1.
Monday, January 30, 2023
Cigna Claims, PDM and Digital Intake
Operations Client Visit
Addressing the “Moments that Matter” for Healthcare
Constituents with a Digital First Digital Now Approach

2.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 2
AGENDA
Site Walk through
Program Review
MeetyourFirstsourceCignateam
Transformation
Meet & Greet
Reward&Recognition
WrapUp
• Results by Functions
• HR processes & Staffing walkthrough
• Implementation progress
• Training & Quality
• Reporting & Governance
• Areas of risk / Mitigation

3.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 3
Firstsource Operations Footprint in Cigna
Chattanooga
Mailroom
USA
Chennai
Trichy Hyderabad
Countries: 2 Delivery Centers : 4
Mailroom Onshore Data Capture / Provider Fallout & Claims
Data Capture Data Capture/
PDM & Claims
PDM/Claims
India

4.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 4
Cigna Operations Organizational View
AD – Associate Director
Srikrishnan Srinivasa
Head of Operations
Sundari Sethuraman
Operations Head
Sean DeSanto
Client Partner
Reetoopan Kaushik
Capability Development Head
Anup Panthaloor
Head of Sales & Account
Management
Venkatgiri Vandali
President, HPHS
Ritesh Dadlani
Quality Lead
Shwetha Jadav
Training Lead
Murali Gopalakrishnan
Operations Head
Padmini Rathnam
Operations Lead
Raghupathy N
Operations Lead
Darren Larson
Operations Lead
Drew Heisig
Operations Lead
Pranesh Raj
Operations Lead
Sasikumar Durai
Claims Director
Sathya Narayanan
PDM AD
Gnanasekar
Transition Director
Karthick Durairaju
Transition Sr Manager
To be Onboarded
Mailroom and Data Capture
Operations

5.
Results by function
Monday, January 30, 2023

6.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 6
Digital Intake Volumetric Details
Highlights
21 Days 20 Days 23 Days 21 Days 21 Days 21 Days
108,539 106,436 113,402
104,329
24,427 20,567 5,173 4,728
5,721 11,971 25,889 …
1,245,037 1,217,624 1,189,941
1,040,387
-
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
1,000,000
1,100,000
1,200,000
1,300,000
1,400,000
-
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
450,000
JFM AMJ JAS OND
Volume Distribution
Mails Fax Referrals Appeal Overall Volume
91.28%
91.26%
90.47%
89.97%
8.72%
8.74%
9.53%
10.03%
1.96%
2.24%
2.18%
2.30%
0.46% 0.43% 0.43% 0.45%
0.00%
0.50%
1.00%
1.50%
2.00%
2.50%
70.00%
75.00%
80.00%
85.00%
90.00%
95.00%
100.00%
JFM AMJ JAS OND
Volume Distribution %
Mails Fax Referrals Appeal
82%
18%
Claims
Non-Claims
Received Average Volume of 391K per month for 2022
• Incoming was consistent across months from Jan-Jun, whereas downward trend from
Jul-Dec (specifically from Oct-Dec)
− For Jan-Jun’22 received 410K volume/month, weekly average volume of 96K
− For Jul-Sep’ 22 received 396K volume/month, weekly average volume of 90K
− For Oct-Dec’ 22 received 346K volume/month, weekly average volume of 81K

7.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 7
0.01%
0.02%
0.18%
0.83%
39.99%
58.97%
0.01%
0.02%
0.20%
0.70%
39.53%
59.53%
0.01%
0.02%
0.23%
0.70%
39.71%
59.34%
0.01%
0.02%
0.21%
0.70%
39.07%
59.99%
Single HCFA
Multi HCFA
Medicaid
SuperBill (Non Standards)
Multi Claim
Single Claim
Bill Type wise Vol %
JFM AMJ JAS OND
Digital Intake Bill Type Volume Mix (Claims)
85
199
1,820
8,374
402,576
593,675
62
236
1,972
6,713
380,321
572,699
78
173
2,197
6,723
382,203
571,153
45
171
1,842
6,110
340,267
522,394
Single HCFA
Multi HCFA
Medicaid
SuperBill (Non Standards)
Multi Claim
Single Claim
Bill Type wise
JFM AMJ JAS OND
Highlights
Single & Multi Dental contributes 99% of the volume
Month on month bill type mix has been similar

