Sales Training For TheHealth Advantage Membership

Presented By: Felicia Betancur and Teresa HeinitzDate: July 31, 2017

Selling Karis360To Your Customers

Today’s agenda

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• Background and focus of The Karis Group• What are Karis360 Services? • What types of services are provided?• Why do our members love Karis360 services?• How do members obtain services? • What can members expect?• Selling Karis360: The Basics • 12 common questions• Test time

Value-added service – now available

• {Add text and product sheet that portrays where and how Karis360 services are made available}

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Introducing The Karis Group

What does Karis do for us?

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The Karis Group serves customers who have membership in Karis360…

• The Karis team works directly with members, focusing on relevant solutions for each member

• Member gains an expert working on their behalf• May serve before, during and after a procedure or medical

event• In this role, members gain…

• Relevant, timely information • A better understanding of complex healthcare processes• Addresses member specific issues or problems• Reduces out-of-pocket portion of medical bills after

insurance, if any, has paid claims

History of service

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• Founded in 1996 by Drs. Tony and Felicity Dale

• Helping people navigate the complexity of this marketplace before, during and after a healthcare event

• Serving over 1 million people• Located in Austin, Texas

The Karis Group celebrated its 20th

anniversary in 2016

Strategy and approach

• Karis is based on the Greek word meaning “grace” • When working with The Karis Group, you will always

witness a certain grace and kindness when they’re serving members, providers, and in their overall approach to work

• The Karis Group’s core values integrity, humility and excellence, guide their daily interactions

• Faith-based business model helping members achieve desired outcomes within the healthcare marketplace

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What is a faith-based business?

• The Karis Group bases its business on Christian beliefs and a business model where they hold a higher purpose in their daily work, beyond financial success

• Not unlike many larger and quite successful entities such as Chick-fil-A or Hobby Lobby, Karis applies its principles in everything they do

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One example of a “higher purpose”

• Each month, The Karis Group sets aside 10% of the company’s profit for charitable causes in Austin, Texas, and around the world

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On February 25, 2017our team attended the blessing and dedication of a “tiny house” that took Ramon (pictured above) from being homeless to a brighter future.

Business focus

• The Karis Group is focused on making healthcare work by…

• Providing a complementary service solution to the Health Advantage Membership- that adds value to your product and service offering – our trademarked Karis360 solution

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What is Karis360?

Let’s start with what it is…

• Karis360 is…

• A concierge-type service where members are served by professional Advisors

• Getting results for people who are dealing with the healthcare marketplace – before, during or after an event

• Services are accessed via a toll-free number or open an inquiry (“case”) via Karis’ website

• Only available to its members

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…and what it’s NOT!

• Karis360…

• Is not insurance

• Does not provide money to pay bills or claims

• Results can not be guaranteed – outcomes are unique and vary with each member situation

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Introducing Karis360® services

• We offer a customized version of Karis360 which includes 4 services…

• Karis Healthcare Navigator®

• Karis Surgery Saver®

• Karis Bill Negotiator®

• Karis Chaplaincy ServiceTM

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Karis360Healthcare Navigator®

Karis360

Healthcare Navigator®

• Based on member input and preference, an Advisor will search for doctors, hospitals and other healthcare providers in the member’s area and schedule their appointments, if needed.

• Advisors will assist the member in finding the most affordable & convenient solution to their prescription drug needs

• Karis360 Advisors will provide cost estimates for various outpatient procedures including X-rays & mammograms, colonoscopies, MRI, lab testing

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Karis360

Healthcare Navigator®

• Member Advisors can help find alternative care in areas such as Acupuncture, Massage Therapy, Homeopathic and Naturopathic medicine

• Your Advisor will schedule your primary care and specialist visits, labs, imaging, flu shots and more all on your schedule and at your convenience

• Karis Member Advisors can organize the transfer of a member’s medical records between providers to ensure their care providers are working with accurate information while saving members the time and effort of getting this done

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Let’s examine 6 ways members can use

Healthcare Navigator…

Karis360

Healthcare Navigator®

•#1 Provider Searches

• Based on member input and preference, an Advisor will search for doctors and/or hospitals and other healthcare providers in the member’s area to provide options for the member and schedule their appointments, if needed. Members only need to contact Karis Member Services, and they will do the rest!

