Card Tech Secur Tech 99 Daniel B Perrin

Card. Tech Secur. Tech’ 99 Daniel B. Perrin Vice President of Public Affairs Real. Med - Indianapolis, Indiana Phone: 317 -580 -0658 Email: dperrin@realmed. com

Today’s Healthcare Claim Problems u Slow turn-around time u Lost claims u Returned claims u EDI problems u Need to re-file claims u Frustration Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999

Today’s Claim Problems For Providers u Cost to resolve a single claim is $8. 00 u Source: Coopers & Lybrand LLP/Entermedica Resources u Focus away from delivering quality care u No direct link to connect all related parties Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999

Today’s Claim Problems For Payers u Per-Claim Cost: $11. 00 u Hindered ability for: u case management u utilization review u reserve forecasting u efficient customer service u Causes tension between members, employers, providers, and payors Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999

Current Process In The U. S. Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999

Current Process Video u Two Minute Video Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999

What is Real-Time Claim Resolution ? u Real time claim resolution means your claim is resolved without you filing any paper work, before you leave the physician’s office u An Explanation of Benefits is printed out at the point of service u Instant on-line eligibility verification u u u Is the patient insured? How much has been spent to meet the deductible (YTD) Are there any major exemptions in the consumers policy? Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999

The Real. Med Solution 1. Patient needs care 2. Check-In without paper 3. Eligibility verified 4. Diagnosis & Treatment Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999 5. Claim submitted 6. Claim re-priced & adjudicated 7. EFT ordered at Payer discretion; EOB printed

Real-Time Resolution Pilot Results Speed Average elapsed time from claim transmission to completion of repricing, claim adjudication, and acceptance of the claim by the physician’s staff 69 seconds Acceptance Rating of Real. Med Software and Networking by Pilot Physicians and Practice Managers 8. 5 out of 10 Ease of Learning Software Learning Curve Nine Claims Accuracy Percentage of Error-free Claims 99. 96% Reliability Network Uptime 99. 88% Ease of Installation Install Team Performance Rating Ease of Use Claim and General Inquiry Calls to Real. Med’s Customer Service Center Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999 94% One call per pilot site each week, 20% of pilot sites made no calls

Pilot Participants Comments Pilot Program Participants u “Until now, there has been no easy or affordable solution for claims processing. Real. Med has provided us with a user friendly claims processing system that is affordable for everyone, ” said Dr. Kevin Mc. Callum, an Indianapolis-based Internal Medicine physician. u “As far as Real. Med is concerned, I have used it during the pilot program for about a month now, and it is astounding. It accomplishes what it needs to in a very user-friendly application, ” said Christopher Green, Practice Manager for North Star Pediatrics in Fishers, IN. u “We are able to access benefit and claim information in a matter of minutes. Because we are a specialists/surgery practice, we have a critical need to know what the benefits are while the patient is here in our office, ” said Ms. Lucy Kelly, Practice Manager for Indianapolis’s Northside ENT Clinic. Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999

Live Mid-Year’ 99 u American Community Mutual Insurance Company u Benefit Systems u Sagamore PPO (largest in Indiana) Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999

Role of Smart Card u Payers have choice of smart card or existing paper or plastic card u Authentication u Identification (all providers receive a smart card) u Multi Application u HCFA (Health Care Finance Administration) regs on use of the internet Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999

Questions u Discussion Card. Tech/Secur. Tech - Chicago, IL - May 11 -14, 1999