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CGI RAC Region B Outreach Region V Hospital Associations

CGI RAC Region B Outreach Region V Hospital Associations. May 19, 2009. Today’s Agenda. Introductions RAC Mission CGI Corporate Overview CGI in Healthcare Staff Credentials Processes for Review and Recovery Contact Information Questions and Answers. Introductions. Key Staff

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CGI RAC Region B Outreach Region V Hospital Associations

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  1. CGI RAC Region B Outreach Region V Hospital Associations May 19, 2009

  2. Today’s Agenda • Introductions • RAC Mission • CGI Corporate Overview • CGI in Healthcare • Staff Credentials • Processes for Review and Recovery • Contact Information • Questions and Answers Confidential

  3. Introductions • Key Staff • Rob Rolf, CGI Vice President • Mary Hoffman, CGI RAC Project Director • Dr. Percival Seaward, CGI Contractor Medical Director • Sabrina Katsaris, CGI Audit Manager • William Davis, PRG Schultz RAC Project Director • Dr. Earl Berman, PRG Schultz Contractor Medical Director Confidential Confidential

  4. CGI RAC Mission CGI’s mission for the RAC Region B is to identify improper payments through the detection and collection of overpayments, the identification of underpayments, and the implementation of actions that will prevent future improper payments utilizing their Customized Auditing Software (CAS) 5.0 software. Confidential

  5. CGI Corporate Overview • World-class IT and business solutions provider • Ranked 12th in “Global Outsourcing 100” list • End-to-end IT management, consulting, systems integration, business process services • 26,000+ members; 3,500 clients; 100+ offices worldwide • Vertical expertise in six key industry verticals • Quality delivery and client satisfaction focus • ISO 9001 and SEI CMMI Level 3 certifications • One of the best delivery track records in the industry Confidential

  6. CGI in Healthcare • One of the most seasoned, diverse staffs in the industry • Providing claims recovery solutions to healthcare payers for over 18 years • Performed audits for BlueCross BlueShield companies, national HMOs, large commercial payers, and State Medicaid agencies • Developed methodologies, processes, and software tools, which assist in the identification of claims for audit, as well as the management of the audits themselves • Blends staff members from systems, claims and clinical backgrounds to develop innovative solutions that are effective and produce results • Varied level of expertise has allowed our team to develop solutions that are customized for each business environment Confidential

  7. Solutions for Healthcare Payers Fraud Consulting & Software Pharmacy Consulting & Software Financial Consulting IT Consulting & Software Clinical & Coding Services Healthcare Payer Services and Solutions Confidential

  8. Staff Credentials • CGI staff members have extensive backgrounds, training, and certifications in the areas of healthcare management and clinical coding. Each member of our team has at least one of the following certifications, with many members having multiple certifications: • Medical Doctor • Certified Coding Specialist • Registered Health Information Technician • Registered Health Information Administrator • Registered Nurse • Certified Professional Coder • Certified Professional Coder – Hospital • Registered Pharmacist Confidential

  9. Staff Hiring and Training • Candidates are screened and interviewed extensively • Background checks performed on all hires • Recruit from industry organizations when possible • Strong team with low staff turnover • Professionals include clinicians, certified coders, CPAs and IT experts • Continuing education required • Goal is to hire from Region B states for RAC project Confidential

  10. Contact Information Call Center for RACB Toll Free: 877-316-RACB E-mail: RACB@cgi.com http://RACB.CGI.com 10 Confidential Confidential

  11. Questions Confidential

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