Medrium Karvy And Dashboards Overview Morristown April 2007

Medrium, Inc.Healthcare Solutions

Karvy Transition Project


Project Kick-off: Project Kick-off: DoneDoneProject Content Endorsement:Project Content Endorsement: WIPWIPResource Planning & Allocation:Resource Planning & Allocation: WIPWIPPhantom System Preparation:Phantom System Preparation: WIPWIPIdentify Seeding Team:Identify Seeding Team: WIPWIPSOW & SLA’s Preparation:SOW & SLA’s Preparation: DoneDoneSOW & SLA’s Review & feedback:SOW & SLA’s Review & feedback: N/SN/SWar Room Planning & Resources:War Room Planning & Resources: N/SN/SEstablish Communication SOP:Establish Communication SOP: DoneDoneEscalation Process:Escalation Process: N/SN/SRules Clean-up & Updates:Rules Clean-up & Updates: WIPWIPReporting & Billing SOP:Reporting & Billing SOP: WIP0WIP0

ControlControl ImproveImprove AnalyzeAnalyze MeasureMeasureDefineDefine

Define Phase Project ChecklistDefine Phase Project Checklist


SOW & Contracts

Resources

Infra

stru

ctur

e

Logistical PrerequisitesLogistical Prerequisites

• Lock seeding team & travel schedule• Identify and endorse human resources to hire for project• Review rules status and establish rules committee• Discuss infrastructure & technology requirements

What do we need to accomplish this week?

• Ensure we’re all on the same page with SOW principals• Review pricing & billing requirements• Ensure phantom system is ready on time• Understand project FTE cost and commit funds

Medrium, Inc.Healthcare Solutions Original Timeframe – To Be Revised by X-TeamOriginal Timeframe – To Be Revised by X-Team

• Critical paths should be discussed and rescheduled per resources availability• Principal project path to be approved by X-team by end of week of April 9• Karvy will be updated with revised schedule accordingly


People Infrastructure

Customers Process

Impact Quadrant RecordImpact Quadrant Record

1. 2 FTE’s for data analysis & war room ops

2. 1man month for phantom system R&D development

3. 2 DE’s + 2 leaders for seeding assignment in India

4. Prasad to conduct system training + 1 DE for support

5. Project leadership to visit Karvy for readiness review

6. Karvy talent pool list

1. Complete customer list with profiles (workload, etc.)

2. VOC questionnaire

3. All new customer accounts to be sent to Karvy

4. Ajuba handling + termination notice (60 days)

5. Emergency customer communication plan

6. Customer compensation plan

1. Phantom system required H/W & S/W

2. War room locale and communication equipment

3. Provide Karvy with adequate system access rights

4. New workflow features

5. Review Karvy’s infrastructure & disaster recovery plan

6. New rules set to be updated on the system

1. Bi-weekly project leadership calls

2. Monthly billing

3. Reporting – Karvy vs. Medrium

4. Rules clean-up and ongoing exceptions review

5. Escalation SOP


Sl.No Name Process Skill SetsJoined on 04/02/2007

Will join on 04/16/2007 Will join in III Batch

1 Mohammed Younus Medical Coding

Certified Professional Coder from AAPC. Coded for Specialties like Radiology, Diagnostic Radiology, Emergency Room, Cardiology, Pathology, and Interventional Radiology. ?

2 Krishna S Medical Coding

Worked on Specialties like Radiology, Evaluation & management, Surgical, Gastroenterology, Internal medicine, Acute patient care, Inpatient medicine and cardiology. Certified Professional Coder from AAPC ?

3 K Krishna Kumar Medical Coding

Experienced in Coding for specialties like Radiology, E/M Outpatient, E/R, Orthopedic, Pain Management, Cardiology, Ob/Gyne, Anesthesia, Gastroenterology. Certified Professional Coder from AAPC ?

4 Usha Kumari Pandey AR

Worked on Accounts Receivable for Physician Practices. Worked on aging claims for Medicare, Blue Cross,etc. Worked on Denials and Rejections from clearing houses. Worked on Medical Manager software. ?

