1. Medical Practice Innovations, Inc. 8/8/20151 ASP Models in Practice Management Systems and Billing Services Presented by: Anthony J. Sarro, Jr. BSCE Medical Practice Innovations, Inc. 8210 Avenue J Brooklyn, New York 11236 (718) 444-6575 www.mpimed.com

2. Medical Practice Innovations, Inc. 8/8/20152 Introduction With the advent of internet technologies, Application Service Providers (ASPs) provide an alternative to traditional software licensing. Much talk is out there about Application Service Providers (ASPs ) in Healthcare. But what practical (and profitable) practice management system and billing service models are being offered under the ASP model? This seminar will define ASPs and explore the opportunities these technologies bring to medical practices, groups and enterprises.

3. Medical Practice Innovations, Inc. 8/8/20153 Overview of Seminar This seminar will: u Review traditional options for Practice Management systems and Billing Services u Define Application Service Providers (ASPs) u Compare ASPs to traditional Client/Server Applications u Identify opportunities for ASP models in Healthcare u Describe ASP models for Practice Management systems and Billing Services

4. Medical Practice Innovations, Inc. 8/8/20154 Traditional Billing Operation Options u In-House Practice Management Systems (In-house billing operations) u Outsourced Billing Services

5. Medical Practice Innovations, Inc. 8/8/20155 In-House Practice Management Systems u Licensed Client/Server Software and Hardware (Well maintained & quality = EXPENSIVE!) u All Billing & IT staff in-house u Front desk well equipped to do their jobs u In-house control maintained u ALL facets of the billing operation managed in-house (from front desk through to payment) u Tendency to focus on patients, records and billing (often neglecting follow-up & collections) u Turnover threatens stability of operations u Difficult to outsource in the future if needs arise

6. Medical Practice Innovations, Inc. 8/8/20156 Outsourced Billing Services u Teams of individuals available with specialized skill sets u Focus on follow-up & collections insured u Leaves in-house staff to focus on front desk & patients u Puts billing operations at a distance from the practice u Difficult to bring back inside u Eliminates need for in-house software & hardware u Eliminates expense of IT personnel u Eliminates need for billing operations management

7. Medical Practice Innovations, Inc. 8/8/20157 Application Service Providers (ASP) Another way of accessing and utilizing software applications u Remotely installed and managed off-site u Providers & office staff connect remotely via the internet u Virtual Private Networking (VPN) is used as a secure link u No need to install locally (reduces/eliminates server requirement) u Software is rented (monthly fee) rather than purchased/licensed u Easy to install & maintain u Reduced hardware and software expense and administration u Lower cost to access superior technology u Lower cost of ownership (software/hardware, maintenance fees) u Flexibility and ease of bringing in-house

8. Medical Practice Innovations, Inc. 8/8/20158 ASP vs. Client/Server Tradeoffs u Reliance on ASP provider for all application maintenance and data backups u Reliance on Internet connections (DSL, ISDN, FRAME RELAY, T-1 depending on size) for access to application and data u Not available at all locations u Limits system administration options u Additional network security essential

9. Medical Practice Innovations, Inc. 8/8/20159 ASP Models in Healthcare u Physician Practice Management Systems (In-house billing operations) u ASP Models in Outsourced Medical Billing Services u New and Flexible Hybrid ASP Models (Combined Practice Management Systems & Medical Billing Services)

10. Medical Practice Innovations, Inc. 8/8/201510 ASP Models in Practice Management Systems (In-House Billing Operations) Practices that wish to keep all billing operations in-house can use practice management systems available through ASP models as a solution for their billing operations platform. u Full billing functions u Lower operational and ownership costs u Can discontinue service (after terms of contract) u Has the option to bring system in-house at a later time (if the ASP provider has a Client/Server option)

11. Medical Practice Innovations, Inc. 8/8/201511 ASP Models in Outsourced Billing Services Innovative billing services are emerging with ASP models in place for low cost controlled access to client data from all practice locations. u Front desk enterprise-wide scheduling u Queries and reports on demand u Encounter form printing (tied back to service to identify missing charges) u Demographic data entry u Sometimes……Charge entry! u Access at the point of care NOTE: The billing service still performs all claim submission, follow-up, statement processing, and payment posting.

12. Medical Practice Innovations, Inc. 8/8/201512 Flexible Hybrid ASP Models New to the market are Hybrid ASP providers offering both full-featured billing systems and a la carte billing services that are flexible and tailored to the individual and dynamic needs of the practice. u All billing functions available at all locations u Option at any time to outsource (or bring back in-house): u Electronic claim submission (EDI functions) u Paper claim printing and mailing u Patient statement processing (including patient calls) u Payment posting u Practice analysis u Coding analysis u Dillegent and effective Follow-Up and collections

13. Medical Practice Innovations, Inc. 8/8/201513 CONCLUSION With the availability and evolution of Internet technologies, cost effective, secure and flexible practice management software systems and outsourced billing service solutions are now available through distributed ASP models as viable alternatives to traditional choices.