AGED CASH REPORT

Cardiology

www.RemitDATA.com

Overview of Reimbursement Pro™

What is Reimbursement Pro? Reimbursement Pro is a web-based reimbursement tool that works alongsideANY practice management software on the market including Medisoft/Lytec©, Medical Manager/Intergy©, Mysis/Medic©, GE/Centricity©, NextGen© and many more! Reimbursement Pro tools include management reports, collection tools, and benchmark comparative studies. Best of all -there’s NO NEW SOFTWARE to buy or install. Our goal is to help you better manage your reimbursement process so you can get what’s coming to you- your cash!

What is the benefit? INCREASED CASH FLOW and IMPROVED PRODUCTIVITY! It’s that simple. Our tools provide you with a proven way to work collections, accelerate your cash and cut your labor costs. The results have been outstanding with most clients reducing denials by 20-30% and saving countless hours of labor. Please read our real-life testimonials on the next page.

What do I get? Reports, tools, benchmark studies and much more (see examples on following pages):

1. Insight™ Management Reports: These real-time reports help you pinpoint problematic collection issues and eliminate the source. With one click, you can review your overall denial rate, most common denial reasons, denial rates by procedure, aging reports, and much, much more. And these reports can be broken out by payer, by physician, by collector, etc. Use these management tools to determine if you have an intake issue, a billing issue, a process issue, an education issue or a disciplinary issue.Many RemitDATA clients have lowered their average denial rate to under 5% which means a HUGE improvement in cash flow! These reports help you IDENTIFY problematic reimbursement trends and fix them.

2. QuickTurn™ Collection Tools (Including our new “Q”) : QuickTurn tools are a collector’s DREAM! While our Management Tools help you track and improve reimbursement, QuickTurn was built to help collectors to “work” those collections more efficiently. Most providers still use antiquated processes and paper-based systems to work collection is. Reimbursement Pro users simply log into their account and click on their “Q” where collections are worked in a dynamic and real-time environment. And managers can track the Q to see where denials are in-process and monitor results. The result is that your staff doesn’t work from stacks of paper EOBs, but from a real-time, web-based tool that organizes and prioritizes their workflow. Faster cash, less labor. These tools help you work collections more quickly and effectively.

How does it work? The service is simple. We get copies of your Electronic Remittance Notices (ERNs) as you receive them - either direct from the payer (Medicare, Blue Cross, Medicaid, Aetna, Cigna, etc.), or fromyour clearinghouse if you use one. Not getting ERNs? No worries! Our highly-trained staff can help get you set up. Once set-up, our solution AUTOMATICALLY uploads copies of your ERNs. You simply log into your HIPAA-secure web account and start improving your cash flow immediately! No software, no servers, no hassles!

What are the next steps? Try it out for free! If you are not convinced of the value - then you owe us NOTHING. If you like what you see, simply sign up, and pay the low annual subscription fee. Please call 866885-2974, email [email protected] or visit www.remitdata.com to set up your trial today.

© 2008 RemitDATA, Inc. All Rights Reserved Telephone (866) 885-2974 | Fax (901) 312-7770

Testimonials

“RemitDATA is an excellent management tool to track, evaluate and correct internal reimbursement processes. It is extremely user friendly and allows the user to work denials with ease. I would recommend this product to anyone who wants to get a better handle on denials in their practice.”

- Rick Roney, Executive Director, Montgomery Cardiovascular Associates

“Because of Reimbursement Pro, we have been able to significantly reduce our denials for invalid diagnoses by educating our physicians and billing staff. Without it, there is no way we would have been able to pin point the problem areas.

- Eddie Barber, Executive Director, Cardiology Associates of North Mississippi

“If I took RemitDATA's Reimbursement Pro™ away from my billing department, they would kill me.”

- Jeanne Sakamoto, Practice Administrator, Santa Monica Hematology Oncology

“We’ve been using RemitDATA’s Reimbursement Pro™ for some time now, and have found it to beextremely helpful in our reimbursement process. We are glad to recommend this innovative company.”

- Vishal Ganju, Operations Manager, Ashland Bellefonte Cancer Center

“Our company has been involved in Oncology reimbursement for many years and frankly, I was blownaway by the power of Reimbursement Pro™. This simple-to-use web-based tool will provide tremendous value to our clients and to any physician practice seeking to accelerate cash flow, increaseproductivity and reduce expenses."

- Pete Lauterbach, CEO, AmerOnc, Inc.

"By utilizing RemitDATA's Reimbursement Pro™ our billing staff has substantially reduced the time it takes to bill and follow up on secondary claims. Integrating the software into our billing process hasresulted in a measurable improvement in our accounts receivable for our Medicare pay classes."

- Steven Elconin, Executive Director, Tower Hematology Oncology Medical Group

“RemitDATA’s Reimbursement Pro™ has been a tremendous benefit to our practice. Our investment in their low annual subscription fee has paid for itself many times over. And we love the integrateddocument imaging of WebScan Pro™. What a powerful combination!”

-Linda Edwards, Practice Manager, Hope Community Cancer Center

“We first signed on with RemitDATA because my staff loved the OnDemand EOBs and I loved the Management reports. Since becoming a customer we have learned there is MUCH more to thispowerful web-based tool. Reimbursement Pro™ has helped us to increase our efficiency and accelerateour cash in a way that has made a serious impact to our bottom line.”

