare-bones, but it functioned. But we were so ecstatic. Like, Dolma and I were like, “Oh, my God, this is exactly what we needed. You’re hired.”
Andrew: I see him on your website. He has a Ph.D. in physics, MS in computer science and economics. I could see that you guys have a really good team. How much did you have to pay, or how did you work out the ability to pay? You didn’t have any funding at that point, right?
Lauren: No. Yeah, we sold them a vision.
Andrew: And then they would get shares in the vision.
Lauren: I don’t think they knew that at the time, but, yes, yeah.
Andrew: And so you just said what? “Will you work and build this out?” They said, “It’s an interesting challenge. We’ll take it.” Julian, the student who did the bulk of the work, did you agree to pay him anything, or was it just a side project for him?
Lauren: Yeah, we were paying them, like, by the hour. I don’t even remember. It was, I’m sure, totally unfair, but I said, “Listen . . . ” Like, I wasn’t paying myself at that point. I now had quit my personal training corporate wellness job, fully bootstrapped. I’m not even sure how I survived, you know, that year, but I did. But, you know, I’m like, “Listen, I’m not paying myself. I will pay you as much as we can by the hour to build, you know, the software.” And of course, it continued to unfold.
So Jeseuan specifically was, like, really intrigued by the challenge. I got the opportunity a few weeks ago to interview them for the first time. It was about physicists saving healthcare, and I did the interviews, and it was really touching. You know, they said that these are . . . essentially, the explanation was that they’re solving tangible problem.
Andrew: And so that’s what drew them to work with you even though they were getting paid less than they deserve considering their knowledge? And, you know, who’s watching your kids while this is going on?
Lauren: So my life looks a little bit different today. I have . . . well, that school right now and then aftercare, but I have a full-time nanny. And she was actually with me through all of this. She was our Saturday night babysitter when I was still married, and then she started working more and more. And as I could pay her more, she’s also been very kind to me by probably working for less than she deserved, but now . . .
Andrew: Fair to say that also your costs were lower for child care and others because you were in Puerto Rico?
Lauren: I think definitely yeah, even tuition included. But I also have met somebody that has been . . .
Andrew: I saw your wedding photos online. I was looking to see who you got married to before who was in the WWE, I couldn’t find it, but I saw your wedding photos all over the place.
Lauren: No, no wedding photos. No wedding photos. We’re not married.
Andrew: Oh, wait a minute, you know what? There are several Lauren Cascios who are pretty well-known, including the one who works at Microsoft’s HoloLens, and I think search results get mixed up with hers. Okay, so you’re with someone now.
Lauren: It’s been two and a half years, and I met him. He actually moved here for the tax incentives. Like, this January will be three years. So I met him in February of 2016, and we started dating. He’s been, you know, a great rock in the last couple of years for not just me but the kids. They adore him. You know, my family helped me a ton along the way. My mom came here for like three months I think, just to, you know, help with the kids. It really takes a village, not easy.
Andrew: All right, let me take a moment, and then I want to come back and see the one thing that was so important for you in your client calls in the early days that you had to keep taking notes on it. I want to come back and talk about that.
First, I’ve got to talk about a company called HostGator. Lauren, I’ve been talking about HostGator for a long time, and still, I keep checking in with our developer and saying, “Why didn’t you pick HostGator first when we started our company?” We decided to get into chatbots because I thought that chat was the future. Email is being used less and less, chat is being used more, businesses need to reach their customers using chat apps like Facebook Messenger or iMessage, etc. I said, “Michael, why weren’t they your first choice?” And he said, “Well, they’re more of a beginner site.” I said, “What do you mean?” “Well, they charge very little and they do, like, shared hosting and . . . ” I said, “But did you know, Michael, that they do more than that?” He said, “What do you mean?” I said, “Well, they do more than just, like, shared cheap hosting.” He said, “Well, I’m all over their site. I don’t see it.”
And he went over to their site to look, and it’s true. If you’re on their site and you don’t look for it, all you see, Lauren, is, like, the 60% off or the 20% off or whatever discount they have. You see a price that’s $2, $3 per month or somewhere around there, and you don’t realize that, “Yeah, those are the starting introductory prices.” Because most people who are shopping for web hosting companies are just starting out and they don’t know if their idea will take off or not and they just sign up for whatever cheap product there is.
What HostGator does is they say, “Okay, if that’s where the majority of our potential new customers are, let’s meet them there,” but behind that, as their clients’ businesses grow, they have more expensive packages that do so much more, and they just don’t publicize it. And everything, including like a dedicated server or including WordPress managed hosting, the stuff that the competition does for a lot more money, they say, “We have economies of scale. We’re part of the big . . . ” I think it’s the biggest hosting company on the planet at this point, “So we could do it at a cheaper price.”
