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Transcripts For SFGTV 20140817

Accuracy. And again, things shading where uhc did much better with over all accuracy, from improving doing better than eight of the past, since the audits that we have completed. The payment accuracy, and this is one, where uhc barely missed our standard at 9748 uhc, our standard is 9950. So, because of the frequency, of errors, just barely missed or satisfaction level. And here is where we get into the over payment and the under payments for the errors. And for insample we have a total of 12 errors and 9 insample errors and three out of sample errors. Of the errors identified, four of the errors were manually adjudicated errors related to medicare coordination of benefit and two were related to charges that were incorrectly denied. And uhc did agree to all four of these errors and reprocessed the charges, prior to our audit and so uhc did know about these error and did correct them prior to the audit. We also have two errors, and regarding two out of sample errors. And regarding anxil

Transcripts For SFGTV 20141116

Multiclarity base and there was a transparency resolution passed by the board of supervisors and that claims be moved to all payers claims data base and in june the Health Service board approved the wellness plan and a key component of that wellness strategy of the wellness plan is the database. Some of the work weve been doing in items now coming in together. As we look at our milestones, i have already just called out some of the first few ones dating back in 2012 to 2013 and really we have spent all this year trying to realize that goal out of those resolutions, to that end we did in january of this year bring to the board our recommendation on the 205 budget which included the claims data base. In february of this year we included the blackout notice for the rfp and did release that in march. In june the wellness plan which is an integral part for our Going Forward strategy and also in june the rfp process wrapped up and we noted our notice of intent and we have spent direction neg

Transcripts For SFGTV 20140818

Provide us with information to determine what is the over all impact. And are the over payments or under payments . And so that is just. Why dont you apply it . We dont believe in extrapolating out to say, because we had a 5 error here that means that it is 5 Million Dollar error in the universe. Why not . So it is just our they have done an analysis and determined that is not the process that we utilize and but we do work one on one. We do work one on one with the administrators to determine, the over all impact. And in the universe. So it does not mean that we stop at the sample, we work closely with them to determine, how many claims are affected. Other questions, from commissioners . So, you know, sample of the claims, what percentage of that in the total universe . It is, we use an error of driven formula, to select our sample. And it is not a, we are not taking a percentage of over all universe of claims. Understood, but what percentage of that 220, is two percent of the total un

Transcripts For SFGTV 20141115

Vp of account management in addition erica, the Business Manager of our Chico Service center and shes here to let you know how those new process has resulted in some test calls and procedures that weve done. Erica barlson. We have implemented in the packet before you. Once implemented we started doing testing. So weve been testing for the last week and we also provided some review over the accounts as well. With that, what we did find was that there was a call with human error and based on that we are going to continue to identify ways to train the individuals to continue to focus on training as well as coaching individually one on one. Thank you. Questions, comments from commissioners . Yeah, i made a couple of phone calls again and had a couple people make phone calls. The anybody thats on the back of the card, one of the numbers should probably be eliminated in my opinion because it was so aggravating and actually the nurse hotline is the best number but that is not in the back of t

Transcripts For SFGTV 20141114

Not asking for the actual bids. I was with a public candidate for a substantial part of my career, i know that we had vendors provide a public response and one for proprietary. Im not down to that detail, im just suggesting that upon conclusion of a project of this nature it would be helpful to know who the panel was and what the criteria were used to make this selection. Its very simple. I went on the website trying to find this document and spent couple of hours trying to do so and i couldnt find anything say all claims data base. I think we get kicked out of here at 4 00. Im sure we can do this in the future. I think its a great idea. I think we need to think about before we bring contracts to you because there are many, that we provide all the information to make it so that you are informed, and i totally agree with that. I dont mean to be argumentative. I think its great and being over the contract area we can provide the information that you want. Great. Thank you. Any other ques

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