EOBGuard
Executive Summary
Vision Statement
Empower every American to never overpay a medical bill again, turning opaque healthcare billing into transparent, patient-controlled finance and saving families thousands yearly.
Problem Summary
Medical billing errors cost Americans billions annually. Patients receive inflated bills from providers that don't reflect insurance adjustments shown on the EOB, leading to overpayments of hundreds or thousands per claim. Reddit users report $8k bills dropping to $1.2k, $1200 phantom nursery charges disappearing, and routine visits billed after insurance already paid.[Reddit Post]
Proposed Solution
EOBGuard is an AI-powered web/mobile app that lets users upload medical bills (PDFs/images) and EOBs. It uses OCR and AI to extract key amounts, automatically compares 'Patient Responsibility' vs billed amounts, highlights discrepancies in red/green, and generates customized dispute letters/scripts with the exact phrasing that works: 'I'm looking at my EOB and it says my patient responsibility is $50. Your bill does not reflect the insurance adjustment. Please correct it.'**
Market Analysis
Target Audience
Primary Persona: 'Sarah the Skeptical Patient'
- Demographics: 35-55yo, middle-class, family with kids, employed full-time
- Pain Points: Receives 3-5 medical bills/year, dreads calling billing depts, overpaid $800 last year on ER visit
- Behaviors: Checks insurance portal weekly, saves all EOBs in folders (per Reddit), active on r/personalfinance, r/HealthInsurance
- Tech Savvy: Comfortable with apps like Mint/YNAB, scans documents with phone
- Lifetime Value: $15/month x 12 months = $180/year
Secondary: Chronic patients, caregivers for elderly
Niche Validation
Strong validation from source Reddit post. 4.1k upvotes (95% ratio), 195 comments shows massive resonance. Top comments reveal real pain: $8k→$1.2k surgery bill (1k+ upvotes), $1200 nursery scam exposed via itemized bill, anesthesiologist balance billing fights. This isn't theoretical—users are actively fighting these battles weekly and winning with persistence.
Google Trends Keywords
Market Size Estimation
$450M Serviceable Market. Focus on employed insured (150M) in high-cost states (CA, NY, TX, FL) with digital health adoption >50%. SAM = 150M x 3 claims/year x 10% error rate x $200 avg overcharge x 5% penetration x 15% take rate = $450M.
$15-45M Year 1 Obtainable. Target r/personalfinance (1.2M members), Reddit health subs (2M+), Product Hunt. Conservative 50k users x $10/mo avg x 6mo retention = $3M ARR. Optimistic: 150k users = $15M ARR.
$4.6B+ opportunity. 270M insured Americans average 4 doctor visits/year = 1B+ claims. Studies show 80% contain errors, averaging $300 overcharge/claim. KFF Analysis. TAM = 1B claims x 5% adoption x $30 savings x 10% take rate = $4.6B addressable.
Competitive Landscape
Fragmented space with clear gap.
- ClaimMedic/MedicalBillingExperts: Enterprise B2B services for providers (~$100/hr). ClaimMedic
- Resolve/DrBills: Consumer apps for negotiation (~$99/claim success fee). Limited automation. Resolve
- Health Insurance Portals: Manual EOB viewing, no bill comparison
EOBGuard Gap: First AI-native consumer tool for automated EOB-bill comparison + dispute generation. No direct competitor.
Product Requirements
User Stories
As a patient, I want to upload bill PDF + EOB PDF so AI can extract all amounts automatically.
As Sarah, I want color-coded comparison (green=match, red=discrepancy) so I instantly see overcharges.
As a busy parent, I want 1-click dispute letter generation with my exact numbers and proven script so I avoid calling.
As a savings tracker, I want lifetime savings dashboard so I see ROI and justify Pro subscription.
As a chronic patient, I want batch upload for multiple bills so I process family claims together.
