CSCs DirectConnect Connectivity Solution

1
CSCs DirectConnect Connectivity Solution

• ROI Analysis Data Request

2
DirectConnect Business Data Request

• Financial Data
• Gross and Net Revenue, split by payer
• Institutional and Professional claim volume ( of
  claims and s), split by payer
• Rejection information ( volume and number of
  rejections), split by reason and by payer if
  possible
• Denial information ( volume and number of
  denials), split by reason and by payer if
  possible
• Current electronic transaction fee and other cost
  information (eligibility, claims, remittances,
  etc.)
• Process Data
• Visit volume by major service line (ED,
  Inpatient, Clinic, Day Surgery)
• Staffing data (scheduling, pre-registration,
  registration, billing, follow-up)
• Current eligibility verification process
  information
• Current claim status process information

3
DirectConnect Technical Data Request

• Systems Information
• Scheduling, Registration, Billing System
  Information
• Inpatient and Outpatient
• Electronic Transaction System information
• Eligibility verification system(s)
• Bill scrubbing and clearinghouse system(s)
• Remittance posting system(s)
• Telecommunications/Connectivity Information
• Existing network connections to Medicare, Blue
  Cross, other large payers

4
CSCs DirectConnect Connectivity Solution

• ROI Analysis Sample Output

5
Hospital Eligibility Verification ROI Model

• Major Assumptions
• Eligibility verification performed on 83 of
  encounters, 39 of current inquiries are via
  telephone
• Future state will be 100 eligibility
  verification with 70 via DirectConnect

Revenue Enhancement Interest on Cash
Acceleration Reduced Time per
Transaction Reduced Re-work Transaction
Fee Savings
219,500 Key Data Bad debt expense Jan04-Sep04
of 2.28 used as proxy for total
write-offs Percentage of write-offs due to
eligibility errors 1.41 Eligibility checks
currently performed on 83 of encounters 47,800
Key Data Total reject rate currently 6.84 of
rejections due to eligibility problems
approximately ¼ of total rejections Days
Acceleration is 45 days, discount rate of
3.5 541,900 Key Data Time to verify a claim
manually is 20 minutes Time to verify a claim
electronically is ½ minute 39 of verifications
are currently done manually Current claim volume
510,000/annum 32,300 Key Data of
rejections due to eligibility problems
approximately ¼ of total rejections Future time
to do a verification (weighted average) 3.8
minutes 102,000 Key Data (Clearinghouse
estimated per annum)
Total Ongoing Benefit 943,500/annum
6
Hospital Claims Status Inquiry ROI Model

• Major Assumptions
• Inquiry currently performed on 65 of claims, 46
  of current inquiries are via telephone
• Future state will be 100 claims status inquiry
  with 80 via DirectConnect

Interest on Cash Acceleration Reduced Time
per Transaction
33,200 Key Data Total reject rate currently
6.84 100 of rejections currently followed-up
on of rejections influenced by status inquiry
66.7 Discount rate of 3.5 169,300 Key
Data Time to perform inquiry manually is 10
minutes Time to perform inquiry electronically
is 1 minute 46 of verifications are currently
done manually Current claim volume
510,000/annum
Total Ongoing Benefit 202,500/annum