A key factor of the UMR advantage is that we are, first and foremost, a TPA and we offer the flexibility and personalized service of a TPA. Last modified: 8/2/11 © 2011 United HealthCare Services, Inc.
The pillars of our service Although we serve more than 1,400 customers (most of whom have multiple plan designs), we clearly understand that each customer is a unique organization with a different culture, varying short- and long-term strategies and unique approaches to plan design and cost containment. Our customers appreciate that we don’t have a one-size-fits-all approach, and as a result we build long-term relationships. We work to: Understand our customer’s unique needs and company culture Promote familiarity with customers, their plan and their employees Be accountable for service delivery and improved plan results Last modified: 8/2/11 © 2011 United HealthCare Services, Inc.
Developing a long term partnership Our overall strategy at UMR focuses on the long-term. We want our relationships with clients to be long-term; we want to lead the marketplace long-term and we want to keep growing. To do that, we have developed a three-step agenda. The first is to Execute on our commitments. Our goal is to always work as a team on commitments we make both internally to each other and externally to our clients, their plan members and their advisors. Part of that execution includes operating efficiently and with financial discipline and ensuring we all are accountable. UMR is also in an unique situation. We differentiate ourselves as a true TPA but with the resources and reach of a national carrier. We can do more than the average TPA! Beyond that it’s a simple but prudent goal to deliver service excellence to members, providers and customers. Like any healthy business we want to attack the market through innovation, taking advantage of UnitedHealthcare’s competitive network, developing solid and creative reporting and product solutions and continuing to look for creative ways to grow. Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
Service excellence in: At UMR we don’t just aim at service excellence. We deliver it. Our Customer First business model ensures accountability is embedded across your service team. I’ll get into the detail of our implementation model but let me assure you—the detailed approach means we get it right the first time. We take our time training the CSAs starting with six weeks in the classroom followed by a full month on the job with limited authority, concentrated audits and close mentoring. And as we administer your plan, we conduct individual audits in claim and call. Each CSA has five calls recorded every week to review service accuracy and quality. We conduct a corporate audit of each service office to make sure our company standards are met for processing accuracy. UMR provides monthly and sometimes even daily or weekly reports for claim transactions, check registers , and even care management and (if you opt for Optum Rx) prescription usage online. We supply quarterly standard reports as desired using Advantage Suite by Thomson Reuters and an annual Plan Performance Analytic Review which merges clinical findings with claim costs and trends against normative data for application in strategic planning or benefit modifications. Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 2/16/12 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. If a client chooses consumer-driven plans and value-based benefit design, UMR offers a trained Consumer Concierge to act as their advocate and provide cross-functional customer service (medical, CDH and Dental) beginning at pre-enrollment and continuing throughout the life of the plan. Our pharmacy services partner, Optum Rx, has dedicated UMR resources and user-friendly Web and mobile tools to boost member compliance. UMR also has strong online tools to help members keep track and understand their benefits and monitor not only their claims but their own health. Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 2/16/12 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. If a client chooses consumer-driven plans and value-based benefit design, UMR offers a trained Consumer Concierge to act as their advocate and provide cross-functional customer service (medical, CDH and Dental) beginning at pre-enrollment and continuing throughout the life of the plan. Our pharmacy services partner, Optum Rx, has dedicated UMR resources and user-friendly Web and mobile tools to boost member compliance. UMR also has strong online tools to help members keep track and understand their benefits and monitor not only their claims but their own health. Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 2/16/12 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. Our pharmacy services partner, Optum Rx, has dedicated UMR resources and user-friendly Web and mobile tools to boost member compliance. UMR also has strong online tools to help members keep track and understand their benefits and monitor not only their claims but their own health. Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 2/16/12 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. Our pharmacy services partner, Optum Rx, has dedicated UMR resources and user-friendly Web and mobile tools to boost member compliance. UMR also has strong online tools to help members keep track and understand their benefits and monitor not only their claims but their own health. Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 11/8/11 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. If a client chooses consumer-driven plans and value-based benefit design, UMR offers a trained Consumer Concierge to act as their advocate and provide cross-functional customer service (medical, CDH and Dental) beginning at pre-enrollment and continuing throughout the life of the plan. Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 11/8/11 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. If a client chooses consumer-driven plans and value-based benefit design, UMR offers a trained Consumer Concierge to act as their advocate and provide cross-functional customer service (medical, CDH and Dental) beginning at pre-enrollment and continuing throughout the life of the plan. Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 11/8/11 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 11/8/11 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 11/10/11 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. Last modified: 11/10/11 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 11/10/11 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. Last modified: 11/10/11 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 11/10/11 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. Last modified: 11/10/11 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 11/10/11 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Care management nurses as well as disease management and wellness coaches provide members with ongoing support to live as healthy a life as possible. Our care management is integrated with claim operations so UMR provides seamless member interaction and that increases first-call resolution as well. Last modified: 11/10/11 © 2011 United HealthCare Services, Inc.