8.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 8
Highlights
• Started meeting Quality SLAs beginning July 2022
• TAT SLAs showing improvement trend
• Focused approach on TAT SLAs
− Initiated PET project to improve TAT performance
− Improvement trend noticed across LoBs
Digital Intake SLA Performance – Jan to Dec 2022
Attainment/Output
(overall performance)
22
Timeliness
(functional performance)
27 15
Quality
(functional performance)
35 19 23 19
31
JFM’2022
JAS’2022
41 13 29 13
OND’2022
25 24 18
29
AMJ’2022
54
54
53*
54
42
42
42
42
4 7
12 -
12 -
5 7
12
12
11
12
Total SLAs Met Not Met Total SLAs Met Not Met Total SLAs Met Not Met
*Return letter Quality SLA effective from Feb’2022

9.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 9
• OCR enhancements rolled out till wave 19 and shall be an ongoing process
• Implemented User Management Tool to ensure only tenured and top
performers are deployed for decision making / Business rules validation queue
• Kick started “Quality Club”
• Cigna Premier League is rolled out to reward top performers
Digital Intake Quality SLA Performance
99.00%
95.66%
97.52%
98.68%
98.09%
98.10%
99.14%
99.13%
99.09%
99.04%
99.06%
99.41%
99.60%
90.00%
92.00%
94.00%
96.00%
98.00%
100.00%
Target Tier 1 Linear (Tier 1)
Tier 1
98.00%
91.01%
94.96%
95.74%
94.99%
96.28%
98.09%
98.41%
98.40%
98.02%
98.12%
98.31%
98.67%
80.00%
84.00%
88.00%
92.00%
96.00%
100.00%
Target Tier 2 Linear (Tier 2)
Tier 2
99.00%
98.09%
99.38%
96.08%
97.81% 97.43%
99.24%
99.07%
99.01%
99.16%
99.10%
99.26%
90.00%
92.00%
94.00%
96.00%
98.00%
100.00%
Target Quality Linear (Quality)
Return Letters
Highlights
• Started meeting Quality SLAs for Tier 1 and
Tier 2 since Jun’ 22
• Meeting SLAs from Jul’ 22 onwards for
Return Letters
Key Initiatives

10.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 10
100% 100%
97.39%
99.91% 99.93% 99.93% 99.86%
99.60% 99.95% 100.00% 100.00% 99.86%
70%
80%
90%
100%
AMJ JAS Oct'22 Nov'22 Dec'22
Target 75% w/n 12 Hrs
100% w/n 24 Hrs Linear (100% w/n 24 Hrs)
Digital Intake TAT SLA Performance
99%
79.23%
85.49%
77.78%
96.61%
99.39% 93.48% 99.98%
20%
30%
40%
50%
60%
70%
80%
90%
100%
JFM AMJ JAS OND
Target 48 Hours 72 Hours
99%
99%
76.64%
95.19%
99.96%
99.99% 99.99%
86.11%
98.39%
99.96% 99.99% 99.99%
60%
70%
80%
90%
100%
AMJ JAS Oct'22 Nov'22 Dec'22
Target 99% w/n 48/72 Hrs
100% w/n 60/84 Hrs Linear (99% w/n 48/72 Hrs)
99%
99%
83.67%
99.83% 99.61% 99.93% 99.94%
93.70%
99.99% 99.99% 100.00% 99.99%
60%
70%
80%
90%
100%
AMJ JAS Oct'22 Nov'22 Dec'22
Target 99% w/n 24 Hrs
100% w/n 36 Hrs Linear (99% w/n 24 Hrs)
100%
100%
98.05% 99.05%
98.78% 99.68% 98.69%
89.84%
99.88% 99.76% 99.92% 99.95%
70%
80%
90%
100%
AMJ JAS Oct'22 Nov'22 Dec'22
Target Predetermination 100% w/n 12 Hrs
State Claim 100% w/n 24 Hrs Linear (State Claim 100% w/n 24 Hrs)
Highlights
• Linear line indicates improvement
trend in all LoB Q-o-Q
Key Initiatives
• Pet project initiative
• Technology issues resolved
• Team alignment with respect to inflow
• Line balancing initiative
• PPH Improvement initiative
Unified View - 48 / 72 Hours Mails Fax
Appeals Referrals

