Client Update
Renae Walsh
PROVIDER RELATIONS REPRESENTATIVE As I desire to learn more and expand my job responsibilities, I have come to UCS! I graduated from Carrington College in Medical Billing & Coding. My family includes my daughter Lily (age 5) and my husband Danny. My parents divorced when I was younger and both remarried, so I have my mother’s side of the family here and in Florida, and my father’s side of the family in Texas and Alabama. I have a Doxie/Poodle mix named Bella and a fancy rat named Lucy. I enjoy spending time with my husband and daughter, camping, DIY projects and karaoke. On the weekends you can find me relaxing at home, camping or on a day trip somewhere. Someday, I’d like to have a large plot of land (somewhere nice) where I can retire and live off the grid. The most interesting place I have lived so far would be Eielson, AFB in Alaska. Living in Alaska was so much fun and is a gorgeous state. I’d go back and visit anytime! I’d love to show my husband and daughter the Northern Lights. If I’m relaxing at home, my favorite TV shows are Game of Thrones, Last Man Standing and Longmire. My favorite movies are Face Off, The Fifth Element, Moulin Rouge and Grease. Quite the array!
Carrie Wicklund, CCS CLAIMS EDITING ANALYST
I’ve spent the last several years coding IP/DRG Claims, retro review and prior authorizations. My background is in Medical Billing & Coding and my main strengths are that I am a team player and that I have a willingness to learn new things. When I’m not working, I love to watch The Walking Dead! My family consists of my mom, dad, 2 sisters and 2 brothers. I have had a boyfriend for the past 7 years. He is a chef and former sailor! I have a 14-year old Dachshund named Oscar as well.
NEW EMPLOYEES! Started May 22, 2017 Stacey Youngblood
CLAIMS EDITING ANALYST My education is in Sports Medicine and I have about 15 years of medical-related knowledge. So far, the staff has been warm and welcoming. Whether the issue directly impacts your team or not, everyone is willing to pitch in when help is needed. I love to hike (which has helped me to lose 45 pounds so far), shopping and spending time with my family. I spend my weekends doing these things or lounging by the pool side. My family is too competitive to play board games, but we love the New Jersey Nets (home state) and the New Orleans Saints. My favorite movie of all time would be Dirty Dancing. My immediate family is my lovely, talented daughter who is about to embark on college & pursuing her dreams of becoming a vet tech. I have one older brother and my parents. We are the typical New Jersey family - loud, sarcastic, but most of all, determined to all live a happy and healthy life. I also have a tuxedo cat named Bello who is 14 years old. My best friend Charlie is a Dachshund (weiner dog) who will be 5 years old this November. I also have a big, Brazlin Mastiff named George who tops the scale at 180 pounds!
IN WELCOMING THEM!
MARKETING SPECIALIST Employee Since: September 15, 2015
Education: Strengths:
BS, Marketing & Public Relations HTML/CSS Certification CPC-A, Certified Professional Coder
• Considerate • Quirky • Good Listener
Best Part of Working at UCS:
I enjoy my fellow employees. They have become like family. I enjoy being creative and am glad my work is generally well-received by others. This company has a lot of integrity, which means a lot to me. Each person strives to go above and beyond, which is rare to find.
Hobbies:
• Swimming • Road Trips • Spending time with family & friends
My family includes:
• My parents - still married after 38 years • Two sisters (Pam & Liza) • Husband (Dan) • Daughter (Mary Jane)
Do you have any pets?
Ashford - 5 year old potbellied pig
What goal(s) do you hope to accomplish in the next 5 years? • Become a Marketing Manager with an office • Run (not walk) a 5K • Visit all 50 states (only 5 left to go!) • Become the best version of myself (will take longer than 5 years)
Favorite TV Shows / Movies: TV Shows: • The Young & the Restless • The Impractical Jokers • Blindspot • Criminal Minds
Movies: • Serendipity • The Neverending Story • Message in a Bottle • One True Thing
Who is your role model & why?
