Client Update July 2017
Regional Sales Manager & Stop-Loss Specialist Start Date:
August 15, 2016
Education:
Sanford Brown - Medical Assisting
Strengths:
• I’m very bold and believe in taking risks. • I love learning new things. • I’m compassionate. I will be the first to bug you for a donation to a good cause.
Weaknesses:
• I have chronic “foot in mouth” syndrome. • I always think I’m in trouble. • I’m a crier.
Best Part of Working at UCS:
Hands down the people. As a former client, I’ve now experienced the full gambit. From a client perspective, my needs were always prioritized, and when no programs were available to maximize my cost containment efforts, UCS built them for me. How could I not want to work for a company that pro-actively sought ways to bring me and my clients greater value? Now that I am here, if I have a question I can walk down the hall to a number of resources and seek an answer. It truly is a team effort here, and every new idea is considered as a possible new initiative. Not to mention how much money they saved me. I knew when I was a client that I wanted to someday be a part of this incredible team.
What would someone find you doing on a weekend?
I love going to thrift stores, discount stores and seeing what kind of deals I can get. If you mention my clothing, I will likely tell you where I purchased and for just how little I paid for it.
Do you collect anything interesting? If so, what & why?
Well, yes, and try not to judge me too hard here... but I collect unicorns. It is a long story, so if you want to know how it started, just ask me.
Do you have any pets?
Yes, I have three cats - a beautiful solid white long haired by the name of Oliver Funk, a super smart grey/blue striped short hair named Peekas Tee, and the cutest calico you’ve ever seen who goes by Lillian Putian. Also, my husband has two ball python snakes. He used to have roughly 80 snakes, so I’m ok with just the two.
Who is your role model & why?
My sister. I love her more than anyone on the entire planet. She takes care of our mother and is my best friend and confidant. I am also extremely protective of her, and try to fly out to see her as often as I can. I’m actively trying to convince my family to just pack up and join me out here in the desert.
What is your greatest accomplishment?
Enduring. No matter what has been tossed my way, I have always endured.
Favorite Quote or Life Motto:
“Though she be but little, she is fierce.” - Shakespeare
What major goals do you hope to accomplish someday?
I would love to start a family, but with a few health concerns, we are not sure that is in the cards for us. If not, we would absolutely love an adopted child as much as any we would create.
Favorite recipe:
We have an extremely well-loved dish called Pasta Bake. When we lived in Georgia, we were a known crash pad for friends, family and friends of family who became like family. If I texted that Pasta Bake was on for dinner - ALL of them showed up.
Weirdest thing that ever happened to you:
In 2008 when my dad passed, a financial lending organization placed the deceased status under my name on a card we held jointly. It spread everywhere, and even suspended my license somehow. I received letters in the mail addressed to “The Person Handling the Final Affairs of the Late Susan Dye”. My friends even threw me a funeral. I’m happy to report that I’m alive and well now.
Things people do not know about you that you wish they did:
I love empowering and encouraging people, and I try to do that as much and as often as I can. I will be the first to celebrate your victories and soothe your troubles by reminding you of just how incredible you are. Having a bad day and need a cheerleader? Having a great day but think it could be even better? I’m your girl. Let me tell you why you rock.
Household chore you LIKE to do:
Clean the floors. Lavendar Fabuloso floor cleaner is a scent made for the gods.
Your family includes:
I have my wonderful mom, sister, brother, husband, a dad in heaven, nieces and nephews, and a million children in my life who call me “Uncle Susan.”
Which cartoon character do you think you relate to most & why?
Oh, that’s a tough one. Spongebob maybe? He’s always up for an adventure and has an annoyingly positive outlook on life.
SOLUTION 1 Medical Implant Solution Powered by
United Claim Solutions is pleased to announce that our newest Cost Management Solution is designed to effectively limit plan liability for Medical/Surgical Implants. This solution offers our clients the ability to reprice implants with laser-like focus, and dramatically reduce the cost of such items.
The Challenge
Determining the reasonable price of medical implants is a common source of frustration for Payors, Carriers and Health Plans alike. The absence of a UCR-like database leaves few options available, and Providers have therefore been free to charge excessive mark-ups over their acquisition costs. Attempting to secure legitimate invoices is frequently met with resistance/avoidance from the Providers, and ambiguous Plan Document language often fails to protect the Health Plan upon appeal.
UCS Implant Solution
With the information now available to UCS, we can review all claims with implants and offer our Clients a factual data-driven resource as to the cost of those devices. Based on plan language or the Client’s specific instructions, UCS can determine a reasonable mark-up for the implant(s), and reprice the claims accordingly.
UCS Data
Our unique collection of medical implant data includes the following:
240,000+ Unique Implants
374
Implant Categories
700,000+ 555,000 4,800+ Price Ranges
Implant Price Points
Implant Vendors
3,100+ Reporting Facilities
As is the case with many UCS Solutions, we recommend that a review of your Plan Document language is in order‌ and that it take place before a claim is received. Protecting your Plans from excessive liability upon appeal is a critical factor in the success of this program, and UCS is willing to assist our Clients with this amendment and pay for the review of your Master Plan Document Language.