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Karis360

Healthcare Navigator®

•#2 Prescription Drug Cost Comparisons

• Help members with drug searches and price comparisons. Advisors will assist the member in finding the most affordable & convenient solution to their prescription drug needs

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Karis360

Healthcare Navigator®

•#3 Health Cost Estimates

• Karis360 Advisors will provide cost estimates for various outpatient procedures including imaging like X-rays & mammograms, colonoscopies, MRI, lab testing and so much more, helping members know what to expect before their appointments

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Karis360

Healthcare Navigator®

•#4 Help Identify Alternative Treatment Options

• Member Advisors can help find alternative care in areas such as Acupuncture, Massage Therapy, Homeopathic and Naturopathic medicine

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Karis360

Healthcare Navigator®

• #5 Appointment Scheduling

• Your Advisor will schedule your primary care and specialist visits, labs, imaging, flu shots and more all on your schedule and at your convenience

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Karis360

Healthcare Navigator®

• #6 Medical Record Transfer

• Karis Member Advisors can organize the transfer of a member’s medical records between providers to ensure their care providers are working with accurate information while saving members the time and effort of getting this done

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More about Karis360…

Karis360

Surgery Saver®

• Helps members when a non-emergency surgical procedure is being considered

• Karis’ specialized Advisors provide a cost, quality and availability comparison of up to 5healthcare facilities in the member’s area

• Comparison includes the prescribing physician and their preferred facility

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Karis360

Bill Negotiator®

• The Karis team of experts focus on reducing the member’s out-of-pocket portion of medical bills after insurance benefits have been applied, if applicable

• Members can access Karis Bill Negotiator after a single, related medical incident where the combined total of medical bills exceeds the threshold of $1,000

• The overall savings discount earned through negotiations of the out-of-pocket portion of medical bills typically ranges from 40% to 70%

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Tangible financial outcomes

• Since 2005, the Karis Bill Negotiator service has

provided over $200 million in total savings for members and effectively reduced

the member’s medical bills/amount owed by 70%• After Karis goes to work, about 24.7% of

members end up owing nothing on their outstanding medical bills

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Karis360

Chaplaincy ServiceTM

• At any stage in a member’s healthcare experience, from learning a diagnosis or facing life-changing decisions, a member may need emotional and/or spiritual support

• Karis Chaplaincy Service provides compassion and understanding

• Chaplaincy Service is available to assist members when the stresses of life become overwhelming. All the member has to do is reach out to the Karis Member Services team

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Why do people contact Karis?

• To save money on the out-of-pocket portion of their medical bills

• To secure concierge-type support services such as finding a doctor, specialist, facility, transferring medical records, or help in setting appointments

• For assistance in searching and comparing facilities, providers, prescription costs in their market

• To explore options for their non-emergency surgery, including quality and cost comparison

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Why do people love these services?

Delivering a great member experience

The services of Karis360 assist members by…• Helping clarify complicated healthcare subjects• Reducing out-of-pocket medical bill expenses • Locating affordable and quality healthcare services• Providing a pleasant and helpful experience• Providing timely, relevant and professional service

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How long does Karis360 services take?

• Majority (90%+) of Healthcare Navigator inquiries are resolved in one call

• Majority of Surgery Saver calls and gaining the detailed comparative data is completed within 5 business days

• Majority of Bill Negotiator services are completed within 4 to 6 weeks. Time to complete varies widely based on the complexity and number of out-of-pocket bills being worked. The overall average completion time is 42 days (2016)

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What members are saying…

“Thank God for Karis360, they helped a lot with doctors and the plan information we needed - thanks..”

“Timely, personable, knowledgeable and very pleasant!!!!”

“My advisor was pleasant, helpful and very kind. She walked me through each step and I found all my doctors quickly”

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What members are saying…

“Karis360 does a great job in getting prescription pricing for its members.”

“We are very impressed and happy with the excellent help we received”

“My advisor was the sweetest and most helpful person I have come in contact with for a long time-she was genuinely concerned about my situation.”

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How do members obtain Karis360 services?

How do your members obtain service?

Member Inquiry

Once enrolled in Karis360 services, eligible member calls the toll-free service number to request Karis360 services.

Service is Described

Karis listens, triages the inquiry, sets expectations, briefly describes the service and what action or outcome can be expected

Member Inquiry is Resolved

Many requests are handled in one-call or it is resolved after further work, with updates to the member, keeping them informed until

resolved

Conclude Call and/or Complete Request

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Ready to serve • Members may reach The Karis Group for service 3 different ways

• Through a Karis-administered toll-free phone number personalized for your Health Advantage Membership program (provided during Implementation). If all team members are busy, the member will have an option to request a call back retaining their place “in line” or may opt to leave a voicemail.

• The member may leave a voice message and a Member Advisor will return a message within four hours during business hours (Monday – Friday, 9am – 5pm Central Time) or next business day if after hours or on holidays

• Or by going to our website (www.thekarisgroup.com) to request service by clicking on “Member Access”, then “Open A Case” in upper right corner of home page

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What can members expect?

