Page 1

Highlights In ThisInIssue Highlights It’s About Partnership ...............................2

This Issue

Interview with John Morris.........................3 PPS –Transforming Payment Process.....4

It’s About You .............................

Insight 2 From A Coding Analyst..................5

Jimmy’s In the House................................6 Key Opinion Panel Discussions. Employee Spotlight...................................7 15

PHX Forum........................ St. Jude2012 Charity.........................................8 16

It’s About Partnership At the PHX family of companies, we believe that building Customer partnerships is fundamental to achieving success and that synergy is the source of the power that drives sustainable, competitive advantage for us and for our Customer partners. We build these partnerships using six core principles: Understand how the competencies and capabilities of each Customer match those of PHX Understand the needs specific to each Customer’s business Share our core values, aspirations and the passion that each employee brings to servicing every Customer Deliver quality results without impeding the Customer’s operational efficiency Resolve issues quickly and completely Bring innovation that adds value to each Customer’s business Ultimately, successful partnering is about trust and to build trust we work hard every day to deliver on our promises.

Customer Satisfaction Survey…..What we’ve learned “We have great customer service.” That’s an aspiration that’s heard within many organizations, but is that really true? Many say it, yet rarely take the time to test the validity of service standards for their clients. Customer service satisfaction surveys are an excellent way to measure whether or not your business is meeting expectations of your customers and should be a core tool for measuring customer loyalty.

What should be measured? Customer Loyalty: What customers like about you and what they dislike. Knowing what keeps them coming back over and over again is the secret to success. Effective Communication: Collecting the voice of the customer through surveys is essential in understanding perceptions that customers have of your products/services. It’s necessary to keep lines of communication open and is a vital input to maintaining our value proposition. Spotting Trends: Beyond understanding the drivers of customer satisfaction, a key benefit of customer satisfaction studies is identifying patterns in customer feedback and then developing strategic plans to increase satisfaction levels. This is also an important component of the product/service development process. Recently, PHX designed a survey with the goal of collecting data from two specific subsets of our client base in order to measure overall customer satisfaction among different levels of key influencers within an organization. The first segment was distributed in September 2012 for the Operational User group and the second segment is scheduled to be sent to an Executive group in the first quarter of 2013.

Some of the highlights of the survey were: Overall Satisfaction level with PHX was high with 84% of respondents registering top 2 box scores of either “satisfied” or “very satisfied.” 71% of respondents felt that PHX was a “better” to a “much better” alternative to other cost management solution alternatives. Satisfaction with different variables of PHX consisted of 86.7% for Quality of Service, 83.6% for Product Value and 83% for Usage Experience thus signifying Service as being the highest rated variable. This customer satisfaction survey provides PHX with baseline metrics that measure the pulse of the customer. The intent is to establish trends over a course of time since customer expectations are continuously changing. Also, since this is only one of many methods within a host of tools that will better allow us to respond to the voice of our customers, we need to integrate other imperatives to obtain customers perspectives. Most importantly, these directional scores will highlight the appropriate measures we need to institute to remain customer focused and to reinforce the fundamentals of the PHX culture – fulfillment of customer needs with the highest level of service.

Interview with John Morris In October 2012, PHX was excited to announce the welcoming of NHBC into the PHX Family. NHBC specializes in the management of healthcare network relationships for a broad base of clients including Third Party Administrators, Insurance Companies, Health Maintenance Organizations and Self-Funded Employer Groups. Its product portfolio enables access to a myriad of networks that can be customized to fit the business rules and geographic coverage requirements of its clients while ensuring the deepest discounts available. John Morris, President of NHBC (a PHX company) is playing an integral part in this transition. eCubed recently had the opportunity to interview John about his thoughts on becoming a part of the PHX family, and the changes affecting the healthcare environment. eCubed: NHBC brings an extensive portfolio to the PHX Family, would you agree? John: Yes, NHBC brings long-term, loyal clients, a dedicated staff, a significant increase in the number of network contracts available and positioning in the marketplace with several products which will expand the PHX suite of services. eCubed: How do you think NHBC joining PHX will change the industry? John: The combination of NHBC, PHX and Pay-Plus gives us the unique ability to offer a true end-to-end solution. From the time a patient leaves the doctor’s office to the moment the payment clears the bank, PHX is an integral part throughout the entire process. eCubed: Being able to offer a true end-to-end solution sounds like a game changer! What do you see as the long-term goals for the company? John: For the short-term I would say that making this the most successful merger possible, and then leveraging the effects of this merger to the best of our ability. However, for the long-term, it would have to be identifying where the market is going and acting on it. eCubed: I’ve heard that NHBC is very passionate about giving back to their community and is involved with a local Charter school, how did that come about? John: This initiative was 100% employee-driven. During a time of significant financial stress, both for the company and for many of the employees, NHBC’s staff volunteered time and energy to help the kids of Midtown Primary. The donations and drives for food, backpacks and various school supplies help ensure that the under-privileged children whom Midtown serves are not underserved in terms of education and opportunities. This was a completely organic effort which reflects the kind and generous nature of our staff. eCubed: That must be rewarding to be able to give back to the local community, especially given the current economic climate. What would you say has been your biggest professional accomplishment so far?

