California Victim Compensation Program Benefits of Using a Bill Review Service Julie Nauman, Executive Officer California Victim Compensation Program

California Compensation Program Fiscal Year 2011/2012 Applications received: 53,373 Bills Received: 192, 462 Bill Line Items: 570,447 Payments Made: $70,422,450

California Victim Compensation Program Bill Review Service Since 1992, CalVCP has contracted with Medical Data Exchange or MDX Significant savings through: o Fee schedule o Eliminating charges for services billed that are non incident-related or consistent with the injuries

California Victim Compensation Program Medical Fee Schedule Prior to CalVCP medical fee schedule Medical expenses were paid at 100% of billed amount Accounted for 40% of CalVCP costs Payers typically use some form of fee schedule. Unusual for a payer to simply pay all medical bills in full as CalVCP did previously

California Victim Compensation Program Establishing Bill Review Service Staff previously negotiated with hospitals regarding expenses exceeding $10K Provided approx. $400,000 savings per $1.6 million submitted Even still, savings represented only a small percentage of medical bills

California Victim Compensation Program Fee Schedule Depending on solvency, CalVCP used variations of the Medicare Fee schedule to include plus and/or minus 20% Current Board approved rate is a flat Medicare rate of payment

California Victim Compensation Program Why Use BRS? Cost effective Technical expertise is needed for complicated rule-based system Requires updates to tables and interfaces with licensing boards Allows quick turnaround for changes Contractor prepared to make rate & payment adjustments to support program

California Victim Compensation Program Costs vs. Benefits BRS Costs approximately $550,000 annually BRS Provides Significant Savings $1.8 million average annual dollar savings for the contracted service vs. in-house processing of bills Over $337 million in expenses submitted to MDX in FY 11/12; $80 million paid Net cost savings of nearly $257 million;76% reduction in bill amount!

California Victim Compensation Program Thank You - CalVCP Public Affairs