CLIENT UPDATE
Account Executive Start Date:
November 19, 2009
Experience:
Like my father and his father before him, and all the male members of my family, my professional career began in the construction industry. I was a project manager for many years before the construction crash in the early 90’s, which ultimately directed me to a much steadier industry – health care cost containment and to UCS.
Hobbies:
• Spending time with my family, camping, hunting, fishing, quad and side-by-side outings, and time on our pontoon • I am also a licensed foster parent, minister, and notary
Strengths:
• Organization - Give it to me, I will process it, put it in a format & tie it up with a bow • Dependability - If I say I will be there, I will be there. Thanks mom & dad for the great health - I have yet to miss a day of work calling in sick • Wittiness - I get it... tell the joke and even though I am blonde, I usually get the punchline and have to explain it to my friends
Weaknesses:
• Patience - My grandmother always said “I want what I want when I want it, and I want it now.” I typically live by this - not always a good thing • Food and consumption thereof – always a challenge to pass up all the things I know I shouldn’t – but I try • Over amping – I love to “ride a bicycle with roller skates on” – I have to slow the pace sometimes
Who is your role model & why?
My grandmother, Vera Watson, will always be my role model. Even though she is no longer here for me, I find myself thinking of how she would handle any situation I am in. She taught me the secret – “you can’t be happy with anyone else, unless you are happy with yourself, and so, you must be happy with yourself.” Of course another of her favorites she passed on to me was “if you want a helping hand, look on the end of your arm.”
What is your greatest accomplishment?
I’d like to think the best is yet to come, but I will say I have two beautiful children: a daughter (Tamra, 33) and a son (CJ, 31). They have blessed me with 8 grandkids between them. I am a “daily” grandparent – although I am not sure if they keep me young by listening to Metallica or if the gray is getting grayer!
What major goals do you hope to accomplish someday?
Raising my three granddaughters to be happy, productive, well-rounded individuals. One of the most important accomplishments for me is to ensure that they are not educationally cheated.
Things people do not know about you that you wish they did:
I am one of the proudest native Arizonans on the planet – and if you know Arizona, you know why that is a big accomplishment! Not only am I a native, I am a fifth generation and have two more generations after me – most people that live in Arizona are transplants – I love sharing stories with the newcomers about “what used to be there.”
Favorite TV Shows / Movies?
I am addicted to “This Is US” on NBC. My favorite movie is a tie between “A River Runs Through It” and “Legends of the Fall.”
Favorite Quote or Life Motto:
Life is all about how you handle Plan B
Favorite recipe:
Anything I can cook with my 10 year old granddaughter Brooke – she is going to be a chef when she grows up
Last thing you purchased online?
Checkboard Vans for my 14 year old granddaughter Kylie – she HAD to have them!
Household chore you LIKE to do:
I am a houseplant fanatic – I LOVE nurturing – I like to think I can bring anything “back to life.”
I just learned how to:
I am working on sewing. I just bought a sewing machine, but let’s just say I have yet to create anything I would brag about.
Favorite board game?
My son recently introduced me to “Cards Against Humanity” – funniest game ever! I am not much into sitting & playing games. I can’t sit still that long.. (hence the patience as a weakness)
Your family includes:
My mother, God rest her little soul was 5’2” and 103 pounds, yet she bore 5 of us, and to say it nicely, none of us are petite! I have twin sisters that are younger than me (but people always ask who is older) and two brothers (one older, one younger). There must have been something in the water, because (with the exception of the twins), we are all three years apart. My mother was also a twin. Unfortunately, my older brother is our oldest living relative ~ we lost our grandmother, aunt, mother and father all in a 9 month time frame about 10 years ago.
What cartoon character do you think you relate to most & why?
I guess I’m going to have to say Daisy Duck – you know, the mothering type.. that’s me!
Accounting
REMINDERS 1
Please reference the invoice number on the payment backup, so we can apply it to the correct invoice.
2
Please make sure you are sending payment to the correct address: United Claim Solutions PO Box 1007 Caldwell, ID 83606 TIN: 81-5149270
Solution Showcase
Medical Implant Solution Powered by United Claim Solutions is pleased to announce that our newest Cost Management Solution is designed to effectively limit plan liability for Medical/Surgical Implants. This solution offers our clients the ability to reprice implants with laser-like focus, and dramatically reduce the cost of such items.
The Challenge Absence of UCR data makes it difficult to determine reasonable price Providers charging up to 9,000% of acquisition costs Securing legitimate invoices is met with resistance and avoidance from providers Plan Document language often fails to protect the Health Plan upon appeal
UCS Implant Solution
For In-Network & Out-of-Network Claims!
Offers a reasonable mark-up over cost as specified by Plan Document language at ER Group level
UCS funded drafting of effective & clear Master Plan Document language Applications for both in-network and out-of-network claims
UCS Data
Offered at a % of Savings!
