1. Revenue Integrity for Providers
August 4, 2016

2. Value Proposition SourceHOV Reimbursement Integrity Solutions:
Proprietary & Confidential
Value Proposition
SourceHOV Reimbursement Integrity Solutions:
Platform for identifying and recovering underpayments
Integrate with in-house patient accounting and contract management systems
Increase cash flow
Alleviate or eliminate expense associated with in-house team
Avoid timely follow-up limitations contained in provider agreements
Correct client contract management system
Maximize reimbursement
Accurate contractual allowances
SourceHOV performs all the work

3. Solution Differentiators
Proprietary & Confidential
Solution Differentiators
A "risk free" contingency based fee arrangement where SourceHOV identifies and recovers 2%-5% of all third party payer reimbursed claims with a 98.6% recovery success rate from all contractually obligated payers.
For every $1.B in paid claims, Providers experience $7M- $15M in previously unrecognized, unrealized “Underpayment" revenue annually.
Unique Preferred Provider/Payer process program
26 years national industry experience
Unrecognized, Unrealized revenue contingency success fee arrangement

4. Specific SourceHOV Differentiators
Proprietary & Confidential
Specific SourceHOV Differentiators
Provider of outcomes, based on our “Cutting Edge” technology
Proprietary technology – we own the code
.NET environment
SQL based environment
Sophisticated rules-based engine
Table driven architecture
Entering the production phase, more than 80% of our work will be automated utilizing our proprietary technology
Manual processes will encompass the loading and updating of contractual arrangements and importation of associated electronic fee schedules
Minimally intrusive to client, designed with that sensitivity in mind
Access to certified coding team
SourceHOV will bridge the Payer/Provider gap resulting in;
Cost savings
Improved and consistent payment accuracy
Enhanced provider, member, and employer group satisfaction

5. SourceHOV Advantage Resources
Proprietary & Confidential
SourceHOV Advantage Resources
People
Process
Certified Public Accountants
Registered Nurses
Financial Analysts
Preferred Payer Process
Relationships with payers in 38 states
Technology
Experience
Proprietary State of the Art Technology Platform
SourceHOV owns the code
Have not met a clause, term or condition we could not accurately program in arriving at expected reimbursement
26 years
$4+ Billion recovered on behalf of our Provider clients

6. Revenue Integrity Service Offerings
Proprietary & Confidential
Revenue Integrity Service Offerings
Identify and recover all dollars rightfully and contractually due providers from all third party payers
Increase bottom line 2% - 5% of net patient service revenue. Eliminate false positives variances and reduce in-house staff expenditures
Contract Management
Foundation for All Services | Expected Reimbursement Contractual Allowance | Technology Based Platform
Business Rules Based Engine Table Driven Architecture
Load, Maintain All Payer Agreements
Data Mining and Analytics | Ensures compliance
Predictive Contract Modeling/Benchmarking
Measure Revenue Impact of Contract Terms Develop Market Specific Strategies
Utilize Historical Claim Data | Benchmarking
Rate Comparison and Setting | Multiple Scenarios
Monitor Payer Contract Performance
SourceHOV
Underpayment Services
Identify and Recover Underpayments
Retrospective, Concurrent | All Payer All Products
2%- 5% Unrecognized, Unrealized Revenue
Root Cause Analysis | Hold Payers Accountable
Avoid Timely Follow-Up Limitations, Penalties
Shadow Client System
Calculation Adjudication Engine
Expected Reimbursement | Contractual Allowance
Supplement, Compliment Client System
Daily Comparison | Eliminate False Positives Identify Areas of Risk
Data Mining and Analytics
Store all data 837/835
Unlimited on-demand query, reporting capabilities
No delays | immediate response
Access 24/7, no hardware software expenditures
Denials Management
Identification and resolution | Capture reason, remark codes
Reason, remark codes reflect payer specific verbiage
Eliminate systemic, re-occurring | Client/SourceHOV resolve
Track, monitor success rate

7. Related Challenges – A Powerful Solution
Proprietary & Confidential
Related Challenges – A Powerful Solution
Contract Management
Underpayment Identification & Recovery
Data Mining and Analytics
Predictive Contract Modeling & Benchmarking
Denials Management
Contractual Allowance Posting or Shadowing

8. Key to Success - Get it Right From the Start
Proprietary & Confidential
Contract Management
Foundation supporting all immediate and future reimbursement initiatives
Load and maintain all third party payer contractual agreements
Accommodates unlimited contract years for respective payer
Contract start and stop dates allow retrospective adjustments
Scan and attached contractual agreement to respective account
Calculate complicated terms and conditions via programmed rules
Prompt updates and immediate system enhancement releases
Key to Success - Get it Right From the Start

