Done that evaluations they do not have the blessing of the first people in San Francisco. Thank you very much. And i give you back the 18 seconds that i have here. Thank you, next speaker . I havent started yet. But this machine is going. Thank you. My name is inaudible jackson. And this is the first time of my knowledge knowing that these two commissions have met together. It will be very good if you the commissioners would come out into the community which you was doing at one time and meet with the people that live in the community, i have brought some information to you because i have a greater concern because of the fact bay view Hunters Point was mentioned. And here is a map. That is supposed to be showing an area where homes are to be built. And shipyards. This is a bogus map. And i would like to say this. Where goals are in the behind the close doors come to light and there is a lot of things going on hyped closed doors that is really ridiculous. You know, i hate saying being a
5061 for adjustment and recovery and are pending reimbursement. Is any of this provided to us in writing . Yes. Its included in ann hewitts report. Its not in the analysis what you told us in terms of how many claims and the dollar values. Is that included somewhere in it is. Its included in the last column in the tables pages 1112 estimated Group Financial impact. Its the column. And the na is because you have determined its annoy a systemic error. Thats right. Its an error that we did not agree with or an error due to process or which was not systemic repeatable. I just want to make clear if you disagreed you did not do a Financial Analysis even though our auditors continue to disagree with you. You just said is we dont agree and we are not going to show you the numbers. Correct. If we did not agree, we did not run a corrective analysis. We appreciate your opinion on the matter and would like to see the numbers on this. For future we would like to see them, totally we understand reas
Some information to you because i have a greater concern because of the fact bay view Hunters Point was mentioned. And here is a map. That is supposed to be showing an area where homes are to be built. And shipyards. This is a bogus map. And i would like to say this. Where goals are in the behind the close doors come to light and there is a lot of things going on hyped closed doors that is really ridiculous. You know, i hate saying being a resident of San Francisco since 1943, a city that i love, and i have lived in bay view Hunters Point since 1948, i have been before both of you commissioners, submissions, not you commissioners, and you know, and it is sad i also brought and i was at a meeting last night. Okay, sweetheart. This was never approved. In fact the map was changed. And added to another area. And it is sad. You know i would like for the Health Commission to do something about bay view Hunters Point. And no statistics have been given and last 15 years of the depth of how man
Component of that wellness strategy of the wellness plan is the database. Some of the work weve been doing in items now coming in together. As we look at our milestones, i have already just called out some of the first few ones dating back in 2012 to 2013 and really we have spent all this year trying to realize that goal out of those resolutions, to that end we did in january of this year bring to the board our recommendation on the 205 budget which included the claims data base. In february of this year we included the blackout notice for the rfp and did release that in march. In june the wellness plan which is an integral part for our Going Forward strategy and also in june the rfp process wrapped up and we noted our notice of intent and we have spent direction negotiations with our vendor with being ready to bring that to you today. Just an overview, what we are proposing here in our apcd overview is that our data sources we bring in will be our medical claims, pharmaceutical claims
We did add one recommendation regarding a Second Review for claim denials over 10,000. We had one audit error over 200,000 denied in error. We are recommending a denial audit put in place. That was my recommendation. I can see why we would do that because someone was very unhappy that it was denied in error. So this is where the process is. So uhc, im sorry i have forgotten your name, i apologize, does your report of the last time address this finding . Rene marcus, United Health care. I do have an update on this, i dont have it in writing as of yet. Okay. Why dont you give it to us orally and provide it later. So Additional Research investigation was conducted and i am happy to report that United Health care does have an internal control in place for billed charges currently right now the threshold is 25,000 in claims and greater. If it goes 0 , it goes through a Second Review to ensure it was denied correctly. The recommendation that the threshold be lower to billed charges from 10,0