Serving plan members Last modified: 11/10/11 As you can see, our model is built around the plan members and customers to meet their needs in the most efficient manner. Taking care of plan members is critical to plan sponsor satisfaction so we concentrate on providing accurate, fast and compassionate service to them. specialized teams that designate contacts by customer to increase accountability and familiarity. Each client is assigned a dedicated team that’s focused on accuracy and turnaround. They get to know each plan in detail and often get to know members by name. Customer Service Analysts (CSAs) answer the phones and pay claims so they have all the information they need to respond quickly to a call. We find this approach results in more than 90 percent of inquiries resolved on the first call. On average each CSA has more than 6 years of experience and take ownership for their customers The CSAs are joined by Customer Specialists who solve day-to-day claim issues and work with experts throughout UMR to maintain quality in our daily operations. We maintain a ratio of 2,300 plan members to one CSA. The team also includes a claim supervisor. Last modified: 11/10/11 © 2011 United HealthCare Services, Inc.
Your customer-first service team On the plan sponsor side, each customer has a dedicated Strategic Account Executive (SAE) who becomes an expert on that client’s culture, objectives, benefit strategy and expectations. Client Service Consultants support the SAE and, of course, the client in service delivery and are key facilitators for tracking, fact gathering and delivering reports, contracts, plan summaries and ID cards. SAEs are accountable for their client’s overall satisfaction and: Partner with clients and their advisors in enhancing their plans and savings through ongoing analysis and regular results meetings Are a single point of contact for escalated issues and liaison between clients and UMR Have self-funding knowledge Hold a strong partnership with Account Executives Bilingual SAEs are available. SAEs are supported by Customer Specialists who: Solve day-to-day claims issues as well as escalated, complex customer service challenges Work with experts throughout the organization to maintain quality of daily operations Provide technical expertise to the team Also part of the customer teams are Client Service Consultants who: Support clients and their SAEs in day to day questions or issues Partner with the SAEs in service delivery and tasks for the account Are key facilitators for tracking, fact gathering, and information delivery such as reports, contracts, and plan summaries, ID cards, etc Care management SAEs and Optum Rx SAEs join the team to take care of specific product issues or questions. Customers also have access to specialized teams that designate contacts by customer to increase accountability and familiarity. Access to online reporting and analysis supports financial reconciliation as well as facilitates strategic decision making. Our best-in-class ancillary services include vision, hearing and telemedicine products. Stop loss focuses on delivering the best carrier, contract type with quick claims filing and reimbursement. Network administration maximizes the access and savings associated with local, regional and national networks. And UMR’s consumer-driven solutions specialists work directly with clients and their advisors to develop multi-year strategies and incorporate value-based benefit design if it fits their strategy. Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Your Strategic Account Executive Your designated SAE plays a key role during implementation. He/She serves as your single point of contact with UMR for escalated issues. He/She also becomes your liaison and advocate with UMR. Strategic Account Executives hold an authoritative role within the UMR structure. They are able to influence decisions and provide superior, proactive service in managing accounts. All UMR SAEs have self-funding expertise and form strong partnerships with Account Executives. What that means is we have a clearly identified team of people, all of whom understand your plan, your concerns and your needs. Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Your Strategic Account Executive To insert a photo into the rounded box take the following steps: Right click on the box and select “Format Auto Shape.” Click the “Colors and Lines” tab. In the “Color” drop down menu under the “Fill” section, select the option “Fill Effects.” Select the “Picture” tab and click on the button called “select picture.” Then browse to find your photo. Make sure you check the box that says “Lock picture aspect ratio.” This will insure that your photo does not get distorted. NAME, your designated SAE plays a key role during implementation. NAME serves as your single point of contact with UMR for escalated issues. He/She also becomes your liaison and advocate with UMR. Strategic Account Executives hold an authoritative role within the UMR structure. They are able to influence decisions and provide superior, proactive service in managing accounts. All UMR SAEs have self-funding expertise and form strong partnerships with Account Executives. What that means is we have a clearly identified team of people, all of whom understand your plan, your concerns and your needs. . Meet [Insert name here] See instructions on right to insert a new photo Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
Your Strategic Account Executive NAME, your designated SAE plays a key role during implementation. NAME serves as your single point of contact with UMR for escalated issues. He/She also becomes your liaison and advocate with UMR. Strategic Account Executives hold an authoritative role within the UMR structure. They are able to influence decisions and provide superior, proactive service in managing accounts. All UMR SAEs have self-funding expertise and form strong partnerships with Account Executives. What that means is we have a clearly identified team of people, all of whom understand your plan, your concerns and your needs. . Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Your customer-first service team On the plan sponsor side, each customer has a dedicated Strategic Account Executive (SAE) who becomes an expert on that client’s culture, objectives, benefit strategy and expectations. Client Service Consultants support the SAE and, of course, the client in service delivery and are key facilitators for tracking, fact gathering and delivering reports, contracts, plan summaries and ID cards. SAEs are accountable for their client’s overall satisfaction and: Partner with clients and their advisors in enhancing their plans and savings through ongoing analysis and regular results meetings Are a single point of contact for escalated issues and liaison between clients and UMR Have self-funding knowledge Hold a strong partnership with Account Executives Bilingual SAEs are available. SAEs are supported by Customer Specialists who: Solve day-to-day claims issues as well as escalated, complex customer service challenges Work with experts throughout the organization to maintain quality of daily operations Provide technical expertise to the team Also part of the customer teams are Client Service Consultants who: Support clients and their SAEs in day to day questions or issues Partner with the SAEs in service delivery and tasks for the account Are key facilitators for tracking, fact gathering, and information delivery such as reports, contracts, and plan summaries, ID cards, etc Care management SAEs join the team to take care of specific product issues or questions. Customers also have access to specialized teams that designate contacts by customer to increase accountability and familiarity. Access to online reporting and analysis supports financial reconciliation as well as facilitates strategic decision making. Our best-in-class ancillary services include vision, hearing and telemedicine products. Stop loss focuses on delivering the best carrier, contract type with quick claims filing and reimbursement. Network administration maximizes the access and savings associated with local, regional and national networks. And UMR’s consumer-driven solutions specialists work directly with clients and their advisors to develop multi-year strategies and incorporate value-based benefit design if it fits their strategy. Last modified: 11/10/11 © 2011 United HealthCare Services, Inc.
Your Strategic Account Executive Your designated SAE plays a key role during implementation. He/She serves as your single point of contact with UMR for escalated issues. He/She also becomes your liaison and advocate with UMR. Strategic Account Executives hold an authoritative role within the UMR structure. They are able to influence decisions and provide superior, proactive service in managing accounts. All UMR SAEs have self-funding expertise and form strong partnerships with Account Executives. What that means is we have a clearly identified team of people, all of whom understand your plan, your concerns and your needs. Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
Your customer-first service team On the plan sponsor side, each customer has a dedicated Strategic Account Executive (SAE) who becomes an expert on that client’s culture, objectives, benefit strategy and expectations. Client Service Consultants support the SAE and, of course, the client in service delivery and are key facilitators for tracking, fact gathering and delivering reports, contracts, plan summaries and ID cards. SAEs are accountable for their client’s overall satisfaction and: Partner with clients and their advisors in enhancing their plans and savings through ongoing analysis and regular results meetings Are a single point of contact for escalated issues and liaison between clients and UMR Have self-funding knowledge Hold a strong partnership with Account Executives Bilingual SAEs are available. SAEs are supported by Customer Specialists who: Solve day-to-day claims issues as well as escalated, complex customer service challenges Work with experts throughout the organization to maintain quality of daily operations Provide technical expertise to the team Also part of the customer teams are Client Service Consultants who: Support clients and their SAEs in day to day questions or issues Partner with the SAEs in service delivery and tasks for the account Are key facilitators for tracking, fact gathering, and information delivery such as reports, contracts, and plan summaries, ID cards, etc Care management SAEs and Optum Rx SAEs join the team to take care of specific product issues or questions. Customers also have access to specialized teams that designate contacts by customer to increase accountability and familiarity. Access to online reporting and analysis supports financial reconciliation as well as facilitates strategic decision making. Our best-in-class ancillary services include vision, hearing and telemedicine products. Stop loss focuses on delivering the best carrier, contract type with quick claims filing and reimbursement. Network administration maximizes the access and savings associated with local, regional and national networks. And UMR’s consumer-driven solutions specialists work directly with clients and their advisors to develop multi-year strategies and incorporate value-based benefit design if it fits their strategy. Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Your Strategic Account Executive Your designated SAE plays a key role during implementation. He/She serves as your single point of contact with UMR for escalated issues. He/She also becomes your liaison and advocate with UMR. Strategic Account Executives hold an authoritative role within the UMR structure. They are able to influence decisions and provide superior, proactive service in managing accounts. All UMR SAEs have self-funding expertise and form strong partnerships with Account Executives. What that means is we have a clearly identified team of people, all of whom understand your plan, your concerns and your needs. Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Your customer-first service team On the plan sponsor side, each customer has a dedicated Strategic Account Executive (SAE) who becomes an expert on that client’s culture, objectives, benefit strategy and expectations. Client Service Consultants support the SAE and, of course, the client in service delivery and are key facilitators for tracking, fact gathering and delivering reports, contracts, plan summaries and ID cards. SAEs are accountable for their client’s overall satisfaction and: Partner with clients and their advisors in enhancing their plans and savings through ongoing analysis and regular results meetings Are a single point of contact for escalated issues and liaison between clients and UMR Have self-funding knowledge Hold a strong partnership with Account Executives Bilingual SAEs are available. SAEs are supported by Customer Specialists who: Solve day-to-day claims issues as well as escalated, complex customer service challenges Work with experts throughout the organization to maintain quality of daily operations Provide technical expertise to the team Also part of the customer teams are Client Service Consultants who: Support clients and their SAEs in day to day questions or issues Partner with the SAEs in service delivery and tasks for the account Are key facilitators for tracking, fact gathering, and information delivery such as reports, contracts, and plan summaries, ID cards, etc Last modified: 11/10/11 © 2011 United HealthCare Services, Inc.
