sourcehov proprietary, confidential and copyright 2013 results that exceed expectations sourcehov...

SourceHOV Proprietary, Confidential and Copyright 2013

Results That Exceed Expectations

SourceHOV Company Overview

Client Name – SourceHOV Corporate Capabilities

Date


Agenda (sample)

2

Introductions

Corporate Overview

Transaction Processing Solutions» Healthcare Solutions» Financial Services Solutions» Government Solutions

Legal Solutions

Analytics Solutions

Technology

Specific Solution name here – based on what is being pitched

Q&A/Next Steps


Introductions (sample)

Client Name Team» Attendees

• Names and Titles

3

SourceHOV Team» Attendees

• Names and Titles

3

SourceHOV Proprietary, Confidential and Copyright 2013SourceHOV Proprietary, Confidential and Copyright 2013

Corporate Overview

4


SourceHOV

5

SourceHOV is a global provider of transaction processing solutions,

strategic consulting and data analytics services. Our solutions are

delivered through innovative technology platforms and streamlined

workflows based on client-specific business rules.

The company's services deliver improved quality and increased

efficiency, and when coupled with data analytics, can provide clients

the critical quantitative insight and business intelligence to support

more effective decision making.


SourceHOV Business Unit Overview

6

» Payers Processing and adjudication of

claims, member enrollment and provider credentialing

» Providers Medical coding: International

Classification of Diseases ICD-9 and ICD-10

Compliance: under/over payment analysis

Medical records management

Transaction processing solutions for Healthcare payers and providers

Transaction Processing Solutions

Healthcare Financial Services

» Mortgage and auto loan application processing (document preparation digitization, indexing, and archival)

» Accounts payable processing for non-purchase order invoices

» Outcome processing, including print-mail and ePresentment, for financial institutions, insurances and utilities

» Electronic storage of data and documents

Transaction Process solutions for the Financial Services Industry

Government

» Tax return processing for cities and states

» Records management for city, local, county and state governments (vital records include birth, marriage, death and land registry, etc.)

» Electronic storage of data and documents

Processing solutions for Government


SourceHOV Business Unit Overview

7

Legal Processing Solutions Alpha Analytics

» Project management support for all phases

» Notifications and outreach to claimants

» Collections and analysis of claimant information

» Claimant support (call center, website, etc.)

» Administration and adjudication of claims

» Distribution of settlement funds

Processing of legal claim settlements of class action and mass tort lawsuits

» Extraction, exploration and transformation of data

» Develop specific solutions as needed by clients

» Partnerships (SAS, Hadoop, Pivotal – when ready)

» Significant depth of talent with over 25 PhDs

Data analytics business services


“End-to-End” Service Provider – entire lifecycle from origination to outcome processing

Deep Domain Experience across Industries Served

Strong Client Retention – client loyalty

» Serves more than 50% of the global Fortune 100» Average of nine years for top ten clients» 95% renewal rate on long-term contracts

Global Provider - U.S., Canada, China, India, Mexico and the Philippines

Scalability

Well Positioned Technology Leader with Wholly Owned IP

Key Differentiators

8


More than 12,500 employees supporting operations in 80+ delivery centers globallyHIPAA, NIST, DIACAP compliant; FISMA, PCI, NARA certified; SSAE No. 16

Local Presence with Global Strength

Balanced global footprintAccess to skilled resources with follow-the-sun capabilities

The right mix of proximity, cost savings and time zone alignment

9


Delivery Centers and Locations (contd.)

10

AlabamaGeorgiana

PhoenixArizona

BrinkleyArkansas

CarsonChico Hayward Los Angeles Ontario Sacramento San Francisco San Jose Woodland Hills

California

AuroraEnglewood

Colorado

Miami Palm Beach GardensTallahasseeTampa

Florida

Forest Park Newnan

Georgia

PalatineRantoul

Illinois

Des MoinesIowa

LondonLouisvilleMount Vernon

Kentucky

Upper Marlboro

LouisianaBelle ChaseNew Orleans

Maryland

NorwoodMassachusetts

FaribaultMinneapolis

Minnesota

AlbuquerqueNew Mexico

CharlotteNorth Carolina

Las VegasNevada

BinghamtonFarmingdaleKingstonNew York

New York

IrmoSouth Carolina

AmarilloDallasEl PasoFort WorthHoustonIrvingSan AntonioSouthlake

Texas

Salt Lake CityUtah

Sioux FallsSouth Dakota

Washington (2 Locations)

