MDeverywhere 1

Physician-CentricRevenue Cycle Management Company

Christina Patrick Director of Business Development

2010

MDeverywhere 2

About MDeverywhere

MDeverywhere’s mission is simple – to increase your practice revenue

Founded 1995, 500+ EmployeesCurrently Serving:

– 3,200 physicians nationwide– Over 60 different specialties– Solo practitioners, group practices, faculty

practices, hospitals

MDeverywhere 3

Software & Workflow

Web-Based Software– Fully integrated practice management and

electronic medical record system– eClinicalWorks is MDeverywhere’s EMR

business partner If requested, we will interface to other EMRs

– Software is delivered as a service via the Internet – No Servers

Workflow– Practice: Schedule & register patients and enter charges via web,

handheld or EMR

– MDeverywhere: Automate the eligibility process, transmit claims, enter payments, appeal denied & underpaid claims, work accounts receivable

MDeverywhere 4

The MDeverywhere Difference

We will increase revenue 5% to 15%

Automate Eligibility

Decrease Denials by 90%

Enforce Payer Contracts

Increase Patient Volume

Visibility&

Control

Earn PQRI & ePrescribing Bonus

MDeverywhere 5

How We Increase Revenue:1. Eligibility Decreases Denials

MDeverywhere 6

How We Increase Revenue:2. Rules Engine Reduces Denials 90%

Handheld & web-based charge capture delivering rules at point-of-care– 15 Million pre-defined Payor Specific rules

including:

– Additional rules built based on your denials = System Gets Smarter

• Incorrect Diagnosis Code• Bundling/Unbundling• Missing Modifiers

• PQRI & E-Prescribe Measures• Invalid Referring Physician• Global Period Edits

MDeverywhere 7

How We Increase Revenue:3. PQRI & E-Prescribing Rules = 4.0% Bonus

Physician Quality Reporting Initiative (PQRI)– Rules engine supports the current PQRI quality

measures

– If a patient is eligible our rules engine automatically enters PQRI procedure codes

– Result: 2.0% Medicare bonus

E-Prescribing rules will earn you the 2.0% Medicare bonus

MDeverywhere 8

How We Increase Revenue:4. Payor Contract Compliance

Commercial payors underpay claims by 7%– We build a knowledge base with your payor

contracts and payment rules (multiple surgery reduction, etc.)

We know what you are supposed to be paid on every claim

– Appeal every claim where the payment is less than the contracted amount

MDeverywhere 9

Payor Contract ComplianceIdentify Underpayments

MDeverywhere 10

Payor Contract Compliance Appeal All Underpayments

Wisteria Insurance Company 100 Payor Lane, Suite 100 Big City, FL 77777 Regarding:

Patient Name: Jones, Pat Patient ID Number: 333-33-3333 Provider Name: SMITH, HENRY, M.D Date of Service: 01/04/2005 Payor Claim No.: 121123-12345

Dear Sir/Madam:

According to our agreement with Wisteria Insurance Company, the total allowable indicated on the Explanation of Benefits (EOB) for the above referenced claim is incorrect.

Total Expected Allowable: $97.21 Total Actual Allowable: $89.55 Remaining Allowable Due: $7.66

A Comparison of Allowable report is attached that provides additional detailed information regarding this claim, the services rendered and information regarding expected reimbursement by line item. Please review this information and process for appropriate disposition. If the information that I have provided regarding your obligations and reimbursement policies is in error, please provide applicable details to that effect. If it is not, please adjust the allowed amount and remit any additional monies owed. Your Prompt attention is greatly appreciated.

MDeverywhere 11

How We Increase Revenue:5. Increase Patient Volume

Patient marketing and recall plan– Review current patient database and set

patients up on recall plans (Annual visits, preventative exams, etc.)

Reduce patient no show rate– Appointment reminder system calls patients to

remind them of upcoming appointments

MDeverywhere 12

How We Increase RevenueSummary

Decrease Denials By 90%

+ Earn 2.0% PQRI Medicare Bonus

+ Earn 2.0% E-Prescribing Medicare Bonus

+ Increase Revenue 7% by Enforcing Payor Contracts

+ Increase Patient Volume

= 5 - 15% Average Increase Revenue

MDeverywhere 13

Our Web Based Practice Management and EMR Software offers Improved Visibility, Transparency and a Streamlined Workflow– Patient Ledgers

– Patient Accounts Receivable

– Electronic Medical Record

– Management Reports

Visibility & Control

MDeverywhere 14

Visibility & Control:Patient Ledger

MDeverywhere 15

Visibility & Control: Patient Accounts Receivable

MDeverywhere 16

Visibility & Control: Electronic Medical Record

Receive $44K per provider from the HITECH ACT

MDeverywhere 17

Visibility & Control:Management Reports

Financial Reports– Aging– Net Collection– Denial Summary– Denial Detail– Procedure Analysis– Executive Summary– Payor Mix– Charge, Payment, Adjustment

Web based reports by doctor and department are available to different users based on their access level

MDeverywhere can also create custom reports for your practice

Clinical Reports– Quality Measures– Asthma Control Assessment– Diabetic Compliance

Scheduling Reports– Wait List Status– Appointment List– No-show Summary

MDeverywhere 18

MDeverywhere Services & Fees

Automated electronic eligibility verification reduces benefit denials

Rules engine reduces denials

Payor contract compliance software finds payment errors

Recall and appointment reminder system increases patient volume

Tools to Increase Revenue

Rules engine supports PQRI & e-prescribing = 4.0% Medicare bonus

Web Based Software

Patient Registration & Scheduling

Handheld & Web Charge Capture

Management Reports

Outsource

Billing Functions

Payment Posting

Denial Handling & AR Follow-up

Patient Statements & Calls

In-HouseTraditional MDeverywhere

Basic

Electronic Medical Record Software

Premium Prem Plus

MDeverywhere 19

…our product is a paid claim

www.mdeverywhere.com

Physician Revenue Cycle Management Company