Overview

ONQ Operating Company, LLC (“ONQ”), offers technology, offshore, and near-shore labor solutions to the healthcare revenue cycle management (“RCM”) industry. Situated in Santiago de Veraguas, Panama, our access to highly skilled, low cost labor insures that we deliver high performance at a low cost to our clients. Our bi-lingual Spanish-English call center associates provide a highly sought after skillset at a fraction of the cost when compared to other alternatives. All associates are managed and trained from the ground up by seasoned health care RCM executives who previously owned, managed, and eventually sold, a mid-size RCM business in the United States.

Our unique, customized approach is aimed at helping our clients improve performance, reduce costs, and consistently deliver high quality results. ONQ achieves this through a combination of technology and labor solutions that are already developed and are then deployed to address each client’s needs. Our proprietary RCM process control software, known as ClearView, is the only process control software available in the RCM industry developed by RCM experts. This software enables owners & managers of RCM businesses to monitor critical aspects of their operations in near real time with little to no effort.

Our labor solutions include the perfect combination of experienced bi-lingual call center associates from Panama City, recent graduates from the University Of Panama, and seasoned RCM executives from the United States. ONQ maintains a very strong relationship with the University Of Panama enabling us to train, employ, and retain “top of the class” graduates. ONQ is highly regarded as one of the top employers in Santiago de Veraguas, Panama due to our community involvement and the employment opportunities we offer to the people of the city.

Products and Services

ONQ’s first engagement started in 2013 with a consulting arrangement in which ONQ would build a billing company for a large, premier radiology group in Houston, TX. The billing company was formed and the resulting billing company contracted with ONQ to provide call center and BPO services in Panama. The project was extremely successful and the relationship with this client continues to be strong today.

While ONQ still maintains the knowledge and experience to provide superior consulting services in healthcare RCM, our sole focus now is on growing the labor outsourcing services and technology offerings. We believe these offerings to be highly scalable, especially when compared to consulting services that consume executive time.

LABOR OUTSOURCING SERVICES:

Contact Center
• Our College-educated, bilingual associates (English and Spanish), are trained and skilled in handling inbound and outbound calls from patients and payers. Every contact center associate receives thorough training on the U.S. healthcare system, RCM services, and the Health Insurance Portability and Accountability Act (HIPAA).

• ONQ boasts a state of the art Cisco enterprise-grade call center infrastructure. Complete with video capabilities, each phone enables face-to-face interaction with clients, tracks key performance indicators, and enables high flexibility in call routing.

• ONQ maintains year round, onsite executives from the U.S. healthcare industry in the Panama office. Having US Healthcare executives managing the operation onsite provides clients and prospects tremendous comfort and serves OnQ as a key differentiator since no other BPO or Call Center operation has that claim.

Business Process Outsourcing

• ONQ provides complete solutions for nearly the entire revenue cycle including
     o demographic entry 
     o charge entry o payment posting
     o accounts receivable follow-up
     o electronic rejections
     o scheduling
     o insurance verification
     o any clerical or data entry task

All clients are assigned dedicated account teams. Once dedicated to an account, employees are committed to that client and are not moved from client to client. This is an important distinction from our competition and comes as a response to market demand and our own experience as former billing company owners. 

TECHNOLOGY OFFERING:

• ONQ is passionate about data driven analytics. As former billing company owners and managers, our team has an intimate understanding of the challenges our clients face and the importance of fast, actionable information. ONQ has created the only commercially available visual business intelligence process control software in the RCM industry. Our product, named ClearView, offers near real time, comprehensive insights into our client’s business processes enabling them to make fast, accurate business decisions with little to no effort. This web-based tool is compatible with Macintosh, PC’s, and tablets and is accessible anytime, anywhere the user has Internet access.

• ClearView is loaded with easy-to-understand dashboards, interactive analyses and colorful displays that provide crystal clear insight into business operations in mere seconds. Ad-hoc reporting is also available which allows customizable reports and dashboards exactly how the user wants to see them. ClearView is pre-packaged with a powerful Denials Management System, an unparalleled Charge Posting Process Control System, Key Performance Indicator (KPI) reporting, provider facing AR Management Reports, sophisticated Cash Flow Analyses, Employee Production reports, and many more. The power of ClearView results in significantly enhanced client performance at little to no additional cost to the client.