5 Ayesha Begum AR

Worked on Medical Manager software for Accounts Receivable for physician billing. Also worked on denials and watch for rejections from clearing house. Worked on aging claims for Medicare, Blue Cross, Medicaid and commercial insurances. ?

6 Sumesh PS AR Worked on AR side to call and get the status of the claims and Patient Eligibility. Also handled denials and Rejections. Worked on Software's like Medisoft and IDX. ?

7 Sudhakar AR

Worked on AR calling Medicare, Medicaid Commercial Insurances and No Fault and Workers Compensation. Also worked on Charge Entry and Payment Posting. Denial Analysis and Checked epaces website for Pt eligibility and Claim Status. Worked on Medisoft and IDX. ?

8 B Swapna AR Worked on AR calling to get the status on the claims. Good at documentation and follow-ups. ?

9 Mohd. Ismail AR Worked on AR side to call and get the status of the claims and Patient Eligibility. Also handled denials and Rejections. Worked on Software's like Medisoft and IDX. ?

10 S.Kalpana Medical Billing

Worked on SYNERIOS (MD-SYNERGY) and Compu-Medic. Worked on Patient demographics, Charge Entry and Cash Posting. Print and maintain process data documentation. Also worked on denial analysis. ?

11 T Sharada Medical Billing

Worked on Patient Demographics and Charge Entry. Also worked on Payment posting, denials and adjustments to patient accounts. Some experience is Re-filing of claims post rejections. Worked on Medisoft software. ?

12 Neeraja Pedamallu Medical Billing

Worked on Patient Demographics, Charge Entries and Cash Posting. Also has fair experience in Denial Management. Good working experience on Workmen's Comp and Auto Accident Insurance. Fair competence in areas of HMO, PPO and POS. Thorough knowledge on LMRP's.Billing experience in specialties like Cardiology, SNF, Radiology, Gynecology, Pediatrics and Anesthesia. Worked on Billing software's like, Medisoft, Claim Gear and Lytec. ?

13 B Kalyan Babu Medical Billing

Worked on software's like IDX, Mysis Tiger windows version, Centricity GE version, Medic (Version 4.8) Medical Manager and Medisoft (Version 8.0). Worked on Patient demographics, Charge Entry and Cash Posting. Also worked on Secondary claims and Quality. Worked on specialties like ER, Radiology, Orthopedics, Cardiology, Gastroenterology and Pulmonary diseases. ?

14 Ch. Mohan Pratap Medical Billing

Worked as a Transaction Process Associate for a Dental Billing Practice. Having sound knowledge of capturing the data of the insurance claim, verifying the information of patient, provider with all dental procedure codes with the description. Worked on Client Software , HOD( Host On Demand).

?

15 M Naveen KumarMedical Billing and US Health Care Services

Worked for a leading Payor in US. Well versed with US Healthcare. Work profile included uploading of agreements for providers who are contracted with the insurance companies. Worked on Single Point plus, PIMS (provider information management system) and Metavance.Also worked on Medical Billing side on Charge Entries and Cash Posting. ?

16 T Rama Chandra Shekar US Health Insurance

Worked on software's like Single point plus, PIMS (provider information management system) and Metavance. Worked on payors side. Well versed with US Healthcare. Work profile included uploading of agreements for providers who are contracted with the insurance companies. ?

17 P Vijay KumarUS Health Care Services

Worked on payors side. Well versed with US Healthcare. Work profile included uploading of agreements for providers who are contracted with the insurance companies. Worked on Single Point plus, PIMS (provider information management system) and Metavance. ?

18 P Santosh KumarUS Health Care Services

Worked on payors side. Well versed with US Healthcare. Work profile included uploading of agreements for providers who are contracted with the insurance companies. Worked on Single Point plus, PIMS (provider information management system) and Metavance. ?

