DON T DROWN IN A SEA OF PAPER Jopari ebill Jopari ProPay Jopari Provider Portal Jopari Adjustor Portal Jopari Remittance Gateway Jopari Attach

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1 DON T DROWN IN A SEA OF PAPER Jopari ebill Jopari ProPay Jopari Provider Portal Jopari Adjustor Portal Jopari Remittance Gateway Jopari Attach

2 Jopari ebill Takes the Cost and Pain of Paper Out of Medical Transactions Jopari Solutions, Inc. s Jopari ebill product delivers full State jurisdictional and Federal EDI transactional (ASC X12N) compliant electronic medical bill and attachment processing to Property & Casualty Payers (Workers Compensation, Auto Medical and other coverage areas) through a hosted transaction gateway, in addition to an expanding Payer-Provider connectivity network. With Jopari ebill, electronic medical bills and attachments are received from Providers, billing services, clearinghouses, and other sources. They undergo indexing, validation for required data, are normalized and delivered to the Payer in their required specified formats, ready for medical bill processing. Jopari ebill, since 2007 has established itself as the Workers Compensation Industry s leading electronic billing solution, providing you with the winning strategy for ebill compliance and improved processing performance. Capabilities Jopari ebill allows you to immediately achieve full compliance with state and federal administrative transaction and operating rules, thus ensuring a nationwide, fully compliant solution for electronic bill and Attachment exchange as well as remittance advice delivery. Jopari ebill reduces mailroom manual workload, automates indexing, and ensures that only complete clean bills enter into the Payer s bill review or claim management system thereby significantly reducing, and in many cases virtually eliminating, manual and paper intensive processes. Jopari ebill furnishes the P&C industry s leading connectivity network consisting of 4,000+ Payers and excess of 850,000 Providers, both directly and in partnership with most of the prominent regional and national clearinghouses. Benefits Jopari ebill directly generates savings in administrative expenses by: improving bill data input accuracy; eliminating incomplete bills, missing attachments and duplicate bill submissions; decreasing bill/payment status call volumes; and establishing a Provider self-service data tracking and auditing capability.. Jopari ebill is integrated with many leading bill review and claims management systems, and therefore capable of delivering bills in the format the Payer s existing applications expect a critical step in minimizing implementation impact on Jopari client IT resources.

3 Jopari ebill Connecting with 4,000+ Payers & 850,000+ Providers Features: Supports the Full Set of ASC X12N Transactions 837 / 275 [Bill / Attachment] TA1 999/997 / 824 [Acknowledgments] 277 [Bill Status Inquiry / Response] 835 [Remittance Advice] Other mutually agreed formats (as needed) Ensures The Payer Only Receives Clean Bills Interchange-level Validation ASC X12 Validation Clean Bill / Jurisdictional Edits / Attachment Rules Payer-specific Edits and Rules Converts Bills to Payer s Specified Format No Need to Modify Existing Applications Support for Non-Standard EDI Bill Formats Images of HCFA / UB / NCPDP /other state forms rendered from Bill Data Payer Rule Dependent (Optional Feature) Attachment files as TIF, PDF, HL7, as well as other formats Includes Management of Provider Relations EDI Trading Partner Agreement generation, execution and management Provider recruiting, service and support Provides Enhanced Document Management Solutions That Improve Claims Operations Inbound Images of Bills / Attachments (Payer / Configuration Specific) Meta Data / Image Indexing