-Krista Crump, Practice Manager, Hematology-Oncology Associates

“Southeast Cancer Network (SCN), Inc. is a leading cancer center in the Southeast and we are alwaysseeking ways to improve our operations. SCN has used a competitive solution to Reimbursement Profor nearly a year now. We were so impressed with the process improvements, reporting tools andcustomer support that we made the change to Reimbursement Pro™."

- Brian Driskill, VP of Operations, Southeast Cancer Network


Reimbursement Pro Report Descriptions

NOTE: Reimbursement Pro is compatible with ALL commercial payers who provide an ANSI-compliant ERN. Reports can be created for an entire practice or separated by physician, payer, collector, etc. These reports are available “realtime” (as soon as your ERN is uploaded), or can be set to “auto-generate” on a weekly or monthly predetermined date. Reimbursement Pro is 100% web-based, and 100% flexible to meet your needs.

1. Executive Dashboard Report: This report gives you a quick glance of 5 major “gauges” of your overall performance. In less than 60 seconds, the dashboard highlights your AR team’s performance and directs your steps towards fixing problem areas.

2. Claim Summary By Reason Code: This report tells you WHY you were denied, ranking the Medicare Reason Codes from most frequent denials to least. Problem codes can be identified and reduced/eliminated through staff education or billing process enhancements. Finding out WHY you are being denied is the first step!

3. Claim Summary by Reason Code and Procedure: This report reflects the reason codes listed above, but also lists each procedure (under each reason code) that was denied (ranked by dollar amount). Use this report to pinpoint the reason for claim denials as well as procedures being denied with those codes. The report shows your most common denials first with procedures receiving those codes ranked from highest $ billed to lowest. Pinpoint procedures receiving your most common denials codes, find examples easily in the claim detail report and investigate why you were denied. Then, provide training, new processes or audits to eliminate the denials.

4. Claim Summary by Procedure: This report gives your denial rate by procedure, ranking them by dollars billed. Some companies prefer to look at their data from a “product line” standpoint, and this report is for them. This report can be sorted down to the modifier level to further determine the source of the denial problem.

5. Claim Summary by Procedure and Reason: This report reflects the same procedure codes listed above, but provides a drill down into the REASON codes generated each time a procedure is billed. This report is the SAME as #3 above, except it is sorted FIRST by procedure AND THEN by reason code.

6. Aged Claims Report: Is your staff working old claims? Chances are you have no way of knowing without this report. This report summarizes and groups claims by whether they are paid or denied and then by aging bucket. 7. Average Payment Lag By Procedure: This report tells you the average age (DSO) for each procedure. “Hold Days” tells the number of days from the “Date of Service” to the day Medicare received the claim. “M/C Days” tells the number of days Medicare had the claim before adjudication. This report makes an EXCELLENT scorecard to motivate your AR team!

8. Charge Master Review-Carrier: This is an excellent management report that allows you to quickly review your charge master by payer. You can see, by payer, procedure and in total, the percentage of your billed charges that a payer is allowing and paying. Look for items with percentages of 100% (you may be billing below allowables!), or below 50% (you should reconsider taking assignment on these items!). YOU CAN ALSO EASILY PREDICT YOUR WEEKLY CASH FLOW WITH THIS REPORT!

9. OnDemand EOB: Click hyperlinks on the Claim Detail Report or use our powerful web search engine (screen shot of the web search engine displayed below) to produce HIPAA compliant, patient specific EOBs to your screen in only a few seconds! Just think –no more stacks of un-needed EOB cluttering up desks, no photocopying, no black magic markers. It is a collector’s dream come true! Only the EOB you want – only when you need it. In fact, we become your electronic “EOB Filing Cabinet” from your start date forward. A HUGE time-saver which can pay for the service in less than 90 days!

10. Q – Workflow Management Tool: Reimbursement Pro contains “Q”, our new powerful work-flow management tool. Now, instead of working from paper EOBs, or from existing printed reports, collectors simply log into their “Q” each morning to begin working their denials. From the Q, they can work denials, pull patient-specific EOBs, create Review Forms, add status notes, transfer to other users, and more. Managers can then track the results via Q reports and User Performance metrics. Q is truly the future of working denials. You have to try it to believe it! 11. OnDemand Forms: What a time-saver! If you are weary of hand-writing the necessary Review forms, then you will LOVE our new OnDemand Forms feature! Once our service confirms that a denial will require the review process, we pre-populate a report and place it into your weekly batch. This unique service NOT ONLY saves you 10-15 minutes per form, but guarantees 100% accuracy versus manual copying. Medicare, Blues, state Medicaid forms and many more!! Huge time-saver!