So if you’re out there listening to me, or Lauren, if you’re listening to me right now and you’re starting something new, yeah, you can go to hostgator.com. I’ll give you a URL where you can get an even bigger discount than the one on their homepage. But if you don’t like their hosting package, the one that’s on their homepage, because you have a bigger business and what you’re expecting is so much more, well, guess what? The same low price attitude that HostGator brings to their cheapo intro prices, intro products, they bring to their better, more established businesses too. They just don’t publicize it heavily. So what I’m going to do is I’m going to give you a URL where you can sign up, and I want you to know that as you want to scale up, including after you sign up for the cheaper product, you can scale up with them.
So here’s a URL where you’re going to get a bigger discount than as far as I know, they offer anyone else, up to 62% off their already low prices. Prices start at $2.64, but after you sign up for whatever you sign up here, you can also level up and get the bigger and better plan. If you use this URL, not only will you get that, but you’ll also be tagged as one of my listeners, and they will take phenomenal care of my listeners because I have a big mouth. You should see the emails that go back and forth when one of my listeners has one small issue. It’s like, “Oh, my God, Andrew is never going to leave us alone. Let’s just take care of this person.” Right, here’s the URL, hostgator.com/mixergy, M-I-X-E-R-G-Y. Think of the gator, hostgator.com/mixergy.
Here’s what I have in my notes that I want to bring up to you, Lauren. You would go and present your program, which had become a SaaS, software as a service product, you start to listen to potential clients and you took notes on all the nos that you heard. You heard a lot of knows, what were you taking notes on? What was it that was so important that shaped your business?
Lauren: So usually, a no is because your software doesn’t do something that is really an issue for them. I’ll give you an example. When we first presented InsureLynk and PatientLynk, our client said, “Well, what about all the credential management and geocoding and management for providers? That’s all part of this.” And so ProviderLynk was born.
Andrew: Let’s talk about what ProviderLynk is. What are they asking you specifically? What about providers? Tell me more. Flesh that out for me if you could.
Lauren: So some of the things that we did for them in the member management are things like automating. This is really common in a lot of industries but healthcare specifically, automating enrollment. Have you ever wondered, like, why your insurance company has, like, your birth date wrong or your name is misspelled? It’s because a lot of that is happening on, like, data entry. And so if you can automate the enrollment process, you can mitigate a lot of those first . . . you know, those errors first. You can provide profiles of people where you can upload documentation like birth certificates or, you know, Social Security cards and just give it a license.
Andrew: Just to be sure that their client is identified properly in the insurance company system. This was not a company that was started in the ’90s. This is a company that was started 3 years ago, 2015, right? You’re saying to me in 2015, they were not letting people sign up online, digitizing the whole thing? I thought they were. I signed up for insurance in the early 2000s, and it was a website I think. No?
Lauren: Yeah. Yeah, you can do . . . I mean, you can do enrollment, but they’re not managing it and you don’t have a way of managing it. So when you . . . often when you, like, call a call center from an insurance company and you’re complaining about something, they’re taking notes, and maybe they’re editing a profile but they’re not editing a centralized profile that you also have access to, that your doctors also have access to, that everybody in the organization regardless of what branch or states they’re in has access to. And so that’s part of the problem. So it was a problem with members. And I know that’s hard to believe but . . .
Andrew: It’s shocking to me. 2015. And so then the other thing that’s shocking to me, you kind of addressed this with our producer, that if you can do this with such a low small group of people, I told you to check you out to make sure you’re a legitimate. I looked your people on LinkedIn. I saw there were 11 people. You said with pride, “We just hired our 12th person.” You’re 12 people. You’re still a dozen, these insurance companies have tons of resources, more than you do. You’re telling me that they couldn’t hear, “Hey, Lauren just came up with this great idea to digitize, let’s just go and digitize this. Here’s what we should be doing.” Why not? There was an answer to that.
Lauren: Yeah. I mean, they’re not tech companies. Insurance companies underwrite risk, and they process claims, and that is their job. They have networks of providers that they need to manage, they have networks of members that they need to understand, and they’re not . . . you know, one, health care has not really kept up with the rest of the sectors, but two, that’s not what they’re doing. Just like we are not an insurance company, they are not tech companies. And we’ve had prospects try to . . . give you an honest anecdote here. We’ve had prospects try to copy what we’re doing, and then they’d come back, one in particular, I won’t give a name on this one, came back, like, 18 months later with this, like, really janky version of, like, you know what they thought the interface was looking. They realized, “We couldn’t get this right. What do you do?” And like, “Well, sign a pilot and we’ll explain it.” And so, yeah, I mean, they’ll try, and that’s fine.
