As one of a select list of companies chosen to participate at the William Blair & Company’s 15th Annual Private Equity Conference in September 2012, AdvantEdge’s President and CEO, David Langsam, described how AdvantEdge has grown both organically and through a disciplined acquisition strategy to become one of the largest providers in the medical billing, coding and practice management industry. In an industry that is experiencing increasing regulation and cost pressures, acquisitions are one of the most efficient solutions to the challenge of achieving the scale needed to make the investment in technology that enables providers to comply with increasingly complex government reporting while also reducing unit costs for healthcare professionals.
2. Enabling Healthcare Providers to Thrive
AHS is a technology enabled provider of
Revenue Cycle Management Services,
Informatics, and Expertise that enables
healthcare providers to maximize
financial performance and eliminate
compliance risks.
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3. About AdvantEdge
AdvantEdge Healthcare Solutions
Top 10 medical billing, coding and practice management company
Over 675 employees in 8 regional offices in the US and 1 office in Bangalore, India
Collecting over $1.25B for its physician clients
Recognized industry leader - uniquely positioned
Clients are typically large medical group practices with a high propensity
to outsource due to practice characteristics
Clients trust that we deliver the best performance for the money, and
expertise specific to their specialty
Since 1966, AdvantEdge (and/or its acquired entities) has served some
of the nation’s most respected healthcare institutions
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4. Business Characteristics
Highly predictable recurring revenues and strong cash
flow
Superior client retention
Significant Operating Leverage: Scalable platform
based on proprietary technology and workflow
Effective buy-and-build strategy: Integrate, Migrate,
Operate
Sales & marketing focus with aggressive organic
growth strategy
Management Team has extensive industry, acquisition
and integration experience
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5. Market Leading Strategy
Creating Value for Clients, Employees, and Stakeholders through:
ZERO CLIENT
GROWTH EFFICIENCY TECHNOLOGY INTEGRATION
ATTRITION
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6. Geographic Presence
AHS has a broad footprint across the US and Bangalore, India
AHS Office
AHS Client
AHS Clients (Multiple/many clients)
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7. AdvantEdge Value Proposition
The Problem
Constant threat Attract & retain
of reduced high-quality
reimbursement staff
rates
Increasing
complexity & Technology and
regulatory staff investments
requirements are expensive
The AHS Solution
More Money, Faster
Compliance, Built-in
Business Intelligence and Reporting – Anytime/Anywhere
Client First™ Service
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8. Proprietary Technology
Claim
Scrubbing Smart edits:
Compare LOS, Dr.,
Proc & Diagnosis
Codes, Coverage,
Dictated Reports Interfaces w/over Electronic Claims
Computer- With or w/o
Sex, Pt. History
600 payors, all ANSI
demographics transactions: 837
Filing, Remittance &
Assisted Coding Natural Language (claim), 835 (ERA), Eligibility Checking
Processing 276, 277,
Flag Exceptions 278 (status)
HL-7, CSV, ADT,
Virtual
Interface EMR, ACC Manager Parameter-based
Demographics electronic tasking and
WorkFlow
Engine Charges workflow
Reports i5 management
Accession #s
HIPAA-secure
All ANSI denial
InfoEdge client web
Business codes from EOB’s, Denial
portal, drill-down,
auto-routing, work
Intelligence data export, Management
queues by function,
scheduled &
Client contracts by defined workflow
ad-hoc reports
proc and effective
date, exception rules,
auto-routing, work
queues, reports
Contract Management
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9. Business Intelligence and Reporting
InfoEdge Web-based Reporting Portal
Anytime anywhere access to practice information
Fully secure with customized authentication capabilities
All reports delivered through secure, HIPAA compliant portal
Business Intelligence Platform
Summary information on physician dashboard
Detailed information via “point and click” technology
Standard and customized reporting available
Ad hoc
Memorized
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10. Market Opportunity
The market for the Company’s services is Large and growing market:
estimated at $4B - $8B Physician expenditures
increasing by 8% + / yr.
Office-based
RCM
Increasing shift to
outsourcing (RCM); currently
less than 20% of total
$0.70 Largest competitor has
under 5% of total market
$3.30
$4.00
In-House: $4.00
Practice Management Hospital Based MD
RCM
AHS Target
Market
Target markets
Billing and Practice Management Service Market (Falcon Capital): $8.0B
Total RCM Market (Wallingford Capital/HBMA, 2007): $4.7 B; top 10 billing cos.: $1.0B
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