John: Designing and spearheading our ProPoint system. From the design and development through conversion and deployment, I was integrally involved in bringing this system to life. This was a very hands-on project and I enjoyed being able to work with everyone from IT to programming to claims negotiations, testing and learning every element of the software to make sure it was efficient and effective. Second to this is leading the team that survived the collapse of our former parent company, Medical Capital. All of our sister companies, which numbered more than 15, did not survive this collapse, which made our survival and perseverance all the more poignant. The last piece is, being part of the growth of NHBC from where it was 10 years ago to the point of acquisition by PHX. eCubed: That is quite the list of professional accomplishments. Now, if you weren’t the President of NHBC, a PHX company, who would you like to trade lives with for a day and why? John: The life that I would love to experience would be that of Secretary of State. I am enthralled by the incredible amount of knowledge that must be possessed, as well as the constant challenge. Ultimately, the role provides so much opportunity to improve the world, while protecting the U.S. at the same time. eCubed: What a great choice, Secretary of State – so I take it you also like to travel? John: I enjoy traveling, I love to learn about different cultures, I speak French and Chinese and come this July with my trip to Morocco, I will have walked on 5 continents in just 9 months. eCubed: So with all of that travelling, I’m sure you’ve picked up some pretty great souvenirs. What would you say is your most prized/treasured possession? John: A Soviet watch. I was back-packing through Europe, staying at a hostel in Copenhagen approximately 2 years before the collapse of the Soviet empire. I was an American staying at a youth hostel during the Reagan years, and at the same time a group of Soviet athletes were also staying at this hostel. I ended up trading them some of the things I had brought with me for some of their goods, and one fellow actually took his watch off and gave me his watch. So I have this Soviet watch with these great memories, but more importantly, it’s symbolic of how two extremely competitive nations, at the height of the Cold War, could still produce individuals who could relate so effectively and get along as people so well. eCubed: Lets end with a fun one, tell us something (talent/ hobby) that few people know about you? John: I enjoy renovating historic houses, some of which have won awards, most recently renovating one of the last remaining stick style homes from the 1890’s. This renovation was presented by the Knights of Kansas City and County Council and was published in a historic preservation book.

Pay-PlusTM Solutions…Transforming the Payment Process At its annual 2012 Forum, PHX announced the formation of a new subsidiary, Pay-Plus™ Solutions, Inc. (PPS). Since the announcement, PPS has successfully implemented its services to numerous Payors and Providers who are realizing the Pay-Plus solution to be the next generation in e-payments. Progressively, Payors have been facing mounting pressures from the resulting increase in administrative costs, operational inefficiencies and complicated processing requirements. An electronic payment and remittance solution such as PPS simplifies the payment process of health plan Payors delivering significant savings of both time and money. Because PPS understands both the TPA and broader Payor marketplaces, it consistently demonstrates the capabilities of its products to fulfill the operational, financial and regulatory needs of the market while also providing exceptional customer service. As a result, Pay-Plus outperforms industry estimates by converting 90% of all paper checks to electronic payments which consequently cuts printing costs by nearly 50%. We talked with one of the first Payors to implement PPS, Chris Crowley, President of BeneSys, Inc. and asked him to relay their experience with Pay-Plus. Prior to selecting Pay-Plus, BeneSys conducted an extensive comparative analysis of e-payment providers and chose PPS based on several factors: Cutting edge technology and experience to reach a high % of providers Smooth Implementation Process managed every step of the way with a dedicated project leader Credibility by working with a subsidiary of a trusted and proven partner such as PHX