MVP Feature Set
Document OCR + AI extraction (billed amounts, patient responsibility, dates, providers)
Side-by-side comparison view with discrepancy highlighting
Auto-generate dispute letter (PDF + email-to-billing)
Basic savings tracker (input corrected amount, calc savings)
User dashboard (bill history, status tracking)
Non-Functional Requirements
HIPAA-compliant - Encrypt all PII/health data at rest+transit, SOC2 Type II within 6 months
99.5% OCR accuracy on standard medical PDFs (train on 1k samples)
<2min processing time end-to-end for single bill+EOB pair
Mobile-first responsive - iOS Safari + Android Chrome priority
GDPR/CCPA ready - Data deletion, consent management
Key Performance Indicators
Primary: Verified Savings/Active User - Target $150/user Year 1 (5 bills x $30 avg)
Activation: First bill processed within 3 days of signup (>60%)
Retention: D30/D90 - 50%/30% (sticky due to ongoing bills)
Viral: Reddit shares of savings wins (>1.3 coefficient)
Dispute Success Rate - 85%+ bills corrected after using generated letter
Data Visualizations
Visual Analysis Summary
Post engagement proves explosive demand. 4.1k upvotes/195 comments with top comment (1k+) validating exact pain point. Market TAM validates billion-dollar opportunity from billing errors alone.
Loading Chart...
Loading Chart...
Go-to-Market Strategy
Core Marketing Message
'Your $8k medical bill is probably wrong. Upload your EOB + bill. Get your real balance in 60 seconds. Fight back with 1-click dispute letters that work.'
Initial Launch Channels
Reddit-First Launch:
- Post demo video in r/LifeProTips, r/personalfinance, r/HealthInsurance (source post proves demand)
- Product Hunt #1: 'Fight medical bills with AI' (target healthcare category)
- Twitter/X micro-influencers: 10 personal finance docs (50k+ followers) x $500 sponsored tweet
Strategic Metrics
Problem Urgency
Critical
Solution Complexity
Medium
Defensibility Moat
Multi-year data moat + network effects. Each processed EOB/bill trains billing pattern AI (common errors, provider tactics). Users share 'win templates' that improve dispute success rates for all. High switching costs once savings history/dashboard built. 80% margins post-scale.
Source Post Metrics
Business Strategy
Monetization Strategy
Freemium + Success Fees.
- Free: Upload/compare 1 bill/month, basic dispute script
- Pro ($9.99/mo): Unlimited bills, AI dispute letters, phone script coaching, savings tracker
- Premium ($24.99/mo): Auto-file disputes, attorney network, tax deduction reports
20% take rate on verified savings (e.g., $500 savings = $100 fee). Upsell path: Free→Pro (80% conversion via proven savings).
Financial Projections
Month 12: $125k MRR. Launch: 1k free users (Reddit/Product Hunt). 20%→Pro ($10k MRR). Month 6: 10k users, 25% Pro + $50k success fees = $35k MRR. Month 12: 25k users, 30% Pro + $75k fees = $125k MRR ($1.5M ARR). Viral coefficient 1.3x from 'I saved $800!' Reddit posts.
Tech Stack
Node.js + FastAPI - Node for real-time dashboard, Python FastAPI for OCR/AI document processing (pdfplumber + Llama3.1).
PostgreSQL - Relational for users/bills/savings history + Vector extension for AI embeddings of dispute templates.
Next.js 15 - App Router for web+mobile responsive, SEO for 'medical bill dispute' searches, Turbopack for fast builds.
Core APIs: Tesseract.js/Google Vision (OCR), OpenAI GPT-4o-mini (amount extraction/dispute gen), Plaid (link insurance portals), Twilio (automated billing calls), Stripe (freemium billing).
Risk Assessment
Identified Risks
1. OCR accuracy on messy medical PDFs (curved text, handwritten notes) 2. HIPAA compliance costs delay launch 3. Insurance portals block scraping for auto-EOB fetch
Mitigation Strategy
1. Hybrid OCR (Google Vision + post-processing LLM correction), 500-sample human validation 2. Launch non-HIPAA MVP (user-upload only), add BAA with AWS within 90 days 3. Manual upload first, add Plaid-like insurance API integrations Q2