Client Co-pay and Fee Display at Check-in Webinar April 28, 2010 Presented By Thayne Parker, Accounts Receivable Manager Tom Paquette, Senior Data Analyst / Programmer

2 Overview Business Goals: Accurate display of Private Pay Fee (including discount, if any) or Co-pay (depending on the client’s fund source) Clearly defined and consistent check- in and collection process Accurate co-pays and fees, charging all payers consistently-compliance

3 Next Steps Policy for Collections and Fee Determination Expectations Delineate responsibility Design Computer Solution New process for assigning insurance co-pays New components in CMHC to allow insurance co-pays to be entered and clearly viewed by staff Implementation Training Communication Review, Revise, Improve Define Business Goals Obtain Executive Support Identify Solution Review, Revise, Improve Process Clarify Expectations Design Program Train, Communicate & Implement

4 Develop new CMHC Components

5 Co-pay Code Maintenance

6 Client Specific Co-pay Assignment

7 Eligibility Maintenance

8

9 Display Methodology

Find the LOWEST priority 3 rd party fund source that was in effect on date of planned event Is co-pay code on fund source blank? Is co-pay code on fund source NONE? DONE No co-pay or private fee Display ‘No Fee’ Find next lowest priority fund source that was in effect on date of planned event DONE Display Co-pay from Co-pay table NO YES A potential co-pay situation exists Was planned service & duration covered on date of service? NO If neither of the DONE boxes are hit from the 1st process, then continue below to calculate the PRIVATE PAY FEE Find the private pay record in effect at the time of the planned service Is there a level specified ? Find fee that corresponds to the service that was in effect at time of planned service DONE Display Private Pay Fee DONE Display Private Pay Fee Is there a standard fee? NO YES NO DONE Display ‘No Fee’ YES DONE Calculate fee using discount percentage in effect at time of planned event Is there a fixed fee per visit? NO YES 2nd Process Private Pay Fee 1st Process Co-pay

11 mtSchedule Display

12 Check-in Display

13 Lessons Learned Review the set-up in CMHC for all Fund Sources not just Private Pay Set up Private Pay Fund Source with it’s own Rate Table If Co-pay code not set up for client – will revert to private pay discount or fee Co-pay displayed is an ‘estimate’ – actual charge billed to client’s account is based on response from payer Create edit tools to identify clients with no co-pay code Encourage communication to identify clients with an incorrect fee displaying

14 Recap

15 Planning and Implementation Implementation Planning Design Define Business Goals Gain Support Document the Process & Expectations Design CMHC Specifications Research each fund source Prepare detailed document outlining covered services and co-pay amount Develop plan to train & communicate Add co-pay tables Update client eligibility records Train Communicate Test, measure, adjust & refine as necessary

16 Client Co-pay and Fee Display Questions and Answers