“Overall, the implementation was very straightforward, and we are running like clockwork. PPS is already exceeding our expectations in terms of cost savings. Moreover, my initial goal was to achieve 60% penetration on the provider dollars within 6-9 months…And within 60 days, PPS was already eclipsing 70%”. Chris Crowley, President of BeneSys In addition, the rigor of the Pay-Plus process has positioned it as the Payor’s PPACA (Patient Protection and Affordable Care Act) solution. That means that even if a Provider does not want to accept the payment electronically through Pay-Plus, Payors will be compliant with the mandate and ready to offer this option without changing internal workflow. Pay-Plus Solutions has become the next generation for e-payments for the healthcare industry. Its easy integration process and evident benefits align with strategic business goals of a Payor organization. For more information about Pay-Plus Solutions, check out their website at

SIIA National Educational Conference In October 2012, PHX attended SIIA’s 32nd Annual National Conference at the JW Marriott in Indianapolis, IN.

As per previous years, PHX made a presence on the exhibit floor with our full suite of products and our new exhibit booth. In addition, the PHX Family of companies was introduced, which now includes Pay-PlusTM Solutions and the newly acquired NHBC. In order for everyone to get immersed in the expanded PHX, we hosted our very first Hospitality Suite during a SIIA Conference. Guests enjoyed cocktails and appetizers while taking pictures in the PHX photo booth and were eligible to win one of the many raffles that were given away throughout the evening. Our top prize winners excitedly walked away with an American Express gift card, iPad 3 and a $2,500 gift certificate towards a vacation of their choice!

Tom O’Connor and Amy Hartigan

Robert Belvedere and Bryan Russo

“This year SIIA assembled an extremely impressive lineup of speakers during their educational sessions. So much attention has been given to the rules and regulations of Healthcare Reform over the last several months I think SIIA did a great job in getting back to the basics this year. The theme for SIIA in 2012 was “Raising the Game” and this is exactly what our industry needs at this point. After speaking with several PHX clients who presented during SIIA’s educational breakout sessions, it was apparent to me that this industry is turning full circle and getting back to the basics of healthcare, specifically in the self-funded community. I’m looking forward to next year’s event and what it will offer PHX and our clients”. Jason Formani, Regional Vice President at PHX

Insight from a Coding Analyst Sarah Sebikari – MHA, CPC, Senior Coding Analyst – PHX Sarah Sebikari was born into a family of doctors in Uganda, Africa and had a natural interest in science. However, breaking away from the family mold, she decided to pursue her undergraduate degree in Social Sciences, specializing in Economics and French. After receiving her Bachelor’s degree from Makerere University Kampala in Uganda, Sarah emigrated to New Jersey and decided to take a billing and coding class at the Manhattan Institute where her interest in the healthcare industry was sparked. After realizing that this was a field in which she excelled, she decided to pursue her Master’s degree in Healthcare Administration at Seton Hall University. Sarah’s passion for the coding industry began early in her career as apparent by her decision to become a Certified Professional Coder (CPC). “There is dynamism in coding, which keeps it exciting and ever changing,” Sarah says. This dynamism is what keeps her so involved and inspires her to learn more about the field and industry, and with the replacement of ICD-9 codes with ICD-10 codes set to change on October 1, 2014, there certainly won’t be a dull moment. “This is one of the most challenging reforms in the coding world – moving from approximately 17,000 codes to over 140,000 codes. However, I am lucky that I work for a

company that truly values the importance of education and training, so I know we will be prepared for the change.” Sarah has published four articles for the American Academy of Professional Coder’s (AAPC) magazine, “Coding Edge” and was featured on the cover of the October 2012 issue. Sarah’s inspiration for these articles comes from what she experiences on a daily basis in the coding world and her desire to give coding advice and tips to others in the industry. Sarah has been with PHX for nearly four years and is a Senior Coding Analyst in the editing department where she has special expertise in coding several outpatient physician specialties. Always having that hunger for the industry and a love of education, Sarah plans on going back to earn her Accredited Healthcare Fraud Investigator(AHFI) certification as well as a Six Sigma Green Belt (SSGB) certification! Nonetheless, in her spare time Sarah loves to travel, just recently traveling back to Uganda to visit family and visiting Nairobi while in Africa. As for the future, odds are good that we will be seeing more of Sarah’s articles in upcoming issues of the Coding Edge and a few more initials to the back of her name.

