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Linked In Conifer Overview


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A brief overview of Conifer Revenue Cycle Solutions

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Linked In Conifer Overview

  1. 1. Conifer Revenue Cycle Solutions SM © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  2. 2. Revenue Cycle Operator View Solutions High Full Revenue Cycle Complete Revenue Cycle is optimized to use existing resources Full Revenue Cycle Optimization on-site and leverage extended centralized centers of excellence Optimization Multiple Elements Multiple elements of the Revenue Cycle are optimized of the Revenue Cycle (ie. HIM/Coding + Billing & Collections) Single Element of An entire element of the Revenue Cycle is the Revenue Cycle optimized (ie. Billing & Collections) Value Functions of Pieces of the Revenue the Revenue Cycle Cycle are optimized Technology Cost Reduction Liquidity Revenue Cycle Management Improvements © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  3. 3. Conifer Revenue Cycle Solutions Mission Statement We partner with our clients to improve healthcare delivery by providing: • Consistent financial stability and performance • Innovative ideas and integrated solutions • Industry thought leadership, and • Superior service. © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  4. 4. Conifer is Unique 5 Million Patient Accounts Processed Annually Over $9 Billion Annual Net Revenue Under Management Fully scaled operating platform and technology 60+ hospital, DIC and ASC clients 2,000+ Employees Stephen Mooney, President “We are a healthcare company whose strategies align directly with the providers’ mission of delivering quality care in the communities they serve.” © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  5. 5. Service Map Pre-Registration Pre-Registration Billing, Collections, Financial Clearance Financial Clearance Billing, Collections, Payment Posting, Payment Posting, Denial Management: Financial Counselling Financial Counselling Denial Management: Insurance Insurance Medicare Medicare Patient Arrival & Patient Arrival & Check-In Check-In Medicaid Medicaid Self-Pay Real Time Registration Real Time Registration Self-Pay Real Time Clearance Real Time Clearance Real Time Counselling Real Time Counselling Pre-Certification Pre-Certification Initial and Continued Initial and Continued Medical Records Medical Records Stay Authorization Stay Authorization Coding Coding Case Management Case Management © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  6. 6. Conifer Fact Sheet Performance Highlights • 7 Centers of Excellence for Revenue Cycle Managed Care Managed Care Medicare A/R Medicare A/R A/R Days A/R Greater than Greater than 60 Optimization across the U.S. A/R Days A/R Greater than Greater than 60 180 days 180 days days days • Proprietary technology and workflows • Cash Management expertise spanning over a Overall Reduced Reduced decade reduction MC A/R MCR A/R of 20 days by $264M by $29M • Local expertise with implementations at large or 27% or 55% or 46% local hospitals in most regions of the US Data Source: Tenet’s metrics December 31, 2003 – December 31, 2008 2,000+ Employees Geography Center for Patient Access Services (CPAS) Regional Patient Access QA Team Clinical Resource Center (CRC) National Medicare/Medicaid Center (NMC) National Insurance Center (NIC) Middle SG&A Support National Programs and Collections Modesto Conifer Headquarters 85 55 Medical Eligibility & Counseling Services On-Site Alhambra St. Louis (MECS) Technology Front 530+ FTE’s Services Back 180 240 Atlanta Anaheim Boca Raton Frisco © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  7. 7. Our Pre-Service & Patient Access Differentiators • Pre-Service: CPAS & MECS – Pre-Service Financial Clearance – Pre-Service Patient Liability Calculation and Collection Efforts – Patient Financial Counseling and Center for Patient Access Services Eligibility Screening for Financial (CPAS) Assistance Medical Eligibility Counseling • Real-Time Service: Patient Access Services (MECS) Management Full On-Site Patient Access – Scheduling Management – Registration – Financial Clearance – Financial Counseling – Point of Service Cash Collection © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  8. 8. Our A/R Management Differentiators • MicroSegmentation™ • Patient Friendly Communications • Patient Satisfaction Survey • Online Customer Portal Billing • Call Recording/QA • Proficient in over 30 Languages Collection & Follow-Up • System Integration Specialized Account Follow up • Six Sigma Black Belts Primary & Secondary Bad Debt • Results Driven Work Flows Collection • Customer Care Center Coordinated Legal Effort • Staff talent includes: – PhD – MBA – RN – CPA – M.Ed – PMP © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  9. 9. Key Performance Indicators Indicators Conifer Leading Performance Practice Benchmark Self-Pay Collections - % of Revenue 12.0% >=10% (Uninsured)1 Self-Pay Collections - % of Revenue 63.6% >=60% (Balance After Ins) 1 Days in AR1,3 51 days <=55 days Total AR > 90 days1,3 17.5% 15% - 20% Insurance and MCR AR Aged >90 Days2,3 11.3% <= 15 - 20% Data Source: 1Accenture study of Tenet’s revenue cycle metrics September 2008 2HFM –RC Key Performance Indicators 3Includes A/R normally written-off to bad debt at 180 days © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  10. 10. Conifer’s data integration solution allows new clients to be implemented efficiently Data Integration Technologies • Real-Time (HL7) Interface • Batch Services Data Management Technologies • Mapping Services • Data Integrity Audit Trail • Event Tracking & Control Reconciliation • File transfer processes include real-time, daily balancing programs • IT Operations provides weekly reconciliation reports on inventory IT Operations Dashboard • Monitors inbound and outbound data transmissions in real time to ensure timely and accurate processing • Configurable alerts identify anomalies and notify support staff immediately Productivity Technologies • Workflow Services • Payor Data Integration • Predictive Dialer • Identity & Credit Data • Skip Tracing • Letter Generation © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved. Client Portal • • Patient Portal
  11. 11. Technology Map Patient Liability Calculator ACE® HPF® ACE® HPF® InterQual® InterQual® ePREMIS® HPF® ACE® InterQual® © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  12. 12. Credentials & Industry Commentary Most Recent CFO Survey Results, July 2008 “(Conifer’s) entrance into the market won’t 21% 4% “Had I engaged Conifer squash all other earlier we would have debt buyers, but it avoided many of our changes the game,” financial struggles” Michael Klozotsky, Joe Murgo, VP Health Analyst Kaulkin Ginsberg Partners of America Health Care 75% Exceeded Met “Sometimes it’s easier to Not Met “New healthcare sourcing models are outsource a complicated emerging in response to new business function and have and IS organization challenges. At the experienced personnel least, your healthcare organization should there ready to jump on it.” evaluate the sourcing potential for its HFMA, Executive Roundtable environment.” Gartner Research, Sourcing: Publication New Realities for Healthcare © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  13. 13. experience innovation 877-CONIFER