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REVENUE CYCLE MANAGEMENT FOR DME

REVENUE CYCLE MANAGEMENT FOR DME. 41 Madison Avenue, 25 th Floor, New York, NY 10010, USA Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com. SUNKNOWLEDGE ADVANTAGE. THE REASONS WE ARE UNIQUE. 41 Madison Avenue, 25 th Floor, New York, NY 10010, USA. Key Facts.

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REVENUE CYCLE MANAGEMENT FOR DME

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  1. REVENUE CYCLE MANAGEMENT FOR DME 41 Madison Avenue, 25th Floor, New York, NY 10010, USAPhone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com

  2. SUNKNOWLEDGE ADVANTAGE THE REASONS WE ARE UNIQUE Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  3. Key Facts SUNKNOWLEDGE OVERVIEW • Serving US healthcare industry since 2007 • Robust & scalable infrastructure • State-of-the-art technology and systems • Highly skilled and trained staff with good communication skills and in-depth knowledge of process • Structured training, feedback and coaching • HIPAA-HITECH compliant • State-of-the-art office inbuilt with all redundancies – power, infrastructure and others Office at 41 Madison Avenue, 25th Floor, New York, NY 10010 Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  4. Contact Center • Clinical Services • Administrative Services SUNKNOWLEDGE SERVICE PORTFOLIO • Provider Support • Member Support • Member Retention Program • Clinical Help Desk • Utilization Management • Medication Therapy Management • Hospital Re-admission Management • Therapeutic Interchange • Formulary Management • Medical Coding & Billing • Claims Administration • Enrollment Processing & Member • Fulfillment • Credentialing • Premium billing and collections • Analytics • IT Services • Claims /Drug Utilization Analysis • PDE Analysis • RAF Analysis • Payment Reconciliation • Telemedicine Services • Remote Patient Monitoring • Application Development & Support • Technical Support • Technical Documentation We provide services to Providers – Physicians, Hospitals, DME, P&O, Home Health Care and Pharmacies Payers – Commercial Plans, MA Plans, Medicaid HMOs, MAPD/PDPs, IPAs, MSOs, TPAs, PBMs and RBMs Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  5. SUMMARY OF SERVICES Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  6. HIPAA COMPLIANCE SUMMARY Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  7. REVENUE CYCLEMANAGEMENT Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  8. REVENUE CYCLE MANAGEMENT – KEY PROCESSES Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  9. SERVICE HIGHLIGHTS • Up to 97% collection rate in accounts receivable • Real-time eligibility checks & fast authorization • 100% HIPAA-HITECH compliance • Rapid claim status analysis in denial management • Turnaround time less than 48 hours max. • Low service fees with no hidden cost • Zero lockup service contract that can be cancelled anytime • Excellent references from reputed clients across the US • Real-time audits and custom reporting Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  10. REVENUE CYCLE MANAGEMENT • Setup DME companies in DME billing system, receive orders, generate claims, payment posting and follow-up with payers and patients • DMEPOS • Physicians / Hospitals • Pharmacy (WC/ PIP) • Work with physicians to enroll them with payers, setup billing systems with fee schedules, review clinical notes, code CPT/ICD, submit claims, payment posting and follow-up with payers and patients • Setup billing systems for submission of WC/PIP claims, code and apply correct modifiers, check eligibility with adjusters, generate claims, payment posting and follow-up • Sunknowledge provides medical billing & coding services - prompt, perfect and professional. • We are HIPAA compliant. Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  11. REVENUE CYCLE MANAGEMENT SERVICES End-to-End Billing Services: • Hospitals/ Physicians • DMEPOS • Pharmacy (WC/PIP) Stand Alone Billing Services: • AR Follow-up & Collection • Eligibility & Auth Verification • Pre-Auth Service • Credentialing • Patient Collection • Coding Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  12. PRACTICE MANAGEMENT & BILLING SYSTEM Sunknowledge billing executives have experience in working on several industry standard practice management and billing software: • Sunknowledge can provide medical billing & coding services using customer’s billing system or can setup customer’s practice in a billing system managed by Sunknowledge. Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  13. APPROACH • CHALLENGES • TASK DESCRIPTION CHALLENGES & OUR APPROACH Patient Demographics / Insurance / Charge Entry • Missing information / Key-in errors • Increased denial rate • Increased TAT • Transaction audit to minimize errors; reduces denial due to missing patient information Eligibility Verification • Time consuming with limited staff • Secondary verification not carried out • Assignment of adequate staff • Completion of secondary verification • Rigorous audit Checking Authorization Requirement and Obtaining Authorization • Assignment of adequate staff • Systematic and regular follow-up with physicians’ offices & payors to collect documentation and obtain authorization • Proper tracking mechanism • Time consuming with limited staff • Documentation collection requires continuous follow-up • Increased TAT Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  14. APPROACH • CHALLENGES • TASK DESCRIPTION CHALLENGES & OUR APPROACH Paper Claim Submission • Additional work for printing and faxing/mailing • Delayed filing leading to denials • Lack of information about the actual status • Proper tracking of every submission of paper claims • Moving to EDI based submission whenever possible will reduce cost of manual work and faster payment cycle Rejection Management • Delayed correction and resubmission • Possible loss of payment • Defining KPI for rejection management process and assigning responsibility • Claims reconciliation and exception report generation Payment Posting • Defining guidelines • Review of patient payments • Define KPI – TAT & Accuracy • Denial posting and review • Unapplied balance • Accumulation of backlog • Manual posting • Denials not posted Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  15. APPROACH • CHALLENGES • TASK DESCRIPTION CHALLENGES & OUR APPROACH AR Follow-up & Denial Management • Accumulation of backlog • Denials not posted • Claims reconciliation issue • Regular analysis, follow-up and review • Transaction audit Process Administration and Reporting • Lack of clarity of claims volume and current status affects management decision making process • Impact on overall billing process performance and improvement • Decreased productive efficiency • Proper documentation – process manual, guidelines & checklists • Defining proper tracking mechanism through various reports -Ageing, Status, Daily, Exception • Generate exception reports and regular audit of every process tasks • Defining KPIs and assigning responsibility Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  16. ADDRESSING PROBLEMS WITH EFFECTIVE SOLUTIONS We address problems like: We produce benefits like: Reduced profit margins Process optimization • Caused by • Claims denial • Delayed submission of claims • Inefficient processes • Low productivity • Achieved through • No backlogs in inventory/open order • Significant reduction in payment realization cycle • Reduction in average cost by 40% • Improved efficiency leading to higher productivity Reduced strategic directives Improved financials • Caused by • Operation reports lacking focus on orders received/delivered • Reports on claims submission lacking functional clarity • Achieved through • Timely claims submission, leading to improved cash flow and payment realization by 10% • Significant reduction in denial rate • Increased revenue by 7% Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  17. FACTS FROM A CASE STUDY Sunknowledge recently helped a leading DME Provider in New York improve their complex billing process and achieve long-term bottom-line growth. Here’s how we added value to the client’s existing processes: INCREASED PRODUCTIVITY AND REDUCED OPEN ORDERS: Removed redundant process steps to focus on the critical ones; Created tools / cheat sheets and introduced various process checks to improve productivity OPTIMIZED BILLING PROCESS PROCESS STABILITY:Achieved consistent and better productivity; and higher accuracy through the application of an improvement methodology REDUCED DENIAL RATES:Drastically reduced incorrect coding and combination in bills and developed a thorough understanding of qualifying diagnosis and payer guidelines QUALITY AND EFFICIENCY IMPROVEMENT: Developed clear understanding of peculiarities of DME billing as compared to physician billing; Initiated an internal audit mechanism to identify and rectify errors; Enforced corrective and preventive action scheme OLD BILLING PROCESS Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  18. DME BILLING SERVICES Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  19. DME BILLING WORK FLOW • Order entry based on the Rx received from the Physician • Patient demographics & insurance entry • Provider information entry • Product code entry • Rx & Dx entry (with appropriate timeframe) • If necessary, a telemedicine consultation can be completed to obtain a Rx to expedite the order entry process • Eligibility verification and authorization requirement enquiry • Collection of documents required by payer for auth approval, e.g. face-to-face consultation notes, and obtaining authorization from Payer • Determination that Payer criteria is met before delivery of equipment, e.g. some products have time/frequency/ annual cost limitations f (if criteria is not met, the Patient is contacted and informed of the financial responsibility) • Generation of delivery ticket (based on which delivery is made to the patient) • Creation of claim after receipt of confirmation of delivery • Submission of EDI / paper claim to payers • Cash posting • Rejection & Denial Management • A/R follow-up Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  20. SUNKNOWLEDGE ADVANTAGE • SERVICES OFFERED BY US THAT OUR COMPETITORS DON’T • CPAP user compliance activities including: • Tracking • Contacting and advising non compliant patients • Contacting compliant patients and providing appointment alerts • Scheduling appointment with doctor’s office • Contacting ordering physicians with compliance reports • Sales Support by