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&. U K. Service Units That Deliver Value. Self-funded Solutions Organization. Corporate Support (Louisville). Group Set-Up. Plan Loading. Leased Network Adds. Billing & Enrollment. Humana Self-funded Service Center. Louisville Implementation Coordinator

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  1. & U K

  2. Service Units That Deliver Value

  3. Self-funded SolutionsOrganization Corporate Support (Louisville) Group Set-Up Plan Loading Leased Network Adds Billing & Enrollment Humana Self-funded Service Center • Louisville • Implementation Coordinator • Summary Plan Description • Claims processing • Customer service • Enrollment changes • Funding (finance) Medical Management

  4. Humana Self-funded Solutions Organization Terri Lacefield Director Self-funded Solutions Richard Preasmyer Finance Manager Debbie Griffith Manager KY SFS Angela Beaver Implementation Manager Charles Lashley Customer Service Supervisor Angela Bonner Claims Supervisor

  5. Dedicated Players for a Dedicated Team • Customer-centric • Group Implementation Manager • Claims • Customer Service • Group direct contact • Financial Reporting • Billing & Enrollment

  6. Performance Management Monthly 1:1 Quality Review random sample high dollar audit Creating Lasting Partnerships - Claims • Financial Operations • reporting • Dedicated ASO unit • Financial Recovery • Shared Savings • Advanced Claim Adjudication System (CAS)

  7. Example of Savings @ 20% DiscountOut of Network benefit * employer bottom line cost Total Savings = $1,624.00

  8. Kentucky Self-funded Solutions Claims Controllable Cycle Time -2001 Goal 95% Goal 90%

  9. Self-funded Solutions Claims Financial Accuracy Rates - Kentucky

  10. Self-funded Solutions Claims Payment Accuracy Rates - Kentucky

  11. Customer focused single level one-stop shopping Performance Management Monthly 1:1 Quality Review Silent monitoring Side-by-side observations Closed inquiry audit Creating Lasting Partnerships - Customer Service

  12. e-Business Enabling Member Self-service . . . Jane Doe

  13. Jane Doe e-Business

  14. Kentucky Self-funded Solutions Call Completion Rates

  15. Self-funded Solutions Answer Time (Seconds)

  16. Humana Self-funded Solutions - Service Culture • Enabled Associates • customer focus • e-technology • performance management • business and behavioral measures • S-FAC (Self-funded Action Committee) • dedicated players for a dedicated team • we love our customers • sailing to success • Built to Last . . . Solutions in healthcare needs

  17. John Komp, Dedicated Group Contact Charles Lashley, Supervisor

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