2. InTech Health Ventures
New company – founded in October 2006
Vision - Healthcare technology services company focused on transforming,
connecting and exchanging healthcare through innovative use of technology.
Mission
Providing technology solutions for specific niches that require complex data
sharing or management
Providing technology services to organizations needing technical resources or
expertise with government initiatives
Providing customer oriented solutions enabling them to improve operational
and financial performance
Solutions
SubsidyLink – Retiree Drug Subsidy Program
Technology Services – hospitals, rural clinics, regional data exchange
Accomplishments
350% revenue growth in twelve months
Now facilitating over $20,000,000 in subsidy reimbursement
Actuarial and Benefit Consulting Partners
3. Retiree Drug Program Challenges
Data verification, aggregation, and exchange is complex
Lots of different data sources with different formats
Need experience with complex data management
Must comply with data security and HIPAA requirements
RDS regulatory requirements are complicated, confusing, and frequently change
Initial MMA guidelines were confusing in regard to the subsidy process and
compliance requirements
Application process
CMS/RDS website
Rebate process
Eligible and non eligible drugs
Inconsistent vendor capabilities to do RDS
Significant vendor/PBM difficulty with RDS administrative processes and
compliance requirements
4. SubsidyLink Solution Overview
Administrative process: Data connectivity, aggregation,
Monthly Enrollment File Submissions matching, and management
Timely and accurate submissions
Add/Changes/Deletions
Feedback on CMS eligibility status Other RDS customer issues to
updates consider:
Claims identification and aggregation Liability for accuracy of
Calculation of subsidy amounts subsidy amounts
Monthly/Quarterly/Annual HIPAA compliance
submissions
Accurate calculations of subsidy Program changes
amounts Formulary monitoring
Annual reconciliation Retain claims data for six
Support services for appeals years
Enrollment appeals
Subsidy appeals
SubsidyLink is an outsourcing service that handles the RDS administrative process
5. Who Uses InTech Health Ventures?
Direct Service Customer Model
Employers
Unions
“Virtual Services”
PBMs
TPAs
Referral to InTech
BX BS
Employee benefit consultants
InTech adapts and supports different RDS customer’s needs
6. SubsidyLink Capabilities
Eligibility Updates
Managing retiree list
Handling response errors
Reporting/Data Gathering
Claims/cost reporting
Retiree eligibility and rejection report
Claims Analysis
Part D vs. Part B Drugs
Limit aggregation
Annual Reconciliation
Multiple claims data sources
7. SubsidyLink Value
For RDS participating organizations:
InTech average annual subsidy reimbursement - $575/yr
Reduces internal resources and effort to support RDS process
Insures RDS participant is fully compliant with RDS requirements
On-going customer service specific to:
Identifying and helping customers correct ineligible (rejected) retirees
Check list and scheduled interaction time to complete reconciliation
Technical leadership and resources to initiate and maintain data exchange between
CMS, PBM, TPA, and InTech
Subsidy amount example:
100 CMS eligible retirees
Reimbursement: 100 x $546 PEPY = $54,600
Cost: 100 x $60 PEPY (using $5/PEPM) = $6,000
Net RDS revenue: $48,600
Reduces effort, maximizes subsidy amount, low cost
8. SubsidyLink Pricing
Pricing approaches:
PEPM
Percentage of RDS Subsidy
Actuarial Services not part of
InTech SubsidyLink solution
Comprehensive Service to Manage Subsidy Process
9. Account Management- Customer Support
Account Management responsibilities: InTech commitment:
Consistent on-going RDS information exchange
communications Conference calls
Responsible for RDS relationship Webinars
Facilitates InTech Quarterly Updates
technical/implementation On-site visits if needed
resources
Ability to private label InTech
Customer Support – Technical sales and marketing materials
Services responsibilities: Ability to private label RDS
File/data transfer processes reports
Data management Sales and marketing assistance
Issue resolution
Customer Satisfaction Is Our Top Priority
10. SubsidyLink Testimonials
Transit Employees’ Health and Welfare Fund:
“There is no way that we could have done what InTech HV has done for us, as thoroughly and as
promptly, as they were able to do. They not only got us money we likely would have never found,
they were a pleasure to deal with in the process.”
Bricklayers and Stone Masons Union Local 20 Fund:
“It has been a tremendous benefit in working with InTech. They have done the entire RDS process
correctly, answered many, many, many questions and guided us every step of the way.”
Black Hills Corporation:
“InTech Health Ventures has provided exceptional service throughout the RDS process.”
American Health Care:
“InTech Health Ventures is a great company work with. Their teams of highly trained professionals
are very knowledgeable, caring, understanding, and always there to help with anything you need.
InTech Health Ventures provides me with the best Customer Service I could ask for, and is always
there to answer any of my questions on a level I can understand. The employees provide me with the
information that I request in a timely matter and it is always accurate.”
11. RDS/SubsidyLink Summary
RDS program can be a lucrative reimbursement to employers!
RDS administrative process is a challenge for employers (and some vendors).
InTech greatly simplifies the administrative process as well as helps maximize
reimbursement
InTech provides comprehensive administrative and technical services resulting
in a full service solution for challenging RDS environments
InTech focuses on customer service to help customers be successful with the
RDS program
InTech has strong knowledge and background in the RDS program as well as
valuable expertise in complex data management
InTech offers a robust solution at a fair price
InTech has fully operational customers receiving over $20,000,000 in RDS
subsidy today
12. Discussion – Questions - Recap
Questions?
Review of any parts of presentation?
Thank You!!
