C o r p o r a t e P r o f I l e

Stronger Relationships Deeper Insights

HGS Overview

Who We Are: A global customer relationship management & BPO corporation with its principal North American office in Warrenville, IL

Global Customer Support Services: Global provider of customer support solutions and business process outsourcing by phone, e-mail, chat, and social media with 22,000 employees, and 43 centers located in 7 countries

Leveraging global perspectives: In business for 37+ years; Acclaimed Fortune 100 clients

Consistent Growth: Growing corporation with over $300 million in revenue

Financial Stability: Publicly listed company, financially sound (AA-)

Certifications: Six Sigma, ISO 9001, 27001, HIPAA, GLBA, PCI, eSCM (2012)

At our core...

Clients and their Customers are at the Center of Everything We Do

Vision “To be a globally preferred business process transformation partner for our clients,

creating value in their business through innovative outsourcing solutions”

“To Make Our Clients More Competitive”

Mission

Culture Flexible, Easy to Work With

A “Can Do!” Attitude

Automotive

Banking and Financial Services

Consumer Electronics

Consumer Packaged Goods

Consumer Products

Government

Healthcare

Insurance

Logistics and Transportation

Media and Entertainment

Pharmaceuticals

Publishing

Restaurants

Retail

Technology

Telecommunications

Industry Verticals...

Diverse Industry Experience

Actionable Customer Relationship Management phone | e-mail | web chat | self service | white mail

Customer Care and Product Support

Customer Care Product Support

Member Care Provider Support

Sales Support Analytics and Market Research Satisfaction Surveys

Analytics and Market Research Social Media

Fulfillment and Back Office Processing

Mailroom Services Product and Literature

Fulfillment Imaging Services

Inbound Sales and Order Taking

Inbound Sales Broker Support Order Taking

Service Lines – Actionable Customer Relationship Management

Targeted Services to Meet the Evolving Needs of Our Clients

Business Process Outsourcing

Claims Adjudication Fraud Research

Special Investigation Unit Plan Building

Loading, and Testing

Financial Stability

Diversification to Ensure Both Growth and Risk Mitigation

Employee Strength

Customer Concentration

On-shore/Off-shore Mix

Revenue Distribution : By Geography Revenue : By Billing Currency

Revenue : By Industry

Data Transaction Onshore Calls Function

Claim Services and Support

Mailroom and Scanning

Claims Data Entry

Referral Entry

Claim Audit and

Medical Triage

Claim Payment

and Review 2100 FTEs

Provider Services and Support

Provider Correspondence

Provider Customer

Service

Provider Network

Calls

Pre- Authorization

Calls

Claim Rework

Unit 900 FTEs

Member Services and Support

Benefit and Eligibility

Calls

Claim Dispute Calls

Premium Payment

Plan Renewal

Wellness Care

Support 300 FTEs

Research and Recovery Overpayment

Validation

Overpayment Refund Request

Overpayment Refund Posting

Fraud Research

Refund Calls

500 FTEs

Plan Administration and Support

Sales Support

Underwriting Support

Plan Loading And Setup

Plan Testing

Billing Premium

450 FTEs

Payer Services

Individual HMO Members

Individual Billing Members

Individual PPO Members

5 Processes

Provider Calls PPO

California Member Calls

KANA – Email Support

7 Processes

2 Processes

HMO Small Business

Member Calls

PPO Small Business

Member Calls

2006 2007 2008 2010 – 2011 2009

Group Members Email Support/Provider Dental/ International Middle Market Members Individual Members