11.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 11
Claims Training Update | Jan week 2
Key Call-Out
LOB FTE Start Date Go Live – Ramp Day 1 Current Status OJT Status Status
CSB 15 12-Oct-22 11-Jan-23 Ramp Cleared
Proclaim Wave 1 15 12-Oct-22 23-Jan-23 OJT Cleared
Proclaims wave 2 15 12-Oct-22 23-Jan-23 OJT Cleared
Medicare Wave 1 15 7-Nov-22 9-Jan-23 OJT Cleared
Medicare Wave 2 10 28-Nov-22 30-Jan-23 OJT Cleared
Project
Current Phase/
Overall Status
Start Date FTE Completion Date
Claims 12- Oct-22 70 21-Apr-2023
Claims
Project Description
12 - Oct -22
Training Kick-off
30-Jan-23
Training Completion
Jul’23 (tentatively)
SteadyState
Key Milestone
• CSB OJT Trend
− OJT 1 was at 77% Vs OJT 2of 94%
• Proclaim 1
− OJT 1 was 95% . OJT 2 was 99% & OJT 3 was 99.9%
• Proclaim 2
− OJT 1 was 98.4% . OJT 2 was 100% & OJT 3 was 100%
• MA 1
− OJT score was 98.3%
• MA 2
− OJT score was 98.7%
At Risk Complete
Delayed
On Track

12.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 12
LOB FTE Start Date Go Live – Ramp Day 1 Current Status OJT Status Status
Selection Fallout -
PMMS Follow Up
15 7-Nov-22 9-Jan-23 Ramp Cleared
Selection Fallout--
Facets XC (Baseline + IFP)
15 8-Nov-22 9-Jan-23 Ramp Cleared
Provider Fallout (EDSM) Training Update | Jan week 2
Key Call-Out
Project
Current Phase/
Overall Status​
Start Date FTE Completion Date
EDSM​ 7- Nov-22​ 30
31- Mar – 2023 (Proclaim)
7-Apr-2023 (Facets)
Provider Fallout
Project Description
07 - Nov -22
Training Kick-off
6-Jan-23
Training Completion SteadyState
Key Milestone
• Training extended by 1 week due to non-availability of
training environment in Proclaim and Facets
• OJT extended by 2 weeks due to delay in feedback and
audit backlog for Cigna
• Undergoing calibration with Cigna onshore team for
Ringo reports – for extracting accuracy performance
during OJT
• Instances of defects marked outside the Articles,
leading to 61 rebuttals being filed, 21% (13) rebuttals
accepted, and the rest are in calibration
• Completed DAL training for agents and scheduled for
Ops managers
• TTT & ATA training scheduled on 01/30
At Risk Complete
Delayed
On Track

13.
Hiring Process and
Pipeline
Monday, January 30, 2023

14.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 14
Our Hiring strategy
Rejected
1. Registration
and Screening
2. Typing Test
6. Document Collection
21%
3. HR Interview
42 % ONBOARD
Healthcare
Academy
4. Aptitude Tests
and Assessments
5. Ops
Interview
7. Offer
8. Background
verification and offer
%
24%
13%

15.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 15
Workforce management service suite
Forecasting
Statutory/Organization Goals
• Service levels
• KPIs
• Staffing related metrics
Capacity Planning
• Sizing and ramp planning
• Hiring/redeployments
• Seats/IT infrastructure plans
Scheduling
• Scheduling efficiency
• Shrinkage planning
• Advisor/seats utilisation
• Rosters – shifts breaks, offline meetings
Real Time Management
• TAT
• Planned/forecast vs. actual
• Advisor Utilization
• Schedule adherence
• Incident logging tracking
• Escalations management
Reporting
Status Updates
• Performance reports and reviews
• Management reporting
• Client reporting
• Internal reporting
FORECASTING
REAL TIME MANAGEMENT
CAPACITY PLANNING
SCHEDULING REPORTING
Short Term
Service Goals
Long Term
Budgeting
• Headcount
• Seat/ IT Planning

