Elisa Elderbaum IT Business Advisor National Government Services, formerly Empire Medicare Services Collecting, Managing, & Analyzing User Feedback

2 Agenda Introduction - National Government Services Reports –Compliance Reports –Operations Reports –Continuous Improvement Lessons Learned Future Improvements

3 National Government Services

4 Serves over 22.5 million people with Medicare in 26 statesServes over 22.5 million people with Medicare in 26 states In 2006, responded to 10.4 millions callsIn 2006, responded to 10.4 millions calls Processed over 208 million Medicare claims and administered benefits of more than $87.9 billionProcessed over 208 million Medicare claims and administered benefits of more than $87.9 billion Currently at 240 portsCurrently at 240 ports Contact center locations:Contact center locations: –Syracuse, NY –Bohemia, NY –Harrisburg, PA –Milwaukee, WI –Indianapolis, IN –Manchester, NH –Cincinnati, OH

5 Medicare Insurance Programs Part A – Medicare Hospital Insurance (Hospitals) Part B – Medicare Supplementary Medical Insurance (Doctor’s Offices) Part C – Medicare HMO Program Part D – Medicare Prescription Drug Benefit

6 Self-Service Options Medicare Part A Patient Eligibility Claims Status Financial Information (Check Remittance) Commonly Requested Telephone Numbers Commonly Requested Addresses Commonly Requested Websites Hours of Operation Seminar Information HMO Information Appeal Rights Medicare Part B Patient Eligibility Claims Status Patient Deductible Status Procedure Code Pricing Seminar Schedules Earnings Commonly Requested Telephone Numbers Commonly Requested Addresses Fax-On-Demand Information Appeal Rights

7 Reports Compliance Reports Operations Reports Continuous Improvement Dashboard

8 Compliance Reports

9 The Centers for Medicare and Medicaid Services (CMS) have established Service Level Agreements that contractors must meet National Government Services submits these weekly reports externally to CMS to remain in compliance

10 Compliance Reports

11 Operations Reports

12 Operations Reports Reports used internally for day-to-day maintenance of the systemsReports used internally for day-to-day maintenance of the systems –IVR Port Utilization –Application Failure Report –Host Transaction Failure Report

13 IVR Port Utilization Daily IVR Port Utilization Report Period: 07/01/07 – 07/07/07

14 Port Utilization Trends IVR Port Utilization 2007 YTD

15 Backend Transaction Failures

16 Continuous Improvement

17 Continuous Improvement Reports are generated daily, weekly and monthly for to track IVR activityReports are generated daily, weekly and monthly for to track IVR activity Augments automation by identifying areas for improvement critical to the success of automationAugments automation by identifying areas for improvement critical to the success of automation Reports are used internally to identify improvement areasReports are used internally to identify improvement areas Reports are also used externally as a continuous education processReports are also used externally as a continuous education process

18 Completed Transaction Summary TransactionCount Play Eligibility Information3,641 Play Claim Information391 Play Claim Details229 Play Last 3 Checks Information116 Play HMO Information24 Others64

19 Failed Transaction Summary TransactionCount Medicare Number Not Found4,814 Caller Exceeded Maximum Retry Attempts 279 Incorrect Patient Date of Birth249 Caller Requested Operator186 Caller Exceeded Response Timeout122 Others216

20 Failed Transactions by Provider X5 X1 X2 X3 X4 X1 X2 X3 X4 X5 Failed Transactions by Provider Provider Transaction Failures X1 23 X213 X313 X411 X5 10 TOTAL445

21 Lessons Learned

22 Lessons Learned Improvement is a continuous processImprovement is a continuous process Empower your live agentsEmpower your live agents –Teach them the automated system so they can teach your callers Listen to your callers; factor in their wants & needs into your improvement plansListen to your callers; factor in their wants & needs into your improvement plans Treat automated “agents” like live agentsTreat automated “agents” like live agents –Train and refine the automated “agent” Use IVR system reports to help guide the improvement processUse IVR system reports to help guide the improvement process Technology can only take you so farTechnology can only take you so far Analyze the data – don’t wait until the end of the project. Understand what it meansAnalyze the data – don’t wait until the end of the project. Understand what it means

23 Future Improvement

24 Future Improvement DashboardDashboard –Single real-time, view of entire system by application, backend, and system perspective Trend AnalysisTrend Analysis –Analyze trends in call volume, call types, system utilization, etc –Allows for point or spot analysis

25 THANK YOU! Elisa Elderbaum IT Business Advisor National Government Services