0

10

20

30

40

50

$0

$80,000

$160,000

$240,000

7846

5

9330

7

9298

0

A9500

9351

0

9921

4

9301

5

9332

0

7847

8

7848

0

32

44 45

29

45

27 3038

32 32

Procedure

Days S

ale

s O

uts

tan

din

g

$ P

aid

DSO by ProcedureFor Top 10 Procedures Ranked by $ Paid

0-30

31-6061-90

91-120121-150151-180

180 +

0-30 69.5%31-60 18.6%61-90 3.6%91-120 4.1%121-150 2.1%151-180 0.4%180 + 1.7%

Total: 100.0%

Aged Cash Graph

DOS to Pymt Date

15.85%PI97

9.92%OA24

8.31%PR18

7.05%PR16

5.03%CO18

53.84%Others

PI97 15.85%OA24 9.92%PR18 8.31%PR16 7.05%CO18 5.03%Others 53.84%

Total: 100.00%

Most Common Denial CodesUnexpected Denials Only

90.26%PAID

7.38%

DENIALS

2.36%

EXPECTEDDENIALS

PAID 90.26%

DENIALS 7.38%

EXPECTED DENIALS 2.36%

Total: 100.00%

Payor Adjudication Summary

Denied=Allowed of $0, EXP Denial = PR96/46/204 or PR50/57 with GAor GY Modifier. Downcode=CO57 and allowed >$0.

Report ID: 93

Page 1 of 1

© 2008 ALL RIGHTS RESERVED

Monday, April 14, 2008

PAY DATES FROM 3/1/2008 TO 3/31/2008 FOR ABC Cardiology Associates

0%

4%

8%

12%

16%

20%

$0

$80,000

$160,000

$240,000

7846

5

9330

7

9298

0

A9500

9351

0

9921

4

9301

5

9332

0

7847

8

7848

0

14%17%

8%6%

8%3%

6% 5% 7% 7%

Procedure

Den

ial R

ate

$ P

aid

Denial Rates By ProcedureFor Top 10 Procedures Ranked by $ Paid

Unexpected Denials Only

CLAIM SUMMARY BY REASON CODEPAY DATES FROM 3/1/2008 TO 3/31/2008 FOR ABC Cardiology Associates

COUNTBILLED PERCENTPAIDALLOWED

Unexpected Denials

PI97 - Payment adjusted because the benefit for this service is included in the

payment/allowance for another service/procedure that has already been

adjudicated. This change to be effective 4/1/2008: The benefit for this service is

included in the payment/allowance for another service/procedure that has

already been adjudicated.

16%$0 227$0 $29,440

OA24 - Payment for charges adjusted. Charges are covered under a capitation

agreement/managed care plan. This change to be effective 4/1/2008: Charges

are covered under a capitation agreement/managed care plan.

10%$0 142$0 $44,060

PR18 - Duplicate claim/service. 8%$0 119$0 $31,473

PR16 - Claim/service lacks information which is needed for adjudication. At least

one Remark Code must be provided (may be comprised of either the Remittance

Advice Remark Code or NCPDP Reject Reason Code.)

7%$0 101$0 $39,534

CO18 - Duplicate claim/service. 5%$0 72$0 $24,333

PR27 - Expenses incurred after coverage terminated. 5%$0 70$0 $25,710

CO50 - These are non-covered services because this is not deemed a `medical

necessity' by the payer.

5%$0 67$0 $31,345

CO16 - Claim/service lacks information which is needed for adjudication. At

least one Remark Code must be provided (may be comprised of either the

Remittance Advice Remark Code or NCPDP Reject Reason Code.)

5%$0 65$0 $13,628

PR109 - Claim not covered by this payer/contractor. You must send the claim to

the correct payer/contractor.

4%$0 53$0 $9,294

PR26 - Expenses incurred prior to coverage. 4%$0 53$0 $28,972

PI96 - Non-covered charge(s). At least one Remark Code must be provided

(may be comprised of either the Remittance Advice Remark Code or NCPDP

Reject Reason Code.)

3%$0 50$0 $9,890

PR32 - Our records indicate that this dependent is not an eligible dependent as

defined.

3%$0 48$0 $11,353

OAB13 - Previously paid. Payment for this claim/service may have been

provided in a previous payment.

3%$0 44$0 $11,866

CO97 - Payment adjusted because the benefit for this service is included in the





2%$0 35$0 $6,670

PR31 - Claim denied as patient cannot be identified as our insured. This change

to be effective 4/1/2008: Patient cannot be identified as our insured.

2%$0 30$0 $7,220

Report ID: 20

Page 2 of 8Monday, April 14, 2008


CLAIM SUMMARY BY REASON AND PROCEDUREPAY DATES FROM 3/1/2008 TO 3/31/2008 FOR ABC Cardiology Associates