4 Jopari ProPay The Next Generation of Payment Capabilities The industry leader in Property & Casualty ebilling connectivity and payment processing introduces the next generation of payment capabilities Jopari ProPay. For too many years the P&C industry standard for processing medical payments has been to generate a paper check and attach an Explanation or Reimbursement or Benefit (EOR or EOB). But the expectations of the provider community have changed because electronic methods of making payments and returning remittance information are widely deployed. Technologies such as Electronic Funds Transfer (EFT), Electronic Remittance Advice (ERA) and even the use of credit card based payment systems are becoming more widely accepted. These methods can be much more efficient and desirable and are available right now from Jopari. Jopari ProPay brings to the P&C industry flexible, full spectrum payment methods that work in concert with a Payer s existing bill review, claim, and financial systems, allowing Providers to choose the payment method that best suits their practice or organization s needs. Jopari ProPay leverages advanced disbursement technologies to: (1) reduce costs of payment processing; (2) increase accuracy; and (3) streamline cash and remittance flows for both Providers and Payers. Features The Full range of secure payment methods checks, paper EOBs, EFT, ERA, and Payment Cards Secure Online Provider enrollment for EFT as well as full banking information management routines, eliminating the need for a Payer to store and handle that data Access to a growing network of enrolled Providers for EFT\ERA Integrated Provider Portal to allow searching/viewing/downloading EOB and payment information, virtually eliminating the need to distribute paper copies State-of-the-art fulfillment capabilities to support, when needed, the output and mailing of checks, EOBs, forms, and correspondence Ensuring the highest security with full audit trail and user access controls Backed by an Industry-leading engineering team and technology infrastructure supporting hundreds of Payers and thousands of Providers across all 50 states

5 Jopari ProPay Eliminating the Pain and Cost of Paper Benefits: Jopari ProPay streamlines payment processes and remittance advice management, ensuring compliance with federal and jurisdictional operating rules/timelines while creating a full audit trail of all disbursement activities Payers have complete visibility to and control over the payment process, affording claims financial staff with functionality that often exceeds even the capabilities available from their internal or banking systems. Jopari ProPay Reduces the overall expense of making payments by offering a unique array of payments methods that afford both the Payer and Providers the optimal means to fulfill the medical reimbursement component of claims management and handling of accounts receivables Jopari ProPay makes self-service tools available to Providers, reducing the volume of payment status inquiries to the Payer s Help Desk and Claims Staff allowing them to focus more on claims outcomes Jopari ProPay robust payment tools measurably improve the accuracy and timeliness of payment transactions which will deliver additional benefits for both Payer and Provider financial staffs Jopari ProPay is engineered to allow for integration with Payers and Providers financial systems and banking arrangements, so that existing processes and relationships are in fact augmented

6 Jopari Provider Portal The Jopari Provider Portal product offers Medical Providers the functionality to deliver full ASC X12 electronic bill and attachment processing to Property & Casualty payers (Workers Compensation, Auto Medical and other coverages), as well as return of Remittance Advice information, while providing a complete audit trail of the transactions. Electronic bills and attachments sent by Providers, their clearinghouses, or other sources are indexed, validated, normalized, and delivered to Payers in their formats so they are ready for processing. The Essential Compliance Resource Jopari Provider Portal enables full and immediate compliance with state and federal medical EDI Administrative Transaction and operating rules. And is being used by Providers and Payers in every state. Improved Payment Cycles Jopari Provider Portal expedites processing by Payers, ensuring that only clean complete bills enter into Payers bill review processes thereby reducing or virtually eliminating duplicative / incomplete bill submission that so often entails costly adjudication and payment delays. Industry-Leading Connectivity Jopari Provider Portal Jopari offers the P&C industry s most extensive connectivity network including integration with most leading practice systems, revenue cycle management systems, as well as clearinghouses. Jopari is continually building our global connectivity partner network to serve the transaction processing needs and objectives of our expanding connected Payer and Provider communities.

7 Jopari Provider Portal The Industry s Chosen Connectivity Network Features: Supports the Full set of ASC X12 Transactions 837 / 275 [Bill / Attachment] TA1 999/997 / 824 [Acknowledgments] 277 [Bill Status Response] 835 [Remittance Advice] Other mutually agreed formats (as needed) Ensures Only Clean Claims are Received by Payers Interchange-Level Validation ASC X12 Validation Clean Bill / Jurisdictional Edits / Attachment Rules Provider-specific Edits Payer-specific Requirements Supports a Wide Range of Methods for Submission Direct data entry for low-volume Providers, or those with limited IT capabilities Portal upload from your existing system of medical bill data EDI file interfaces Attachment files can be faxed, uploaded to the portal, or submitted by automated feeds Includes the Management of Payer Interfaces EDI Trading Partner Agreement generation, execution, and management Payer recruiting, servicing and support Online full audit trail of all edits, responses, and remittance information

