Proprietary and Confidential BJC Hospital POS Collections Overview July 22, 2014

Proprietary and Confidential BJC POS Collections Program - Goals and Objectives Goals –Financial Improvement - expanded POS collection program will result in increased patient collections, decreased Free Care and reduced vendor collection costs –Enhance Patient Experience - improved communication prior to and at point of service through notification of financial responsibilities and discussion of payment resolution options Objectives –Develop and Implement Collections Operating Model that will lay the leading practice foundation to support the ability to ‘Ask’ patients for and to accept payments –Optimize POS Collection workflow from Scheduling through Point of Service –Enhance Technology and Reporting to drive accountability and sustainability –Program will NOT focus on Service Deferral or Denial activities 2

Proprietary and Confidential BJC POS Collections – St. Louis Hospital Provider Market ProviderMarket % 1 POSElective Deferral? InsuredUninsured SSM Health Care22.00%YesNo Mercy13.50%YesNo SLU/Tenet Health System5.75%YesNoYes - 20% upfront St. Anthony’s6.50%YesNoYes – no set amt St. Luke’s3.80%YesNo 3 Sources: 1.St. Louis Healthcare Industry Overview 2013, St. Louis Area Business Health Coalition (2014) 2.Provider specific collections data obtained through Huron market analysis and contacts at provider facilities St. Louis area hospital providers are collecting at POS but not deferring services if patient is not able to pay ProviderPOSElective Deferral? InsuredUninsured Metro ImagingYesNoYes – 100% upfront Watson Imaging CenterYesNoYes – 50% upfront Professional ImagingYesYes – $ 125Yes – 50% preferred The Imaging Center (IL)YesNoYes – 50% preferred Imaging Centers are collecting at POS but only deferring services if an uninsured patient is not able to pay

Proprietary and Confidential BJC POS Collections - Activities Update 4 POS Vendor Tool Selection – Completed contracting with Recondo POS Estimation tool. Kick-off and Technical Set-up timelines in process. Collections Communications – In partnership with Rev Cycle Leadership, presented initiative to BJC Department Leaders, Physician Liaisons, Compliance, Marketing, WUSM Business Directors, and other key partners to POS program Training Plan and Reporting Solution – Developed curriculum to support POS collections training and reporting in partnership with Patient Access and Training team Pre-Implementation Activities – Completed activities (i.e., training materials, technology updates) in preparation for implementation phase Future State Operating Model – Finalized proposed service area roll-out, workflow, scope, and approach in partnership with Patient Access and Rev Cycle Leadership teams. Obtained approval from hospital Revenue Cycle Steering group. WUSM Clinic Follow-up– Completed shadowing activities at WUSM clinics (GYN and Orthopedics) to understand current collections practices

Proprietary and Confidential BJC POS Implementation Approach and Timeline 5

Proprietary and Confidential POS Collections – Primary Services Facility Roll-Out Timeline 6 Implementation Timeline by Week Facility 7/147/217/288/48/118/188/259/19/89/159/229/2910/610/1310/20 BJH SLCH PHC MBSH Pre-Arrival Center MBMC BJSP PWHC CH / NHC AMH BHC BJWC Radiology and OP Surgery Radiology, OP Surgery Cardiology Radiology and OP Surgery TBD - Radiology and OP Surgery Huron LedBJC Led Huron Led and BJC Shadowing Radiology and OP Surgery Upcoming POS Go-Live Dates: BJH, 7/23 and SLCH, 8/13 Implementations consist of Training, Go-Live and Transition weeks

Proprietary and Confidential BJC POS Future State – Key Operating Model Highlights Workflow - Pre-Arrival and POS Registration Areas will work in collaboration to attempt patient collection and accept payments. Collection Amounts –A Standard ‘Ask’ Collection amount will be utilized during primary phase roll-out to allow staff to focus on building a strong foundation on how to ask for and accept payments –Using data driven approach to develop standard amounts (e.g. $100) by high level service (e.g. MRI, CT, Surgery) that will be consistent across facilities and limit credit balances Payer Scope –Collection activities will include Managed Care, Medicaid, and Uninsured patients –Exclusions will apply to traditional Medicare, dual coverage, workers’ compensation, auto insurance, and Veteran’s Administration due to difficulty in upfront estimate determination Payment Processing –All collections areas will utilize Payment Navigator Tool to process payments and accept credit/debit card and check as forms of payment –Cash will be accepted at Point of Service based on meeting all required security protocols and logistical requirements (i.e., lockbox) as well as defined reconciliation and cash handling procedure produced by Security Audit department 7

Proprietary and Confidential BJC POS Training and Education Plan 8 PeopleProcessTools Documentation GuidelinesWorklist UpdatesSoarian/SMS Updates Scripting/Role-PlayingStandard Ask GuidelinesPayment Navigator POS Collections OverviewSecurity MeasuresNew Credit Card Machines Quality ReviewPayment HandlingGoal Setting Super User PreparationFinancial Assistance OptionsReporting Change ManagementPayment Options Training Approach –Live classroom training sessions as well as on-line modules for all Pre-Arrival and Registration Staff –Super-users will be identified at each facility to provide continued support and sustainability –POS Collections training will be incorporated into Patient Access staff new hire training

Proprietary and Confidential What Questions to You Have? 9