COUNTBILLED PERCENTPAIDALLOWEDPROCEDURE

Unexpected Denials

PI97 - Payment adjusted because the benefit for this service is included in the





16%$0 227$0 $29,440

93307 $18,575 $0 $0 63%ECHO EXAM OF HEART 143

78465 $6,650 $0 $0 21%HEART IMAGE (3D), MULTIPLE 47

93543 $900 $0 $0 3%INJECTION FOR HEART X-RAYS 6

75724 $655 $0 $0 0%ARTERY X-RAYS, KIDNEYS 1

93015 $600 $0 $0 1%CARDIOVASCULAR STRESS TEST 3

93545 $480 $0 $0 1%INJECT FOR CORONARY X-RAYS 2

93325 $420 $0 $0 3%DOPPLER COLOR FLOW ADD-ON 7

93312 $255 $0 $0 3%ECHO TRANSESOPHAGEAL 6

99223 $175 $0 $0 0%INITIAL HOSPITAL CARE 1

93556 $170 $0 $0 1%IMAGING, CARDIAC CATH 2


78890 $100 $0 $0 1%NUCLEAR MEDICINE DATA PROC 2

99255 $90 $0 $0 1%INPATIENT CONSULTATION 2

92980 $85 $0 $0 0%INSERT INTRACORONARY STENT 1

99221 $85 $0 $0 0%INITIAL HOSPITAL CARE 1

99212 $40 $0 $0 0%OFFICE/OUTPATIENT VISIT, EST 1

OA24 - Payment for charges adjusted. Charges are covered under a capitation

agreement/managed care plan. This change to be effective 4/1/2008: Charges

are covered under a capitation agreement/managed care plan.

10%$0 142$0 $44,060

92980 $7,254 $0 $0 1%INSERT INTRACORONARY STENT 2

78465 $6,057 $0 $0 4%HEART IMAGE (3D), MULTIPLE 5

33249 $3,686 $0 $0 1%ELTRD/INSERT PACE-DEFIB 1

93510 $3,232 $0 $0 2%LEFT HEART CATHETERIZATION 3

93307 $2,212 $0 $0 6%ECHO EXAM OF HEART 8

99232 $1,874 $0 $0 11%SUBSEQUENT HOSPITAL CARE 16

93641 $1,544 $0 $0 1%ELECTROPHYSIOLOGY EVALUATION 1

93320 $1,486 $0 $0 6%DOPPLER ECHO EXAM, HEART 8

A9500 $1,420 $0 $0 3%Tc99m sestamibi 4

93015 $1,286 $0 $0 3%CARDIOVASCULAR STRESS TEST 4

93545 $1,129 $0 $0 2%INJECT FOR CORONARY X-RAYS 3

78478 $1,103 $0 $0 4%HEART WALL MOTION ADD-ON 5

78480 $1,101 $0 $0 4%HEART FUNCTION ADD-ON 5

J0152 $1,006 $0 $0 2%Adenosine injection 3

93325 $909 $0 $0 6%DOPPLER COLOR FLOW ADD-ON 8

93543 $615 $0 $0 2%INJECTION FOR HEART X-RAYS 3


99213 $579 $0 $0 6%OFFICE/OUTPATIENT VISIT, EST 8



99244 $476 $0 $0 1%OFFICE CONSULTATION 2


93880 $436 $0 $0 1%EXTRACRANIAL STUDY 1

93925 $433 $0 $0 1%LOWER EXTREMITY STUDY 1

93744 $338 $0 $0 1%ANALYZE HT PACE DEVICE DUAL 2

Report ID: 20

Page 2 of 39Monday, April 14, 2008


CLAIM SUMMARY BY PROCEDUREPAY DATES FROM 3/1/2008 TO 3/31/2008 FOR ABC Cardiology Associates

PAIDBILLED COUNTALLOWEDPROCEDURE

% OF

TOTALDENIAL RATE

78465 16%HEART IMAGE (3D), MULTIPLE 629$637,558 $246,537 $184,596 3%

UNEXPECTED DENIALS 87$46,210 $0 $0 14%

EXPECTED DENIALS 11$9,733 $0 $0 2%

PAID 531$581,615 $246,537 $184,596 84%

92980 9%INSERT INTRACORONARY STENT 127$398,659 $105,553 $84,302 1%



PAID 115$364,571 $105,553 $84,302 91%

93307 18%ECHO EXAM OF HEART 1,196$358,296 $121,061 $87,655 6%



PAID 978$316,887 $121,061 $87,655 82%

93510 10%LEFT HEART CATHETERIZATION 326$299,801 $71,361 $58,436 2%



PAID 293$268,296 $71,361 $58,436 90%

93320 7%DOPPLER ECHO EXAM, HEART 998$205,513 $49,091 $36,066 5%



PAID 932$191,836 $49,091 $36,066 93%

93015 7%CARDIOVASCULAR STRESS TEST 528$153,759 $62,179 $44,773 3%



PAID 491$143,396 $62,179 $44,773 93%

93325 7%DOPPLER COLOR FLOW ADD-ON 1,019$140,025 $43,265 $32,475 5%


EXPECTED DENIALS 10$913 $0 $0 1%

PAID 948$130,309 $43,265 $32,475 93%

A9500 6%Tc99m sestamibi 368$127,840 $93,314 $69,852 2%




Page 1 of 25

Report ID: 19

CLAIM SUMMARY BY PROCEDURE & REASON CODEPAY DATES FROM 3/1/2008 TO 3/31/2008 FOR ABC Cardiology Associates

PAIDBILLEDREASON CODE COUNTALLOWEDPROCEDURE

% OF

TOTALDENIAL RATE

93320 7%DOPPLER ECHO EXAM, HEART 998$205,513 $49,091 $36,066 5%


$1,486 $0 $0 15% 8OA24 - Payment for charges adjusted. Charges are covered under a capitation

agreement/managed care plan. This change to be effective 4/1/2008: Charges are covered

under a capitation agreement/managed care plan.