My role models are my parents. My dad graduated from Ohio State University with a Bachelors in Chemical Engineering and worked for the Department of Defense for 40+ years and my mom was a 3rd grade teacher before they retired early a few years ago in Henderson, NV. They raised three daughters around the same age, which brough a lot of havoc and drama, but they still managed to keep their marriage strong. They brought us up to be respectful and considerate, and that family was the most important thing. They were overprotective, but as a parent myself now, trying to raise a child with good values and a good heart, I can see why. I love them and appreciate them caring so much.
Do you collect anything? Stuffed Seals
Which cartoon character do you think you relate to most & why? Heimlich from “A Bug’s Life” We have many of the same characteristics: • Fluffy • Happy • Idealistic • Anxious • Hopeful
• Excitable • Sensitive • Quirky • Timid (until trust is established) • High Expectations
POWERED BY INTRODUCES
Medical Implant Solutions
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
Determining the reasonable price of medical implants is a common source of frustration for Payors, Carriers and Health Plans alike. The absence of a UCR-like data base leaves few options available, and Providers have therefore been free to charge excessive mark-ups over their acquisition costs. Attempting to secure legitimate invoices is frequently met with resistance/avoidance from the Providers, and ambiguous Plan Document language often fails to protect the Health Plan upon appeal.
UCS Implant Solution
With the information now available to UCS, we can review all claims with implants and offer our Clients a factual data-driven resource as to the cost of those devices. Based on plan language or the Client’s specific instructions, UCS can determine a reasonable mark-up for the implant(s), and reprice the claims accordingly.
For In-Network & Out-of-Network Claims!
Offered at a % of Saving s!
UCS Data
Our unique collection of medical implant data includes the following:
240,000+ 374 Unique Implants
Implant Categories
700,000+ 555,000 4,800+ 3,100+ Price Ranges
Implant Price Points
Implant Vendors
Reporting Facilities
As is the case with many UCS Solutions, we recommend that a review of your Plan Document language is in order‌ and that it take place before a claim is received. Protecting your Plans from excessive liability upon appeal is a critical factor in the success of this program, and UCS is willing to assist our Clients with this amendment and pay for the review of your Master Plan Document Language.
For more information on our Medical Implant Solutions, please contact your Account Manager or call us today!
(866) 762-4455
Grasping the
Anyone who is overweight, does not exercise, ages, smokes, or has a genetic tendency is at risk for developing Diabetes Mellitus type 2. (That’s just about everyone). Type 2 diabetes may develop so gradually, the affected individual may not realize the signs and symptoms are related. Genetic predisposition can’t be changed. However, lifestyle choices can affect the development of DM type 2. How does someone at risk take first steps to control diet and make it healthier? It’s a common misconception that a diabetic diet or diet monitoring means that foods need to be restricted. In other words, the foods that make life worth living can never, ever be eaten again. This is not true. The healthy eating guidelines are the same for everyone. Sweets are allowed when consumed in small portions. The same foods can be eaten by the family and preparing separate meals are unnecessary. A diet should consist of fruit, vegetables whole grains, lean proteins and heart healthy fats. • When the body is deprived of calories or there is serious diet restriction, (example cutting out all sweets or cutting portions below serving size), there will be cravings. Most diets recommend that 1,200 calories be consumed to help prevent cravings. Unfortunately, when a craving hits, most quick food choices are high in sugar and fat. A small serving of dessert, as a treat, can be incorporated into the diet. • Unless there is high blood pressure, heart disease or advisement from a physician, food can still be seasoned. All salt does not need to be completely removed from a diet. FYI: Some high sodium foods are canned soup and vegetables, cold cuts, salad dressings and some cereals. • Healthy fats aid in satiety and are necessary to prevent vitamin deficiency. However, fats are calorie dense. Fats also slow digestion. For people with diabetes or prediabetes, slowed digestion makes itmore difficult for insulin to work effectively. (Blood sugar may be high hours after a meal). While somefat in the diet is good – MORE is definitely not better. Are some carbohydrates better than others? Knowing the glycemic index and glycemic load can help when deciding what food to eat. The glycemic index (GI) is a value assigned to food. The value assigned to a particular food indicates how quickly or slowly it causes an effect with the blood sugar. A glycemic index of 100 is the same value assigned to glucose. (Remember glucose? It’s that large sugar molecule that needs help from insulin to get into the cell so it can be used as fuel). • High GI food has a value of 70 – 100, • Medium GI food has a value of 56-70 • Low GI food has a value of 0-55 So, why should anyone care? Foods low on the GI scale tend to foster weight loss and a steady blood sugar. This is perfect for people with diabetes or those seeking weight loss. A low GI food tends to release glucose slowly and steadily.
