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PublishMyrtle Thornton Modified over 8 years ago
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1 Brad Bowlus President, CEO PacifiCare Health Plans.…a health and consumer services company making people’s lives better Consumer Aligned Service Leadership
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2.…a health and consumer services company making people’s lives better Key Service Initiatives One Company, One Business Approach – Standardized Business Practice Significant Investments In Technology Business Requirements Better Matched To System Capabilities Consolidating Service Centers From 5 To 3 Expansion Of Ireland Service Center
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3.…a health and consumer services company making people’s lives better What Has Changed ? Business Model Shift From Capitation Challenged PacifiCare Service Leadership In 2000 & 2001 –Risk Model Now Stabilized –Lessons Learned Incorporated Average Speed to Answer (1) 30 21 Abandonment Rate (1) 2.9% 2.8% Claims Financial Accuracy 97.4% 98.7% Auto Adjudication (Professional) 60% EDI 45% Claims Inventory (2) 503K 248K DROH (2) 13.3 5.2 Current Service Metrics As Strong Or Stronger Than Anyone In The Industry 2001Current (1) Commercial Only. All Other Metrics On Combined Commercial & Secure Horizons Basis. (2) 2001 Metrics As Of January, 2001.
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4.…a health and consumer services company making people’s lives better Claims Payment Capabilities All Claims / All Products
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5.…a health and consumer services company making people’s lives better Days To Turn Claims - $ Weighted
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6.…a health and consumer services company making people’s lives better The PPO Service Advantage Cross-Functional Teams Enrollment Customer Service Claims Medical Management Fully-Integrated Workstation Fully-Integrated Work Station Approach To PPO Service Levels 90+% First Call Resolution
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7.…a health and consumer services company making people’s lives better Brand New Day – “Consumer Aligned” Service Leadership Electronic Toolsets Designed For “First Call” Resolution Expanded Customer Service Hours (7AM To 9PM) New Member Welcome Call Program Quality Incentive Program For Customer Service Associates Expanded Web Portals, Linking Quality Index, Disease Management Programs, Provider Directories Multi-State & Multi-Product Billing / “On-Line” Bill Presentment FSA Card
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