4th NATIONAL MEDICAL BANKING INSTITUTE

February 22-23, 2006

Nashville, TN

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Visioning Session #1:  A Healthcare SABRE?  Revolutionizing Healthcare From the Inside Out Using

the Lockbox-Patient Accounting Axis

Design:  How an emerging axis between two basement operations can fundamentally transform

healthcare -- Moderated; 2 Panels

Panel #1:

Jim Ribelin, Executive Vice President of Operations & Product Management

Herae, LLC, San Diego, CA

Jeff Troutman, Senior Vice President & Marketing Manager

PNC Bank - Treasury Management Dept, Pittsburgh, PA

Presentation:  Electronic to Electronic, Payer to Provider - What's the Bank's Role?

Session Focus/Summary:

The U.S. healthcare industry handles payments largely on paper, the way it has done for decades. U.S. healthcare generates 600 million paper envelopes, checks and explanation of payment forms each year, and the average cost for processing each payment envelope is $9.20. Physician offices spend $5.5 billion a year to process claim payments. Claim payment processing is one of the most time-consuming staff functions. Healthcare is now where banking was in 1980s, before debit cards and utilization of the internet to complete banking transactions. When these electronic processes were implemented, banking saw costs go from $1.07 at the teller window to $0.01 for the same transaction done over the internet. Some HIPAA transactions that benefit payers have been implemented.  However, physicians still don't realize how much they spend to process paper payments, and many don't have a strategy for HIPAA 835 transactions that improve workflow and reduce costs. This session will present research, pros and cons of paper vs. ERA and EFT, and challenges and solutions for electronic payment processing.

Learning Objectives:

1. Participants will learn about the challenges and solutions for payment processing for healthcare providers.

2. Participants will learn how HERAE and PNC have teamed up to provide a direct deposit system for the healthcare industry (case studies of providers working with HERAE and PNC will be presented).

3. Participants will learn about banking as a transaction success story and how the healthcare industry can learn from the banking industry's adoption of electronic transactions.

Biography:

Jim Ribelin is currently Executive Vice President, Operations and Product Management of HERAE.  Jim is responsible for internal operations, product strategy, product management, marketing and public relations.  Jim oversees the customer support and service team that works closely with HERAE clients guarantee customer satisfaction.  Prior to joining HERAE, Jim was the Vice President, Product Management at Verilé/Abovehealth, a leader in providing web-based information on behalf of health plans for all their external constituents.  Before Verilé/Abovehealth, Jim served as Senior Director of Product Strategy at MedUnite where he was responsible for a number of activities including the organization's product strategy.  Previous to MedUnite, Jim served as Director of iBusiness for NDCHealth.  At NDCHealth, Jim managed a number of multi-million dollar business relationships and worked with companies like Medscape and Viacom.  Before NDCHealth, Jim held numerous positions at CIGNA Healthcare's southwest division, including work in Medical Economics and with CIGNA's first online provider web portal.  Jim has been a featured speaker at MGMA and at Amisys Customer Conferences.  

Jeff Troutman is Senior Vice President of PNC Bank, National Association in the national healthcare group.  Mr. Troutman has been a key player in developing PNC's direction for serving the heatlhcare industry.  He has been involved in HIPAA strategies and tactics since 1996, from both industry and PNC perspectives.  Mr. Troutman brings to this role previous PNC experience that includes, business development for National Corporate Finance, where he is credited with expanding the array of products and financial services offered by PNC.  Prior to joining PNC in 1992, Mr. Troutman served as an associate with Interstate Hotels Corporation where he spent time working within the real estate M&A group.  Mr. Troutman is a member of the Association of Financial Professional and a member of the WEDI clinical documentation group.  He is a board member of the Big Brothers Big Sisters of Greater Pittsburgh and a member of the Board of Governors at the Longue Vue Club.

Panel #2:

Jay Foster, Vice President

eGistics, Inc., Dallas, TX

Lori Daugherty, Chief Operating Officer

WorkingRX, Inc., Salt Lake City, UT

Presentation:  Paperless Processing - How Do We Really Get There?

Session Focus/Summary:

The focus of this session is to examine in detail how imaging can enhance every facet of the claim to cash revenue cycle by examining a real life example of its integration into an existing business process.  Roadblocks, pitfalls and other unplanned considerations will be discussed.  Executives responsible for any and every business aspect in the claim to cash process will be interested in attending this down to earth discussion.

Learning Objectives:

1. Participants will see a real life example of how imaging plays a crucial part in many aspects of the billing and collection life cycle.

2. Participants will better understand the pitfalls of undertaking a paperless solution.

3. Participants will better understand the potential of imaging to reduce DSO, improve customer service and gain efficiency.

Biography:

Jay Foster is Vice President of Customer Solutions for eGistics, Inc. and is responsible for solution design and vertical market sales.  He has been intimately involved in initiatives in the healthcare and remittance processing industry.  Prior to joining eGistics, Mr. Foster has held various management and leadership roles in sales, delivery and solution design for leading edge technology start-ups.  He has also held positions in large technology companies including Oracle and Dun & Bradstreet.  For over 25 years, Mr. Foster has been involved in applying technology to real business issues as an end consumer, consultant and solution creator.  Mr. Foster holds a BS from the University of Houston.

Lori Daugherty is the Chief Operating Officer for WorkingRX.  She has over 17 years of healthcare and financial services experience that include Workers Compensation, Medicaid, Medicare Part B and Third Party contracting, billing and collections.   Prior to joining WorkingRX, Lori held management positions focusing on operations, reimbursement and pharmacy benefit services, such as President of regional workers compensation PBM, Vice President & Controller for a medical supply company and VP of Operations for a workers compensation medical cost containment company.