9. Contract Management Advantages Load & maintain all agreements
Proprietary & Confidential
Contract Management
Load & maintain all agreements
Scan & attach all agreements
Advantages
Contract stop & start dates
Unlimited contract years

10. Retrospective Underpayment Identification and Recovery
Proprietary & Confidential
Retrospective Underpayment Identification and Recovery
Review third party contractual reimbursement for the most recent 2-3 year period
Recover previously unidentified and unrecognized revenue
Contingency fee based on monies identified and recovered from third party payers
Monitor past and future contract performance detecting root cause
Monitor and identify coding and billing irregularities
Root cause analysis
Identify and correct systemic issues
This money is rightfully and contractually due your organization!

11. Concurrent Underpayment Identification and Recovery
Proprietary & Confidential
Concurrent Underpayment Identification and Recovery
Review third party contractual reimbursement
Monitor all claims at the time of final billing
Monitor and identify coding and billing irregularities
Identify and pursue all underpayments at time of initial payment
Avoid timely follow-up contractual limitations
Root cause detection, analysis and correction
Correct and Prevent future systemic issues
Contingency fee based on monies identified and recovered from third party payers

12. Underpayments Advantages All claims all payers
Proprietary & Confidential
Underpayments
All claims all payers
Retrospective and Concurrent
Advantages
Correction and prevention - systemic issues
Preferred Payer Process and Relationships

13. Underpayments Advantages
Proprietary & Confidential
Underpayments
Identify and recover unidentified / unrecognized revenue
Avoid timely follow-up limitations
Advantages
Success based contingency fee based on dollars recovered
Root cause detection and analysis

14. SourceHOV Workflow Process
Proprietary & Confidential
SourceHOV Workflow Process
Upload
Claim Files
SourceHOV
Reimbursement Integrity and Data Analytics
Platform
Contract Management :
Foundation supporting all immediate and future reimbursement initiatives
Load and maintain all third party payer contractual agreements
accommodates unlimited contract years for respective payer
Contract start and stop dates allow retrospective adjustments
Scan and attached contractual agreement to respective account
Calculate complicated terms and conditions via programmed rules
Prompt updates and immediate system enhancement releases
Underpayment Reports
Claim Line Level
SourceHOV
Recovers Monies 2a
Scan and Load
Payer Contracts Load Fee Schedules
SourceHOV 5b 4 3
Reports / Exports 2b
PDF
Contingency Fee
Excel
Data Mining 7 5a
Reports / Data Mining Access
Monies Directly Received by Client
837i / 835i
Claim Files
Payer Contracts / Fee Schedules
Client 1a 1b
On-Demand 6

15. Contract Predictive Modeling and Benchmarking
Proprietary & Confidential
Contract Predictive Modeling and Benchmarking
Review client current contract modeling processes and procedures
Accurate expected reimbursement for future and current agreements
Multiple scenarios utilizing the most recent one year patient data set
Arrive at the total dollar and percentage increase or decrease
Powerful and popular tool
Option to choose a fixed monthly or per agreement fee

16. Contract Predictive Modeling and Benchmarking
Proprietary & Confidential
Contract Predictive Modeling and Benchmarking
SourceHOV processes, client analyzes results
Accurate, expected reimbursement for current & future agreement
Advantages
Multiple scenarios utilizing most recent one year patient data set
Arrive at total dollar and percentage increase or decrease

17. Contractual Allowance Posting or Shadowing
Proprietary & Confidential
Contractual Allowance Posting or Shadowing
Third party payer calculation engine and adjudication system
Calculate and post contractual allowance and expected reimbursement
Shadow or replace your existing in-house contract management system
Correct and supplement your current process
Appropriate patient registration and payer plan assignment

18. Contractual Allowance Posting or Shadowing
Proprietary & Confidential
Contractual Allowance Posting or Shadowing
Third party payer calculation and adjudication technology system
Calculate and post contractual allowances and expected reimbursement
Advantages
Appropriate patient registration and payer plan assignment
Shadow, supplement or use as primary system

19. Proprietary & Confidential
Denials Management
Identification and resolution of claim and service level denials
Capture from remittance advice by reason and remark codes
Reason and Remark code descriptions reflect payer specific verbiage
Identify and eliminate systemic and re-occurring denials
Route to proper client staff to work
Company can work at client discretion
Track successful recovery of all denials