NEW!
For In-Network & Out-of-Network Claims!
Offered at a % of Savings!
SHOWCASE
e l b u o D ty Du
2 Next Level Reporting & Analytics As your Out-of-Network Cost Reduction Partner, United Claim Solutions (UCS) is provided with and maintains data which can be very useful in the analysis of Non-Par claim exposure. With our experienced team and resources, we can put that data to work for you; helping to identify areas where future OON costs might be avoided. Aside from the Detailed Savings Analysis, which UCS provides to clients and prospects which outlines how we can reduce costs through the application of our various solutions, UCS has the ability to provide additional reporting at the "Next Level." These drill-down reports offer a perspective of your OON claim experience which might not be recognizable in a day-to-day, claim-by-claim environment. Through the aggregation of claim charges and the bundling of medical codes, UCS provides a thought provoking look at the most costly OON claim characteristics. Top Dollar OON Providers ■ Which OON Providers have submitted the highest aggregate charges? ■ Can the Primary PPO work to contract with these Providers? ■ Does a Narrow Network option make sense? ■ How can UCS help to minimize these costs? Top Dollar OON Services ■ Which medical procedures rank highest in aggregate OON charges? ■ Is there a lack of Primary PPO services for these procedures? ■ Does a Narrow Network option make sense? ■ Does the Plan Document need to be addressed with regard to these procedures? ■ Would a wellness program or EAP help to eliminate some of these services? ■ How can UCS help to minimize these costs?
QUESTION:
How do I get my “Next Level” reporting?
ANSWER:
Ask your account manager for it! Simple as that!
Top Dollar OON Diagnoses ■ Which diagnoses rank highest in aggregate OON charges? ■ Is there a lack of Primary PPO services for the treatment of these diagnoses? ■ Does a Narrow Network option make sense? ■ Does the Plan Document need to be addressed with regard to these conditions? ■ Would a wellness program or EAP help to eliminate some of these conditions? ■ How can UCS help to minimize these costs? Top Dollar OON Members ■ Which Members under the Plan rank highest in OON charges? ■ Would a wellness program of EAP help to eliminate some of these costs? ■ Could a Case Manager be invited to speak with these Members about PAR options? Next Level Reporting: In addition to these standard "Next Level" reports, UCS can help to provide other customized reporting which allows you to clearly apply your expertise as Health Plan and Benefit Consultants. Our goal is to help you manage your OON Health Plan claim costs, and we understand that some of those controls must be implemented before a claim is incurred. We trust that these reports, and others that you may request, will assist you in retaining more of your clients, and attract the attention of your prospects.
7
BENEFITS of SWIMMING
Helps manage weight
Expect to burn around 367 calories after just 30 minutes of breaststroke – that beats walking, cycling and even running. The Calorie Cruncher on swimming.org can tell you how many calories your preferred swimming stroke burns.
Reduces stress levels & raises self-esteem
According to a survey of 4,000 swimmers undertaken by Speedo, 74% agree that swimming releases stress and tension, 68% say that being in the water helps them to feel good about themselves and 70% feel mentally refreshed after swimming.
Boosts your mood
Another study shows that swimmers, no matter what level, are less prone to tension, depression, anger and confusion when they’ve been swimming. It means that novice and amateur swimmers can feel just as good as the pros, thanks to the release of feel-good hormone serotonin.
Strengthens muscles
The resistance of water can be 44 times greater than air, meaning you have to work harder to move through it. It’s like working out with weights or machines without the need for expensive equipment, which makes swimming an affordable way to strengthen your muscles.
Low-impact & sweat-free exercise
You’re only bearing about 10% of your weight when you swim due to the buoyancy of water. With greater ease of movement and less strain on bones, joints and muscles, swimming has a lower risk of injury than many other forms of exercise. As a swimmer, you’ll never get overheated or feel sweaty because the water around you is constantly cooling you down!
Improves your sleep
People who undertake vigorous exercise such as swimming are around twice as likely to report on having a good night’s sleep, according to a poll by the National Sleep Foundation. They’re least likely to report sleep problems, with most avoiding problems like insomnia and waking too early.
Lowers disease risk
Not only is swimming kind to your heart and a great form of cardiovascular exercise, it’s also shown to control blood sugar levels, lower blood pressure and reduce levels of bad cholesterol in your blood. So by swimming regularly, you’re less likely to develop illnesses like type 2 diabetes, heart disease and stroke.
Source: https://www.tescoliving.com/articles/8-reasons-why-swimming-is-the-best-way-to-lose-weight-and-get-fit-quickly
EMPLOYEE BIRTHDAYS: July 10: Shawna West, Account Executive
ANNIVERSARIES: July 1:
Patty Beissel, Account Manager 12 Year Anniversary
OFFICE CLOSURES: July 3 - 4 in Observance of Independence Day
JULY CLIENT CONTEST:
2 How long does a single taste bud live? A. 5 Days B. 10 - 15 Days C. 30 - 60 Days D. Forever
SEND SUBMISSIONS TO:
Amanda Hertig - Marketing Specialist Email: ahertig@unitedclaim.com
CHANCES TO WIN!
Thank You for Reading!