1. Confidential 1
Healthcare
SingleVIEW Methodology
Presented By:
Associated Data Services, LLP
Revenue Cycle Check and Balances for Healthcare Receivables

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Revenue Cycle Check and Balances for Healthcare
We provide a complete Financial Platform
that balances and reconciles ALL
Payments with Claims
Our solution is a timely and accurate
accounting of all financial transactions for
accelerating the posting and revenue
recognition for the provider …

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What we do…
• We provide a complete electronic environment
• Convert and Process
– ERA’s
– Paper
– Patient/Self Pays
– Correspondence
• Archival & retrieval
• Detail level search and analysis
• Controlled work queue environments
• Balance and Reconciliation
• Match and Review through a Single View environment
• Generate
• Post

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System Highlights
• Both ERA and Paper Documents
• Paper Portal provides Real-time view
• Proven and stable environment
– Over 3m EOB’s processed monthly
– Over 16 years in business
– No 3rd
party software – business totally owned
• We shorten the revenue cycle process by providing NEXT day
processing
• Highly configurable system
– Designed to conform to customers environment
– Configurable business rules
– 837 files
• Implementations – 6 weeks or less
• SingleVIEW Side-by-Side Comparisons
• All transactions stored for 7 years
• Complete Search Engine capabilities
• HIPAA II Compliant - September, 2010
• Auto-Posting

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Process Flow …

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Healthcare Revenue Cycle
Co-pay Claim
Created Sent to
Clearing House Claim sent
To Payer
Payer
Review
Claim &
Submit
Payment
Decision
EOB w/Check
EOB w/ACH
ERA w/Check
ERA/ACH
EOB/Zero Pay
ERA/Zero Pay
Correspondences
Bank
Lockbox
Provider
Secondary
Denials
Self Pay
Write-Off
SingleVIEW

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Islands of Information - Today
Paper EOBs
Bank Account
ACH/Checks Deposits
Accounting
System
(Auto Posting)
Imaging System
Customer Service
ERA’s
Secondary
Processing
Denials/Appeal
Process
Co-Pay Self Pay

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Healthcare Revenue Cycle Flow
Paper EOB
ERA
Secondary
Correspondences
Denials
Self Pay
Reporting
Co Pay
Input Output
Provider
Payer
Bank
Provider
Payer
Bank
• 837 File
• Sample 835 Posting File
• Sample Self Pay Posting File
• Denial Codes
• Co-Pay Information
• ERA Files
• Secondary Letter
• Self Pay Billing File
SingleVIEW
• ERA
• Paper EOB
• ACH to Bank
• Paper Checks
• Zero Pays
• Correspondences
• EOB Images
• ACH Files
• Index Files
• Rescan Images
• 835 Posting File
• Paper EOB
• ERA
• Self Pay Posting File
• Secondary Processing Files
• Denial Re-submission
• Secondary Claims
• Paper
• Electronic
• Rescan Request
• Billing File for Payment

9. Confidential 9
ProviderProvider
ERAs 835
PayersPayers
837/Printer Files/ Billing Database
ACH
Consolidated 835
EFT
Paper EOBs Check
BANKBANK
Lockbox
Scanned paper
EOBs
835
Consolidate 835
Denial Detection
Parsing
837/835/ACH/Printer Files
Secondary Detection
Un-matched Exception
Handling
Claim - Remit - Payment
Reconciliation
Reports
ERA Processing
CereSoftCereSoft
Paper EOB Conversion
Data validation with Claims
Create 835
EOB Processing
Web portal Status/ Reports
EOB Images

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The Financial Connection
Monthly, Weekly or Daily Financial Summary

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This is paper checks without EOB’s.
This tells us there may be ERA’s to be
re-associated
This tells us that
an EOB arrives
but without a
check
This is the all
paper section that
flows from the lockbox
This is non financial
documents that are
in a paper format
This is EOBs with the
payer paying zero
amount
This is all the paper
self/private pay
This is where we had
paper EOB with a
check
This shows the total
payments made with a
paper check
This shows the total
payments made via
an ACH transaction
This shows the total
ERA’s process
This shows the total claims
process that was matched and un-matched

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There is a Difference
Today With SingleView

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Cash Balancing
SingleVIEW Methodology

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Main View
Cash Balancing

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The ICONS
To view all claims/EOB that are on the system
To view all payments that were process on the system
To view all denials that were process on the system
To view all secondary found during processing of EOB
To view all cash process from all areas from Check, ACH
and Patient Pay
To view from the claim type (Paper or ERA or Patient) in
balancing the cash that was process
To view all work that are currently available in all
work queues within the system
To view all the paper that was process that includes
Paper EOB, Correspondences, and Patient Pays.

16. Confidential 16
Cash Posting – Main View
Number of
Checks
Deposited
Breakout of Checks
to EOB/ERA
Total Patient Claims
associated To the Checks
Number that did not
have 837 claims
associated to
payment
Total Deposit for
all funds
Number of accounts
that had 837 data
to match with the
EOB and Check

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Cash Balancing – Historical View

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Check Payment View
Click Icon to see claim
associated to check
Click Check Number
To View the Check
Click F under File
To see 835 Conversion

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Payment View
with Check Image

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Account associated to Payment
Click on Account Number to
see 835 or Image and the Check
No Claim Paper EOB with Check

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All accounts that were associated
with the check that were process

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SingleVIEW Methodology
837/EOB Image or 835/Check

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Demonstration
Customer Portal