Washington

St. LaurentMississagua

Canada

Obergon (2 Locations)

Mexico • Owned Facility

69 locations in the United states, Canada and Mexico (1) with 5.0K employees


Delivery Centers and Locations

11

Country Locations EmployeesIndia 11 5.0Philippines 2 2.3China 2 0.5Total 15 7.9

India• Chennal• Kanchipuram• Madural• New Delhi• Salem• Thanjavur• Trichy

China• Nanchang• Xian

Philippines• Clarck• Subic

• Owned Facility

15 delivery centers and over 7-9k employees in the Philippines, China and India


Organizational Structure

12

CEO

CFO General Counsel

Chief Marketing

Officer

PresidentTransactionProcessing Solutions??

SVP, Financial

Services and Government

SVP, GlobalOperations

SVP, Global Technology

SVP, Healthcare President, Rust SVP, Alpha

Analytics


Transaction Processing Solutions

13


Healthcare

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Our Healthcare Solutions Portfolio:

Claims Processing , Adjudication and Analytics

Coding, Consulting and Training

Reimbursement Integrity

Medical Content Management

Document Lifecycle Management

Healthcare

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Trained for operational excellence; helping clients improve revenue cycles through quality and scale

Healthcare Solutions

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Capable, intelligent and efficient teams serving large, highly complex acute care facilities – to reduce cycle times, limit resubmissions, reduce operational waste - putting more focus on patient care

Proven, scalable and innovative healthcare processing solutions delivered to the largest providers and payers -public and private

Enabling payer/provider collaboration processes, effectiveness and cost management

Payments, Presentment and Communications

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Comprehensive Enrollment and Verification

Accepts member and provider submissions using physical, electronic and online modes; providing robust verification and entitlement

Coding, Consulting and Training

Electronic and physical payments and lockbox services; presentment and communications to fulfillment and payment

Deep industry expertise and robust platforms provide customers with knowledge-based solutions at the core of their claims

Complex Adjudication and Analytics

Fundamentally changes how claims and re-submissions are managed; increased speed and streamlined processes

Online Self-Service


Healthcare Provider OverviewFull-service healthcare consulting and transaction processing firm serving clients for over 30 years

Solutions that help our clients manage medical record environments and maximize revenue integrity and performance in a regulatory compliant manner.

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Consulting Health Data Management

Business Intelligence Analytics• SourceHOV Audit Track• Revenue Integrity Analysis &

Valuation• Contract Modeling• RAC Audit Process Management

Coding, Consulting & Compliance• Coding• Coding Audit• Documentation Improvement• Interim Management• Staff Augmentation• ICD-10 Readiness• RAC Audit support

Radiology Data Management• Radiology Analog film storage• DICOM Film Digitization• Digital Document

Management & Retention• Record Lifecycle Management

& Destruction

Planning Implementation Operations

• Document Storage• EMR Conversion Support• Medical Record Repository• Document Lifecycle

Management• NARA Compliant Storage

Medical Content Management

Create Value Optimize PerformanceDiscover Opportunity

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Compliance and Data Integrity


SourceHOV Solutions: Connect Payers, Providers and Members

18

Providers Members/ Patients

Reco

rds

conv

ersi

on,

Inde

x an

d H

ostin

g

Physicians,

Hospitals,

Clinics, etc.

EDI a

nd P

aper

Cla

ims

&

Corr

espo

nden

ce (P

CH)

A/R Management, Remittance, EOB, Cash Posting, Presentment

Lockbox/ Bank Funds TransferExplanation of Benefits

Archival & Retrieval

18

Payers

Prin

t Im

age

/D

ata

Capt

ure

/ PC

H

Pre-

Adju

dica

tion;

Web

Re

porti

ng

EON

/Ad

judi

catio

nEn

rollm

ent

PayerSystems

(EnrollmentSettlement etc.)

Verifi

catio

n /

Codi

ng/

Billi

ng

Mem

bers

/ P

atien

ts

Out

com

es(p

rint,

emai

l, fa

x, e

tc.)