Andrew: So they sign a pilot agreement, meaning they’re piloting, trying out your software. They understood what your software did. They said, “Okay, now we got it. We took notes. We took screenshots. We’re going to go and create it.” They went to create it, then they came back to you and said . . .
Lauren: No. In the sales process they were like, “No, we can build that easily,” and then they came back and signed the pilot when they figured out that it was not so easy to build.
Andrew: Oh, I see, they weren’t even copying after. They were trying to copy before. Okay. And so I could see how you’re doing this. What I don’t understand is how do you Lauren get in front of so many insurance companies when I call up my insurance company, and I can’t even get a person on the phone. That’s a pride of theirs. How are you getting them on the phone to try to sell them?
Lauren: So we’ve actually been really . . . so in Puerto Rico, you’re in a really interesting place because you have multinational companies here. You have Fortune 500 companies here. So it’s really easy to meet people. The island is like 2.5 million people, and the business sector is even smaller. Dolma worked in insurance for 12 years, essentially knew everybody. And if we didn’t, we knew somebody who knew somebody. So it was easy to get in front of the insurance companies here, pilot populations here, and then they talk to their stateside offices and Latin American offices. So I call Puerto Rico a launch pad for that reason.
Andrew: Makes a lot of sense.
Lauren: Same with partnership. So we partnered with one of the second largest pharmaceutical company in the world from Puerto Rico on a global project. And it was because we were here. We had gone through an accelerator program, they met, you know, who sponsors us. They met Dolmarie, my partner, and a year and a half later, we have a partnership with them. So it’s an interesting place to build the company.
Andrew: All right, I can see that. And then the other thing you said to our producer was, you said, “If you sit in a corporate meeting long enough, eventually executives are going to start telling you their problems.” How would you get to just sit in their room, in their offices for that long so you could absorb their problems? Hear them complain?
Lauren: Well, I think the key to sales is that you’re not just talking. You have to go in very open to listen to what your customers really need. And sometimes you can’t . . . you know, your prospective customers, you can’t help them because you are just not in that vertical. You know, your software is not going to solve their problem, and you can’t rebuild an entire software. But if you listen long enough to all of the nos and the explanation for the nos and you just listen to . . . you ask questions. Dolmarie is really good at this. She asks questions about their operation. And, you know, you just get in and then you ask more detail. So for example, credentialing. Imagine you’re an insurance company and you have to credential every year 25,000 providers. That means you need a list of 10 items from a provider, 25,000 [inaudible 00:47:13].
Andrew: To make sure that they have the right credentials, that they’ve updated their learning, and that they have their credentials to actually perform the work that they’re getting paid by the insurance company to do. And you have to keep track of all those people. And so you hear that they need to credential them, and you hear them talk about it in what way? What are some of the problems that they would bring up?
Lauren: Well, I mean, it’s expensive. They spend anywhere between $500 and a few thousand dollars per provider if they’re outsourcing it. And if they’re trying to do it in-house, they’re just . . . I mean, you have people, providers’ teams driving to offices. People don’t answer their phone. You haven’t had credentials updated in, you know, two years, three years. They’re not even supposed to be billable in your network. And so these are . . . this was an example, and it’s how some of the functionalities in ProviderLynk were born. We were like, “Well, you know, we’re doing it for members, we can do it for providers too, and they can just access the same way members do.” And so that was just from listening.
Andrew: Let’s talk about, close this out with a business issue that relates to a personal potential crisis and how you handled it. 5 a.m., you wake up. You get your kids to school. You get your kids to school that early by the way?
Lauren: At 5? No, they go to school at, like, 7:15.
Andrew: Oh, wow, that’s still early. Okay, so 5 a.m. you wake up so you can get the kids to school and you find out you lose a deal. Do you remember this? Why did you lose the deal and then how are you present with your kids and not, like, frustrated with them and how do you contain those issues?
Lauren: Well, I mean, in general, it’s taken me a lot of time to learn how to compartmentalize, like, my life in general, the highs, the lows. I will preface this by saying that, you know, a personal life and business life is a balance. You’re not ever going to be perfect in either place, definitely not both places. So I do remember this morning where I, like, woke up to text messages that we have lost a huge prospect that accounted for probably 50% of our revenue projection and thinking, “Okay, I have to get the kids up and deal with this.” I’m probably more short-tempered with them when I’m, like, a little bit stressed.
Andrew: Yeah, [me too 00:49:37].