10 Processes

Provider Calls HMO

Dental Calls

Global Insurance - Calls

45 FTEs

100 FTEs

260 FTEs

665 FTEs

1200 FTEs

Pre-Authorization

Calls

Provider Network Calls

Overpayment Calls Financial Recovery

HAO and POC

15 Processes

Member Calls –

Middle Market Group

Overpayment Validation

HGS Calls Journey

Leveraging Claims Experience to Deliver Calls

Payer Expertise

Member Services

Provider Services

Plan Sponsor Services

Claim Experience

40 Million Claims

High Dollar and

Complex HCFA / UB04

Claims

Calls Experience

Member Calls –

1.5 Million Calls

Provider Calls –

6.5 Million Calls

Operational Expertise

First in Quality –

All Delivery Centers

99.8% Pay Incidence Accuracy

Compliance

HIPAA

SAS 70

GLBA

Process Enhancements

All Ideas Matter –

AIM

Diet Six Sigma

Sharing Best

Practices – Spark

People and Tenure

200 Claim Associates at 100%

QA in 2010

Average Leadership Tenure of 7 Years

Over a Decade of Healthcare Payer Experience

Scalability

Annual Growth of 60% for Last 10 Years

Blended Shoring

Disaster Recovery

and Business

Continuity Plan

2000

2011

Healthcare Payer Summary

E nga gem ent E xpe r i ence E xpe r t i s e E xce l l ence

Performance Management

System

Business Excellence

Assurance Control Improvement

Organization Capability Group

Compliance and Audit Group Quality Group Continuous Improvement

Group

• International Standards and Regulations • Risk Management

• AIM – ALL IDEAS MATTER • Diet Six Sigma • Six Sigma Projects • QPEP — Quality Professional Excellence Program

• Excellence Frameworks • Perception Management • Brand Building

• eSCM / COPC • 5 Business Methodologies • 250 Processes, Practices and Procedures • SPARK — Best Practices Repository • 360 Available Practices • 6 Papers Published in National and International Forums

• ISO 9000, ISO 2700, HIPAA, GLBA, SAS, PCI • 2300 Risks and 2500 controls in place • Internal Auditor program developed, 18 internal auditors trained • 2 Internal Assessments and Audits • 2 DR Test completed and reported

• Operations Quality • Transition Quality • Shared Services Quality • Quality Tools and Macros Development • Quality Forum

• 1000 Operational part of Central repository • 25 accounts transitioned • 250 Metrics part of Shared Services • 100 Automation tools tracked

• 2600 Ideas, 240 Ideas Implemented • 350 People trained on Diet Six Sigma • 30 BB Trained • 60 Projects , 7 completed • Total saving of $200 K

• 300 QA trained and 75 certified till date

Continuous Improvement and Innovation

QPEP SPARK Concept Training

Let’s Talk Excellence

Performance Improvement

Productivity Tools

Process Changes

Financial Benefits

Business Growth

Voice of Process

Business Feedback

Voice of Customer/Client

AIM (Kaizen)

PCS

8-D

Diet Six Sigma

Six Sigma

Lean

DFSS

TRIZ

• Idea Generation and Processing Tools • Seven Basic Quality Tools • Seven M&P Tools • Decision Making Tools • Project Management Tools • Statistical Tools

• Lean Tools

• DFSS Tools

• Innovation Tools

Process Improvement – Example 1

Re-Routes Reduction from 31.4% in Dec 2005 to 0.11% in Jan 2011

Define • To reduce the Reroute of claims and thereby reduce cost of claim processing

Measure and

Analyze

• Percentage of reroutes were measured during transition

• The categories of edits and reasons were tracked and analyzed

Improve

• Incorrect duplicate edits were identified and eliminated

• Provider function edits and errors were identified and process improvement were recommended

• Reroutes because of skill set gap were identified & team was trained to eliminate the reroutes

• System up gradation issues were tracked, and therefore errors reduced

Control

• The reroutes reduced from 31. 4% to 0.11%

• The edits were continuously monitored to identify opportunities for improvement and process

improvement solutions recommended

Impact

Process Improvement – Example 2

• Purpose and Objective : To reduce documentation errors and standardize the process • The Challenge: Incorrect documentation • The Solution: A documentation tool was developed • Benefit: Tool has been adopted by the client

0

10

20

30

40

50

60

70

80

Jan Feb Mar Apr May Jun Jul

72

34

13

5 3 3 2 2 2

Task element documented Letter Verbiage correct Task created correctly

Correct Letter Sent Letter sent Other

Denial Code Correct Remarks created correctly Task result correct

Jan ’09

~50%Errors due to

Documentation

Jan ’09 to Jul ’09

72 Errors Reduced to 0

Improving Performance with Focused Process Improvement

Process Improvement – Example 3

• Purpose and Objective : To automate the initial phase of rider mapping before loading to Dynamic Plan Load. • The Challenge:

– Manual work – Cycle time – Dup Accumm Errors – Complex process logic

• The Solution: “Rider Mapping Automation Template ” was developed • Reduction in Cycle time

Prerequisites 39 mins

COC CR 28 mins

COC NP CR PAR

32 mins

PLYR CR 20 mins

PLYR NP CR PAR 30 mins

Cycle Time 149 mins

Prerequisites 39 mins

Automated Output 30 mins

Cycle Time 69 mins

Reduction in Rider Mapping Issues from 83.72% to 46.62%!