$2,338 $0 $0 15% 8PR18 - Duplicate claim/service.

$1,211 $0 $0 11% 6PR109 - Claim not covered by this payer/contractor. You must send the claim to the

correct payer/contractor.

$681 $0 $0 9% 5PR27 - Expenses incurred after coverage terminated.

$683 $0 $0 6% 3CO50 - These are non-covered services because this is not deemed a `medical necessity'

by the payer.

$993 $0 $0 6% 3PR16 - Claim/service lacks information which is needed for adjudication. At least one

Remark Code must be provided (may be comprised of either the Remittance Advice Remark

Code or NCPDP Reject Reason Code.)

$528 $0 $0 6% 3PR32 - Our records indicate that this dependent is not an eligible dependent as defined.

$662 $0 $0 4% 2CO109 - Claim not covered by this payer/contractor. You must send the claim to the

correct payer/contractor.

$507 $0 $0 4% 2CO16 - Claim/service lacks information which is needed for adjudication. At least one

Remark Code must be provided (may be comprised of either the Remittance Advice Remark

Code or NCPDP Reject Reason Code.)

$506 $0 $0 4% 2CO18 - Duplicate claim/service.

$350 $0 $0 4% 2PI96 - Non-covered charge(s). At least one Remark Code must be provided (may be

comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code.)

$662 $0 $0 4% 2PR26 - Expenses incurred prior to coverage.

$517 $0 $0 4% 2PRB9 - Services not covered because the patient is enrolled in a Hospice. This change to

be effective 4/1/2008: Patient is enrolled in a Hospice.

$331 $0 $0 2% 1CO13 - The date of death precedes the date of service.

$210 $0 $0 2% 1OA18 - Duplicate claim/service.

$65 $0 $0 2% 1OA96 - Non-covered charge(s). At least one Remark Code must be provided (may be


$175 $0 $0 2% 1OAB13 - Previously paid. Payment for this claim/service may have been provided in a

previous payment.

$176 $0 $0 2% 1PR31 - Claim denied as patient cannot be identified as our insured. This change to be

effective 4/1/2008: Patient cannot be identified as our insured.


$765 $0 $0 38% 5CO45 - Charge exceeds fee schedule/maximum allowable or contracted/legislated fee

arrangement. (Use Group Codes PR or CO depending upon liability).

$240 $0 $0 31% 4COB22 - This payment is adjusted based on the diagnosis.

$350 $0 $0 15% 2OA22 - Payment adjusted because this care may be covered by another payer per

coordination of benefits. This change to be effective 4/1/2008: This care may be covered by

another payer per coordination of benefits.

$65 $0 $0 8% 1OA23 - Payment adjusted due to the impact of prior payer(s) adjudication including

payments and/or adjustments. This change to be effective4/1/2008: The impact of prior

payer(s) adjudication including payments and/or adjustments.

$176 $0 $0 8% 1PR96 - Non-covered charge(s). At least one Remark Code must be provided (may be


PAID 932$191,836 $49,091 $36,066 93%

($1,324) ($296) ($211) 0% 4CR2 - Coinsurance Amount

($60) $0 $0 0% 1CR38 - Services not provided or authorized by designated (network/primary care)

providers.

($435) $0 $0 1% 5CR50 - These are non-covered services because this is not deemed a `medical necessity'

by the payer.

$65 $65 $0 0% 1PR27 - Expenses incurred after coverage terminated.

$1,014 $532 $1 0% 4PR96 - Non-covered charge(s). At least one Remark Code must be provided (may be




Page 6 of 80

Report ID: 19

https://www.remitdata.net/remitdata/client/eob.jsp

http://www.remitdata.com/reports/MIA-MOA%20Claim%20Codes.pdf

http://www.remitdata.com/reports/Remark%20Codes.pdf

https://www.remitdata.net/remitdata/index.jsp?client/GenerateEob.action?uploadId=332785&r45ccn=0206355315900&claimDisposition=-1

https://www.remitdata.net/remitdata/index.jsp?client/GenerateEob.action?uploadId=332785&ssn=181603612&claimDisposition=-1











































PERCENTAMOUNT PAIDALLOWEDBILLEDAGING

AGED CLAIMS REPORT


PAID CLAIMS

$2,727,086.53 $1,086,310.24 $875,799.92 0 - 30 69%

$965,003.35 $328,692.78 $234,331.06 31 - 60 19%

$151,849.70 $61,077.40 $45,201.73 61 - 90 4%

$110,641.00 $58,323.93 $51,659.94 91 - 120 4%

$73,143.00 $31,871.74 $26,924.56 121 - 150 2%

$17,104.45 $6,970.99 $5,521.11 151 - 180 0%

$218,126.25 $105,587.48 $21,507.50 181+ 2%

$4,262,954.28 $1,678,834.56 $1,260,945.82 TOTALS AGED FROM DOS TO PAYMENT DATE

AVERAGE AGE OF PAID CLAIMS 33

DENIED CLAIMS - UNEXPECTED ONLY

$122,682.00 $0.00 $0.00 0 - 30 30%

$58,761.00 $0.00 $0.00 31 - 60 15%

$68,343.22 $0.00 $0.00 61 - 90 17%

$57,666.50 $0.00 $0.00 91 - 120 14%

$29,711.00 $0.00 $0.00 121 - 150 7%

$18,902.50 $0.00 $0.00 151 - 180 5%

$47,006.50 $0.00 $0.00 181+ 12%

$403,072.72 $0.00 $0.00 TOTALS AGED FROM DOS TO DENIED DATE

AVERAGE AGE OF DENIED CLAIMS 83

$4,666,027.00 $1,678,834.56 $1,260,945.82 TOTAL

NOTE: Claim reversals (CR codes) are excluded from both the paid and denied sections. The denied section is reporting only

on unexpected denials.


