Medical Banking Strategy

Presenter: Nav Ranajee,

VP Healthcare Strategy
Date: September 14th , 2004
© ABN AMRO Services Company 2004
 Agenda
Medical Banking Strategy

Healthcare Industry Challenges

Medical Banking Solutions


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 © ABN AMRO Services Company 2004
 Medical Banking Strategy

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 © ABN AMRO Services Company 2004
 ABN AMRO Overview
Global Reach
 175 year history with a global branch network spanning 60 countries
 One of the largest banks in Europe
 $601 billion EUR in total assets
United States
 Established in the US in 1941
 Largest foreign owned bank in the US with $168 billion in domestic assets
 Over 22,500 employees
 11 regional corporate finance branches and over 400 commercial & retail branches
 Mid-west presence comprises of LaSalle Bank and Standard Federal Bank
 Complete Suite of Banking Services
Treasury Management
Financial markets
Asset management/Working Capital/Mortgage
Commercial Card Services

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 © ABN AMRO Services Company 2004
 Mission

ABN AMRO Services Company (AASC)

MISSION
Our mission is to become the banking leader in providing value
added products and services to the healthcare industry. We will
offer quality solutions that will enable healthcare organizations
to reduce their operating costs and to increase their revenue.

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 © ABN AMRO Services Company 2004
 Why Banks and Healthcare?

Healthcare is a Multi-Billion dollar industry. The cost to administer $30B

in transactions is $300B annually. This represents a significant
opportunity for the Bank to increase its market share and revenues.

The basic complexity of the healthcare payment environment creates

significant market demand for solutions that can resolve their revenue
cycle challenges.

As a natural aggregator of payments, Banks are well positioned to be

able to offer solutions to streamline the payment channel of Healthcare
Organizations.

The Healthcare Insurance Portability and Accountability Act (HIPAA) has

opened up an opportunity for Banks to offer outsourced products that can
enable compliance to the electronic transaction set stipulations.

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 © ABN AMRO Services Company 2004
 Healthcare Industry
Challenges

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 Healthcare Landscape
Industry
Challenges Government

HIPAA/ Prompt Pay Provider

Regulations (Hospital,
CCRC, Clinic)
Rising malpractice
insurance costs

Rising Health Care

3rd Party
Costs
Vendors
(clearinghouses/
Patients / process
Benefit Cost Shift from outsourcing etc.)
Employers to Consumer
consumers
Patient Value Chain
*Revenue Cycle

Technology
Payors
Reduced Reimbursement (Insurance Employer
Company) Group
Manual Processes (Self-Insured
or Premium)
*The revenue cycle is the process that begins when a patient comes into the system and
includes all activities that lead up to the billing and collection process. Source: Cap Gemini.

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 © ABN AMRO Services Company 2004
 Complex Payment Flow

Regulations, Compliance

Information Flow Complexity: Provider $ Medicare, Medicaid

 Choosing Plan Type (Hospital, CCRC) Government
(Employer & Insurance Co.) $  S r
Pa Pr i d,
y ici ica
 Regulations and Compliance Pharmacy C
Re lai n g,
,M
e d
c o ms EO
(HIPPA, etc.) nc , A B ic are
ili
at c c o ed rd
 Registration, Benefit io
n
un $ M g Ca
t u
Dr
Verification, Pre-Certification
 Billing of claims c e ss  Member information
dicatio
n Pro 3rd Party
 Pricing and EOB issues  A d ju $ Per diseased member
Adjudication process of claims fees Vendors

eRrificaicatiyo,n


V rtif -pa les

Ce Co ctib
$ du

eg tio
$

De
Pa B

ist n,
Insurance y
pr ill

ra Pre
em i
Company ng

tio
iu
Payment Flow Complexity: Coordination of m
s/

n, -
 Enrollment (Payments, FSA, Re
Benefits

Be
co
nc
MSA, HRA, etc.)

n
ili
Other Insurance a

$ Premiums
ef
tio
 Claim payment and Account

it
n
Companies,
Reconciliation Medicare
 Medicare, Medicaid, Senior Employer
pl a
n t s,
Drug Card o o se a
en
ym tc.) Group
h P e
 Diseased member fees C llmen,t H( RA, Self-Insured
o A
 Insurance Plan Premium and nr
$ EFSA, M
S
or Premium
Account Reconciliation Individual
 Co-pays and Deductibles
/
Consumer
Source: Cap Gemini

