ü Physician code editing

a.     50% of all physician claims have coding errors

b.     98% of all hospital claims have coding errors

c.     Line item documentation reflecting errors

d.     Reduce your healthcare expenditures by 6% to 10%

ü Out-of-network claim settlement

a.     Solutions powered by PMCS www.pmcsonline.com

b.     Out-of-network medical claims are 12% to 25% of all claims

c.     85% of all medical claims are below $5,000

d.     Average discounts are 20% below allowable charges

e.     Nearly 400,000 providers under contract

f.     Reduce your healthcare expenditures by 3% to 5%

ü Hospital Bill Review

a.     Solution powered by PMCS/AMPS www.advancedpricing.com

b.     Physician desk top review

c.     We identify undocumented charges

d.     Reduce your healthcare expenditures by 3% to 4%

ü Pharmacy Benefit Expense Manager

a.     Powered by PNPS www.pnpsonline.com

b.     Pharmacy Benefit Managers ("PBM's") are not transparent

c.     Plan Sponsors receive 100% of verifiable rebates

d.     Payer pays acquisition costs plus a dispensing fee

e.     Reduce your pharmacy expenditures by 6.8% to 10.5%

Healthcare Illustration Tool