Oklahoma HIMSS Meeting

1. Oklahoma HIMSS Meeting Fred Richards CTO/Co-Founder November 2, 2005

2. Introduction The Key to A Successful RHIO Clinical Transaction Justification Administration Transactions Improve Workflow

3. The Key to a Successful RHIO To build a successful RHIO, all you have to do is one thing: Provide a service that produces a return on investment for its members. That’s it.

4. Roles To Support the Mission Define Standards for Interoperability Communication Business Data Processing Transaction Implementation Eliminate Competitive Collaboration Concerns Education Training Privacy, Security and Legal Issues

5. Define an Effective Area Administrative State Wide Clinical MTA (Medical Trading Area) where more than 80% of Physician and Patient Activity is provided. Multiple Community or Hospital Centered RHIOs Oklahoma

6. Oklahoma Example

7. Lab/Radiology Test Result Distribution An Average Test Result Distributed on Paper is requested 3 Times (Health Bridge Study) Reduction in Paper Mailing Costs Less follow-up from patient do to faster result deliver. Physician knows where to look for results.

8. ePharmacy Reduces Drug Cost Formulary Presentation Saves an Average of $3.24 per Prescription Employers and Health Plans Contribute Sierra Health Plans Sponsors 5,000 Providers Savings for Physicians in Managing Refills. Drug interactions are a soft savings.

9. Case Study – UHIN Challenge Connect providers and payers state-wide Put technology on provider desktops Work with community to collaborate Develop workable standards and open architecture Solution Technology manages clinical and administrative transaction flow Solution ties providers and payers together Application at each entity provides access Results First successful RHIO implementation in USA Tremendous reduction in payment cycles 100% Hospital and Payer Connectivity 90% Physician Group Connectivity

10. UHIN Usage This represents the customers in healthcare and who we target. By healthcare Providers we mean hospitals, physicians, and many other types of medical providers And by Payers, represented here by the dollar sign, we refer to health insurers like Aetna, Anthem Blue Cross, United Healthcare, HMOs, Medicare, and Third Party Administrators who process health benefits for self insured employers Between these two parties there are billions of trx that go back and forth every month. Today only about 15% are automated 85% of these trx are handled manually on telephone and on paper. HTP software automates these payment related transactions between hospitals and payers Payers are now ready for electronic-business but the hospitals do not have the necessary software for electronic –biz - HTP has been in the Payer market and now is the opportune time to aggressively go after the provider market focusing on hospitals. This represents the customers in healthcare and who we target. By healthcare Providers we mean hospitals, physicians, and many other types of medical providers And by Payers, represented here by the dollar sign, we refer to health insurers like Aetna, Anthem Blue Cross, United Healthcare, HMOs, Medicare, and Third Party Administrators who process health benefits for self insured employers Between these two parties there are billions of trx that go back and forth every month. Today only about 15% are automated 85% of these trx are handled manually on telephone and on paper. HTP software automates these payment related transactions between hospitals and payers Payers are now ready for electronic-business but the hospitals do not have the necessary software for electronic –biz - HTP has been in the Payer market and now is the opportune time to aggressively go after the provider market focusing on hospitals.

11. Administration Utah enjoys 25% lower health care costs compared to Nation Average – Dr. Sundall Mercy Health Partners finds $15 Million in new revenue in 6 months. Correct Eligibility a Key to Effective Clinical Transactions Accepted Model for Paying for Services. A Methodology for funding RHIO Activities.

12. Claims Conversion to HIPAA a Major Project for Everyone Move to Real-Time Adjudication Major Payers in Utah Runs Adjudication every Hour Real-Time Claim Adjudication Examples Palmetto – BC/BS of SC Georgia Medicaid Anthem – Limited Scope Returns Claim Status or Remittance Huge Savings

13. Eligibility Eligibility Correct, 95-97% of Getting Paid Check Eligibility at Registration Check Eligibility as Scheduling Appointment Check Eligibility on Created Claim Check Self-pay and Bad Debt Obtain ROI by Checking Eligibility Often Eligibility is the Key to Every Process

14. Case Study – Mercy Health Partners Challenge Self-pay Accounts Other Vendor Options Too Costly Solution – HTP Transaction SentinelSM Data Feed from HIS Operational within 30 days Results 320,000 Accounts Processed through August ‘05 $14.0 Million Found (> $1 Million/month)

15. Claim Status Monitor Claim Progress Let Computers Perform the Work Let people add value to the process Fix Problems Quickly Allina Health One Payer Reduced One FTE Increased Revenue by $75,000 per Month by Eliminating Write-offs

16. Remittance Advice (ERA) Payers are Starting to Market ERA Payers Offering EFT New “Check 21” Applications Automate Postings New Lockbox Applications Improve Posting

17. New Workflow for Administration

18. RHIO – The Platform for Administration Major Payer/Provider 835 Implementation Takes 6 Months in Current Environment RHIO Process Projected to Take 6 Days CORE Rules Expected to Expand Use of Eligibility Concentration of Providers Produces Incentives to Payers for Innovation Educate Payers that of Savings at Payer as Well as Provider

19. Goal of a RHIO Improve the cost and quality of the delivery of healthcare for the community and most importantly–our family!