Quick Facts. Company. Services and Solutions. Contact us. We are proud members of

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1 Company Phoenix Healthcare Services provides customized solutions for effectively managing medical practices of all sizes and has solidified its status as a premiere full-service revenue cycle management and provider solutions company nationwide. We possess the reputation, scope, service, knowledge and technology to successfully partner with your practice so you can stay focused on what you do best. Services and Solutions Coding services performed by certified professional coders Billing and revenue cycle management services performed by certified medical reimbursement specialists Managed compliance services performed by certified compliance specialists Contracting, credentialing and payer management services including provider portal and tracking under-and overpayments Electronic health record connectivity, offering functional, simple and fast interfacing with more than 100 popular EHR s Patient financial engagement solutions promoting a financial dialogue between provider and patient Quick Facts Served clients across 20 states in 16 specialties Represent all-size practices, from sole providers to multi-specialty hospital groups with 50+ providers Maintain 100% client satisfaction since 2008 Increase revenues as much as 8% from payer contract analysis, renegotiation strategies and dramatically reducing overhead Save practices on average 4 10% in operational costs with collection increases up to 30% Data securely managed in SSAE16-certified data centers with first-class redundancy Connected to more than 2,500 payers, including advanced under- and overpayment analytics Awarded Gold Standard status by retaining a 99.6% clean claims rate Refreshingly simple fees Contact us Practice intelligence reporting solutions providing integrated operational, financial and clinical analytics We are proud members of AAPC (American Academy of Professional Coders) AMBA (American Medical Billing Association) HCCA (Health Care Compliance Association) MGMA (Medical Group Management Association) NAMSS (National Association Medical Staff Services) Office Franklin, TN Local: Toll Free: Fax: Web: Office Bradenton, FL Local: Franklin, TN 37064

2 Our Culture Every Day See what s behind it H E A L T H C A R E S E R V I C E S Mission To help medical practices of all sizes navigate the evolving healthcare environment by providing them with customized billing and management solutions so they can make the patient, not paperwork, their focus and top priority. Vision To be the leader in knowledgeable, reliable, customer service-oriented medical billing and management solutions, recognized for fostering a corporate culture of excellence and trust among its clients and employees. Core Service Values Professionalism Products, services and interactions with Phoenix staff are the best in class with consistent and competent delivery of results. Respect The Phoenix Healthcare Services staff is known for treating each person with individual consideration, understanding and dignity. Responsiveness Phoenix readily and willingly reacts to client requests and suggestions, and are timely in following up on these requests. Competence Phoenix is known for its expertise, high standards and delivery of reliable results. Empathy Phoenix understands what it s like to walk in the shoes of its clients, and treats each person with care and understanding. So you can stay focused,,,,, Web

3 Phoenix Full-Service Revenue Cycle Management So you can stay focused Why people choose our RCM service. Scope. Expertise. Innovation. Unbeatable Value and Savings. Empowering reports and benchmarking KPIs Benchmarking with key performance indicators (KPIs) is a proven method of driving operational performance and increasing efficiencies. Choose from hundreds of standard reports, other reports from similar companies in our space, or custom reports created to suit your specific needs. In addition, we can attach and manage dashboard plugins to completely automate revenue cycle monitoring and analysis. Set your goals and we continuously monitor practice and provider performance against each target. Reports can be pushed via , exported to Excel/PDF or displayed as interactive dashboard screens with color-coded charts, graphs, gauges and tables. Valuable payer contract analysis We have the technology, knowledge and technical expertise to analyze detailed data to identify payer underand overpayments. Our solution and workflow identify thousands of dollars in potential lost underpayment revenue and assists staying compliant with payer overpayment refunds. Automated scheduling and appointment reminders Enjoy the flexibility of customized views and templates for your specific scheduling needs. Reduce no-show rates by taking advantage of custom, automated schedule reminders voice, text and hearing impaired along with status reports that are conveniently sent directly to our desktop. Effecient eligibility and benefits verification Minimize the number of keystrokes and valuable office personnel resources by covering the major payers automated eligibility and benefits information directly from the scheduling software or practice management system. Flexible and fast charge capture Pre-loaded fee schedules, modifiers, CPT, and ICD-9 codes make entering a charge fast and easy. Using EHR pass-through technology, or a free mobile application (for ipad and iphone) to enter charges electronically and view appointments, eliminates the paper. Impressive patient financial engagement and accounts receivables management To maximize patient collections and important cash flow, we leverage secure innovative SaaS technologies including secure delayed settlement, payement plans, card on file, and visit estimator with available PM integration. Following specific practice protocols, customized patient statements are mailed with the option for payments via web portal. Ongoing insurance AR management We monitor closely claims that are not processing within the contractual and usual adjudication times. Once claims are identified outside our benchmarks, our accounts receivables departments follow up with the payer for claim status and take the appropriate action to speed up the average days to pay. Effective claim denial management Managing denials is a crucial focus to a thriving revenue cycle and is one of the hardest areas to manage and follow up on. Thus, it s an area that is typically not invested in. We have the tools and technology to identify and respond quickly to incorrect denials and, if necessary, communicate time-of-service denials to the applicable practice stakeholders to reduce the chance of the same denial occurring. Reliable review and pre-scrub tools We boast an average clean claims rate of over 99 percent as well as acceptance from all payers. Claims are reviewed by trained, certified coders and reimbursement specialists. Before uploading to the clearinghouse, we run claims through pre-scrubbing solutions to identify any payer-specific requirements, LCD and NCCI. Seamless claim processing We send applicable primary, supplemental and secondary claims electronically to increase claim acceptance rates and payment times. They re sent to the payer within our pre-agreed timeframe typically 24 or 48 hours from charge creation. We also keep in touch with payer changes, saving you from the timely, costly task. Accurate payment posting All payments are either sent directly from the payer to the practice s dedicated address or via electronic funds transfer. We will save you time by receiving electronic remittance advices (ERAs) directly from the payer. Plus, receiving the ERA so quickly enables us to follow up on unpaid claims faster and forward the balance to supplemental payers to speed up the average number of accounts receivable days.,,,,, Web

