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Conifer Revenue Cycle Solutions                                   SM




© Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
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.
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.
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.
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.
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.
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.
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.
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.
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
Technology Map                                                         Patient Liability
                                                                         Calculator             ACE®


                     HPF® ACE®




                                                                                             HPF®

                                                                                             InterQual®
 InterQual®

ePREMIS®




                     HPF®                                                         ACE®
                                              InterQual®

  © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
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.
experience innovation




877-CONIFER
www.coniferhealth.com

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Linked In Conifer Overview

  • 1. Conifer Revenue Cycle Solutions SM © Copyright 2009 Conifer Health Solutions, Inc. All Rights Reserved.
  • 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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.