1. Get Your House In Order! Doug Barry, President

2. Agenda Common Observations – Need Help? –Recognizing The Signals –Internal Resources & Limitations –Technology –Human Capital Getting There –Developing the Plan Considerations for Partnering – Style Preference –Big Box –Focused Talent

3. Financial Performance Signals Declining Volume Cash Comparison to Net Revenue Bad Debt Days in A/R Cost to Collect Vendor Expense

4. Financial Performance Signals Failure to Report and Evaluate Trends over 3 to 4 Year Period can result in a Miss-diagnosed Structural Issues. Also can help to identify root causes and a be a tool for building consensus with next steps

5. Failure to Forecast Operating Results to include Course Correction Initiatives Opens the Doors for Over/Under Reactions.

6. Patient Access Signals Administrative Denials Reworking or Rebilling Minimal Measurement Abilities Minimal Accountability Accuracy Rates of < 98% Point of Service Collections are Minimal

7. Business Office Signals Cash Collections Denials Days in A/R Bad Debt DNFB Reworking Claims

8. Business Office Signals

9. Uninsured Management Signals Minimal Pre-Service Financial Counseling Effort Lacking Presumptive Eligibility Tools Lacking Patient Liability Estimation Tools Outsourced Services Unchecked Minimal Outpatient Advocacy Technology Needed Customer Service Challenges Patient Complaints Emergency Department E&M Levels

10. Vendor Usage Signals Vendors Usage Lacks Optimal Results Duplicative Conversations Patients Confused High Cost – Low Return Performance Measurement Seems Secondary Missing Accountability - Teeth Not Aligned with Market Rates Reporting Needs Not Being Met

11. Looking at Resources Existing Staff and Applicable Skills Capacity to add Space and Equipment Budget to Invest in the Right Technology Staff Experienced Using Technology Solutions Return on Investment Financial Priorities

12. Planning the Project Determining the Budget Setting Time Line Expectations Gaining Management Support Carve Out Where External Support is Needed

13. Selecting the Right Partner Big Box vs. Focused Talent –Scale –Time Line –Budget Level of Knowledge Needed –Broad –Detailed Key References Tools Needed Return on Investment

14. In-Source, Multi-Vendor, United Solution

15. End Game Managed Care Contracts are Claims Friendly Vendor Contracts Reflect Market Rates and Contain Performance Guarantees Financial Performance Accountability at All Levels Bad Debt is Trending Downward Cash is 99% aligned with Net Revenue Self Pay Cash Improves Patient Satisfaction Scores Improve Reporting Allows for Action

16. Questions? Doug Barry President of Cardon Outreach dbarry@cardonoutreach.com Phone: (281) 296-1771 Toll-Free: (800) 417-4845