16.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 16
24 Nov 2023
25 Aug 2023 25 Aug 2023 6 Oct 2023
6 Oct 2023 13 Oct 2023
Proclaim – Selection Fallout
68 FTEs (83 HCS)
64 FTEs (78 HCS) 4 FTEs (5 HCS) 4 FTEs (5 HCS) 3 FTEs (4 HCS) 15 FTEs (18 HCS) 12 FTEs (15 HCS)
PROCLAIM – SELECTION FALLOUT
Proclaim (PPS) Baseline /
XREF / RTF
PMMS Follow Up EPS for Proclaim
CEF (PMHS, Proclaim, CPF) PMHS (PCS) Baseline
Proclaim / PMHS Pended
Claim
4 FTES
3 FTES
15 FTES
12 FTES

17.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 17
3 Nov 2023
Facets XC (Baseline +
IFP)
Facets – Selection Fallout
54 FTEs (70 HCS) 2 FTEs (3 HCS) 2 FTEs (3 HCS) 2 FTEs (3 HCS) 1 FTEs (2 HCS) 6 FTEs (8 HCS)
FACETS – SELECTION FALLOUT
CST (Baseline +
IFP)
Provider Unattached
(Baseline + IFP)
PNI (PIMS/Facets)
EPS for PathWell
(Facets)
Medicare
1 Sep 2023 6 Oct 2023 20 Oct 2023 20 Oct 2023 3 Nov 2023
2 FTEs (3 HCS)
XPF Baseline / XPF
AIMS
6 Oct 2023
6 FTEs (8 HCS)
Pended Claims -
Facets (Baseline + IFP)
3 Nov 2023
2 FTES
2 FTES
2 FTES
2 FTES
1 FTES
6 FTES
6 FTES
54 FTEs (70 HCS)

18.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 18
{
Proclaim – Claims Processing
30 FTEs (32 HCS) 20 FTEs (24 HCS)
Proclaim – Skill 2
Proclaim – Skill 1
TBD
24th May 2023
10 FTEs (20 HCS)
Proclaim – Skill 1
22nd Sep 2023
PROCLAIM – CLAIMS PROCESSING
60 FTEs (76 HCS)

19.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 19
CSB MSC – Claims Processing
12 FTEs (14 HCS) 17 FTEs (20 HCS) 3 FTEs ( 5 HCS) 10 FTEs (14 HCS) 7 FTEs (12 HCS)
CSB MSC – CLAIMS PROCESSING
CSB MSC Phase 1 – W 1 CSB MSC Phase 1 – W 2 CSB Checks
CSB MSC Phase 2 CSB Policyholder PHS
11th May 2023 8th Aug 2023 TBD
TBD TBD
18 FTEs (25 HCS)
CSB PMU
TBD
67 FTEs (90 HCS)

20.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 20
Medicare Advantage – Claims Processing
15 FTEs (19 HCS)
MEDICARE ADVANTAGE – CLAIMS PROCESSING
QNXT – Claims
processing – Wave 1
23rd May 2023
10 FTEs (14 HCS)
QNXT – Claims
processing – Wave 2
31st May 2023
25 FTEs (33 HCS)

21.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 21
Healthcare Talent Availability for Ramp Beyond Current Scope
Hyderabad
Chennai
Trichy
Bangalore
Talent Profile In-House External Profiles
Claims - 10
Provider Ops - 28
Membership - -
CIP Certified
CIP Certified
Talent Profile In-House External Profiles
Claims 70 73
Provider Ops - 65
Membership 16 21
Talent Profile In-House External Profiles
Claims 119 34
Provider Ops - 10
Membership - 7
Infra setup can be accomplished in 4-6 weeks for all the locations
Talent Profile In-House External Profiles
Claims - -
Provider Ops - -
Membership 5 -
CIP Certified

