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

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

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

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

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

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.

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

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

Reimbursement Tracking Module

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

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).

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

Sample Coding Feedback

Fee Analysis

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

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