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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 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 20140814

Adjusted and they say that i dont want you telling me that it is adjusted in ten days, but i want you to call me to tell me that it has been adjusted i dont want to assume that it is done, i want that confirmation and they asked for, a commitment from them to give them a call. And being able to track the keeping of the commitment from the member, if you tell them that you will call them on a certain day, did you really do it or not . And most administrators do not have the external reporting capabilities to show if they are keeping the commitment with the member and there is a lot of noise generated by unhappy members that dont get a call back. And so we want the reporting to be provided and there is only two that can do it and it is only for the select clients and we want uhc to do it but today they are not able to do provide those to clients. It is complicated for the members who have medicare, and i try to track the bills, and because the time being and you dont know when you hit yo

Transcripts For SFGTV 20140815

In time for a september Board Meeting and we could certainly keep in touch and look at those, but to your point, if there is no october meeting it will be move before the final, final will be done and it is just a timing matter. And you know, i can certainly, connect with our audit team and find out. That would be good. Obviously, they are guide interested. Absolutely agree. Agree. Thank you. Any other Public Comment . All right, seeing none, this is not an action item and we are not approving at this point. Why dont we take a i am sorry, under estimated, how long this will take, and i note that we have different times as everyone noticed that . And the problem is that the public cant see that. And so using this one, let us be back at 2 40. Next item please. Item 7, approval of wellness plan, director dodd. The wellness report . So you have seen this before. And i know that stephanie worked with president frasier on her concerns on it. And so we want to bring it back to you for final a

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