1. Pathology Associates of El Paso, P.A. June 3, 2004

2. Per-Se Attendees Eddie Miller, 21 years Regional VP Pathology Division
Jerri Lea Stidham, 21 years
Director of Coding & Compliance
Greenville Pathology Center of
Excellence
Jay McBurney, 8 years
Senior Director Business Development

3. Per-Se Technologies …delivers services and products
through two divisions
Per-Se
Technologies
(PSTI)
$334 million
Hospital
Services
$83 million
Physician
Services
$251 million

4. Professional Component of Clinical Pathology Billing States
TX, CA, NV, MO, CO, OK, LA, AR, AZ, SC, NC, GA, TN, AL, MS, OH, NE, WI, IN, FL, MI, IL, NJ

5. Common Practice Challenges
Reimbursement Decline
Coding: Accuracy / Lost Revenue
Reimbursement Tracking / Payer Monitoring
Physician Enrollment
Managed Care Contract Performance
Business Intelligence / Reporting and Analysis
Technology Upgrades / Maintenance / Interfaces
Compliance / Practice & Billing Process
HIPAA

6. Scope of Services Coding/Charge Management Billing Services
Collections
Access
AR Follow-up & Appeals
Cash Posting
Denial Management
Contract Matrix &
Management
Secondary Billing
Collection Agency Monitoring
Executive Management Reporting
Claims Creation
Clean Claims Editing
Claims Submission
Daily Electronic Claims Filing
73%
Claims Verification
Print and Mail of Paper Claims and Patient Statements
Charge Capture
Electronic/Paper
Coding Audit/Review
Accession Log Reconciliation
Compliance Monitoring &
Training
Annual Charge Master Review
Professional Fee Analysis
Collect Patient Demographic Information
Establish IT Interfaces with Hospitals
Physician Enrollment
We work the “hard to collect” receivables.

7. Accession Number Tracking
Comparison of procedures posted by Per-Se billing system to log in Pathology Department
Benefits:
Improved Charge Capture
Increased Revenue
Confidence in Process

8. Business Intelligence Reporting
Executive Summary Reports
Accounts Receivable Performance Measures
Key Production and Performance Trends
Payer Trends
Collection Statistics
Charge Resolution Trends
Denial Management Tracking

9. Reimbursement Tracking Module

10. Business Intelligence Benefits
Analyses of payer mix, payer performance and reimbursement trends
Analysis of payment patterns to assure conformance with contract provisions
Payer specific follow up protocols in the event of inappropriate payments or denials
Advanced Analytical Reporting
AR Trending, by Site and Service
Referral Analysis

11. Case Review Process
Initial 100% review process until 3% error rate achieved.
All cases are reviewed by Per-Se’ Medical Certified Coding (MCC) personnel.
All cases that are questioned by MCC are then sent to the Certified Professional Coder (CPC) for further review.
Cases are sent to physicians weekly for review.
Dialogue with physician(s) prior to any change(s).

12. Most Common Coding Issues
Not coding for add-on codes (decals, special stains, frozen sections, etc.)
Insufficient documentation to support codes
Applying incorrect level of service to specimens
Not coding for additional specimens

13. Sample Coding Feedback

14. Fee Analysis

15. PCCP Revenue Projection
Post-strip Billable Charges:
$4,192,944
Estimated Gross Collection Rate:
40%
Annual Estimated Collections:
$1,677,177

16. Proposal Anatomic Pathology 10% of net collections, plus postage
Clinical Pathology
13% of net collections, plus postage