Monday, April 14, 2008 Page 2 of 2

REPORT ID 160

0

10

20

30 40

50

60

70CAHABA GBA -MS PART B

0

10

20

30 40

50

60

70BLUE CROSS BLUE SHIELD OF MS

0

10

20

30 40

50

60

70BLUE CROSS BLUE SHIELD OF

ALABAMA

0

10

20

30 40

50

60

70WISCONSIN PHYSICIANS

SERVICE INS. CORP.

0

10

20

30 40

50

60

70BLUE CROSS & BLUE

SHIELD

0

10

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30 40

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70Others

PAYER DSO PERFORMANCEPRIMARY PAYERS

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90BLUE CROSS BLUE SHIELD OF MS

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90BLUE CROSS & BLUE SHIELD

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3040 50

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90BLUE CROSS BLUE SHIELD OF

ALABAMA

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3040 50

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90CAHABA GBA -MS PART B

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3040 50

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90UNITED HEALTHCARE INSURANCE

COMPANY

0

10

20

3040 50

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90Others

POST PRIMARY PAYERS

DSO = DATE OF SERVICE TO CHECK DATE



Report ID: 14

Page 1 of 6


AVERAGE PAYMENT LAG BY PROCEDUREPAY DATES FROM 3/1/2008 TO 3/31/2008 FOR ABC Cardiology Associates

PAYER DAYSHOLD DAYSCOUNT TOTAL DAYS TOTAL AMT PAIDPROCEDURE

Primary Claims $1,198,191 33 14 16 13,542

14 15 439 29 $178,368 78465 **HEART IMAGE (3D), MULTIPLE

14 15 258 28 $77,395 CAHABA GBA-MS PART B

109 25 $73,582 BLUE CROSS BLUE SHIELD OF MS Data not provided by payer

36 49 $16,368 BLUE CROSS BLUE SHIELD OF ALABAMA Data not provided by payer

15 16 23 31 $6,020 WISCONSIN PHYSICIANS SERVICE INS. CORP.

18 7 12 25 $4,575 BLUE CROSS & BLUE SHIELD

14 22 1 36 $427 UNITED HEALTHCARE INSURANCE COMPANY

20 14 725 42 $83,058 93307 **ECHO EXAM OF HEART






138 8 14 146 $1,377 CAHABA GBA-AL PART B


15 5 2 20 $206 BCBS KS-FEDERAL EMPL PGM

299 0 1 299 $105 PREMIER BLUE

16 15 93 43 $82,384 92980 **INSERT INTRACORONARY STENT






11 15 299 26 $68,236 A9500 **Tc99m sestamibi



19 14 241 43 $55,905 93510 **LEFT HEART CATHETERIZATION







9 12 1 21 $179 CAHABA GBA-AL PART B

11 14 745 25 $45,362 99214 **OFFICE/OUTPATIENT VISIT, EST





8 12 19 20 $1,108 CAHABA GBA-AL PART B



1 5 2 6 $143 BCBS KS-FEDERAL EMPL PGM

12 15 403 27 $42,849 93015 CARDIOVASCULAR STRESS TEST




Monday, April 14, 2008 Page 2 of 6

Report ID: 14© 2008 ALL RIGHTS RESERVED

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

14280 - BLUECROSS BLUE

SHIELD OF MS

14281 -CAHABA

GBA-MS PARTB

14294 - UNITEDHEALTHCAREINSURANCECOMPANY


14296 -CAHABA

GBA-AL PART B

14299 - BLUECROSS BLUE

SHIELD OFALABAMA

14300 - BCBSKS-FEDERALEMPL PGM

14301 -PREMIER BLUE

14302 - BLUECROSS & BLUE

SHIELD


14305 -WISCONSINPHYSICIANS

SERVICE INS.CORP.

51%

24%

50%38% 36%

59%70% 73% 73%

49%37%

13%

7%

16%

0%14%

2%

14%0%

16%

14%

12%

36%

69%

34%

61%50%

39%

16%27%

11%

37%

51%

AV

G %

OF

BIL

LE

D A

MT

AVERAGE PAYMENT LEVEL COMPARISON BYPAYER PRIMARY PAYMENTS ONLY

PAID BY PAYER PATIENT PAY/SECONDARY DISALLOWED BY PAYER

TOP 10 PAYERS RANKED BY TOTAL $ PAID

NOTE: Your most profitable payers will have the highest percentages paid and lowest percentages disallowed. Patient Pay and Secondary amounts often require more

efforts to collect. "PAID BY PAYER" reflects actual primary amounts paid as a percentage of total billed. "PATIENT PAY/SECONDARY" Reflect the amount allowed by

payer less amounts paid expressed as a percentage of total billed. This category DOES NOT reflect actual patient pay or secondary amounts. "DISALLOWED BY

PAYER" represents dollars billed minus dollars allowed as a percentage of dollars billed.