Payments
Paymentsand
and the
the flow
flow of
offunds,
funds, represents
represents aa critical
critical component
componentof
ofaa health
health care
careorganizations
organizations revenue
revenue cycle
cycle

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 © ABN AMRO Services Company 2004
 The Health Care Industry is Facing Eight Major Revenue Cycle Issues That
Are Slowing Cash Flow and Impacting the Customer Value Chain
Revenue
Cycle Issues
1. Decrease in Cash 1) Patient Access
Flow Scheduling, registration,
2. Increased Days in 2) Billing eligibility verification, co-
Accounts Receivable
1) Patient Access
pay/deductible collection
3. High % A/R >90 days
4. Increased 2) Billing
Contractual/Bad Debt Charge capture, claims
write-offs generation, claims
5. Increased submission to payer or
Discharged, Not
Final Billed clearinghouse
6. High Volume 3rdrd 3) Payment Posting
Party Denials People The reconciliation and
7. Process Issues
8. Technical Issues
posting of payments.
• Varying levels of 5) Denials 4) Follow-Up/Collections
The follow- up and
technology use Management Technology Process 3) Posting
• Numerous collection activities
systems involved in unpaid or
conversions and partially paid accounts
standardization including secondary billing
• Desire for leading 5) Denials Management
edge technology Involves claims denial and
solutions 4) Follow-Up/ adjudication including
appeals and re-billing.
Collections

Using
Using core
core competencies,
competencies, banks
banks can
can play
play aa role
role in
inthe
the various
various stages
stages of
of the
the revenue
revenue cycle
cycle

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 © ABN AMRO Services Company 2004
 Medical Banking
Solutions

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 © ABN AMRO Services Company 2004
 Product Focus
 ABN AMRO can add value for Healthcare Organizations by offering products
and services that:

 Improve Revenue Cycle Operational Efficiency and provide cost savings via
automated solutions.

 Provide Technology that can enable HIPAA Compliant transactions in a cost-

efficient manner.

 Enable increased Accounts Receivable capture.

 Improve their Patient/Customer Satisfaction.

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 Revenue Cycle Opportunity
Denials
Cash Acceleration
Management
Best Practices (source: Healthcare Finance Management Administration)
•Accurate front-end •Enhanced A/R
information capture Management
•Complete and timely •Reduced A/R aging
service documentation •Technology enabled Data
•Utilization Review Mining
•Process Automation
•Prioritized deployment of
follow-up resources
Banking Solutions
•Healthcare Smart Card •Payments Clearinghouse to
to automate eligibility and digitize, expedite and
capture real time data accurately reconcile
•Image Archive to enable payments.
expedited access to •Information reporting
patient documents •Process automation
•Information reporting to •Cash Forecasting Tools
track denial reasons •Image Lockbox to expedite
payments and view imaged
data online
 © ABN AMRO Services Company 2004
Patient Payment
Strategy
•Point-of-Service Collection
•Enhanced patient
payment alternatives
•Accelerated patient
notification
•Healthcare Smart
Card/Debit card
enables the capture of
patient payments
•Web-based payment
enablement.
•Electronic invoices
Third Party
Payment Compliance
•Automated Contract
Management Tool
•Specialized
collection follow-up
resources
•Technology enabled
tools to capture
correct information
•Information Reporting
•Image Archive of data
for research
•Cash Forecasting Tools
•Digitized payment data
to expedite research
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 Products in Development
 Payments Clearinghouse
 Web-based solution that automates the accounts payable process by executing, distributing and reconciling medical payments via
HIPAA compliant formats.
 Smart Card/Debit Card
 Solution is designed to assist payers in streamlining and expediting the front-end eligibility and payment process.
 Claims Process Outsourcing
 Service that enables the outsourcing of billing, posting and follow-up processes of providers.
 Online Information Reporting
 Web-based reporting tool which enables clients to easily view data and create reports.
 Online Payment and Presentment
 Enables patient bills to be paid online. E-mailing of patient invoices.
 Healthcare Savings Accounts
 HSA product for retail consumers.

 Traditional banking products tailored for healthcare

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 Questions?

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