Lauren: You know, it really is difficult to compartmentalize your life like this because, you know, both sides play, you know, such a meaningful role. But I got them to school, hurried to the office and made sure that I had a huge smile on my face and that I was so inspiring because . . . I hope I was inspiring because I have to remember that, for a very long time, and not now, but for a very long time, everybody in our office was there willingly, not because we were, you know, with such great benefits and pay. And so I had to make sure that, you know, that positivity and optimism still was being reflected in the office. And it’s hard. I think like sometimes the day just ends, and it ends with me sitting in the shower with a glass of wine, like a really hot shower, and trying to shut my brain off.
So it’s something that you learn to deal with. It’s not for everyone. I mean, people ask me all the time like, “It’s not the easy route. Why would you do it?” And I think it’s just, you know, you have the potential of having such great reward that this is all kind of worth it. And when it doesn’t happen and you have these periods of just like, you know, normal where everything is smooth sailing, you get a little bit on edge. You’re a little uneasy. Like, “Well, I need something . . .
Andrew: Even when things are normal you get uneasy.
Lauren: Well, I get uneasy because things are not good or bad. And, like, so I’m really . . . you know, at this point, you said just like bringing the highs down and bringing the lows up and realizing that life is not over either way. And so, yeah, I get uneasy for, like, the normal days. I hate normal days.
Andrew: Well, I don’t imagine you’ve got a lot of normal days where you are. I’m looking at this interview, and I love that we did this. I love how . . . Here’s what I get out of it. First of all, I like that you’re willing to talk about the personal stuff because I think that the entrepreneurial journey needs to be heroic. We need to set entrepreneurs as people who are striving to do something good in the world that is worthy of aspiring to worthy of dealing with life’s challenges.
And by hearing your success, I think that we could see that this is what’s in it for us as entrepreneurs, but I also don’t want to get to a place where we’re making entrepreneurs into these flawless heroes who have perfect lives, which I think is what many people do in the media. And because they do that, anytime anyone listens to them as a personal issue, they think, “I must not be like these heroes who I hear about in the media. I must not be like them because look where I fell short. Someone who I read about doesn’t . . . who I admire never falls a short.” And that’s just not the way that I want to portray entrepreneurs. So I’m glad that we did that.
I’m glad that we heard about how you got clients by being in a smaller market. I’m glad that we understood how you found a problem by looking at things like Excel spreadsheets. I’m starting to understand from these interviews that if anyone is looking for a business idea, forget looking for your imagination. Find your ideal client and say, “How do you use spreadsheets? Can I see your Excel spreadsheets? Can I see your most recent spreadsheet lists in Excel or in Google Sheets or whatever you’re using?” So I see that. I see the nos. So much that I got out of this interview. I hope that you got a lot out of doing it. I don’t know what we could even give you. People are actually going to go to your site and sign up? There are not very many health insurance companies listening to me, listening to this interview. What’s the one for you here?
Lauren: Well, they’re going to go to my site, and they’re going to look at the copyright immediately.
Andrew: Oh by then hopefully it’ll be fixed.
Andrew: And they should go check that out.
Lauren: No, I mean this is part of why both I and my business partner, you know, do, you know, marketing and putting ourselves out there is because we both have really cool stories. And it’s not the norm in media, and it’s not the norm in “Entrepreneur Magazine” and in “Forbes” and “Fast Company” you read, like, these perfect lives with perfect venture capital and, you know, entrepreneurs that never make mistakes. And it is just so far from the truth. You know, the more I meet other entrepreneurs, I realize that we’re all kind of the same. We’re struggling. We’re figuring it out as we go. We make, you know, huge mistakes. We’re not perfect in our personal lives. We all have our issues. So I just like to be . . . you know, I hope that I’m giving out a real portrayal of what it’s like to do this.
Andrew: Well, for anyone who wants to go check out your website, “copyright” and all, check them out, they could go to abartyshealth.com, that’s A-B-A-R-T-Y-S. You know frankly, whatever podcast app you’re listening to me on, if you just probably slide it up or slide to the side, you’re going to see a link to her website and to our sponsors. And the two sponsors that we have for this interview are, I’ve been renting from Regus for a long time. I highly, highly, recommend that you go check them out. Do a tour. Check out what it’s like to work in Regus even if you decide not to work from them. They’ll give you office space, desk space, whatever you need. Go check them out at regus.com/mixergy. And if you want your website hosted right, go to hostgator.com/mixergy.
And finally, I want to congratulate one of our listeners for launch . . . he’s a Trello fan, email, I’d say maybe not hater but doesn’t love email, and he found a way to put all email on Trello boards to make it easier to manage. If you’re curious about it Iain Dooley’s website is benkoboard.com. There’s no, like, special URL. I’m just trying to help him out to get some users for some feedback, benkoboard.com.
Thank you so much for doing this interview.
Lauren: Thank you, Andrew.
Andrew: Well, thank you all for listening. Bye, everyone.