Experienced Candidates

FTE Recruitment PoolFTE Recruitment Pool


Sl.No NameAcademic

qualification Process Status 1 Muralidhar B B.Com (Graduate) Claim Entry Process Joined on April 2nd2 G Suresh Kumar B.Sc (Graduate) Claim Entry Process Joined on April 2nd3 N Sreenivasulu Reddy B.Sc (Graduate) Claim Entry Process Joined on April 2nd4 Ravi Kiran B.Com (Graduate) Claim Entry Process Joined on April 2nd5 Rajendra Prasad B.Sc (Graduate) Claim Entry Process Joined on April 2nd6 Md Haseeb Ali B.Com (Graduate) Claim Entry Process Joined on April 2nd

7 K R KalavathiB.Com, MBA (Post

Graduate) Claim Entry Process Joined on April 2nd8 S Natarajan B.Sc (Graduate) Claim Entry Process Joined on April 2nd9 V Srinivas B.Sc (Graduate) Claim Entry Process Joined on April 2nd

10 G Srivani M.Com (Post Graduate) Claim Entry Process Joined on April 2nd11 B Manoj Kumar B.Com (Graduate) Claim Entry Process Joined on April 2nd12 Maseeh Ullah Khan B.Com (Graduate) Claim Entry Process Joined on April 2nd13 Anthony Sanjay B.Com (Graduate) Claim Entry Process Joined on April 2nd14 Md Ameenuddin B.Sc (Graduate) Claim Entry Process Joined on April 2nd

15 N N SwamyB.Com, M.Com (Post

Graduate) Claim Entry Process Joined on April 2nd16 CH V R Ratna Kumar B.Com (Graduate) Claim Entry Process Joined on April 2nd

Fresher's

Current FTE BenchCurrent FTE Bench

• We’ll be calibrating recruitment pace per our ramp-up capacity

• Bench is being trained internally by Karvy’s DE’s

Medrium, Inc.Healthcare Solutions SOW R1.0 Draft HighlightsSOW R1.0 Draft Highlights

Fees & Payment Schedule• Per Claim Entered (Claim Entry) - 60 cents / claim• Per Line Item Posted (Payment Posting) – 40 cents / claim• A/R Follow up per FTE - $11.00 / hour• Medical Coding per FTE - $11.00 / hour

Term• 3 Years from contract signing

• Payment posting: 86,000 lines / month (projected monthly cost of $34.4K)• Claim entry: 57,000 claims / month (projected monthly cost of $34.2K)• Starting from June 15th onwards till the end of this contract period as a minimum guarantee. • Any decrease in volumes should be communicated to Karvy at least before 3 months time. • Increased volumes of >10% from min guarantee KGS will have 12 weeks of lead time to meet TAT of 48 hrs.

Volume of Work

• 17 FTE’s on A/R Follow-up • 3 FTE’s on Coding• ~20 FTE’s for PP & CE (not in SOW – communicated verbally; should be reviewed and followed-up on) • Any fluctuation in volume leading to increase or decrease FTE’s ≤10% will be borne by KGS w/o any cost to Medrium.

Resource Requirements

Medrium, Inc.Healthcare Solutions Lodging Costs in HyderabadLodging Costs in Hyderabad

Single Double Single DoubleTaj Club Room 8500 9500 220 245Deluxe Room 12000 13250 295 325

Superior 6400 6900 165 180Executive 7300 7800 185 200Residency Room 8000 8500 205 220Superior 8000 8500 Rate as on date Rate as on dateCity Facing Room 9000 9500 Rate as on date Rate as on dateLake View Room 10000 10500 Rate as on date Rate as on date

Single Double Single DoubleITC One 21000 22000 500 525Sheraton Towers 18000 19000 450 475Executive Club 14000 15000 350 375Luxury Suite 40000 40000 900 900Presidential Suite 60000 60000 1400 1400Superior 6000 6600 156 176Club Rooms 8100 9100 225 255

