1.
© FIRSTSOURCE 2023 | CONFIDENTIAL | 1
Digital Intake
Overview

2.
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OverallMailroom& DataCaptureExperienceandCredentials
Paper intake to electronic
Sort, scan all types of
Claims and non-claims
Triage, member eligibility,
index, print, outbound
shipment, keyword search
Color photo, X-ray,
Legal, CD/DVD and other
special processing
Smart Data Capture,
proactive validations,
EDI Conversion
Dashboard, reconciliation
and reports
PROCESSES
220M
Claims Data
Captured to EDI
~4B
Pages
Processed
100%
Adherence to
TAT 30 min
to 48 hours
85%
Claims Processed
by BOTs
1,500+
Mailroom and
Data Capture Examiners
> 99%
Quality Regional
Mailroom Office (RMO)
> 99.6%
Critical Field
Accuracy
30 min
Provider Supply
Chain TAT for
Hospital Orders
350
Sort Types
4 hours
Urgent
Appeals
TAT
12 hours
Appeals
Fax-line
TAT
15
Clients

3.
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DigitalMailroomandDataCaptureEndto EndProcessFlow
• Envelope level prep
• Minimize paper touch
• Bots/AI technology
PAPER SORT
Smart Classification
(Rightshore)
SCAN
• High speed scanners with rear imprinting
• I-enhancement and 2D barcode
• Special handling for X Ray and Color Photo
DATA CAPTURE
(Rightshore)
Web, Email, FTP and
other electronic input
MAIL ROOM
• Intelligent data capture with multiple OCR/ICR engines
• Smart AI/ML algorithm for data comparison and accuracy
• Rule based field level validations and form level (cross-field) data validations
• Integrated with Healthcare Code Sets (CPT, CDT, ICD-10), business rules
• API/File based integration for Provider and Member Lookup
eUpload
ENVELOPE INVENTORY
CD Prep
AI/ML
MAIL PICKUP
Smart Classification
• Electronic sorts RPA/AI/ML
• Document indexing and auto look-up
• Minimal Human Touch
• Smart Classification & Review
• Accountable Mail, Dental, Vision
• CD/DVD processing
• Enrollment, return mail processing
• Prior Auth, Medical Records, HEDIS
• Correspondence, Checks processing
Solution Differentiators
Data Capture –
Onshore/Offshore
Delivery Center
Image Shipment
Data Shipment
Dashboard Reports
Storage & Shredding
Firstsource Mailroom

4.
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AI/ML-DrivenDataCapturetoReduceManualEffortandImproveAccuracy
AI/ML Infusion Key Value Pair
Extraction
Intelligent Word
Recognition
Advanced Image
Enhancement, Cleanup,
and Extraction
Cloud
Portability
EDI
Transformation
Capture Services
- Document Types
- Enrollment Forms
- Authorization Forms
- Medical Records (X-Rays, Photos)
- HRAs/Checks
- Claims & Correspondence
- Channels
- Faxes
- Corporate File Shares
- SFTP
- Cloud Storage (S3)
- Upstream Applications
- Intake Portal (Prior Auth,
Enrollment, Claims)
- Business Process
- API Gateways
- Custom Applications
- Email
- Mailbox
- Shared Folder
- Mail Group
- Outgoing Mail
- Fax
- Print Fulfillment
- Business Process Platforms
- HealthEdge, NASCO, WGS
- Facets, QNXT
- FileNet
- Mainframe
- Content Management Platforms
- FileNet
- Shared Drives
- Data Output
- XML
- JSON
- TIFF
- PDF
- NSF
- ANSI X12 –
837I, 837P,
275, 277 CA
Ingest Prepare Recognize Extract Normalize Validate Export

5.
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ExtensiveExperiencein deliveringHealthcareDigitalIntakeservices
One of Top 5 Health Plans in the US
Leading Global Healthcare Supply
chain exchanges
A leading National Health Plan
• Enrolling Hospitals and Vendors,
Purchase Order Creation from Paper/Fax
requests
• Automation through workflow, OCR, and
analytics platform. AI/ML solution to
identify and redact confidential data
• Global delivery: US, Europe, and India
• Manage 5M+ orders manually
• 85% reduction in processing TAT
• 95% volume turned around in 30 mins
• Urgent and Non-urgent appeals intake.
Processing of appeals received through
dedicated and non-dedicated sources
• Sympraxis® smartly identifies Appeals based
on keywords and processing guidelines
augmented by AI/ML
• TAT improved from 48 hours to 24 hours for
all appeal types
• Manage > 99.5% urgent appeals within 4
hour TAT
• Digital Intake for Claims, Appeals, and Other
Non- Claims documents for last 19 Years
• Unique Engagement model & Proven
Transformation Capability to each of the
service lines
• Introduced error proofing, process control,
and workflow standardization
• Manage 20M+ transactions annually
• Data capture accuracy improved from 96.5%
to 99%+

6.
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UrgentAppealEfficiencyImprovementforoneoftheTop#5HealthPlans
Volume per
Month
1.5 M
Non Keyable
Volume Per
Month
0.4 M
Keyable
Volume Per
Month
1.1 M
Appeal Volume
Per Month
0.1 M
Appeal Filtering
Non-Keyable Audit Scores by
BPQM
Appeal Quality as part of NK
Audit by BPQM
64 OOC errors reported in 5
months for 0.5M appeal
documents delivered
100%
100%
99.987%
Journey to
“Zero Defect”
Causes
• Incorrect Lookup Selection
• Non Standard Input
• P&P Complexity
• Cumbersome Keyword identification
• SPOF – Human Errors
Solutions
• APIs for Lookup
• System Validation
• Role Assignment
• AI / ML identifies Keywords
• ML Smart Validation
Striving to reach 6-Sigma levels

7.
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DigitalMailroomProcessing
Envelope Slicing
Minimal Sorting
Accountable Mail
High Speed Scanning
Outgoing Mail

8.
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Fulfillment
Outgoing Mail Solution
• High speed Xerox printers for printing
appeal acknowledgement letters,
provider correspondence, member not
found letters​
• High speed envelope inserters and
Postage machine​
• Partnership with third party presort
vendor for reduce postage.​
• Outbound express shipment utilizing
USPS, UPS, Fedex

9.
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WebandMobilebasedDocumentIntake- SympliSend
Digital Document Intake - Web and Mobile
Channel
• SaaS Solution with Secure Login and
authorization can be integrated with Health
Plan’s Provider Portal and Provider Apps
• Create patient records as single or a batch mode
• Associate all documents with patient record
• Generate Unique Tracking Number for each
Document submission
• Search and retrieval documents using the
Unique Tracking Number
• Submit and track documents using the Mobile
Channel

10.
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MobilebaseddocumentsubmissionwithSympliSend

11.
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MailroomDashboardandAlertsonWeb

12.
© 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.