Page 1 of 10Friday, April 18, 2008


CHARGE MASTER REVIEW - TOP 30 PROCEDURES BY PAYER

COUNT TOTAL PAIDPROC CODE AVG PAID

PERCENT

OF BILLEDAVG

ALLOWEDAVG BILLEDQTY

PERCENT

OF BILLED

PERCENT

OF ALLOWED

44778465 $1,120 36%$399 44% $178,368 HEART IMAGE (3D), MULTIPLE 81% 447 $494

$73,582 79% 53%$640 68%$808 $1,197 115 115BLUE CROSS BLUE SHIELD OF MS

$77,395 80% 25%$298 31%$374 $1,192 260 260CAHABA GBA-MS PART B

$427 100% 47%$427 47%$427 $910 1 1UNITED HEALTHCARE INSURANCE COMPANY

$16,368 95% 50%$455 52%$477 $910 36 36BLUE CROSS BLUE SHIELD OF ALABAMA

$4,575 80% 77%$381 96%$475 $495 12 12BLUE CROSS & BLUE SHIELD

$6,020 80% 44%$262 55%$327 $597 23 23WISCONSIN PHYSICIANS SERVICE INS. CORP.

76393307 $346 32%$109 41% $83,058 ECHO EXAM OF HEART 77% 763 $142

$19,410 72% 44%$180 61%$251 $410 108 108BLUE CROSS BLUE SHIELD OF MS

$34,960 73% 21%$84.85 29%$116 $400 412 412CAHABA GBA-MS PART B

$371 100% 37%$61.81 37%$61.81 $168 6 6UNITED HEALTHCARE INSURANCE COMPANY

$1,377 80% 39%$98.37 49%$123 $249 14 14CAHABA GBA-AL PART B

$15,246 95% 81%$191 85%$200 $236 80 80BLUE CROSS BLUE SHIELD OF ALABAMA

$206 90% 69%$103 76%$115 $150 2 2BCBS KS-FEDERAL EMPL PGM

$105 100% 70%$105 70%$105 $150 1 1PREMIER BLUE

$5,664 77% 65%$177 84%$230 $274 32 32BLUE CROSS & BLUE SHIELD

$192 100% 62%$192 62%$192 $310 1 1UNITED HEALTHCARE INSURANCE COMPANY

$5,527 77% 25%$51.66 33%$67.29 $204 107 107WISCONSIN PHYSICIANS SERVICE INS. CORP.

9592980 $3,371 26%$867 31% $82,384 INSERT INTRACORONARY STENT 83% 95 $1,045

$22,887 79% 46%$1,635 58%$2,076 $3,558 14 14BLUE CROSS BLUE SHIELD OF MS

$39,469 79% 17%$598 21%$754 $3,553 66 66CAHABA GBA-MS PART B

$16,304 100% 59%$1,482 59%$1,482 $2,500 11 11BLUE CROSS BLUE SHIELD OF ALABAMA

$1,991 100% 95%$1,991 95%$1,991 $2,100 1 1BLUE CROSS & BLUE SHIELD

$1,733 80% 28%$578 34%$722 $2,100 3 3WISCONSIN PHYSICIANS SERVICE INS. CORP.

302A9500 $176 64%$113 79% $68,236 Tc99m sestamibi 82% 604 $138

$27,552 84% 84%$148 100%$176 $176 186 93BLUE CROSS BLUE SHIELD OF MS

$40,684 80% 55%$97.33 69%$122 $176 418 209CAHABA GBA-MS PART B

Friday, April 18, 2008 Page 2 of 10


Reimbursement Pro contains OnDemand EOB™ that creates a patient-specific EOB on-demand. No more will your staff need to file, find, copy, mark up, and recopy EOBs. And yocan use the “Ordered EOBs” option to create a specific batch of patient-specific EOBs in the EXACT ORDER that your secondary bills are printed! Your secondary person simply puts your EOBs with HCFA 1500s and they are done! Saves lots of money on copier costs and labor.

u

MEDICAREREMITTANCENOTICE

CHECK/EFT #:

PAGE #:PROVIDER #: 3000018

2000084DATE: 03/26/2008

CAHABA GBA-MS PART BP.O. BOX 548BIRMINGHAM, AL 352010548

(866) 419-9454

PERF PROV SERV DATE POS NOS PROC MODS BILLED ALLOWED DEDUCT COINS GRP/RC-AMT PROV PD

NAME: HALL, SCOTT HIC: 100005427 ACNT: 115898-3 ICN: 0208079194750 MOA: MA01ASG Y

5000000088 0304 030408 11 1 93015 333.00 0.00 0.00 0.00 0.00333.00OA245000000088 0304 030408 11 1 78465 1,448.00 0.00 0.00 0.00 0.001,448.00OA245000000088 0304 030408 11 1 78478 253.00 0.00 0.00 0.00 0.00253.00OA245000000088 0304 030408 11 1 78480 252.00 0.00 0.00 0.00 0.00252.00OA245000000088 0304 030408 11 2 J0152 342.00 0.00 0.00 0.00 0.00342.00OA245000000088 0304 030408 11 2 A9500 360.00 0.00 0.00 0.00 0.00360.00OA24PT RESP CLAIM TOTAL 2,988.00 0.00 0.002,988.000.00 0.00