Glycemic Index
Foods high on the GI scale help with energy recovery after exercise. This is perfect following a stenuous activity (ex. hiking) or marathon runners, etc. High GI foods tend to release glucose quickly. The glycemic load identifies just how much glucose a food delivers. Ever notice the serving size on a package? Ever think that the serving size listed can’t possibly be right? (It looks so small)! The glycemic load will identify how much glucose a food delivers when the “serving size” is adjusted in real life. The amount of carbohydrate is multiplied by the glycemic index. The result is divided by 100 to obtainthe glycemic load. A glycemic load above 20 will cause blood sugar and insulin to spike. The point of the glycemic load is this: SERVING SIZE MATTERS! Even a relatively moderate GI food, if eaten in a large quantity, will cause an increase in blood sugar. Examples: bananas, grapes, kiwi, mangos, cantaloupe. Foods with a high glycemic index and high glycemic load (should be LIMITED): • white potatoes • corn, pumpkin • cranberry juice cocktail • colas • Raisin Bran, Corn Pops, Rice Krispies, Corn Chex, Corn Flakes • Kaiser roll, French Bread, donuts and bagels, flour • Jelly beans, Snickers Low GI foods are not surprising: quinoa, legumes, skim milk, leafy greens, asparagus, cauliflower, radishes, bamboo shoots, peppers, squash, tomatoes, cucumbers, broccoli, Brussel sprouts, mushrooms, pea pods, and cabbages. Have a sweet tooth? These all have a glycemic load of 7 or less: • 1 oz Dove Dark Chocolate Bar • 1 oz peanut M&M’s • 2 TBS honey • 2 tsp. table sugar Fruits with low GI: • Apples • Dried Apricot • Cherries & Plums • Grapefruit • Lemons & Limes • Nectarines & Oranges • Peaches, Pears, Plums • Strawberries
Monitoring the diet doesn’t have to be painful. It takes commitment!. Everybody “cheats” when trying to eat right. However, while a cheat meal or day happens, it’s important not to have a cheat month (or year)!
EMPLOYEE BIRTHDAYS: June 10: Carolyn Carder, Executive VP June 26: Jenna Setticasi, Software Developer II
ANNIVERSARIES: June 1:
Jorge Juarez, Regional Contract Manager 2 Year Anniversary
June 20: Shawn Dwyer, Senior Systems Analyst & QA Tester 6 Year Anniversary June 20: Josh Perkins, Controller 1 Year Anniversary June 20: Jenna Setticasi, Software Developer II 1 Year Anniversary
CLIENT CONTEST WINNER for MAY! QUESTION: Which 3 races are known as the “Triple Crown” races? ANSWER: Kentucky Derby, Preakness Stakes & Belmont Stakes WINNER: Kathy Gray - $25 VISA Gift Card
Kathy Gray
JUNE
Client Contest
Share your best or funniest summer memory with us! We will share these (anonymously) in the July edition of the UCS Client Update! Each submission enters you into a drawing to win a $25 Gift Card AND this cute adult pool float!
SEND SUBMISSIONS TO: Amanda Hertig - Marketing Specialist By Email: ahertig@unitedclaim.com By Voicemail: (602) 714-3711 Make sure to leave your name, number & company information for the drawing!