Lifecycle of a Claim


Full Spectrum Document Lifecycle Solutions

19 19

Documents are enhanced with additional data & routing approvals to client processes; providing visibility and cross-referencibility with other data sources

Business CommunicationsConversion

Secure and auditable receipt, digitization and data capture of any format , form, document , film, fiche or electronic

Workflow

Physical or electronic business communications services from print and mail centers across the U.S.

Sophisticated platforms for automated rules and ‘need to know’ data extraction for review by analysts and allows for case escalation for client decision-making

Rules-based Platforms

Physical or electronic documents or transactions, are accessed, stored or destroyed in compliance with industry and government regulations

Storage, Deposits, Destruction


SourceHOV provides transaction management solutions from mailroom to presentment, image capture, workflow management and support for healthcare providers and payers.

Accounts Payable

Accounts Receivable

Accounts Receivable Collections

Insurance Processing

Loan Processing

Publishing

Proprietary technology platform

20 years of industry experience

Financial Processes

20

Transaction Volume – 10,000,000+ items / monthAP Mailroom Volume – 2,200,000+ items / month(across all industries we serve)


Financial Services Solutions

21


Financial ServicesFocus Areas:» Mortgage and Auto loan file processing» Accounts Payable» Property & Casualty Insurance» Tax Advisory Services» Surety Claims and Litigation Support??? – is this needed?» Outcome processing

• Includes print/mail and ePresentment

22 22


Benefits

Reduced risk - ensure servicing compliance with new Qualified Written Request rules

A highly secure, one-stop collection point » Increased processing speed

• Lost or slow-to-process faxes, USPS mail, courier mail or email are eliminated

Paper elimination: Work moves to a 100% digital process» Increased margins with reduced costs and increased cycle times by uploading

documents electronically» Customer responsiveness is improved

Anytime, anywhere access to documents and workflows critical to business success

23 23


Finance & Accounting Solutions

Increased cost savings» Typically 40% reduction in AP processing costs

Improved visibility to help manage cash:» Accruals, pending invoices and expense reports

» Early pay discounts

Assistance with migration from paper to electronic» AP vendor portal invoice submission

» AR statement to EBPP

Improved better compliance» Auditable transactions and communications

» Everything we process will be available online

Integration with current business process as a “complementary solution”

24 24


Tax Advisory Services: Benefits

Reduces tax liability

Increases cash flow

Easy-to-implement - solutions are turn-key, performed by experienced technical staff

Auditability - studies are fully supportable upon audit

25 25


Tax Advisory Services: Our Difference

Our People» Technical team has Big 4 experience identifying, documenting and defending studies of all sizes across

industries

» R&D technical leader sits on a national roundtable that meets with the IRS and has structured our deliverables to withstand IRS audit scrutiny

Our Products» We offer internally-developed software solutions for both LIFO and Cost Segregation to prepare our final

product

• LIFO software solution also available

» Our R&D methodology

» Unique collection of solutions is unmatched in the industry

Our process – this section seems clunky – solutions are being mixed together – difficult to follow

» We confirm usability at the outset – what does this mean for the client?

» Our cost seg software allows us to build up costs tenant by tenant, which gives the client the ability to write off improvements by tenant

» We can model all available LIFO scenarios due to our internal use software

» Our customer service response time is 24 hours or less. We have dedicated account managers who manage ongoing project process and communication

26 26


HRO? Meridian?

27 27


Government Solutions

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Our Solutions for Local, State and Federal Agencies

Tax and Revenue Solutions

Vital Records Management

Fraud, Waste and Abuse Identification and Recovery

Lockbox and Payment Solutions


SourceHOV Government

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Data Capture

Scanning /Imaging/Archiving

Fraud Discovery, Analysis and Recovery

Print and Mail , e-Presentment

Lockbox Services

Exception and Error Resolution Processing

First level Correspondence

Our Core Capabilities

30


Individual Income

Corporate

Sales & Use

Withholding

Motor Vehicle

1099

SourceHOV -Tax & Revenue Experience

31


High volume capacity: Over 14 million forms processed annually

Income, Sales, Corporation, Business, and Excise taxes

Six Sigma process methodologies - focus on quality improvement

Fully redundant operations: disaster recovery, business continuity

Industry compliant: SSAE 16 Type II, SOX compliant

Our Tax & Revenue Experience

32


Electronic Conversion and Management of Critical Records

Document imaging and microfilm conversion services

Data capture and indexing

Web-enabled, hosted solution for electronic file storage and retrieval (documentDNA)

