UK-HMO Member Services n n n n

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UK-HMO

Member Services n n n n n Benefit Quotes/questions Problem resolution/tracking. All calls entered & coded into Diamond system & tracked for trends. Parking tickets stamped for all UK employees with UK insurance for all visits to KY Clinic & ancillaries. Registration for KY Clinic and ancillary visits available on 1 st & 3 rd floor for all UK employees with UK insurance & via phone for UK-HMO members. After hours answering service, can page MD on call. Eligibility verification. Help in establishing a PCP, UKHMO or Health Connections. UKHMO 257 -8547 or 800 -955 -8547, Health Connections 257 -1000, or 800 -333 -8874, or RSA 271 -5055 or 877 -855 -9700. Mid October a dedicated Member Services unit will be unveiled.

Communication n n n n Prior to Open Enrollment, reminder post cards are sent. 14 Open Houses were held in 6 locations, Five open forums at three locations. HR sends benefit comparison. Phone/in-person/email: ukhmo@uky. edu, website: www. mc. uky. edu/ukhmo, also linked from Employee Benefits website. Letters are mailed for immediate communication, (mail order Rx, provider changes). Quarterly Newsletters When ID cards are mailed additional information is included in packet. A welcome letter, Certificate of Coverage, Provider Directory, and other pertinent materials are included (such as familymeds. com packet). Provider Newsletters are sent out bi-annually.

Appointments n n Establish a PCP If issues arise contact UK-HMO office for assistance.

Customer Service Calls Total Calls % of Membership % of Total Visits 114 0. 8% 0. 3% 145 1. 1% 0. 5% * Specialties 79 0. 6% ** New Patients 45 0. 3% 0. 1% 66 0. 5% 0. 1% 1791 13. 1% 4. 0% Doctor Issues 28 0. 2% 0. 1% Facility & Staff Issues 12 0. 1% 0. 0% Quality of Care 19 0. 1% 0. 0% Access to Care/After hours Access to Appointments Primary Care Benefit Complaint Question

Membership: 13, 649 (LSA) Specialty Visits from 9/1/00 thru 8/31/01: 14, 239 Primary Care Visits from 9/1/00 thru 8/31/01: 30, 472 Total Visits: 44, 711 • * % of Primary Care Visits • ** % of Specialty Visits

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