1985-04-17 Public Hearing and Regular Meeting

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• Estimated Net Savings: James Benefits projects an estimated net savings of at least .24% of total paid claims. This results in a dollar savings of (.24% x 388,083 = $931.) D. Employee Hospital Bill Review Incentive It is not uncommon for hospital billing errors to occur. Unfortu- nately the dollar amount represented by a hospital billing error can be much greater than those occurring on routine grocery bills or automobile repair bills. n u ii Hospital billing errors cost both the City and the patient unnecees- sary expense. With the proper incentive, patients can be motivated to review their hospital bills and correct any identified errors. When patients review their hospital bill prior to discharge or imme- diately thereafter, there is a high likelihood that they will discover obvious hospital billing errors. Proposed Changes: James Benefits encourages the City to include an Employee Hospital Bill Review incentive to encourage employees to review their hospital bill and correct any identified errors. It is suggested that employees be reimbursed 50% of the corrected overcharged hospital billing amount up to a maximum of $250 per confinement. Estimated Net Savings: James Benefits projects an estimated net savings of 0.24% of total paid claims. This results in a dollar savings of (.24% x 388,083 = $931.) E. Pre-Admission Testing and Outpatient Surgery When in-patient surgery is required, a successful method of reducing the number of hospital days is to have the required diagnostic testing performed on an out-patient or re-admission basis. The plan should require that testing be complete wit in ive days of the con- finement to assure that it will be medically valid. Additionally, many surgeries can now be safely performed on an out- patient basis. The cost advantages of avoiding a hospital admission are obvious. .~1'T1ES BEI'lEfttS