4 Phoenix Contracting Services Strategy, modeling and negotiation Most practices have never re-negotiated their managed care contracts due to the lack of data, technology, expertise and time required. Successfully re-negotiating managed care contracts can yield revenue increases of up to 12 percent. Our services empower you to quantifiably negotiate the most favorable terms and rates. Who We Work With Ambulatory surgery centers Audiologists Behavioral health Chiropractors Clinical laboratories Diagnostic testing facilities Hospitals Multi-specialty group organizations Optometrists PAs/NPs Physical, occupational and speech therapy Physicians Podiatrists Solo practitioners Urgent-care facilities Our Valuable Strategy, Modeling and Payer Negotiation Tools If you can t remember the last time your payer contracts were re-negotiated, don t miss out on the opportunity to save by taking advantage of this valuable service. Our group of dedicated professionals can help you: Establish direct connections with payers, built on the years of investing in valuable, professional, long-term relationships. Skillfully negotiate every payer, armed with real-time charge data for every code in the nation, including your specific ZIP code, as well as proposed language and financial modifications that can be used as counterproposals. Benchmark charges and negotiate terms against prevailing market rates by percentile from the 25th through 95th and identify potential over/undercharges to focus your rate setting. Calculate and store precise payments for your services with the ability to adjust conversion factors and apply percent-of-medicare values to your fees instantaneously. Evaluate new payer arrangements as they are presented to the organization. Assess the potential profitability of expansion opportunities with reliable, real-time data, based on more than one billion actual claims. Resolve late or inaccurate payment problems based on contracted terms. Use data to optimize out-of-network pay and know whether out-of-network reimbursement from the payer is fair. Be able to compare non-par revenue against par-revenue at offered contract rates. Calculate financial impact reports to create what if scenarios, including custom carve-outs and actual payment history. Verify and maintain payer online portals to display correct provider and practice demographics. I have worked with Carrie Dyle for the last 10 years. I found her to be a responsible, knowledgeable professional with excellent work ethics. Whenever I asked Carrie to complete a task, it was done quickly and accurately with the utmost professionalism. Christine Culver Manatee PHO Coordinator We understand your needs. Fast-track service is now available. Contact us for more details.

5 Phoenix Credentialing Services Fast, accurate and secure For physician and organization reimbursement, it s critical to have designated, well-managed credentialing and re-credentialing services. That s exactly what you get at Phoenix Healthcare Services. We combine decades of experience and established payer relationships with state-of-the-art, web-based credentialing software hosted in our SSAE16 HIPPA-compliant datacenter. This promptly and accurately completes the credentialing applications required to become enrolled, re-enrolled, or change or add any group or individual information. How We Can Help Experienced professionals provide peace of mind with comprehensive strategies and services at any stage: Starting a new practice Transitioning from one practice to another Changing or expanding locations Adding new practice specialties Changing your tax ID number or billing address When managed care credentialing paperwork inundates group practices Combining Technology, Experience and Knowledge Fast and accurate. With our managed library of hundreds of credentialing applications and forms, we promptly and flawlessly populate many different applications from a single data entry source. Intuitive tracking and maintenance. Our application tracking feature monitors and identifies expiring credentials to ensure contracts are kept up to date, and it tracks applications throughout the entire enrollment process. Reports and flags. We have more than 75 useful tracking reports and customizable dashboards providing information at our fingertips. Secure and accessible. Providers and external users can access data online. Access can be customized for different groups of users, assuring a high level of data security and easier access. Providing Comprehensive Credentialing Services Agency for Healthcare Administration) Ambulatory surgical center Behavioral health services Bio medical waste CAQH enrollment CLIA application and processing Commercial payers DME enrollment Hospital privilege enrollment Malpractice insurance Managed care Medicare enrollment and re-validation Medicaid Medical licenses NPI registry Primary source verification State licensing enrollment Surgery level II and III registration program Workers compensation payers We understand your needs. Fast-track service is now available. Contact us for more details. Connect with Carrie Dyle. Director of Credentialing, Contracting and Payer Management Services More than 20 yrs of experience