Extends the life of vital information

Improves disaster recovery planning

Nearly 50 operating centers across North America

Vital Records Management

33


FRAUDExchange

A complete solution for managing fraud investigations for discovery to recovery

Specifically designed for:

»Medicaid Program Integrity

» Medicaid Fraud Control Units, (MFCUs)

» Commercial Special Investigations Units

Web-based Solutions

Role-based functionality and security

Electronic Desktop- all data, documents, interviews, notes stored in one place

Recovery tracking-for all receivables

Analytics integration- pre and post pay analytics; can integrate with other systems

SourceHOV – Fraud, Waste and Abuse Solutions

34


Lockbox and Payment Solutions

The collection of all non-tax payments for state and federal agencies through wholesale, retail and specialized lockboxes

Mail processing, image capture Document management technology and operations Platform for business rules processingLockbox and transmission filesRejects, creation of returned letters returned item mailing

35



This might be duplicative of Vital Records Management..

36


Legal Solutions

37


Legal – Rust Consulting, a SourceHOV company

Market leader in Class Action administration and processing

Comprehensive solutions provider» Identification, notification and outreach to potential claimants» Administration and adjudication of claims» Distribution of settlement funds» Advisory services on best practices

High-volume transaction management» Between 400-500 cases annually» High profile cases

• National Mortgage Settlement, GMAC, OCC• Fortune 100 companies and top tier brands• 98% of the American Law 100 firms and federal agencies

38 38


Analytics Solutions

39


Data Stores are Growing 50% YOY

» Organizations today are generating more data in a single day than the entire Internet generated as recently as 2000

» In the past, gigabytes were used to describe data stores; now terabytes and petabytes are commonly used – difficult to manage and interpret

» Legacy data is structured in databases that consist of columns and rows that are identifiable and easily searchable

» Big data consists of unstructured data such as email, voice, media feeds, social media sentiment, video and graphics

• 80% of data today is unstructured – highly valuable, but difficult to search and easily find relevance for analysis

Organizations are looking to use both structured and unstructured data to analyze and optimize business processes

» Need to make real-time decisions ensuring competitive advantage

• Examples include healthcare analysis, financial trading, fraud identification/prevention, telecommunications tracking, biomedical applications and e-commerce retailing

Alpha Analytics

40


Get content from slide about difficulty in creating an in-house analytics practice

Alpha Analytics

41


Services for extracting, cleaning and preparing data for analysis

Hosted or on-premise software tools and infrastructure

Outsourced analytics services and solutions developed using team of experts

» More than 25 Ph.D. economists, statisticians, IT professionals and business professionals

» Expertise in healthcare, financial services, legal, government, publishing and other industry verticals

Enables strong competitive differentiation and ability for clients to bundle data analytics services with other solutions – providing a one-stop shop for clients

Alpha Analytics

42


Legacy in Litigation Consulting, Economic/Statistical Analysis and Expert Testimony Services over the course of the litigation lifecycle (typically on defense)

» Areas of expertise include labor and employment, anti-trust and intellectual property as well as economic impact studies

Clients include more than 200 of the Fortune 500 companies and more than 70 of the AM Law 100 firms

Alpha Analytics

43


Technology Platforms

44


Proprietary Technology Platform for Legal Claims Processing

45 45

Claims Processing Platform

Key Features

Expand services to scale to large and small projects

Enable exception-based

claim review

Refines internal model

Technology Platform

Business Rations

Future Implication

Notification

Mall Management

Data Capture

Exception-BasedClaim Adjudication

Calculation andFunds management

Case Management

Case Statistics

Data Receipting

Data Cleansing

Exception-BasedClaim Adjudication

Calculation andFunds management

Improved Data Management

Improved Workflow Efficiency

Increased Automation of Claims Adjudication Process

Scalable claims processing solutions

Enhanced customer experiences

Entire suite of Claims processing technology and services


Benefits

Enables automation for faster turnaround times, lower costs and improved accuracy

Easy configuration and faster roll out of services (reduced ramp time) with modular components

