State Benefits administrator says claims caught up | NevadaAppeal.com

State Benefits administrator says claims caught up

The director of the state employee health benefits program says the system has caught up on paying old claims.

Jan Marie Reed, who was hired to head the program after the 1999 Legislature reorganized it, said there are now no claims in the system more than 90 days old.

But she quickly added that means 90 days from when the system received the claim, not from the date service was provided by a doctor.

“A lot of claims don’t even get to UICI before 120 days have passed,” she said. “This is from the date we received it.”

According to UICI’s latest report, there have been no claims in the system more than 90 days old since December.

“I’ve been really pounding on them because I don’t think a suspended claim should be over 90 days old,” she said. “If we can’t process it, we need to close it out and let the employee know.”

But she said she has been able to work well with UICI since she headed that company during the reorganization of Nevada’s benefits system.

“For January and February, we’re finally there,” she said.

The benefits program was reorganized after the old company handling claims for state employees collapsed.

When L&H Administrators was fired by the state, UICI and state officials found more than 100,000 unpaid and unprocessed medical claims – many of them in boxes at its offices. It took more than a year to clean up the mess and get the old bills paid. In the process, the plan’s $26 million surplus disappeared and the Nevada Legislature had to pump money into it to ensure the plan covering some 15,000 state workers remained solvent.

As of Feb. 1, UICI reports an ending inventory of 16,821 claims and 4,888 suspended claims – most of them less than 30 days old.

Nearly 90 percent of all claims were processed in 10 days during December with a near 99 percent accuracy rate.

The plan paid out more than $7.3 million in claims and prescription benefits during December and another $6 million in January.