reaching out to: • Existing CPAP users regarding supplies if eligible • Existing diabetic/incontinence users regarding supplies if eligible • Previous patients regarding CPAP supplies and DME products • New leads regarding CPAP supplies and DME products • Constant support through easy access and availability of managers/resources overphone call / video conferencing / screen sharing • Work assignment and management via MyForms • Manage/index documents via applicable document management system Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  21. COMPLETE DME BILLING SERVICE PORTFOLIO WE HAVE THE CAPABILITY TO DO ALL OF THE BELOW MENTIONED SERVICES AS A PACKAGE OR ON A ALA CARTE BASIS. POST BILLING SUPPORT ACTIVITIES PRE BILLING • Eligibility Verification - online • Eligibility Verification - online (with same/similar check) • Eligibility Verification - calling (with same/similar check) • Eligibility Verification - calling (with same/similar check) BCBS • Prior Authorization • Prior Authorization (with dr.'s office follow/up) / Re-authorization • Dr.'s office follow-up • Order entry (patient, provider, insurance, item etc.) • Confirmation • Rejection management • Posting - auto (without audit) • Posting - auto (with audit) • Posting - manual • A/R follow-up • A/R & Denial Management • CPAP Compliance (with patient counseling calls) • Patient collections • Re-supply order calls (to patient to confirm requirement) • Hold (eligibility, authorization, ins. change, manual hold etc.) Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  22. DME BILLING – PRODUCTIVITY METRICS Note: This takes into consideration time taken while working on Brightree Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  23. DME BILLING – KEY FACTS • Secure Information & Data Flow between Sunknowledge and our partners enabled with reliable networking software & hardware (includes secured Virtual Private Networks and FTP sites) • All low pay and no pays reports are sent to the client • Work on re-processing of the denied claims starts immediately after receipt of ERA • ERAs are posted to the respective patients’ accounts • Quality check is conducted at all stages of process • Turn Around Time for this process is 24 - 48 hours Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  24. ORDER ENTRY – SAMPLE REPORT Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  25. ELIGIBILITY & AUTH. VERIFICATION – SAMPLE REPORT Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  26. CPAP USER COMPLIANCE & TRACKING – SAMPLE REPORT Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  27. AR & AR CALLING – SAMPLE REPORT Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  28. DENIAL MANAGEMENT – SAMPLE REPORT Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  29. BENEFITS PROPOSITION • Increased revenue – reduced collection Time (up to 97% collection rate) • Claim submission within 48 hours of receipt of billing input • Adherence to CMS billing requirements • Proper records maintenance and visibility through reporting • Standardization of billing operations Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  30. TESTIMONIALS Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  31. CLIENTSPEAK “I have gone through the collectors claims that they worked yesterday and firstly want to say great job! Everyone was at 40 claims or more for the day and that’s outstanding! Every day we get better and better so let’s keep up the great work! Overall everyone had great accuracy once again and that has a lot to do with you keeping them accountable for what they are doing!Keep this up and we’ll definitely exceed our goal!.” - Practice Manager A Leading DME Provider “ S****** has surpassed his monthly goal and S**** is right behind him!! And, we still have 12 days left in the month! Please extend my deepest gratitude and let them both know how impressed we all are! They are proving this is a job extremely well done and we couldn't thank them enough for their hard work!! Bravo! ” - DME Provider On The West Coast(Client Footprint Across 28 Specialties) Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  32. CLIENTSPEAK “I would like to thank everyone in Sunknowledge team for the great help in our billing process. The quality of work provided is amazing and the expectations are always met. Your effort has made a significant difference to our business. It is our pleasure working with you.” - Billing Manager A Leading DME Provider in East Coast “ Your team amazed me with the manual and the amount of info you provided with that short training session.” - DME Provider On The West Coast(Client Footprint Across 28 Specialties) Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

  33. CLIENTSPEAK “Thank you to Sun Knowledge for an exceptional job that have provided to us. We have had such a great experience with the work they have done.” - CEO of a leading DME Company For Additional Information, Please Contact… READ ALL TESTIMONIALS Ronnie HastingsPhone: (646) 661 7853Email: ronnie.hastings@sunknowledge.com Sunknowledge Services Inc.41 Madison Ave., Suite 2503, 25th FloorNew York, NY 11001, USA Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com 41 Madison Avenue, 25th Floor, New York, NY 10010, USA

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