8 Jopari Adjustor Portal The One-View Solution Jopari Adjustor Portal, brought to you by the leader in integrating Property & Casualty and healthcare industry technology, is designed to assist Payers considering or already transitioning to paperless claims operations. This web-based productivity tool integrates with a wide array of bill review and claims management systems to allow claim staffs the benefit of one-view presentment of incoming electronic and paper-based medical transactions. Paired with the Payer s document management system, Jopari Adjustor Portal is a powerful tool helping to upgrade operational metrics by facilitating fully electronic productivity. Delivers Broad Support for Paperless Workflow to Property & Casualty and Group Health Payers. Offering Comprehensive paperless document management, combined with a secure electronic archive engineered to be compatible with both front-end and back-end Bill Review workflows. Integrated support for existing document management infrastructures, including presentment of: Medical Bill and Attachments Images of the Payment Record (Check or EFT) Images of Remittance Advice (EOR/EOB)

9 Jopari Adjustor Portal Single Workflow Architecture Seamless Support for ebill & Paper Bill Processing Inbound EDI Bill Data / Bill and Attachment Images Inbound Paper-converted Bill Data / Bill and Attachment images Secure User Authentication Individual user access with multi-level Password Security Rules Rights / Roles Administration Establish each users privileges from view only to full processing rights to Administrator roles Create escalation rules and queues, reassignment and modify workflows Bill to Claim Indexing Bill to Provider File Indexing Bill Validation Jurisdictional Rules Payer Specific Rules Flexible Manager / Adjustor View Inbound Task List Management Bill Approval / Payment Approval / Bill Re- Indexing ebill and Attachment View Jurisdictional Payment Timeframe Indicators Rendered Clear View Bill Image Rendering Bill Data Payer Specific Task Escalation Approval / Reject / Re-Index Approval Routing to Bill Review Feedback / Messaging from Bill Review Vendor (Optional) Notes Claim Level / Bill Level Diary Records Claim Level System Events Integration of Notes / Diary to Claims Management System / Documents Payment Approval Workflow Queue (Optional) Approval / Adjustment / Denial Denial Reason / Free Text Accommodation Dashboard View for locating data Robust Search / Retrieve capabilities Support for: Paper-converted Bills, correspondence and reports EDI Bills and attachments Payment Records Diary / Notes

10 Jopari Remittance Gateway Over the past few years, focus by regulators has been aimed at streamlining the reimbursement flows between medical Providers and Payers. A growing inventory of standards and Operating Rules has been enacted. Most of those efforts revolve around the use of Electronic Funds Transfer (EFT) processing and Electronic Remittance Advice (ERA) delivery. Jopari, a leader in assisting Providers and Payers to streamline their payment interactions, introduces Remittance Gateway, the solution enabling full compliance to meet those evolving requirements and improve the payment processes of the Group/Commercial Healthcare as well as Property & Casualty markets. Strategic Management of EFT enrollment and EOR/EOBs Jopari Remittance Gateway enables Payers to automate fully compliant EFT enrollment/management and Remittance Advice (EOR/EOB) communications with Providers. Full ASC X remittance facilities. Standardized online enrollment for Payees. Secure portal services for Payer and Provider staffs. Comprehensive connectivity and support. Global industry linkage. Delivering major expense reductions through: Decreased friction from extra phone calls / added bill cycles Streamlined handling of payment status inquiries Reduced appeal / reconsideration processing Claim adjustors gain 25% more time to handle core claim activities Processing of Provider Reimbursements Jopari Remittance Gateway offers Providers a comprehensive set of A/R cost reduction services including: Single point of EFT enrollment/management for a growing list of payers Online display and management of banking information, controlled by assignable roles/responsibilities of staff Secure online bill / payment status anytime, anywhere Ready access to View/ Download / Print PDFs of EORs/EOBs and payment records Access 835 data as images, Excel or Text files, or even a downloadable 835 Robust archive tools for searching payment history to evaluate past payments / remittance processing activity Cost Reduction With Jopari Remittance Gateway web portal, Provider Payees A/R staff can now quickly find their own answers using self-guided, easy-to-use search criteria and navigation. No more lost, missing, mismatched or delayed remittance information and protracted reconciliation of payments.

