1. 835 Remittance Advice - One Customer’s Journey Suzanne Sarkady – Galen Advisors Natasha Foster – Galen Advisors Joe Heald – GE Healthcare

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5. GALEN ADVISORS OVERVIEW Acquired by a large hospital system in 2012 to perform professional billing for practice acquisitions Majority of billing is for professional fees; also do facility billing for several ambulatory surgery centers Currently bill in over 60 databases Majority of claim and statement formats are linked 5

6. THE ERA / EFT PROJECT As of May 2014 Galen was receiving ERA / EFTs for only 6 payers Medicare, Medicaid, BCBS, Cigna, Aetna and UHC - 73% of volume Received remit analysis from GE Healthcare 6

7. REMIT ANALYSIS REPORT 7

8. THE ERA/ EFT PROJECT First contract was for next 5 largest payers - Humana, Coventry, Kaiser, Tricare and Amerigroup Added an additional 19 payers over the next 6 months Now have ERA functionality for 30 payer IDs – 89% of volume 8

9. CHALLENGES - ENROLLMENT Each remit had to be enrolled in 20 different tax IDs Each payer had different rules; not all could be completed by the remit team EFT enrollment was often a separate process Galen not notified of approval; ERAs would just “show up” Had to dedicate a resource to track enrollment ERAs would come with no EFT and vice versa 9

10. ENROLLMENT TIPS Complete the most current enrollment process; forms and information can be found on the EDI Services portal Confirm if ERA/EFT enrollment are separate processes Validate that TINs and NPIs are registered with the correct address to avoid rejected paperwork Confirm the ERA delivery method – GE or Emdeon Validate completion of enrollment with payers 10

11. CHALLENGES – DATABASE VOLUME Receive remits for 20 tax IDs between 61 databases ERAs are delivered to EDI services; files are grouped by tax ID and delivered to the master database “GBS” GBS distributes ERAs; distribution reports show how checks are dispersed to the 13 remit formats within each of the 61 databases Payer data often conflicts with hierarchy sending remit data to wrong databases 11

12. GBS DISTRIBUTION REPORT 12

13. GALEN ECOMMERCE REMITTANCE MENU 13

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15. CHALLENGES – DATABASE VOLUME Use EDI Services reports to verify delivery of and track missing ERAs Remittance Advice Reports Remit Summary Report 15

16. REMITTANCE ADVICE REPORTS 16

17. REMIT SUMMARY REPORT 17

18. CHALLENGES – DATABASE VOLUME Reconciliation difficult – 13 remit formats in 61 databases Use CGI report to determine outstanding ERAs 18

19. CGI REPORT 19

20. CHALLENGE - REJECTIONS Top Rejection Reasons  - Charges out to a different insurance  - Transaction message codes - Recoups - Sequester adjustment  Created rejection reports to quantify and prioritize rejection issues 20

21. GALEN REJECTION REPORT 21

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24. OUTCOMES AND NEXT STEPS Received 61K remits in Jan 2014 and 112K in Jan 2015 Auto posting from Jan 2014 to Jan 2015 increased 53% to 62% Working down rejection issues so more will post automatically Researching what other remits are available 24

25. PROJECT BENEFITS Improves cash flow Streamlines payment reconciliation process Increases productivity and efficiency by eliminating manual posting Allows for quicker turnaround time for secondary claims filing and patient collections 25

26. ©2015 General Electric Company – All rights reserved. The results expressed in this document may not be applicable to a particular site or installation and individual results may vary. This document and its contents are provided to you for informational purposes only and do not constitute a representation, warranty or performance guarantee. GE disclaims liability for any loss, which may arise from reliance on or use of information, contained in this document. All illustrations are provided as fictional examples only. Your product features and configuration may be different than those shown. Information contained herein is proprietary to GE. No part of this publication may be reproduced for any purpose without written permission of GE. DESCRIPTIONS OF FUTURE FUNCTIONALITY REFLECT CURRENT PRODUCT DIRECTION, ARE FOR INFORMATIONAL PURPOSES ONLY AND DO NOT CONSTITUTE A COMMITMENT TO PROVIDE SPECIFIC FUNCTIONALITY. TIMING AND AVAILABILITY REMAIN AT GE’S DISCRETION AND ARE SUBJECT TO CHANGE AND APPLICABLE REGULATORY CLEARANCE. GE, the GE Monogram, Centricity, and imagination at work are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies. General Electric Company, by and through its GE Healthcare division. 26

27. GE Healthcare Additional Tools Reimbursement Analytics Customized Remit Analysis Report EDI Services Portal 27

28. Reimbursement Analytics Provides comparative healthcare data on reimbursement, utilization and productivity Includes over 100 fields in the ANSI 835 (electronic remits) compared at a state or national level Available for any size practice or health system that employs or manages outpatient providers, submits claims electronically and receives electronic remits Available now! Demonstrations available to show functionality/benefits 28

29. Electronic Remittance Advice – Customized Remit Analysis Is your office still manually posting payments? Are you interested in moving your practice to posting close to 100% electronically? If you have answered yes to either of these questions, then you are ready to work with GE on maximizing your electronic payment posting. We will run a remittance analysis for you that displays the claim volume you are currently submitting through Centricity™ EDI. The report will categorize the payers to show you what you are currently posting and what is available as additional posting programs. Please send an email to Kristen Chalmers: Kristen.chalmers@ge.com to request your free analysis today.Kristen.chalmers@ge.com 29

30. EDI Services Portal Please take a look at our new Services Portal which can be accessed from: https://engage.gehealthcare.com/community/en/edi The Portal Provides the following : Tips and tricks, best practices, videos, and other materials on a large range of topics An interactive collaboration community where you can network with other customers (and GE) by posting questions in the community tab, sharing challenges and best practices Single access point for all your GE Healthcare IT services needs including eServices, customer communities and more Searchable and downloadable resources and documents Quick links to webinar recordings, best practices, product documentation, eServices and more! https://engage.gehealthcare.com/community/en/edi 30

31. Thank you for participating! Questions? 31