Your Strategic Account Executive Your designated SAE plays a key role during implementation. He/She serves as your single point of contact with UMR for escalated issues. He/She also becomes your liaison and advocate with UMR. Strategic Account Executives hold an authoritative role within the UMR structure. They are able to influence decisions and provide superior, proactive service in managing accounts. All UMR SAEs have self-funding expertise and form strong partnerships with Account Executives. What that means is we have a clearly identified team of people, all of whom understand your plan, your concerns and your needs. Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
Access to specialized support services A second level of support provides Customer-first teams access to specialized teams that designate contacts by customer to increase accountability and familiarity. Reporting and analysis – provides access to online reports to support financial reconciliation as well facilitate strategic decision making Care Management – integrated with claims operations which creates seamless member interaction and increases first-call resolution Ancillary services – provides access to best-in-class ancillary services including vision, hearing and telemedicine products Stop loss – focuses on delivering the best carrier, contract type with quick claims filing and reimbursement Consumer-Driven Solutions – comprehensive solution that increases consumer engagement while reducing overall medical trend Claims – dedicated team to your account that’s focused on accuracy and turnaround while working to maximizing the savings on today’s claims costs Network Administration – focused on maximizing the access and savings associated with local, regional and national networks Pharmacy benefits -- has preferred relationship with our sister company, Optum Rx, which offers the best integration, flexibility and lower prescription costs. Last modified: 2/16/12 © 2011 United HealthCare Services, Inc.
Customer-first delivers results Customer-first teams drive accountability, resulting in timely, accurate claims processing as shown by these results. We also externally validate our results through annual SAS70 audits. We audit 3.5 percent of our claims. Additionally we conduct regular customer satisfaction surveys and account management surveys, provide performance guarantees and use consistent feedback metrics. UMR’s auto adjudication rate is greater than 75 percent and more than 70 percent of our claims are submitted electronically, which improves accuracy as well. Last modified: 11/1/11 © 2011 United HealthCare Services, Inc.
A reputation for smooth implementations Transitioning to a new TPA can sometimes be a barrier to making a change. We all know the horror stories. At UMR, we understand how important a smooth implementation is and we pride ourselves on a successful and—if we say so ourselves—impressive track record. We assign experienced transition leaders who oversee a full team that includes the SAE, claim management, supervisory and technical experts from each of our business units. All our teams, and especially our transition leaders, are experts at dealing with unexpected issues without jeopardizing their deliverables. We keep detailed implementation logs, assigning each and every deliverable and task a target date and an owner who is held accountable. Management plays an active role as well. As the implementation moves along, this team then evolves into an ongoing service team—so they understand the issues and the complexities of your plan better than anyone else. Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
A reputation for smooth implementations We assign experienced transition leaders who oversee a full team that includes the SAE, claim management, supervisory and technical experts from each of our business units. Transition team includes account manager, claim management, supervisory and technical experts from all business units. This team evolves into your ongoing service team. Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
A reputation for smooth implementations We keep detailed implementation logs, assigning each and every deliverable and task a target date and an owner who is held accountable. Each deliverable and task is assigned a target date and an owner who is held accountable Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.
A reputation for smooth implementations Management plays an active role as well. As the implementation moves along, this team then evolves into an ongoing service team—so they understand the issues and the complexities of your plan better than anyone else. Management makes sure any unexpected issues are resolved without jeopardizing deliverables Last modified: 11/8/11 © 2011 United HealthCare Services, Inc.