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  1. 1. Physician-Centric Revenue Cycle Management Company Christina Patrick Director of Business Development 2010
  2. 2. About MDeverywhere <ul><li>MDeverywhere’s mission is simple – to increase your practice revenue </li></ul><ul><li>Founded 1995, 500+ Employees </li></ul><ul><li>Currently Serving: </li></ul><ul><ul><li>3,200 physicians nationwide </li></ul></ul><ul><ul><li>Over 60 different specialties </li></ul></ul><ul><ul><li>Solo practitioners, group practices, faculty practices, hospitals </li></ul></ul>
  3. 3. Software & Workflow <ul><li>Web-Based Software </li></ul><ul><ul><li>Fully integrated practice management and electronic medical record system </li></ul></ul><ul><ul><li>eClinicalWorks is MDeverywhere’s EMR business partner </li></ul></ul><ul><ul><ul><li>If requested, we will interface to other EMRs </li></ul></ul></ul><ul><ul><li>Software is delivered as a service via the Internet – No Servers </li></ul></ul><ul><li>Workflow </li></ul><ul><ul><li>Practice: Schedule & register patients and enter charges via web, handheld or EMR </li></ul></ul><ul><ul><li>MDeverywhere: Automate the eligibility process, transmit claims, enter payments, appeal denied & underpaid claims, work accounts receivable </li></ul></ul>
  4. 4. The MDeverywhere Difference We will increase revenue 5% to 15% Automate Eligibility Decrease Denials by 90% Enforce Payer Contracts Increase Patient Volume Visibility & Control Earn PQRI & ePrescribing Bonus
  5. 5. How We Increase Revenue: 1. Eligibility Decreases Denials
  6. 6. How We Increase Revenue: 2. Rules Engine Reduces Denials 90% <ul><li>Handheld & web-based charge capture delivering rules at point-of-care </li></ul><ul><ul><li>15 Million pre-defined Payor Specific rules including: </li></ul></ul><ul><ul><li>Additional rules built based on your denials = System Gets Smarter </li></ul></ul><ul><li>Incorrect Diagnosis Code </li></ul><ul><li>Bundling/Unbundling </li></ul><ul><li>Missing Modifiers </li></ul><ul><li>PQRI & E-Prescribe Measures </li></ul><ul><li>Invalid Referring Physician </li></ul><ul><li>Global Period Edits </li></ul>
  7. 7. How We Increase Revenue: 3. PQRI & E-Prescribing Rules = 4.0% Bonus <ul><li>Physician Quality Reporting Initiative (PQRI) </li></ul><ul><ul><li>Rules engine supports the current PQRI quality measures </li></ul></ul><ul><ul><li>If a patient is eligible our rules engine automatically enters PQRI procedure codes </li></ul></ul><ul><ul><li>Result: 2.0% Medicare bonus </li></ul></ul><ul><li>E-Prescribing rules will earn you the 2.0% Medicare bonus </li></ul>
  8. 8. How We Increase Revenue: 4. Payor Contract Compliance <ul><li>Commercial payors underpay claims by 7% </li></ul><ul><ul><li>We build a knowledge base with your payor contracts and payment rules (multiple surgery reduction, etc.) </li></ul></ul><ul><ul><ul><li>We know what you are supposed to be paid on every claim </li></ul></ul></ul><ul><ul><li>Appeal every claim where the payment is less than the contracted amount </li></ul></ul>
  9. 9. Payor Contract Compliance Identify Underpayments
  10. 10. Payor Contract Compliance Appeal All Underpayments
  11. 11. How We Increase Revenue: 5. Increase Patient Volume <ul><li>Patient marketing and recall plan </li></ul><ul><ul><li>Review current patient database and set patients up on recall plans (Annual visits, preventative exams, etc.) </li></ul></ul><ul><li>Reduce patient no show rate </li></ul><ul><ul><li>Appointment reminder system calls patients to remind them of upcoming appointments </li></ul></ul>
  12. 12. How We Increase Revenue Summary Decrease Denials By 90% + Earn 2.0% PQRI Medicare Bonus + Earn 2.0% E-Prescribing Medicare Bonus + Increase Revenue 7% by Enforcing Payor Contracts + Increase Patient Volume = 5 - 15% Average Increase Revenue
  13. 13. <ul><li>Our Web Based Practice Management and EMR Software offers Improved Visibility, Transparency and a Streamlined Workflow </li></ul><ul><ul><li>Patient Ledgers </li></ul></ul><ul><ul><li>Patient Accounts Receivable </li></ul></ul><ul><ul><li>Electronic Medical Record </li></ul></ul><ul><ul><li>Management Reports </li></ul></ul>Visibility & Control
  14. 14. Visibility & Control: Patient Ledger
  15. 15. Visibility & Control: Patient Accounts Receivable
  16. 16. Visibility & Control: Electronic Medical Record <ul><li>Receive $44K per provider from the HITECH ACT </li></ul>
  17. 17. Visibility & Control: Management Reports <ul><li>Financial Reports </li></ul><ul><li>Aging </li></ul><ul><li>Net Collection </li></ul><ul><li>Denial Summary </li></ul><ul><li>Denial Detail </li></ul><ul><li>Procedure Analysis </li></ul><ul><li>Executive Summary </li></ul><ul><li>Payor Mix </li></ul><ul><li>Charge, Payment, Adjustment </li></ul><ul><li>Web based reports by doctor and department are available to different users based on their access level </li></ul><ul><li>MDeverywhere can also create custom reports for your practice </li></ul><ul><li>Clinical Reports </li></ul><ul><li>Quality Measures </li></ul><ul><li>Asthma Control Assessment </li></ul><ul><li>Diabetic Compliance </li></ul><ul><li>Scheduling Reports </li></ul><ul><li>Wait List Status </li></ul><ul><li>Appointment List </li></ul><ul><li>No-show Summary </li></ul>
  18. 18. MDeverywhere Services & Fees Web Based Software Patient Registration & Scheduling Handheld & Web Charge Capture Management Reports Billing Functions Payment Posting Denial Handling & AR Follow-up Patient Statements & Calls Traditional MDeverywhere Electronic Medical Record Software Automated electronic eligibility verification reduces benefit denials Rules engine reduces denials Payor contract compliance software finds payment errors Recall and appointment reminder system increases patient volume Tools to Increase Revenue Rules engine supports PQRI & e-prescribing = 4.0% Medicare bonus Outsource In-House Basic Premium Prem Plus
  19. 19. … our product is a paid claim Physician Revenue Cycle Management Company