In order to provide the most cost-effective service to the client, Healthcare Horizon has developed a comprehensive Site-Visit package that typically occurs during a two-day site-visit. The clinic should continue to see patients during the site-visit. This package includes the following:

A) Practice Analysis

The Practice analysis is a valuable management tool that helps identify areas of RHC Regulatory non-compliance. This report will recommend areas of the clinic operation that may need to be changed in order to comply with RHC regulations, as well as make recommendations for ways to enhance your reimbursements as a RHC. The Practice Analysis results in a lengthy Administrative Report (over 150 pages) that is intended as a tool for management purposes.

The Appendix section (over 150 pages) includes a variety of forms, memorandums and other important items of value to all RHC's.

Areas of clinic operation that are reviewed during the practice analysis and become part of the Administrative Report include:

While on-site, I will also collect information for inclusion in the Annual Evaluation Report for one RHC location. This report is an annual requirement of CMS, and is an item State inspectors review during their inspection visit. This service is provided in conjunction with the Practice Analysis. This service includes a “mock” State Inspection. I utilize the same format the State Inspector uses and will comment on areas that may need to be changed in order to comply with all State and Federal Regulations.

C) In-Service Training

While on-site conducting the Practice Analysis, I arrive on day one (of two days spent on-site) as soon as possible, to begin the Practice Analysis (specific time will be worked out depending on travel arrangements). This will last until 5:00 p.m., at which time I will conduct the in-service training, which will end at around 8:00 p.m. I suggest the Clinic provide some type of light meal (pizza??) that can be eaten during the training. I will teach while the staff eats.

Manuals are provided for each participant at the clinic. Content of the in-service training includes the following areas:

INTRO. TO RHC's

CERTIFICATION ISSUES

REIMBURSEMENT/BILLING ISSUES

COST REPORTS & OTHER REPORTS

REVENUE ENHANCEMENT, Etc.

D) Written Reports

The Annual Evaluation is a requirement of Medicare Federal Regulations for all RHC's, Provider-Based and Free-Standing alike. Each licensed facility must complete the evaluation once per year. Healthcare Horizon provides this required evaluation in a brief time frame, at a very reasonable expense. Actual cost varies depending on clinic location and the number of clinics being evaluated (a discount is given for multiple sites under one owner). The final negotiated contract amount includes all costs (travel, report preparation, phone, copying, etc.).

E) On-Going Consultation Services

You have the added benefit of utilizing my consultation services anytime for one year from the date on the consulting agreement. This means you can call me, e-mail or fax me questions about your RHC and I will research and provide you with the answers, as provided under the terms of this proposal.

F) Cost Reports

As a client of Healthcare Horizon (by nature of having had a site visit complete with Administrative Analysis and in-service training), you may choose to utilize the cost report preparation services offered in this proposal. Healthcare Horizon sub-contracts a portion of these services, utilizing a leading financial/accounting firm. This organization prepares over (400) cost reports annually, and is the exclusive provider of these services for Healthcare Horizon. This firm does the “number crunching” and Healthcare Horizon performs the gathering, documentation, confirmation and liaison functions. This is a team approach that has resulting in a 100% acceptance rate with CMS. To date, no clients of Healthcare Horizon have had a “pay-back” to Medicare on cost reports prepared in this method.

The philosophy of Healthcare Horizon is that the RHC should take advantage of all options available through regulations and law, but never should the clinic “push the envelope” in any area of the clinic’s operation. There are numerous ways to “work the system” and get away with something when it comes to cost reporting and reimbursement, however, Healthcare Horizon will not suggest nor allow itself to be in a business relationship with any firm or individual who chooses to conduct their business in this manner. Healthcare Horizons clients can be assured they are in the hands of responsible professionals.

“Additional information about these services can be obtained by sending an e-mail to hlthcarehorizons@mindspring.com or by calling Mr. Estes at 800-399-0874. A proposal will be designed to meet the specific needs of your RHC and will be sent promptly.”