Brad Bowlus

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.a health and consumer services company making
peoples lives better
Consumer Aligned Service Leadership
Brad Bowlus President, CEO PacifiCare Health
Plans
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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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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) lt35 gt
  60
• EDI lt25 gt 45
• Claims Inventory (2) 503K 248K
• DROH (2) 13.3 5.2
• Current Service Metrics As Strong Or Stronger
  Than Anyone In The Industry

2001 Current
(1) Commercial Only. All Other Metrics On
Combined Commercial Secure Horizons Basis. (2)
2001 Metrics As Of January, 2001.
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Claims Payment CapabilitiesAll Claims / All
Products
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Days To Turn Claims - Weighted
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The PPO Service Advantage

• Fully-Integrated Work Station Approach To PPO
  Service Levels

Cross-Functional Teams
Enrollment
Customer Service
Claims
Medical Management
Fully-Integrated Workstation
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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