What can your members expect on the first contact?

Karis Member Services Advisor

will triage the member’s need and determine what type

of need it is: Healthcare

Navigator, Bill Negotiator or

Surgery Saver.

Advisor will handle all smaller needs

quickly, if the need requires more time they will describe

the service, approach, timeline

and answer any questions.

Advisor will provide the member with

their direct contact information (email,

phone, fax, etc.)

Note: If Bill Negotiator case is

opened, the Advisor will explain to the

member they will be assigned a skilled Patient Advocate who will negotiate

the eligible medical bills. They will

educate on next steps and that the

Advocate will reach out to the member within 2 business

days.

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Privacy and confidentiality

• The Karis Group takes measures to protect the members’ personal and health information

• When needed to perform our work, The Karis Group will obtain from the member, a Medical Information Release Form, enabling them to legally work on behalf of the member, performing certain tasks such as negotiating bills

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Selling Karis360: Know The Basics

Selling Karis360

• Know how to explain the primary component services; Healthcare Navigator, Surgery Saver, and Bill Negotiator

• Membership is all about helping people deal with the complexities of the healthcare marketplace

• Membership provides comprehensive support by phone --before, during and after a healthcare or medical event

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12 Common questions

Common questions

• Q1: How does a member access Karis360 Service?

• Members call a Karis-administered toll-free phone number personalized for the Health Advantage Membership program, Monday to Friday 9:00 a.m. to 5:00 p.m. Central Time or email anytime at help@karis360.com

• Q2: What is a related medical incident?• A medical event or condition (i.e. an injury, ailment) existing over a

given time period requiring medical treatment such as an overnight stay in a hospital or going to a surgery center• This service does not apply to ongoing care for chronic

illnesses or outpatient testing

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Common questions

• Q3: Can a member’s spouse and/or family members use Karis360 services?

• Yes, a single membership provides benefits to the member, their spouse, and eligible dependents residing in their household under 26 years old.

• Q4: Will Karis360 help me with issues that occurred before my membership went into effect?

• No, as with most other membership programs, the service begins with the first day of membership and continues as long as the member and their family are enrolled in Karis360.

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Common questions

• Q5: Will Karis360 give me medical advice?

• Karis360 Advisors do not provide medical advice and always recommend you speak with your doctor about any diagnosis or treatment questions

• Member Advisors do not recommend types of physicians, if a member is unsure which type of doctor they need, the Advisor will locate a primary care or general practice physician for the member

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Common questions

• Q6: Does Karis call its members?

• Once a case is opened, the only time Karis would call a member is to provide an update on the case, or to gain needed information in order to provide the required services

• Q7: How often is Karis in contact with members who have requested Bill Negotiator?

• Specific to Bill Negotiator cases, after the initial contact with the member, Advocates reach out to members every 10 days to update them on progress, the work that is underway, and keep them up to date regarding the process

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Common questions

• Q8: When does The Karis Group begin working on a new case?

• Advisors start working immediately on the case with the initial call from the member

• In many cases, a signed Medical Information Release Form is required for Karis to work on the member’s behalf

• Member eSigns the form and sends any requisite bills, or other documents as applicable, via fax, mail or email, whatever the member prefers

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Common questions

• Q9: What if a member never sends in their Medical Information Release Form when required?

• Karis will contact the member at least 3 times via phone, email or mail at 10 day intervals over 30 days before closing the case. A case can easily be re-opened once we receive the signed release form

• If a client’s customer service team submitted the case, they will be notified via email when a case has been closed because of a lack of response from the member

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Common questions

• Q10: Are there any exclusions?

• Bills for prescriptions, mental health, abortion procedures, or substance abuse treatment are noteligible for Bill Negotiator (bills from injuries caused by mental health or substance abuse problems are eligible)

• Bills from providers located outside the United States are not eligible for bill negotiation services

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Common questions

• Q11: What about chronic conditions or diseases?

• Karis handles these situations on a case by case basis in consultation with our team

• Karis’ intent is to assist the member whenever possible, but their service is not designed to be used indefinitely

• When these situations arise, Karis will confer with the member, our team, and agree on an approach that is satisfactory to everyone involved

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Common questions

• Q12: Does Karis360 pay medical bills for members?

• No, Karis is not an insurance company, it does not pay any medical bills or pay any claims on behalf of Karis360 members

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Time for a test!

Thank you for your time and attention!

(c) 2017 The Karis Group. All rights reserved. Karis360, Healthcare Navigator, Surgery Saver, Bill Negotiator are registered trademarks.

This document is for client internal training purposes only.

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