Reimbursement / Coding Tip Reimbursement/coding for tympanopalsty – surgical operation to reconstruct eardrum - includes the work involved in harvesting the graft (CPT code 21235), therefore graft is not separately reimbursable if obtained through the same incision used to access the tympanic membrane or middle ear. In addition, exploration of middle ear(CPT code 69440), placement of tubes (CPT code 69436)and membrane repair (CPT code 69610) are all not separately reimbursable/reportable with tympanoplasty procedures (CPT codes 69631 - 69646).

Editor’s Note Did you notice our new name? The editors believe that eCubed better reflects the content and conversation in our newsletter – to Engage, Educate, and Empower.

PHX Talks PHX has partnered with Badgeville to provide an interface to its U Premier Loyalty Program. This global leader in gamification, Badgeville serves more than 200 customers including Deloitte, Samsung, EMC, CA, NBC, and many more. PHX was a guest speaker at their recent conference in San Francisco called Engage 2012. This conference proved that gamification is not a trend, but a movement with over 300 attendees representing hundreds of companies discussing why gamification matters for today’s most successful businesses and how it can be used to drive user engagement. PHX was asked to participate in a panel discussion on how its U Premier Loyalty Program is breaking new ground by creating a modern loyalty program with smart gamification elements within a B2B environment. By applying Badgeville’s Game Mechanics to the cost management software within the new website, PHX has created an engaging experience which provides an innovative, interactive rewards system for their loyal customer base. To see Rita Ferrari, Marketing Manager of PHX discuss “Baking Gamification into your Core Product” on this panel, please click on this link And to see Leo Garneau, Chief Marketing Officer at PHX communicate the purpose of our strategic partnership with Badgeville, please click on this link

Jimmy’s in the House! When you’re asked what your company does, do you find it hard to explain? Do you see blank stares or a bit of confusion? “Delivering advanced cost management solutions for healthcare claim payors” has always been my standard pitch. However, this never seemed to really explain the entire story or justify the rigor of what we actually do. Thus, this was the basis for the creation of a little guy named Jimmy. To try and demystify a complicated process and logically explain what it means to live a day in the life of a claim at PHX. In order to accomplish this, it was decided to present this from the point of the view of a claim….what a claim goes through on a daily basis when it’s subjected to our technology, expertise and services here at PHX. We then created Jimmy, an over inflated claim and used animation to breathe new life into the process. However, what was even more vital was to create a script which effectively used logic and humor to harmonize with the animation. The end result was an animatic rendition of a case study which exemplifies the flow and savings achieved by Jimmy the Claim as he travels step by step through our world. When “Day in the Life of a Claim” was released within our client portal, it was received with much acclaim. Not only did our internal Sales team start using it to creatively explain our process, but we actually had clients who requested the video to use for training purposes. However, the most rewarding part of this experience was that we were able to untangle the process and explain a seemingly complicated industry within a short and delightful video. Now when I’m asked what I do for a living – I bring out Jimmy. Please check out the storyboard of “Day in a Life of a Claim” below. The entire video is located in our client portal.

PHX is on Facebook! During the recent events of Hurricane Sandy, PHX learned just how powerful social media can be, enabling us to communicate important information to our employees during a time of crisis. PHX is excited to be using Facebook as another outlet to keep you informed on what we’ve been up to and where we are going. So make sure to check us out at and “Like us”, because we want you to be up to date on all of the PHX happenings – including news updates, exclusive pictures from PHX events, and career opportunities.

