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Insert Client Logo e4e Healthcare Services Comprehensive Solutions for the Healthcare Ecosystem © e4e – Confidential and Proprietary e4e Healthcare Business • e4e Inc. is a growing, profitable, zero debt and financially strong company. • With over 19 years of rich experience, e4e has a strong heritage of providing end to end Healthcare Services – through our Technology Platforms and Software IP. • A cross-border Healthcare Company with proprietary Software Platforms for Revenue Cycle Management, Claims Processing, Audit and Process Automation. IT • Technology agnostic solutions – experience in working with over 30 Provider and multiple Payer platforms. Enabled Services & BPO • Expertise in System and Platform Integration – System Interface, Electronic Data Inter-change and Workflow Efficiency. • We have processed over 135 million transactions annually and have coded and audited over 30 million charts. 3 Offices in Countries • HIPAA Compliant systems and processes, e4e is also an ISO 9001:2008 certified & SSAE 16 Type II compliant Company. 2500 + Employees Globally Worked with over 6000 Physicians © e4e – Confidential and Proprietary 2 © e4e – Confidential and Proprietary •Customer Support centers •Business Rules Configuration •Fraud , Waste & Audit Solutions •RAC Response Management Solution for Providers •Process Improvement Consulting for Physicians •Ancillary Services for Payers •Business consulting Technology Solutions •Front End Claims Processing and Management •Claims Adjudication and Error Suspense Resolution • HEDIS & HCC Coding Services •Enrollment Membership and Billing Services •Customer Service •Mailroom Service •Grievance, Appeal & Refund Posting •Reports Management Value Added Services •Patient Access Management •Charge Capture including clinical documentation improvement •Claims, Remittance & Denial Management •Hospital, Physician & Remote Coding • DRG Coding •Revenue Recovery & A/R Services •Charge Integrity & Compliance Solutions •Successful EMR driven billing service Payor Services Revenue Cycle Management e4e Service Landscape •Claims Administration Platform •Scheduler •Workflow Solutions including OCR •ICD 10 transition support •Document Management System •Client Service Portal •Member Portal •Managed Services Network & Desktop management 3 Hospital RCM Services Patient Access Management • Scheduling & Registration • Eligibility & Benefit Verification Billing • Data Entry • Cash Posting • Credit Balance Report Medical Coding • Outpatient Visits • Clinic Visits • Emergency Department • Same Day Surgery • Inpatient (DRG) Denial Management • Weekly review to check on denials A/R Follow up • Account Receivables Service • Insurance Follow Up Increased Productivity, Faster Payments, Decreased Costs & Enhanced Patient Service © e4e – Confidential and Proprietary 4 Provider RCM Services • Coding Audit • Charge Master Management • Billing and Coding Research to plug areas of ‘Revenue Leak’ • Account Receivables Service • Calculate projected A/R collections f or outstanding accounts • Monitor, identif y and prevent f uture payment abuses f rom payers • Underpayment Recovery Services Patient Access Management Charge Integrity & Compliance Solutions Charge Capture Revenue Recovery & A/R Services Claims Remittance & Denial Management Remote Coding • Physician and Remote Coding • Coding Staf f Augmentation © e4e – Confidential and Proprietary • Scheduling & Registration • Patient Data Entry • Eligibility & Benef it Verif ication • Point of Service Collection • Charge Capture • Charge Audits f or accurate & compliant billing • Identif y missed charges on retrospective claims • Improvements in Clinical documentation through education session • Seamless integration with Provider Accounting Systems • Electronic Claim Generation and Transmission • Payment Posting • Denial Management • Reconciliation • Ref unds • Provider Data Updates • Patient Billing 5 Payor Services • Member • Provider • Provider/Hospital Directories- Report generation • UM Reports • Statutory Reports • Canned Reports • Receipt and Records of Appeals • Analysis of Appeals • Amount Payable f or f avorable cases • Process f or payment / generate check • Generate provider letter if original denial is upheld • Ref und Posting Data Capture Claim Inf ormation Capture Claim Data Audit Member Validation Benef it Validation Fee Schedule Validation EOB Generation Front End Rules Application and Data Verif ication • HEDIS & HCC Coding Claim Processing & Adjudication Reports Management Member Enrollment • Member Enrollment/ Disenrollment • Provider Management • Benef it Management Grievance Handling & Refund Posting Customer Service Mail Room Services • Scanning and Batching • Optical Character Recognition Conversion © e4e – Confidential and Proprietary • • • • • • • • • Member Inbound Calls • Provider Service • Online Claim Status Query 6 Value Added Services Customer Support Centers • Both Provider & Patient Support Call Centers Business Rules Configuration • Medical Policy Edits • National Correct Coding Initiative • Global Surgery • Procedure-Gender • Add On Codes • Diagnosis-Gender • Diagnosis-Age • Multiple Surgery /Multiple Endoscopy Ancillary Services for Payers • Consulting Services f or Front & Back Of f ice Process Improvements © e4e – Confidential and Proprietary • Plan Benef it Conf iguration • Provider Additions • Provider Contract Uploading • Fee Schedule Maintenance • Rule Upload & Validation Process Improvement Consulting for Physicians RAC Response Management for Providers • Pre-Emptive Audit Solutions • Front End Edits • CMS Audit Support • HEDIS , RAPS Chart Audit • MRA Chart Review, DRG Validation • RAC Response Management including Trackers 7 Delivery Strategy Best of Outsourcing outcomes with “Right-shoring” – a customized combination that combines efficiency and savings Onshore Rightshoring Onsite © e4e – Confidential and Proprietary Offshore 8 The Philippines – Why? Single-country risk diversification for e4e To take advantage of the resource pool – attuned to US culture, language etc To leverage the talent availability in the Healthcare domain – 18,000 registered nurses and 200,000 science under-grads The Philippines is known to have better US-English and accent skills, ideally suited for Customer Service/ Support, Self Pay, Collections, AR Follow-up and Coding domains With ICD-10 conversion fast approaching, additionally tap into the Coding talent, particularly for hospital and facility Coding Some of our Clients also wanted parallel service delivery from the Philippines © e4e – Confidential and Proprietary 9 The Philippines – Competitive Advantage Highly Educated Human Capital Services Industry Orientation © e4e – Confidential and Proprietary Strong Govt. Support Robust IT & Infrastructure American Cultural Affinity 10 e4e Location Thomas George Vice President & Head Client Relations Mobile: +1 813-760-5126 [email protected] Kathleen Maher Associate Vice President Sales & Business Development Mobile : +1 617 512 2318 [email protected] Teresa Crawford Associate Vice President Client Relationship Management Mobile: 214-289-9822 [email protected] © e4e – Confidential and Proprietary 11