HOTEL ROOM CATEGORY

Taj Deccan, Hyderabad

ITC GRAND KAKATIYA

ROOM CATEGORY

THE MANOHAR

Taj Banjara, Hyderabad

Taj Krishna, Hyderabad

HOTEL RACK RATESINR US $

INR US $KARVY RATES

Lodging quotes for seeding team

Medrium, Inc.Healthcare Solutions Immediate Action ItemsImmediate Action Items

• Provide Karvy with Secondary Billing Pricing April 14

• Identify seeding team and travel phases April 14

• Final feedback & buy-in for Define phase plan April 12

• Define project output functions April 11

• VOC questionnaire finalized April 20

• Complete resource allocation for project (+ commence hiring) April 13

• Revised project timeline April 27

• SOW review and feedback April 20

• SLA’s definition and SOW update April 27

• Karvy talent pool CV’s & skill set list April 13

• Establish rules committee and start rules clean-up process April 13

Action Item Deadline


Dashboards & Metrics

Medrium, Inc.Healthcare Solutions Current Situation OverviewCurrent Situation Overview

• Reports are generated and sent via e-mail

• No follow-up & policy enforcement mechanisms

• Comprehensive data in reports – too hard to read and analyze

• Reports are delivered in an intimate manner - no public visibility

• Reports contain a lot of information that resides on the system

• The data in the report is “dead” – no automated formulas to work with

• It’s hard to drill through the report and conduct simulation analysis

• No personal accountability SOPs in place

• No proactive alerts – requires manual monitoring

• Not designed for executive level; too detailed

Medrium, Inc.Healthcare Solutions Post BPM Deployment Business LandscapePost BPM Deployment Business Landscape

Tailored Reports

• Executive• Operational• Center• FTE

Accountability

• Ops level review• System integration• Easier to read• Alerts

Easier Analysis

• Visual data• Click-through• What-if• Simulation• Live data

Better Visibility

• Public display• Behavioral change • Shorten latency• Company msg.

Simply put…

Medrium, Inc.Healthcare Solutions The Gap-StoppersThe Gap-Stoppers

What do we need to accomplish…?

• Complete user activity logging (can be phased)

• User “time clock” – e-punch-in / e-punch-out

• Highest system access level authorization

• Part-time R&D resource – in support capacity (1 man month / year)

• Report in-system embedding for user and customer reporting purposes

• Center display equipment (thin client and two flat screen displays)

• Provide Karvy with viewer licenses (we’ll have a total of 25 viewers)

• Server hardware (TBD post prototyping)

• AMs, site managers, and Karvy dashboard review SOP

• Cost-effective, yet powerful BPM engine

Medrium, Inc.Healthcare Solutions Key MetricsKey Metrics

FTE Productivity (lines/per hour/day/week, etc. – volumes & percentiles):

FTE redundant work factor – measure FTE efficiency in problem resolution

FTE Seniority (time in service)

FTE Turnover Ratio (global metric for Karvy)

FTE Lag Ratio – track “stuck” claims, etc. in the queue

FTE response time (work queue clearance time)

• Lines• Attachments• Procs• Incomplete• ERA’s• EOB’s• Patients• Charges• Patient Payments• Cap Payments• Patient Notes• Claim Notes• Claims Printed• Patients Updated• Claims Updated

Medrium, Inc.Healthcare Solutions BPM Platforms ScorecardBPM Platforms Scorecard

Cost Functionality Ease of Use Development EstablishedJasperSAPXcelsiusSASCompositeCognosQlikTech


IntroducingIntroducing

Crystal Xcelsius™

Our Transformation Engine…

Medrium, Inc.Healthcare Solutions Our Raw Data from the Monthly Report + 20 Minutes…Our Raw Data from the Monthly Report + 20 Minutes…

Medrium, Inc.Healthcare Solutions ……and Add One Formula to the “Totals” Cellsand Add One Formula to the “Totals” Cells

Medrium, Inc.Healthcare Solutions BPM Action ItemsBPM Action Items

• Submit PO to Business Objects for Xcelsius Workgroup April 13

• High-level dashboards design with X-team April 27

• System reports modification May 18

• Infrastructure analysis and preparation April 27

• Work with R&D team on linking to mirror system April 27

• Equipment procurement May 25

• Prototype deployment May 31

• Go to production release June 22

Action Item Deadline

Economy & Finance

Medrium Karvy And Dashboards Overview Morristown April 2007