1. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Welcome Customer Care Training Presenter: Barbara Howrey Next

2. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Lesson Next Lesson: Our Customers

3. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Objective Next Objective Describe who our customers are Identify the customers you will serve

4. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Learn Next What you will learn Five Customer Classifications

5. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Menu Types of Customers As a Customer Care Associate, you will be responsible for working with a variety of customers. There are five unique types of customers. Select a Customer Classification in the menu on the left to learn more. Types of Customers As a Customer Care Associate, you will be responsible for working with a variety of customers. There are five unique types of customers. Select a Customer Classification in the menu on the left to learn more. When you have completed the training... Click to Play Game

6. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Provider A provider is anyone who is licensed to render medical services to a patient. There are two types of providers: Professional Providers Facility/Institutional Providers Learn more...

7. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Pro Providers Professional Providers Anesthesiologist Chiropractor Dermatologist Family Practice Gastroenterologist Internal Medicine OB-GYN Otolaryngology Pediatrician Physical Therapist Primary Care Physician Psychiatrist Radiologist Surgeon Next

8. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Facility Providers Facility Providers/Institutional Ambulatory Surgical Center Hospice Center Hospital Imaging Center Laboratory Residential Treatment Center Skilled Nursing Facility Menu

9. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Member Members A member is a person who has an active membership with an insurance company. They may be insured by their employer as part of medical benefit or they may have purchased the insurance through a broker to obtain an Individual Policy. Types of Members: There are five types of members. Learn more...

10. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Subscriber Next Type of Member Subscriber

11. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Spouse Next Type of Member Subscriber Subscriber’s Spouse

12. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Children Next Type of Member Subscriber Subscriber’s Spouse Subscriber’s Children (Dependents)

13. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Grandchildren Next Type of Member Subscriber Subscriber’s Spouse Subscriber’s Children (Dependents) Subscriber’s Grandchildren

14. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Partners Menu Type of Member Subscriber Subscriber’s Domestic Partner

15. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Brokers & Agents Brokers and Agents Brokers and agents are people who are licensed to sell insurance. What is the difference between a Broker and an Agent? Learn more...

16. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Brokers A broker sells the policy to the member. If the member has any question with a claim or service, the Broker will also call on behalf of the member to resolve a concern that the member has. Next

17. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Agents Their main role is to develop business relationships with new companies. They also keep the relationship they have by continuously offering innovative products and caring service. Menu

18. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Employer Groups An Employer Group health plan is established or maintained by an employer or by an employee organization that provides medical care for participants or their dependents. Benefit Coordinators often represent the Employer Group when interacting with their insurance company. Learn more...

19. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Benefit Coordinators Because most companies have a Benefit Coordinator that acts as a liaison between the group member and the insurance company, employees of the company often enlist help from the Benefit Coordinator in resolving concerns. When calls are received from these coordinators, certain guidelines apply about what can be discussed with the Coordinator about a member. Menu

20. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Internal Internal Customers An internal customer is one that usually works within the insurance company. They may or may not be in your department but it is important that you understand that they are also your customers Learn more...

21. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Internal Customers Examples of Internal Customers Operations Experts Managers Claims Processors/Adjusters Grievance and Appeal Associates Enrollment and Billing Representatives Menu

22. Name That Customer Matching Game Game Providers Members Brokers & Agents Employer Groups Internal Customers Instructions On the next slide is a matching game. Look at the Classification term on the left and find the correct customer that belongs to that classification. Good luck!! Next

23. Claims Processor Has a Benefit Counselor Hospice Center Sell Insurance Domestic Partner Providers Members Brokers & Agents Employer Groups Internal Customers Game Name That Customer Matching Game

24. Providers Members Brokers & Agents Employer Groups Internal Customers XYZ Insurance Thanks Thank You!!