ADJ TO TOTALS: PREV PD INTEREST LATE FILING CHARGE NET0.00 0.000.000.00

0.00

GLOSSARY: GROUP, REASON, MOA, REMARK AND REASON CODES

Payment for charges adjusted. Charges are covered under a capitation agreement/managed care plan. This change to beeffective 4/1/2008: Charges are covered under a capitation agreement/managed care plan.

OA24

Alert: If you do not agree with what we approved for these services, you may appeal our decision. To make sure that weare fair toyou, we require another individual that did not process your initial claim to conduct the appeal. However, inorder to be eligible for an appeal, you must write to us within 120 days of the date you received this notice, unless youhave a good reason for being late.

MA01

In order to comply with HIPAA privacy regulations, this patient-specific Medicare Remittance Notice has been independently reproduced by RemitDATA, Inc. Itwas created from a Medicare Electronic Remittance Advice (ERA) in accordance with the standard paper remittance format stipulated by CMS.

Page 1 of 1

RemitDATA’s new “Q” is the FUTURE of reimbursement management! Managers can pull up the overall Q, and then assign rules so that work is sorted into each collector’s individual Q. Collectors then log into their specific Q and work and update their denials. Managers are able to monitor the overall Q, and track the workload and performance of all the team members.

Reimbursement Pro contains “Q”, our new powerful work-flow management tool. Now, instead of working from paper EOBs, or from existing printed reports, collectors simply log into their “Q” each morning to begin working their denials. From the Q, they can work denials, pull patient-specific EOBs, create Review Forms, add status notes, transfer to other users, and more. Managers can then track the results via Q reports and User Performance metrics. Q is truly the future of working denials. You have to try it to believe it!

RemitDATA’s new “Q” allows you to drill down into the Patient Specific denial screen, where you can review the details of the claim, print up a patient-specific EOB, see all previous denials and history for the claim or patient, create a review or other OnDemand Form, update the status, assign to other users, and much, much more! With WebScan Pro integration, you can easily retrieve needed documents to attach to the claim for resubmission!!

Reimbursement Pro offers OnDemand Form which allows quick generation of various short pay letters,dunning letters and review forms. Forms can be complete and ready to send with just a few key strokesand mouse clicks!

Reimbursement Pro contains OnDemand Forms™, which eliminates the need to manually complete Review Forms and more. Our easy-to-use online version takes a FRACTION of the time of the paper-based version, AND is guaranteed to be 100% accurate (many manually completed Review forms contain multiple errors due to the mind-numbing process of copying data by hand). Simply find the claim(s) you want to review, and then use the auto-populate tools to complete the form and click “Generate Review”. AND, if you are a WebScan™ client, then you can attach any documents which have been scanned into the system! Another huge time-saver. See page 1.

MEDICARE REDETERMINATION REQUEST FORM

DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES

1. Beneficiary’s Name:_____________________________________________________________________

2. Medicare Number:______________________________________________________________________

3. Description of Item or Service in Question: __________________________________________________

4. Date the Service or Item was Received: _____________________________________________________

5. I do not agree with the determination of my claim. MY REASONS ARE:

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

6. Date of the initial determination notice ______________________________________________________(If you received your initial determination notice more than 120 days ago, include your reason for not making this request earlier.)

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

7. Additional Information Medicare Should Consider:____________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

8. Requester’s Name:______________________________________________________________________

9. Requester’s Relationship to the Beneficiary: _________________________________________________

10. Requester’s Address: ____________________________________________________________________

_____________________________________________________________________________________

11. Requester’s Telephone Number: ___________________________________________________________

12. Requester’s Signature:___________________________________________________________________

13. Date Signed: __________________________________________________________________________

14. o I have evidence to submit. (Attach such evidence to this form.)o I do not have evidence to submit.

NOTICE: Anyone who misrepresents or falsifies essential information requested by this form may upon conviction be subject to fine or imprisonment under Federal Law.

Form CMS-20027 (05/05) EF 0444433344444444444444444444444444444445/2005

Don’t forget our other innovative web-based solutions to help your practice achieve optimal efficiency!

WebScan™ is a powerful, document management solution that works via the web. All you need to get started is a scanner and stuff to scan! Simply scan a batch of documents (CMNs, EOBs, Invoices, Employment Documents, AP Info, Patient Satisfaction Surveys, etc.) into a network folder and WebScan™ automatically detects the new batch and uploads it to your account on one of our 100% HIPAA Secure servers located in our state-of-the-art data center.

Sales PRO™ is the leading web-based software program for the homecare industry allowing sales and marketing professionals to track, evaluate and monitor their work. Sales PRO™ tracks how to best reach your accounts, a continuous call report for accounts, key account issues and so much more.