Employee Spotlight Mike Chapman

Provider Payment Coordinator Our latest spotlight of a noteworthy member of our PHX family is on Pay-Plus Solutions’ Mike Chapman. Mike Chapman is one of the original PPS employees and has helped to shape the operational processes at Pay-Plus since day one. A US Navy veteran with a number of years’ experience working with medical patients in a call center environment, Mike joined PPS originally in the membership services group. Mike’s skills quickly became apparent and 5 months ago he began handling the day-to-day financial components of the Pay-Plus operation. “Our success would not be possible if it were not for Mike’s strong work ethic, his demonstrated interest in Pay-Plus, and his commitment and proactive approach to the job at hand” as expressed by Dave Bracken, Vice President of Business Development at Pay-Plus Solutions. Recently, eCubed had the opportunity to talk with Mike about his experiences with PPS. eCubed: What is the best part of your job? Mike: I enjoy the challenge of creating a more efficient way to perform the multiple tasks I am responsible for on a day-to-day basis. Throughout the process I also look for ways to save the company money. eCubed: Tell me about your most rewarding or satisfying experience since you joined the company? Mike: The trust I’m shown from management being allowed to take on additional responsibilities. I like being able to help by taking some of the pressure off management by doing the job completely and accurately. eCubed: A large component of your responsibilities include providing customer service…. What does good customer service mean to you? Mike: A good customer service representative must be very willing to learn the business and internal mechanisms and become very knowledgeable. This allows one to assist the customer and answer any questions they might have quickly. This builds excellent customer satisfaction and trust in the company. eCubed: Since you have a good handle on the fundamentals of customer service— can you give me an example of when you have gone the extra mile for a customer? Mike: I go the extra mile with every customer I interact with to make sure they are getting the right information and best

service we have to offer. I take pride in a job well done and treat every member with same level of customer care. eCubed: What is it like working for a new company such as PPS? Mike: I have never been in a startup company before. It is challenging as everyone is learning the processes together. It’s nice to be able to grow with the company from the ground up. eCubed: I’m sure that also lends itself to the initial stages of forming a corporate culture…. How would you describe the corporate culture at PPS? Mike: PPS has a small family business environment. I can interact with all my coworkers as well as my managers because of the open door management policy. eCubed: What is something most people would not know about you? Mike: I used to be a volunteer firefighter in my hometown in Wisconsin for two years. I was on a rescue squad and engine company. eCubed: That must have been a rewarding job. Mike: Yes, it was a group effort—a whole team puts out the blaze, not just one person…. actually somewhat similar to PPS…we all work together as a team. eCubed: If you could meet one person, who and why? Mike: I would like to meet Brett Favre, former quarterback for the Green Bay Packers. He’s a down-to-earth kind of guy. Given the opportunity, I’d like to sit down and have a burger and a beer with him. eCubed: I’m sure that would be an interesting conversation…What do you like to do in your free-time? Mike: Enjoy spending time with my sweetheart, friends and family. I like to exercise, ride my bicycle, and be outdoors…I enjoy kayaking. I’d like to get into more off-road trail riding. eCubed: It seems like you’re in the right state….Florida is certainly conducive to the outdoors. Thanks so much for your time and PPS is lucky to have an employee like you!

PHX’s Robert Hemmer Nominated for CFO of the Year Award What would a successful company be without its dedicated employees? Their on-going commitment is what enables Premier Healthcare Exchange to fulfill its mission. As an example, eCubed would like to acknowledge that our very own Robert Hemmer, Chief Financial Officer of PHX, was one of a select group of CFOs in New Jersey nominated for the Chief Financial Officer Award of a technology firm. Some requirements for CFO of the Year included: Customer service attitude, outstanding team building skills, the ability to heighten the company’s public image, and being a confidant to the CEO. These are all attributes that Bob possesses within PHX. We extend our admiration to him for his continuous work ethic and accomplishments he’s made to this company over the past two years. Keep up the good work and congratulations!

St. Jude Charity At PHX, we have been moved by the inspirational stories of the precious children supported by the effects of the dedicated staff at the St. Jude Children’s Research Hospital. To assist in raising the much needed funds necessary to continue the efforts of St. Jude, PHX created team “Bridge for Hope”, a team comprised of employees, friends and family members. We would like to thank everyone that contributed to making team “Bridge for Hope” a huge success and one of the top fundraising teams in the New York City division! The St. Jude,”Give Thanks”, Walk was scheduled to take place on November 17th at the Brooklyn Bridge. Unfortunately, it was cancelled due to the devastating impact of Hurricane Sandy. We are excited for next year’s event! For more information on how you can help change the way the world treats childhood cancer, please visit:

Upcoming Conferences PHX will be participating in the following trade shows, conferences and events...Don’t forget to visit us!

