Janesville schools told to cut insurance spending
From the WCLO newsroom:
Insurance consultants say they do not know why the Janesville School District's insurance claims are down. Nearly $30 million in charges were turned in in Janesville, more than $15 million of those were denied and nobody complained.
A representative from the teachers union says, "only a few complained...a few always complain...there was no increase in the number of complaints and the results are statistically improbable."
One consultant told the school board yesterday "it's a perfect storm." There are three factors leading to part of the savings: more claims not medically necessary than anticipated, more medicare or medicaid claims and alliance insurance had various unanticipated savings.
The consultants recommend the school district cut expenditures for insurance 10 percent from roughly $18 million to $16 million.
Aug 20, 2008 at 5:28 p.m.
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This story is very misleading.
The doctors and hospitals submitted 29.4 million in bills to our self funded insurance company. Because we are part of a purchasing alliance, we have agreements that allow us to discount the bill. This portion amounted to nearly 4 million dollars. In addition, nearly 5 million dollars was not paid by our insurance company because the claim falls under Medicare/Medicaid. Another 2.3 million was not paid because it was a duplicate bill. In all of these examples, which make up the bulk of the so called "unpaid claims", the insured had their medical charges covered.
To say that 15 million was denied leads the reader to a conclusion that is false. The consultants did not go a good job in explaining this last night so I will cut the reporter some slack. When I questioned the consultants about this, they either did not understand my question, which could be my fault, or they gave a very poor answer.
Thought you should know,
Bill Sodemann
Aug 20, 2008 at 5 p.m.
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So, half of claims were denied and this is a good provider? Also if next year were all approved would there be a shortfall? Sorry, not enough facts.
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