• ClearView is accessible anytime, anywhere internet access is available. In addition, reports and analyses can be scheduled to automatically be emailed to recipients.

Gathering and analyzing data can be complex, overwhelming and slow. ClearView simplifies the process by pulling data from multiple sources and consolidates it into one place to provide a thorough view into business operations. ClearView can consolidate multiple operating centers on different systems and analyze and report information in one central location. Data is shown in colorful visuals to help easily identify trends, increase efficiency and make analyzing business operations easier. And, it’s fast – access to the information needed is available in a matter of seconds anywhere there is access to the Internet.

The Healthcare Business Process Outsourcing (“BPO”) Market

According to a MarketsAndMarkets.com (“MTM”) report published in January 2014, the global healthcare BPO market was valued at $113B in 2013 and is expected to reach $189B by 2018. The global healthcare BPO market can be divided into pharmaceutical, payer, and provider outsourcing segments.

The pharmaceutical outsourcing market is segmented into contract research organizations (CRO), contract manufacturing organizations (CMO), and business support services. ONQ currently does not target this segment of the market due to our unfamiliarity with the market and the extensive opportunities in segments we are experienced.

The payer market is segmented into claims processing, member services, human resources services, and finance and accounting segments. Claims processing can be further sub-divided into claims indexing, claims investigation, claims adjudication, claims re-pricing, claims settlement, litigation management, and information management. ONQ currently has no clients in this market segment. However, due to the many commonalities with the provider market, it is considered part of our target market.

ONQ’s primary target market, the provider market, is segmented into medical billing, medical coding, medical transcription, and finance and accounting segments. It includes hospital systems, clinics, ambulatory service centers, imaging centers, physicians, and clinicians. In the U.S. alone, the total size of the provider based RCM outsourced services market is approximately $9B and growing (ST Advisors, Compass, Netlson-Hall). Currently, ONQ services only this segment of the healthcare BPO market. Furthermore, ONQ only targets RCM (billing) companies and does not directly contract with the healthcare service providers. This strategic decision provides clients and prospective clients with assurance that they will not be competing with ONQ in the marketplace, while focusing OnQ on larger opportunities. Given that ONQ’s executive team has well established relationships in the providers segment, our focus to this point has been almost exclusively in targeting this section of the market.

Panama

The Republic of Panama is a multi-party democracy with presidential elections held every five (5) years. Each president is limited to one term. President Juan Carlos Varela won the last election in 2014.

Panama’s economy has experienced high growth at a compound annual growth rate of 8.7% over the last ten years. All three major credit scoring agencies (Moody’s, Fitch, and Standard & Poor’s) rate Panama as investment grade credit.

The local currency is the Balboa, which is tied to the U.S. dollar at a 1:1 ratio. U.S. dollars are utilized as the paper currency and are accepted everywhere. Accordingly, ONQ has no foreign currency exchange rate risk.

Unemployment is low in Panama City at around 1.5%. However, employment opportunities are less prevalent outside of Panama City, thus the unemployment rate outside Panama City it much higher at 4-5%. The fact that there are fewer jobs, and almost no white collar jobs available make OnQ a very desirable employer.

The three largest cities in Panama are 1) Panama City in the east; 2) David (pronounced “Dah-veed”) in the west; and 3) Santiago in the center. ONQ is strategically located in Santiago, Panama, where the University of Panama has a large campus. Very few professional employment opportunities exist in Santiago for graduates of the University of Panama. Generally, students must move to Panama City if they wish to find professional employment. A move that the vast majority do not wish to make. ONQ has a very strong relationship with the University and provides graduates with employment opportunities in their home town of Santiago. We are able to pick from the top performers at the University and maintain a large pool of qualified candidates at the University. ONQ has also been successful in recruiting experienced call center personnel from Panama City.