11 Jopari Remittance Gateway Complete Automation of Remittance Workflow Features: Electronic EOR / EOB Delivery EORs/EOBs can be delivered in PDF format, avoiding manual processing and cost of printing, handling, and mailing paper copies Expedites re-association of payment information with EOR/EOB Eliminates lost EORs/EOBs while expediting account reconciliations Frees up staff time for revenue-enhancing functions Seven Year Remittance and Payment History Payees are provided access to up to seven years of remittance and payment history. Secure remote archive delivers a value-added resource Robust search function permits easy access to authentication protected payment data Online EFT/ERA Payee Registration Payees can take advantage of simple online registration to receive EFT payments and electronic remittance from a growing number of Jopari connected Payers. SSAE 16 Type II Assured Performance: All aspects of Jopari Remittance Gateway solutions are SSAE 16 Type attested. Jopari adheres to full spectrum SSAE 16 Type II attestation requirements that apply to all third-party vendor relationships involved in the support of our Remittance Gateway products and services. More information about Jopari s SSAE 16 Type II Certification process is available by request at info@jopari.com.

12 Jopari Attach Innovation in Exchanging Attachments From the same people who revolutionized claim administrative attachment handling in the Property & Casualty markets, Jopari Solutions introduces Jopari Attach. Now Jopari extends that ability to deliver administrative and clinical attachments to Group and Commercial plans utilizing the same set of document exchange tools Providers have been using for years to send millions of attachments per month to Workers Compensation and Auto Medical Payers. The Healthcare Documentation Problem Demand on Providers to deliver much more timely and efficient substantiating documentation to Group and Commercial Payers is growing rapidly. Until now, most requests for healthcare services documentation have been handled by mail, often after claim transactions have already been delivered to the Payer. Changing business conditions have brought about such health plan innovations as real time adjudication, expedited payment models, as well as the need to establish other deciding factors of the care being delivered. These rapid processing models require Providers to expedite documentation in order to avoid incurring costly delays in the adjudication process, both for themselves and their Payers. The Business Solution: Jopari Attach For 10+ years Jopari has furnished the leading connectivity network for the Property & Casualty marketplace. From the start we resolved the documentation exchange challenge by developing innovative tools that deliver great flexibility to Providers in submitting required substantiating documentation, regardless of the level of their internal office automation. These tools include: Secure Portal upload of documents or images Secure fax server using bar coded coversheets FTP or SFTP feeds on image files Web services interfaces with EHR/EMR products Contact: Don St. Jacques at

13 Jopari Attach Payers of all Types Jopari s competitive advantage is establishing innovative integrations with payer systems, including claims adjudication, payments, and documentation management systems. Jopari provides attachment integration with hundreds of P&C Payers today. Group and Commercial Payers rely on many of these same systems and document management tools. This means our unique expertise enables effective and efficient delivery of attachment files for Payers of all types: In their required format With required indexing Allowing automated ingestion into their claims review processes With minimal impact on Payer IT resources Key Features Eliminates mailroom costs with secure electronic delivery Expedites claim adjudication cycles Establishes delivery audit trails for both Provider and Payer Enables significant reductions in duplicate submissions Allows for use of flexible formats Jopari Attach rules-based processing engine allows Payer specific requirements for documentation to be managed electronically, eliminating dependence on manual review Contact: Don St. Jacques at don_stjacques@jopari.com

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15 WHAT OUR CLIENTS SAY ebilling is a prime example of faster, cheaper, better through innovation. Peter Rousmaniere Workers Compensation Industry Expert and frequent contributor to Risk & Insurance Magazine ebill penetration continues to rise and related automated processing has lowered the turn-around time for payments by 33 percent. Kim Haugaard Vice President Network & Medical Operations Texas Mutual Insurance Concentra has seen an improvement in over 15 days in payment cycles, and communications with the claims staff is timelier. Greg Gilbert SVP of Reimbursement and Governmental Relations Concentra, Inc. Since we started e-billing our revenue has increased. Our payments are received faster. With Jopari, we can provide proof of billing very easily. Lauren Eggleston Director of Collections, WolMed Medical P.A. Our customers include a wide variety of providers and many treat WC patients. For both customer satisfaction and retention, it was an imperative for ZirMed to offer ebilling capabilities. Dave Fielding VP of Payer Relations ZirMed, Inc.