Training Description: FH Business Process Model refers to the business organization model of the FH Group and gives us a view of all the areas of expertise within the Group, as well as how they operate and interact with each other. It refers to the set of activities performed by each area on a daily basis and is the basis for the management of Retail or Corporate businesses. They are organized in a consistent way so that one can understand the Group's performance and its organization.

General objective: Understanding how FH Teams operate and interact with each other and wich are the main activities they performe on a regular basis as well as how does FH interacts with our Clients.

Learning objectives:

The participants should be able to:

A. Understand the markets development; Define the value proposition; Understand how products and services are defined; and Know how Brand and Services are promoted.

B. Manage Sales Channels; Provide information to Clients; Assess Health Conditions; and Issue and send contract documentation & health cards.

D. Know how to Manage Network, from analyzing the Market Benchmark to gathering information on prices and services; Receive, identify and provide feedback to Clients; Perform elegibility checks; and Understand how to process co-payments and deductibles;

E. Understand how clinical information is gathered and upload; Know how clinical assessment is performed; Apply the pay to providers process and steps; and Know the quality audit and analysis processes;

F. Understand customer communication; Know hoe to manage the contract requests and premium collections; Understand how contracts can be renewed; Define Client satisfaction; Access the financial performance of products and services; and Manage complaints.

Programme contents:

• Module A. Develop Brand, Product and Services:

1. Define Target Segments and Clients
2. Define Value Proposition
3. Design Products and Services
4. Promote Brand
5. Promote Services

• Module B. Sell to Customer

1. Manage Sales Channel
2. Provide Information to Clients
3. Assess Health Condition (Medical Underwriting)
4. Enroll Clients

• Module D. Provide Medical Services

1. Manage Medical Network
2. Schedule Appointments
3. Perform Elegibility
4. Process Co-payment and Deductibles
5. Authorize Procedure

• Module E. Manage Utilization

1. Assess Clinical Status
2. Reimbursement Client
3. Pay to Providers
4. Assess Quality
5. Audit and Prevent Fraud or Abuse
6. Assess Product and Service Financial Performance

• Module F. Manage Client Relationship

1. Support Client
2. Manage Contract Requests
3. Manage Premium Collections
4. Renew Contracts
5. Manage Overdue Collections
6. Retain and Winback
7. Assess Client and Contract Financial Performance
8. Assess Client Satisfaction
9. Complaints Management

Training Methodology:

This training is based on the expository method, where the topics will be presented one by one to the participants. The fundamental themes of this subject will be explained, adapting the language to a general target audience that does not necessarily have previous knowledge of the subject. Examples will occasionally be used to explain certain cases.

Technical Requirements:

Functional computer equipped with speakers and Internet connection. 

Assessment Methods:

Assessment will take place in one stage at the end of each module: a summative and final assessment in the form of a selection questionnaire (multiple choice and true or false). To complete the each module and the course successfully, the participants must have a minimum mark of 80%.