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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.
