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mcmike

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mcmike

Re: mcmike post# 7280

Wednesday, 09/14/2005 1:22:49 AM

Wednesday, September 14, 2005 1:22:49 AM

Post# of 376163
TNSX notes from the Arch Investment conference: 9/12

http://www.vcall.com/IC/CEPage.asp?ID=94920&CID=

Tuesday at Arch
Laurie Burstein, fund manager for Roxbury Micro-Cap Fund characterized the company in her introduction:
Utilizing it’s proprietary technology Transax provides a service similar to credit card processing for the health insurance industry.

“The health care industry needs help”:
eligibility is open to fraud
claims submission and authorization is time consuming and labor intensive
payment transaction processing “strain” is high
patient document storage is very antiquated as it moves toward electronic medical records (EMR)

Our contracts are with the health insurance companies.
Our solution is tailored to the insurer and the provider’s capacities.

These are the four service functions of our solution:
1. Eligibility verification
2. Realtime Service Authorization/denial
3. Claims submission
4. Service receipt.
We also adjudicate in realtime.
What takes 60-90 days we can now do in 1-2 seconds.

Patients are i.d’d by magnetic stripe, chip, and now a pilot for biometric identification.

Significant savings for the health insurer client administratively, and in fraud reduction.

Developed in Brazil.

The varied entry points to the system allow service for any type of healthcare provider, all of which is TNSX intellectual property.
The solution runs on the front end of the insurer’s legacy systems and talks to the legacy systems in real time.
The network processor is like an ATM transaction manager. It is based on an ATM core.
Authorizer running on ORCL software to autoadjudicate claims. The authorizer takes into account all the rules, plan rules, rules for providers, patient histories, payment codes etc.

A very sophisticated ORCL database.

The health care provider knows almost instantaneously that he will be paid and how much he is going to be paid for the service provided. Allows auto-pay of health care claims enabling realtime payments via electronic receipts.

Current clients
Golden Cross
Bradesco Health, subsidiary of Bradesco Bank

Recurring revenue model with more solutions being installed every month. As we change the business process for the insurer, they don’t go back to paper from electronic.

Negotiating for 2.5 million additional lives in Brazil.

Full site backup with offline capacity.
We provide the hardware/software at no cost.

The fee is variable depending upon the type of transaction and the solution provided for electronic connectivity.

Short term goals
7 million transactions in Brazil in 2005.
Rollout on contracts in place over the next 2 years.

More contracts in works in Brazil including MOUs and a hospital solution. Contract signing involves major changes for the insurer and take 6-9 months to initiate the pilot.

looking for capital raising
Chile, Mexico, Europe, NewZealand 2-3wks
Some contacts are being generated via partnership with Mosaic

Union Dental already presented at Arch in the morning, our first partnership in the U.S.

Would like to do a 5 million dollar raise. We have a number of inquiries to expand our solution. We need to gear up.

Q. Why would you go into a much more competitive marketplace [U.S]? We have a client in our portfolio doing that. Who was the questioner and were they referring to EDI or realtime autoadjudication?

What was capital expenditure to get to cover 2.5 million lives?

We lease terminals from Hypercomm and install a POS only if it is profitable.

Front end of legacy systems
What is the mddleware?
The architecture of the software is Windowsbased from Mosaic software , an ATM core, which has been modified to take healthcare transactions.

Their IP is the software modification and the authorizer.

Transaction codes: ISO via ICD-10 or 11. We are autoadjudicating over 9000 medical procedures and a like number of physiotherapy and dental procedures.

………………..
The Union Dental presentation that preceded the TNSX presentation at the Arch conference discussed their strategic partnership and highlighted the attractiveness to prospective practices of accelerated payments from insurers which can take 60-90 days even for simple claims and 120-150 days for complicated ones currently.

Union Dental stated they were poised for rapid growth, in part, because “decreasing collection time is another driving force for professionals to join our organization.”


..............
I have been told that the ValueRich presentation will also be webcast with a powerpoint presentation but do not know the link yet.

http://www.valuerichonline.com/ny05/index.php?id=nyschedule















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