20. Denials Management Advantages
Proprietary & Confidential
Denials Management
Identification and resolution of claim and service level denials
Track successful recoveries
Company can work at client discretion
Advantages
Identify and eliminate systemic and re-occurring denials
Capture from remittance advice by reason and remark codes reflect payer specific verbiage

21. Data Mining and Analytics
Proprietary & Confidential
Data Mining and Analytics
Store pertinent data for easy retrieval 837, 835, contractual agreements
Unlimited query and reporting capability utilizing stored data
Request query or report, experience no delays, immediate response
Utilize at your request and convenience
Contractual agreements maintained for current and future usage

22. Data Mining and Analytics
Proprietary & Confidential
Data Mining and Analytics
Store and easily retrieve pertinent data including 837, 835, payer agreements
Unlimited on-demand query and reporting capabilities
Advantages
SaaS model available 24X7
No hardware or software cost
Automatics upgrades
No internal support or resources
Insights development
Supplement and compliment Client IT

23. Reimbursement Integrity Program
Proprietary & Confidential
Reimbursement Integrity Program
All Reimbursement Cycle Solutions Include:
Every inpatient and outpatient account
All contractually obligated third party and governmental payers
Unlimited reporting and query capabilities
Reporting on any component contained on the 837 and 835
Timely implementation providing immediate results
Information Technology Friendly:
Data request includes 837, 835, and third party payer agreements
MCP loads and maintains all third party payer contractual agreements
No hardware or software costs
Proprietary SQL based system utilized by our staff
SaaS model

24. Reimbursement Integrity Program Information Request
Proprietary & Confidential
Reimbursement Integrity Program Information Request
Third party payer contractual agreements
Including electronic fee schedules
SourceHOV personnel can copy/scan if you so desire
Electronic 837 or electronic flat UB/CMS file
Electronic 835 or access to explanation of benefits
Payments and adjustments retrospectively and daily forward:
All payments and adjustments by account including transaction code
File to include account number, payer code, transaction code, payment amount, adjustment amount, amount indicator
Fixed field length, any order, one record per line
Please provide record layout
Payment/Adjustment transaction code listing
Insurance plan code listing
Remote electronic access to patient accounting system with capabilities to:
View and Print UB04’s/CMS-1500’s, itemized bills, explanation of benefits and patient accounting notes
Remote electronic access to electronic medical record system/imaging

25. Final Overview Summary
Proprietary & Confidential
Client Implications
Final Overview Summary
SourceHOV Healthcare Clients
2.5% to 5% of paid claims result in underpayments
SourceHOV provides experience and expertise utilizing a professional staff of Certified Public Accountants and Registered Nurses for all services
SourceHOV has partnered with over 1,000 healthcare organizations in 38 states and identified/recovered in excess of $4.0 billion dollars in additional reimbursement
On behalf of our clients we have programmed, reviewed, and negotiated more than 30,000 third party contractual agreements

26. Proprietary & Confidential
Client Testimonials
Without SourceHOV we would not have identified and recovered in excess of $10,000,000 over the last two years.
Senior Manager, Government Contract Management, Large Midwestern University
SourceHOV works hand in hand with our staff assisting in identifying and collecting additional reimbursement. This equaled over $4,000,000 for calendar year 2010.
Director Fiscal Services, Large Eastern University
SourceHOV provided Underpayment Identification and Recovery, Contract Modeling, and Posted Daily Contractual Allowances. We were impressed with all the services. They identified and collected over $70,000,000 during our 10 year partnership.
Vice President, Revenue Cycle Management, Health Services Organization

27. Proprietary & Confidential
Client Testimonials
I have worked with SourceHOV for the past 8 years. They performed an Underpayment Identification and Recovery engagement and now SourceHOV identifies and our staff recovers underpayments concurrently. This has translated into millions of dollars in additional reimbursement over the years. They do all the work and my staff collects.
Director Revenue Cycle Management, Large Midwestern University Hospital Authority
SourceHOV came highly recommended and we have since formed a tremendous business relationship. During the first year of the 2 year retrospective review they have recovered over $2,000,000 in additional reimbursement.
Director Revenue Cycle Management, Midwestern Health System
During our current 7 year relationship, I look forward to receiving the SourceHOV monthly invoice. This is a sign that SourceHOV was able to recoup those dollars that our staff, for whatever reason, did not.
Director Patient Financial Services, Southwestern Healthcare Network