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HomeMy WebLinkAboutMINUTES - 09092014 - C.59RECOMMENDATION(S): ADOPT Position Resolution No. 21514 to add four permanent full-time Account Clerk-Experienced Level (JDVC)positions ($2,980-$3,695) and one (1) Clerk-Experienced Level (JWXB) position ($2,712-$3,365) in the Contra Costa Health Plan division of the Health Services Department. FISCAL IMPACT: Upon approval, this action will cost approximately $346,366 annually. This cost will be offset by Health Plan member premiums. BACKGROUND: The Contra Costa Health Plan is requesting additional staff in its Claims unit for the following reasons: In the past four years, Contra Costa Health Plan's Claims monthly volume has gone from 35,000 to 75,000 (projected for the end of this year.) In 2014 due to the Affordable Care Act, CCHP has added over 35,000 new members and that number is expected to reach 50,000 by the end of the year. This growth in membership increases the workload in claims processing, provider phone calls, provider disputes, refund and reimbursement requests, and auditing. In 2013 CCHP was audited by the CA Department of Managed Healthcare and was found deficient in timeliness of claims APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 09/09/2014 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Candace Andersen, District II Supervisor Karen Mitchoff, District IV Supervisor Federal D. Glover, District V Supervisor ABSENT:Mary N. Piepho, District III Supervisor Contact: Kristen Cunningham, 925-957-5267 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: September 9, 2014 David Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: C. 59 To:Board of Supervisors From:William Walker, M.D., Health Services Date:September 9, 2014 Contra Costa County Subject:Add Four (4) permanent full-time Account Clerk positions and One (1) permanent full-time Clerk position in the Health Services Department BACKGROUND: (CONT'D) payment, and in the effectiveness of our provider disputes process. Due to this audit CCHP is working under Corrective Action Plans, was fined $20,000 and had to go back and audit 3 years of claims payments which totaled over $300,000 in additional payments and penalties. If the Claims Unit does not maintain and improve on its performance, CCHP will fail its next audit and again be fined. Also, if CCHP doesn't stay timely in claims processing, interest charges will be incurred which has improved from payments of $1.5 mil in FY 12/13 to $800k in FY 13/14. The cost of not having permanent positions, or the flexibility to recruit and hire qualified staff causes a direct fiscal impact on Health Services. > CONSEQUENCE OF NEGATIVE ACTION: If this action is not approved and without additional staff, the Claims unit will not be able to meet the mandated requirements of the Health Plan. CHILDREN'S IMPACT STATEMENT: Not applicable. ATTACHMENTS P-300 #21514