Integration with client workflow processes

Continuous enhancements to platforms

46


Internally Developed and Scalable Technology Platform

47

Healthcare Finance

HealthcarePayer

HealthcareProvider

Finance and Accounting

Loan Processing

eContent Management

Analytics Records Management

& Storage

PCH™PCG™

PCX™PCF™

Turboscan™ACE™

Firefly™ Aquila™ Komodo™FCB™

EON™ MCP™

DocDNA™

Sub-Services

Platform Modules

Solutions

» OCR, Scanning Data Entry

» Archival /Retrieval

» Workflow

» Business Rules Engine

» Approval, Adjudication, Fraud Waste & Abuse Analysis

Ethos™

Public


Case Studies

48


Relevant Experience

UnitedHealthcare (UHC) » Location: 15 locations including Offshore Services in India, China, Mexico & Philippines» Volume: Over 3 million pages per month in claims, enrollments, and correspondence» SLA: 30 minutes for expedited appeals

WellPoint/Anthem Blue Cross» Location: Carson, CA; Denver, CO; Atlanta, GA; Offshore Services in Philippines & India » Volume: Over 2 million medical claims per month» SLA: < 4 hours

Top 10 P&C Insurance Company: Document Management for Claims» Location: Carson, CA; Offshore Services in Philippines » Volume : 200,000 medical bills; 1million non-medical images per month» SLA: < 2 hours

Top 5 Bank: Disaster Recovery/Overflow Support of Internal Document Management» Location: Irving, TX; Carson, CA; Offshore Services in Philippines &India» Volume: 15 million pages scanned, indexed, and doc typed per month» SLA: 24 hours

Top 5 Bank: On-Site (FM) and Off-Site Document Management Services» Location: Irving, TX; Carson, CA; Offshore Services in Philippines & India» Volume: Over 25 million images ingested, indexed, and doc typed per month» SLA: Under 11 minutes

Client Delivery

49


Account Governance

50


Effective Communication is a Critical Success Factor

Dedicated Program Manager & Customer Relationship Manager

Daily Internal Meetings with all Sites (Operational)

Weekly Operational Calls with Client Team

Automated Email Distribution of Production Reports

Real-Time, Web-Based Reports – Daily, Weekly & Monthly

Monthly Review of Performance Versus SLA (Dashboard Structure)

Structured Escalation Processes; Internal and with Client Team

Detailed Change Management Process

Quarterly Business Reviews

Executive Annual Reviews and Strategic Partnership Initiatives

Account Governance ModelKey Operational

Management Resources

Executive-Level Project Steering Committee

Dedicated Program Manager

Strategic Account Manager

Solution Engineer

Vice President, IT Services

Senior Business Continuity / DR Specialist

Manager, Information Security / Risk / Compliance

Operations Manager

Human Resources Manager

51


SourceHOV Quality Organization & Alignment

52

Quality Intelligence

Q-CardDevelopment

Continual Improvement Programs

• Real time interactive QM Portal

• Spec, Process, Audit, CAPA, Report Modules

• SLA Gaps / Enhancements

• Small Group Activities• Six Sigma

• Outgoing Quality (CAL)• Stage-wise Quality• Focus Audits• Sampling Plans

Compliance Monitoring Calibration

• Client Vs In-house• Auditors Vs Processors• Center Vs Site

• SOW Mapping (QFD)• Customer / CRM

Interactions• Customer Quality Report

CustomerQuality

Process Management

• CTQ Controls• FMEA, Causal Analysis• Feedback loop, Reactions/CA• Change validation & Sign-off• MOC – Setup Validation

StrategicQuality

Performance Metrics

Quality Ops

52

• Adaptive Database• Logic based on BR &

historic patterns


Six Sigma Program

53

Components of Six Sigma Program

Goal Setting & Deployment

Structured Project Execution

Organizational Alignment

» Active Vision Points

» Annual Objective Setting

» BRWs & Trimester Reviews

» Business Process Management

» Projects Linked to AVPs

» Project Approach Guide

» DMAIC, DMADV Cycle

» SourceHOV Migration Model (DFSS)

» SAT (Minitab)

» SSDT Reviews

» The Six Sigma Organization

» Change Management-A2I

» Competence Recognition; Champions, GB, SAT, etc.

» Ongoing Awareness

» Employee Engagement Tracking


Q&A/Next Steps

54


Contact information: NameO: XXX.XXX.XXXX C: XXX.XXX.XXXXEmail address

Thank You

5555

sourcehov proprietary, confidential and copyright 2013 results that exceed expectations sourcehov...

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