6 Phoenix Payer Management We re leveling the playing field between payer and provider H E A L T H C A R E S E R V I C E S Managing Contracting, Credentialing and Payer Management services is key to maintaining a competitive and profitable practice. Having Phoenix Healthcare Services manage these for you will not only save you time, but will also give you quantifiable returns that directly impact your bottom line. Who We Work With Ambulatory surgery centers Audiologists Behavioral health Chiropractors Clinical laboratories Diagnostic testing facilities Hospitals Multi-specialty group organizations Optometrists PAs/NPs Physical, occupational and speech therapy Physicians Podiatrists Solo practitioners Urgent-care facilities Unbeatable Value Because we are industry experts who fully understand the revenue cycle, and provide fast, accurate and thorough service, you might expect to pay top-dollar for the peace of mind and quality you receive. Typically organizations charge from $150 to $450 per contract with limited critical reactive services and minimal on-going management. You may be surprised to learn that we can offer you these proactive services starting at $50 per contract and $50 per month per provider and practice. How We Can Help We have successfully partnered with practices of all sizes from solo providers to multi-state and speciality healthcare systems covering over 16 States. We can help you by providing comprehensive strategies and services at any stage: Starting a new practice Transitioning from one practice to another Changing or expanding locations Adding new practice specialties Changing your tax ID number or billing address Providing relief when paperwork inundates internal resources Keeping compliant with payers and reducing the chance of audits Providing access to your data via online provider portal Identifying new payers entering markets and re-negotiate existing payer contracts Manage the multiple tasks throught the year to keep providers and practices current. Such as CAQH attestations, NPI and W9 updates, tracking expired documents, manage fee schedules and managed care grid updates. After working in a private school for seven years, I was in the dark on how to become a provider for insurance companies. Phoenix Healthcare Services was crucial in helping me start my private speech-language therapy clinic. I have had excellent service from day one with friendly and helpful staff who are working to navigate the confusing world of insurance companies for me. Lindsay B. Overton MS, CCC-SLP Speech Language Pathologist/Owner, Lindsay s Chatterbox, PLLC

7 Phoenix Denial Management and AR Resolution Services Effectively collecting on old accounts Phoenix Denial Management and AR Resolution Services help medical practices recover unresolved insurance accounts receivables without requiring any changes in current process, new technology or system changes. You ll have a dedicated team of specialists to analyze unpaid and underpaid claims, while working on your system, and then aggressively follow up with insurance companies to recover maximum payments. Key Benefits Support for practices who: Are too busy to work denials Are short staffed Lost of a key employee Experiencing growth Have an inefficient system Want to increase cash flow High return Phoenix Healthcare Services is paid a percentage of what is collected. Therefore there is no up-front capital investment and no monthly minimum fee. Plus Minimal interruption to current cash flow and processes. More valuable resources If required, providing dedicated payer contracting and credentialing staff. A growing challenge and burden on medical practices Unresolved insurance accounts receivables is a very common problem within medical practices of all sizes. Many find that their insurance receivables keep growing despite their own efforts, and it results in a significant financial burden. An ideal solution that doesn t require you to outsource billing Put the money that s tied up in your old AR into your bank account. Receive an expert, ongoing review of your current billing outcomes, including your coding, adjustments, payment posting and follow-up techniques. Lower your working capital needs by reducing your days in AR. Clean up your AR by removing unpayable claims. Focus on what you do best. PHCS has helped medical practices recover tens of thousands of dollars from insurance companies in lost reimbursements and denials. Thoroughly evaluating accounts receivables and key metrics Identifying flaws in existing process Re-engineering the AR process to meet best-in-class practices,, Quickly deploying a team of experts, including certified coders and reimbursement specialists Auditing all accounts to settle unidentified and duplicate payments Managing claims more than 90 days old Sending proven, successful appeal letters to payers Calling patients to verify demographic details or obtain missing information Cleaning up old account receivables