Process Improvement – Example 4

Increasing Graduation Through put

Transition Team Lead – Ensures support for OJT

Results

Evaluation

• Smoother transition from training to production

• Improved retention during the OJT phase.

• Extensive coaching sessions , dissemination

• Effectiveness of training can be measured

Objective

• Continue Camaraderie from training to Production

• Acknowledge extra focus needed during learning

curve

• Ensure majority pass the OJT phase

50% 55% 60% 65% 70% 75% 80% 85% 90% 95%

100%

HMO TRAD INDIV Dental

Before TTL

After TTL

Process Improvement – Example 5

Impacting Bottom line

Repeat Calls based on Type of Claim Call

• Reduction of Claim Rework

• Reduce repeat calls

TIN Name Claims on Repeat File

Gomez – Garcia, Angel 9

Soar Surgery Center 8

Medical Hyperbarics 2

Florida Dialysis 3

Hall, Lacresha 3

Harvard Surgery Center 1

Month Number of

Agents Number of

Repeat Calls Number of

Unique Claims

January 49 99 69

February 64 144 101

March 78 178 123

April 75 209 130

Top Providers making repeat calls

Trends of repeat calls Vs Seasonality

10%

14%15%

17%18%

26%

0%

10%

20%

30%

Claim Status Clarify/Confirm Payment Appeal Inquiry N/A Rew ork Reimbursement Inquiry

AIM – All Ideas Matter

• New Ideas: 483 feasible ideas from 2,600

• Implemented: 40 of these ideas have been implemented

• Key Impact Ideas: – Reduced rework errors by 40% – Improved CSAT on a Telecom engagement

by 4% within 1 month of implementation – Patient appointment errors reduced by

50% in 4 months – Errors in claim adjudication reduced by

28% in 3 months

Key Improvement and Business Impact

Listening to the Agents – AIM

“Load the billing information on the website such as the premium billed, payment posted date payment post, as well as, plan options if there are rate increases.”

“The benefit packet should be sent together with the ID card, not 60 days from the effective date. It's the member's right to know what their benefits are at the start of their coverage.”

“Regular updates and skill check to make sure that phone reps are always aware of the new policies in their respective departments.”

SPARK - Sharing Practices & Replicating Knowledge

• Knowledge assets shared globally - 365

• 287 Best practices

• 6 White papers

• 72 Case studies

REPLICATION

• 36 Practices replicated across geographies

• Replication Impact

• Impact being calculated for replications

• Impact seen in terms of improvement in call quality, reduction in errors, reduction in complaints.

• Key Impact Metrics

• No of errors committed on call reduced from 9 to 4 errors

• Call Quality increased from 82% to 85% and consistently meeting the target

• Resolving appointment cancellation increased from 95% to 100%.

• "QMC scores are increased from 45% to 51 % • Repeat scores reduced from 28% to 23%

• Fatal Error % decreased from 13% to 9%,

• Customer complaints reduced from 15 to less than 5

• Call Quality increased from 74% to 85%

• Certification % increased by 5% i.e. From 87% to 92%

47

20 21

29

36

0

5

10

15

20

25

30

35

40 Replication

Automation & Efficiency, 9 Corporate Social

Responsibility, 1

Customer Satisfaction

Practices, 39

Employee Satisfaction

Practices, 15

Internal Review Mechanism, 27

Learning and Development, 48

Operational Metrics

Improvement Practices, 86

Performance Management, 22

Quality Metrics Improvement Practices, 100

Resource Management

Mechanism, 13

Value Add to Client, 5

Voice of the Customer

100

75

50

25

+100

+75

+50

+25

7

6

5

4

3

2

1

6

5

7

Industry Average HGS Overall HGS Healthcare

Why HGS

Eric Key Business Development – Healthcare Phone : 1 -309 – 229 – 2857 Eric.key@teamhgs.com

Anand Natampalli Vice President – Healthcare Phone: (001)-201-286-7717 anandmn@teamhgs.com