22nd Annual National Health Benefits Conference

National Labor & Management Conference

January 29-30, 2013

February 14-19, 2013

Sheraton Sand Key Resort, Clearwater, FL

Westin Diplomat, Hollywood, FL

Stop by and visit PPS at Booth #201! HIMSS 13th Annual Conference HCAA Executive Forum

March 3-7, 2013

February 5-7, 2013

Ernest N. Memorial Convention Center, New Orleans, LA

Encore, Las Vegas, NV

Did You Know... 1. 2. 3. 4.

Did you know that the famous Walt Disney was afraid of mice? Do Mickey and Minnie count? Did you know you can’t talk while inhaling through your nose? Try it, I double dare you. Why do we eat junk food when we’re stressed? Because “stressed” spelled backwards is “desserts.” No word in the English language rhymes with orange, month, silver, or purple. Be sure to notify Webster’s Dictionary if you figure this one out. 5. Every time you lick a stamp, you are consuming 1/10 of a calorie. I wonder what happens when you lick an envelope..

Trivia Time See how many questions you can answer (without peeking at the answers below).

Questions 1. What can you catch but not throw? 2. T  he man who invented it doesn’t want it. The man who bought it doesn’t need it. The man who needs it doesn’t know it. What is it? 3. I’m part of the bird that’s not in the sky. I can swim in the ocean and yet remain dry. What am I? 4. W  hat is the second-largest day for U.S. food consumption, after Thanksgiving Day?

Answers 1. A cold 2. A coffin 3. A shadow 4. Super Bowl Sunday

5. W  hat percentage of Americans have never flossed their teeth? a. 20% b. 50% c. 60% 6. Pepperoni is America’s favorite pizza topping. What is Japan’s favorite pizza topping? a.Eggs b. Pickled ginger c. Squid 7. W  hich was the first country to issue a Christmas postage stamp? a. United States b. Austria c. Brazil

5. 20% 6. Squid 7. Austria

New Employee List

Account Management

Claims Editing


Susan Fenwick

Kimberly Calavetta Sarah Song

Alexander J. Sperring Leo A. Campos Andrew Hubler

BR & Audit Nurse

Data Analytics

Angela Flanagan-Fisher Gale Hunt Jean Maier Katie Sheeler Melissa Bryan Patricia Holzschuh

Elvia Salas Justin Sandoval Shawn Jordan



D’Nique Gonzalez Yolanda Richardson

Gina Cerniglia Network Repricing

Cathleen Kicak Jessica Hopps-Broyer Tatiana Jackson

BR & A Doc. Retrieval Bethany VanHouten Gabrielle Fitzgerald Jennifer Traynor Justin Warner Kathy Hassel Michelle Franco Tenica Johnson Tracey Warnock

Human Resources

Provider Services Timothy Hubbard Sales

Tara O’Keefe

Bryan Russo Nathan Kalkofen


Customer Service



Valerie Woods

Chris Ehrecke Becky Noether Jessica Padilla Gary Walker Karen Hammack Kathleen Stirling Joseph Dresevic

Victor Zemble Peter Lynch

Joe Iglesias

Account Management

Customer Service



Kathryn Barkley Emily Hinkle

Beverly Bumgardner Laura Parks


Data Entry

Michael Gilbert Mark Kopchynski Jie Li Donald Paulsen

Robert Alcazar Kevin Glass Vicky Waithe

Kimberly Ryan Terry O’Reilly

Amy Atherton

Claim Operations

John Morris

Victoria Allen Jennice Denton Pamela Hilt Constance Loker Bhavani Prasad Joanna Simons

Executive Finance Mary Buchan Linda Hayes Kristine Van Allen

Negotiations Emily Modami Cathy Nason Deborah Wolff Provider Services Monica Fife Caryn Grad

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eCubed - Winter 2012  

Published by Premier Healthcare Exchange

eCubed - Winter 2012  

Published by Premier Healthcare Exchange