1.
© FIRSTSOURCE 2023 | CONFIDENTIAL | 1
Claims Overview

2.
© FIRSTSOURCE 2023 | CONFIDENTIAL | 2
ClaimsExperienceandCredentials
55 M
Manual Claims
Processed
Annually
20
Health Plan
Clients Including 6
top 10
$ 3.7 B
Payments
Processing per
month
$20K -
$250K
Independent
Adjudication
30%
Claims processed
by BOTs
40% Complex
40% Medium
20% Simple
4,640+
Experienced
Claims Examiners
99.9%
Financial
Accuracy
99.6%
Payment
Accuracy
> 99%
in 2 Days
Claims TAT
National, Government,
Commercial plans - Claims
Adjudication
Medical and Dental Claims
Adjudication
Underpayment,
Overpayment
Recovery & Refund
Claim Adjustments,
Appeals, Escalations,
Checks, Correspondence
ASO - Government and
Indigent Plans
CDH Plan Administration
Rework and
Reconciliation
PROCESSES
Pend/EDIT Resolution
and Automation Services
High-Cost Claims
Processing
Late Payment
Interest Processing
Blue Plans - BlueCard,
FEP Claims processing
Claims Complexity

3.
© FIRSTSOURCE 2023 | CONFIDENTIAL | 3
ComprehensiveClaimsExperienceAcrossPlanTypes,ClaimTypesandPlatforms
Plan Type Claim Type Applications
• Commercial
• Medicaid
• Medicare Advantage
• Medicare supplement
• Marketplace
• FEP
• Dental
• Vision
• Facility
• Professional
• BlueCard
(Home, Host, Transmittals)
• Inpatient
• Outpatient
• DME
• Home Health
• SNF
• ESRD
• Behavioral
• Rehab
• Long term / Acute
Care
• Radiology
• Cardiology
• MSK
• Labs
• Ambulatory
• Critical Access
Hospitals
• Emergency
• COB
• Dental
• Urgent care
• Pharmacy
• Maternity
• Office visits
• Facets
• QNXT
• MHS
Powerstepp
• WGS
• BlueSquared
• Diamond
• NASCO
• Amysis
• FEP Direct
• RIMS
• Macess
• IDX
• Paradigm
• PowerQ
• IMPACT
• EBIX
• Client Proprietary
Systems
• VIDASuite
• Health Rules

4.
© FIRSTSOURCE 2023 | CONFIDENTIAL | 4
ClaimsProcessingFootprint
Claims Processing States Supported – Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, New Mexico, New York, Ohio, South Carolina, Texas, Utah,
Virginia, Washington, Wisconsin, Georgia, New Jersey, Kansas, Louisiana, Maryland, Pennsylvania, West Virginia, Indiana, Minnesota, South Dakota, Missouri, North Dakota, Nebraska, Iowa
Oklahoma, Hawaii
Massachusetts
Illinois
Kentucky
Florida
California
Mississippi
Michigan
Texas
Virginia
Arizona
Idaho
New Mexico
Ohio
South Carolina
Utah
Washington
Wisconsin
New York
Present Across 34 States
Georgia
New Jersey
Kansas
Louisiana
Maryland
Pennsylvania
West Virginia
Indiana
South Dakota
Minnesota
Missouri
North Dakota
Nebraska
Oklahoma
Iowa
Hawaii

5.
© FIRSTSOURCE 2023 | CONFIDENTIAL | 5
SuccessfulPartnershipswithHealthPlansDeliveringValueforClaimsOperations
2004
2003
2010
2006
Large Fortune 500 Health
Plan
A Regional Blue Plan
• Local Host Professional
and Facility BlueCard
Claims Adjudication and
record processing
• NASCO - Professional
and Facility claim
adjudication
• Enrollment –
Commercial, Home /
Host, Instate, PPO, HMO
Managed
Healthcare Plan
• Claims Adjudication
support for ~ 8.8 M
Medicaid Claims per
annum
• Medicaid, MMP, MP claims
for 15 states
• Enrollment –834
Exceptions, Demographics
An HMO and PPO
Health Plan
• Claims Processing, provider
Loading, Handling of XC
claims
• FACETS - Provider and
Member contact center
services & Open Enrollment
Support
First Program
Client
Firstsource
Services
19 Years
18 Years
16 Years
12 Years
Partnership
in Years
• Digital Intake, Claims
processing, Consumer
driven Health Plans
• Combined accumulation
reconciliation process
• Group Enrollment for
groups > 100 members

6.
© Firstsource Solutions Limited | Confidential |
www.firstsource.com
Helping customers stay ahead of the
curve through transformational
technologies and capabilities
Firstsource Solutions Limited, a RP-Sanjiv Goenka Group company, is a
leading provider of transformational solutions and services spanning the
customer lifecycle across Healthcare, Banking and Financial Services,
Communications, Media and Technology and other industries.
Our ‘Digital First, Digital Now’ approach helps organizations reinvent
operations and reimagine business models, enabling them to deliver
moments that matter and build competitive advantage.
With an established presence in the US, the UK, India and the
Philippines, we act as a trusted growth partner for over 100 leading
global brands, including several Fortune 500 and FTSE 100 companies.