22.
Implementation
Progress
Monday, January 30, 2023

23.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 23
Cigna Dental EMR - Roadmap
Meeting Cadence
Established
BAU Ramp of
100% Volume
• Exited Backlog
• Return Letters Quality
Issue
Dental Go
Live
Met Quality SLAs for
Tier 1 & Tier 2
Jul 21
Aug 21
Oct’21
Nov’21
Dec’21
Jan’22
Feb’22
Apr’22
May’22
Jun’22
Jul’22
Aug’22
Nov’22
Dec’22
• SLAs Kick Started
• DDC Onshore Go Live
• SHS Go Live
• Moved DDC Offshore
• Reinitiated Return Letter
Processing
Monthly Business
Review established
Touchpoint calls initiated
with stakeholders
Started meeting Quality
SLAs for Tier 1, Tier 2 &
Return letters
EBR completed with
Cigna leadership
Pet project initiated to
improve TAT SLA
SHS Day 2
Go Live

24.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 24
Provider Fallout (EDSM) - Roadmap
Aug 05 - Approval E-
mail from Cigna
Sep 09-
Transition Kick
Off meeting
Sep 20 – 22 -
Due Diligence
Oct 10 & 12 – CIP
Audit
Nov 7 – Batch 1
Training in CHN &
HYD
Dec 15 – Batch 1
OJT in CHN &
HYD
Jan 09 – Batch 1
Go Live in CHN &
HYD
Feb 24 – TTT &
ATA
Feb 27 – Batch 2
Training in CHN &
HYD
Mar 31 – Batch 1 –
100% Ramp
Apr 10 – Batches 3 -
5 Training in CHN &
HYD
Jul 07 – Batch 2 –
100% Ramp
Aug 11 – Batches 3 -5
100% Ramp
Aug 14 – Uptraining
in CHN & HYD
We are here
Aug’22 Sep’22 Oct’22 Nov’22
Dec’22
Jan’23 Feb’23 Mar’23 Apr’23 May’23 Jun’23 Jul’23
Aug’23
Nov 30 - SOW
Signed

25.
© FIRSTSOURCE 2022 | CONFIDENTIAL I 30 January 2023 | 25
Claims - Roadmap
Aug 05 - Approval
E-mail from Cigna
Aug 24 -
Transition Kick
Off meeting
Sep 12 - 27
Due Diligence
Oct 10 & 12 – CIP
Audit
Oct 12 – Training
Proclaim W1 & W2
CSB MSC – W1
Go Live
Jan 9 – MA – Wave 1
Jan 11 – CSB MSC – Wave 1
Jan 16 - Proclaim – Wave 1 & 2
100% Ramp
Jul 03– CSB MSC Wave 2
Nov 07 –
Training
MA – Wave 1
Nov 28 –
Training
MA – Wave 2
Jan 17– Training
CSB MSC – Wave 2
Feb 06 – Training
Proclaim – Wave 3
100 % Ramp
Mar 31 - MA – Wave 1
Apr 4– CSB MSC – Wave 1
Apr 7 - Proclaim – Wave 1 & 2
Apr 21 – MA – Wave 2
Go Live
Apr 11 – CSB MSC
– Wave 2
Go Live
May 15– Proclaim
– Wave 3
100% Ramp
Aug 04 – Proclaim Wave
3
Aug’22 Sep’22 Oct’22 Nov’22 Dec’22 Jan’23 Feb’23 Mar’23
Apr’23 May’23
Jun’23 Jul’23 Aug’23
Dec 02 - SOW
Signed
We are here

26.
© Firstsource Solutions Limited | Confidential | 30 January 2023
www.firstsource.com
Helping customers stay ahead of
the curve through transformational
technologies and capabilities
Firstsource Solutions Limited, an RP-Sanjiv Goenka Group company, is a
leading provider of transformational solutions and services spanning the
customer lifecycle across Healthcare, Banking and Financial Services,
Communications, Media and Technology and other industries.
Our ‘Digital First, Digital Now’ approach helps organizations reinvent
operations and reimagine business models, enabling them to deliver
moments that matter and build competitive advantage.
With an established presence in the US, the UK, India, Mexico and the
Philippines, we act as a trusted growth partner for over 100 leading
global brands, including several Fortune 500 and FTSE 100 companies.