8 Patient Financial Engagement Simplifying the payment process H E A L T H C A R E S E R V I C E S The Patient Financial Engagement (PFE) module promotes a financial dialogue between patient and provider, making collections more affordable, convenient and transparent, whether at the time of service, before or after. Practices can expect an increase in revenue as a direct result, and remain compliant. Key Benefits For Practice: Increase collection rates and profitability Increase cash-flow and decrease AR Intelligent administrative dashboard Improve work-flow efficiency Decrease denied claims Cloud virtual merchant terminal Integrate with your Practice Management Program Increase patient appreciation and satisfaction Top Three Reasons Patients Don t Pay 1. Lack of financial options 2. Statement delays 3. Confusion about what is owed (epay Healthcare, Top 3 Reasons Your Patients Don t Pay, 2013) Multiple Options In One Intelligent Solution Patient financial solutions - Simplifying the payment process. Card on file. Adds convenience to future visits and outstanding balances, and allows for payment plans without compromising security. Delayed settlement. Delayed settlement allows for collection of remaining patient responsibility, post-adjudication, without costly phone calls and statements. Patient plan. Gives patients the option to make manageable payments for large-dollar obligations and outstanding balances. For Patient: Save time with the convenience of online bill pay Increase transparency Worry-free automated payments Clear summary of charges and payment schedule The thought of leaving a grocery store or gas station without paying for products and services is laughable. But that s what happens with about one-third of patients. MGMA, Perspectives on Patient Payments, 2010 Online bill pay - Payments made easy. Accept payments 24/7. Provides a custom URL allowing patients to pay easily and securely.,, Eligibility Inquiry - Determine the right dialogue with confidence. Real-time inquiries. Enables you to query over 400 payers in real time to quickly and easily understand insurance benefits and confidently engage a financial dialogue surrounding patient responsibility. Payment Estimation - Improve efficiency by estimating payment obligations. Payment clarity. Enables you to pre-load payer fee schedules to estimate patient responsibility prior to a procedure or immediately after the time of service. Rises in patient responsibility. Recent estimates say that 30 percent of all provider revenue is coming out of the patient's pocket and according to a study from McKinsey Quarterly, more than half of patients are willing to pay a portion of what they owe up front.

9 Managed Compliance Services So you can stay focused Phoenix Healthcare Services provides comprehensive compliance services and resources to protect medical offices, physicians and patients. We can help you ensure quality care is provided in compliance with OIG and HIPAA requirements, fraud, abuse and anti-kickback laws. 8 Compliance Protocols as required by the OIG guidelines 1. Annual Risk Assessment 2. Written policies and procedures including a Code of Conduct 3. Designated compliance officer and structure 4. Training and education for every employee 5. Auditing and monitoring 6. Reporting and investigation 7. Enforcement and discipline 8. Response and prevention The Mandate For Total Compliance Today s complex evolution of healthcare is changing the way we manage medical offices and partner with hospitals and suppliers. At the same time, the Office of the Inspector General (OIG) mandates total compliance with constantly changing rules and regulations. Without an effective compliance plan, medical offices and stakeholders are at risk for severe fines, penalties and criminal liability. Payers have increased audit programs to reduce fraud, waste and abuse, resulting in more frequent random and planned onsite chart and claim audits. Data mining software makes it easy for them to spot anomalies. Even honest mistakes can trigger an audit, and it is no longer a question of whether or not a practice is audited, but when and to what extent. Providing An Effective Compliance Program After a thorough risk assessment, Phoenix Healthcare Services certified staff creates and delivers an effective compliance program using the criteria specified in the OIG guidelines. Review: We ensure set policies and procedures are clear, current and accurate, while recommending changes and additions. Audit: We audit coding, charting and billing to identify risk areas and assist you in setting up monitoring programs in your operations. Education: We provide staff compliance orientation and continuing education, including HIPAA, ICD-9/10, CPT, HCPCS, False Claims Act and standards of conduct. Communication: We develop reporting systems to monitor questions and complaints. Our compliance team will respond to reports and investigate complaints and violations. Evaluation: We assess the effectiveness of your compliance program, addressing recurring problems and adjusting policies and procedures for regulatory and operational changes. The compliance program offered by Phoenix Healthcare Services is an invaluable resource for medical practices. It alleviates the headache of having to stay on top of evolving rules and regulations, freeing up time and energy to be focused elsewhere. Brian Lasker - President, MGMA, AL, and Birmingham Surgical, P.C.