Our unique collection of medical implant data includes the following:
240,000+ Unique Implants
374
Implant Categories
700,000+ 555,000 4,800+ Price Ranges
Implant Price Points
Implant Vendors
3,100+ Reporting Facilities
The Opioid Most people use prescription painkillers / narcotics responsibly. However, it is estimated that 52 million people have used the prescription medications for recreational purposes, at least once. If a medication, prescribed or not, is taken in a manner for which it is not recommended or intended, it’s drug abuse. • The biggest abusers of opioid, ADHD stimulants and anti-anxiety medications are adults aged 18-25. • Since 1999, the amount of prescription drugs prescribed and sold has quadrupled. The increase in prescription drugs has risen even though there has been no change in the amount of pain Americans report. Residential treatment is becoming necessary for more people. In 2009, information from SDI’s Vector One National database, a privately owned national prescription and patient database, was used to identify that approximately 56% of painkiller prescriptions were written for and received by people who had already received a prescription for painkillers within the previous 30 days. Therefore, the FDA has restricted the ability to obtain certain medications prior to the 30 day time span. Prescription abuse has led to other deterrents by the FDA. • Drug formulations have changed. OxyContin (oxycodone) has been reformulated to be less soluble to reduce injection of the drug. • The monitoring has resulted in changes for the warning labels on opioids • Access to medications is controlled • Opioid overdoses are treated with Narcan (naloxone). Narcan is effective for the treatment of all opioids. Narcan has been available as an injection and was usually administered by health personnel. Due to the increase in opioid use and abuse, a new formulation was developed that can be administered by auto-injector. Abuse of medications becomes more dangerous when the drugs are combined with other substances. Some of the most common opioids seen today are as follows:
BRAND NAMES • Florional with Codeine • Robitussin A-C • Tylenol with Codeine • Epririn with Codeine • Roxanol • Duramorph • Demerol
• Actiq • Duragesic • OxyContin • Percodan • Percocet • Tylox • Dilaudid
STREET NAMES • Captain Cody • Cody • Schoolboy • Doors & Fours • Pancakes & Syrup • Loads • M / Miss Emma • Monkey • Demmies • Goodfella • Murder 8
• Tango & Cash • Jackpot • Oxy 80 • Oxycat • Hillbilly Heroin • Percs / Perks • Juice • Dillies • Apache • China Girl • Dance Fever
Crisis
The signs of addiction will vary. However, behavior change (hostility, grogginess, lack of interest in normal routine, secretive behavior, failure to keep clean) is frequent. Additional signs are below: • Weight loss – Caused by lack of appetite or because eating is not the priority • Abscesses – Besides lack of sterile supplies, harmful chemicals will cause the abscesses • Cellulite – Results from repetitive injections • Scabs – Some heroin abusers pick at their skin • Dark spots on the skin and tooth decay Long term effects of opioid use can include insomnia, increased sensitivity to pain, immunosuppression (increased risk of cancer and infection) and organ dysfunction (lung, kidney). If a loved one has signs of addiction, don’t wait. Without help, the addict will continue to abuse even though there are adverse consequences to the drug use. A health risk is present for anyone in contact with the user. An accidental overdose could occur. Evidence-based treatment, with buprenorphine, has been proven effective in decreasing opiate abuse and cravings.
HOW UCS CAN HELP To help with these potentially catastrophic claims, UCS offers a Behavioral Health Facility guarantee program. Ever wonder why it was developed? Drug abuse and residential treatments programs are multiplying by the minute. With the increase in people who are addicted, it is likely there will be an increased use of the treatment facilities, which is why we are here to help! We utilize the expertise of our Certified Coding & Medicare Repricing Teams We allow Health Plans to comfortably walk away from unreasonably high charges, which provides dramatic savings UCS will assume the roles of appeals manager, negotiator & payer of addiional charges, removing the Health Plan & Payor from further noise & liability
UCS will support and guarantee all of its savings on Ambulatory Surgery Center claims, as well as Behavioral Health Facility claims related to drug, alcohol rehab, detox, residential care & group therapy. This includes appeals management, legal assistance if needed and any additional payments to the provider required to settle the matter.
EMPLOYEE BIRTHDAYS: August 5: Kurt Smith, Director of IT Security/DBA August 14: Tobey Busch, Software Developer II August 18: Renae Walsh, Provider Relations Rep August 22: Essense Garcia, Claims Processor August 28: Stacy Youngblood, Claims Editing Analyst
ANNIVERSARIES: August 15: Susan Dye Ruf, Regional Sales Manager .............................. 1 Year August 16: Marci Watson, Manager of Provider Relations .................... 11 Years August 19: Patty Kreuzer, Sr. Claims Examiner III .................................. 7 Years August 19: Linda Jenkins, Receptionist ............................................... 7 Years August 19: Ali Rose, Sr. Accounting Analyst & HR Coordinator .............. 4 Years August 25: Jordan Hersh, VP of Product Strategy & Development .......... 1 Year
JULY CLIENT CONTEST WINNERS: Question: How long does a single taste bud live? Answer: 10-15 days
Drawing Winners: Deb Eovaldi & Judith Hall ................. $25 VISA Gift Card
CLIENT TRIVIA QUESTION: Approximately how many yellow school buses transport children to & from school every weekday in the USA?
A. 480,000
B. 900,000
C. 270,000
Answer enters you into a drawing to win a $50 VISA Gift Card! SEND SUBMISSIONS TO:
Amanda Hertig - Marketing Specialist Email: ahertig@unitedclaim.com
Thank You for Reading!