January 27, 2013
Insurance Payment Delays Causing Hardships for UIC Employees
MARIA MORALES’ daughter, who has GoldenHar Syndrome,
needed an ocular prosthesis at a cost of $2,200. Morales, Associate Director in
the Office of Student Financial Aid, promptly paid the portion she owed after
insurance, $840—but the doctor refused to give her daughter the eye until full
payment was received from the insurer.
FACED WITH the choice of letting her daughter go
without her prosthetic eye for the better part of a year, Morales paid the
entire $2,200 out of pocket…then waited nine months for the Quality Care Health
Plan (QCHP) to reimburse her.
MORALES IS just one of the thousands of UIC
employees whose physical, financial, and emotional well-being is being
compromised by the State of Illinois’ budget disaster. Without sufficient
revenue flow to pay its bills, the State is floating QCHP and Quality Care
Dental Plan (QCDP) payments to healthcare providers and patients for month
after month after month. The result: compromised credit scores, provider
demands for payment in advance of services, unnecessary interest charges to
both providers and patients, and useless Flexible Savings Plan (FSA) dollars.
301 days behind
“THE DELAY in payment of QCHP and QCDP claims by
the State is a concerning and ongoing issue,” said Katie Ross, Director
of Human Resources Administration from University Human Resources. “Due to its
economic situation, the State does not have sufficient funds to maintain a
timely and regular payment schedule.”
TO HELP keep State employees informed, the
State’s Department of Central Management Services (CMS) created a
website—updated frequently—to provide the date of claims currently being paid
for the Quality Care health and dental plans, Ross noted. Visit http://www2.illinois.gov/cms/Employees/benefits/Insurance/Pages/QCHPQCDPClaimPaymentDelay.aspx,
or access the site from NESSIE.
ACCORDING TO a statement on the site, “The State of Illinois is facing a difficult
and unprecedented funding situation which has significantly impacted the State
Employees' Group Insurance Program through the delay of claim payments under
the Quality Care Health Plan and the Quality Care Dental Plan…Funding
availability is based on State revenue, which fluctuates from month to month.
“AT THIS time funds remain insufficient to pay
claims on a normal schedule, and we cannot estimate when a regular payment
schedule will resume. Claim payments will be released according to the claim
process date and available funding. CIGNA, the claims administrator, continues
to process claims in a timely manner, but release of claims must be held until
revenue is available. Late payment interest is paid to healthcare providers on
health claims that take longer than 30 days from the receipt of a complete
claim submission to pay.
“IF YOU decide to make arrangements with your
out-of-network provider to pay the outstanding balance or establish a payment
plan, your provider should reimburse you after they receive payment from CIGNA.
It is your responsibility to make reimbursement arrangements with your
provider.”
AS OF January 24, claims processed through
March 29, 2012, have been released to QCHP-contracted providers: a whopping 301
days’ delay. Claims processed through February 2, 2012, have been released to
non-QCHP-contracted providers.
A CIGNA representative reported on Jan. 3 that
there was “a 43-week hold on checks” from CIGNA to State of Illinois employees.
THE SITE also provides a client services
feedback form that invites users to send messages describing how the delay in
claims payment is affecting them, as well as contact information for questions.
“We encourage employees to use these mechanisms to provide feedback and seek
assistance with concerns about delayed payment,” said Ross.
Credit ratings in
distress
MULTIPLE STAFFERS report having their credit endangered
or actually damaged due to the State’s late payments. One employee who asked to
remain anonymous received a call from the provider asking her to pay her $8,500
hospital bill. She contacted an insurance representative and was told they
probably would not pay the bill until seven to eight months after her hospital
stay. The insurance rep “told me the provider would place my bill with a
collection agency, which will eventually affect my credit rating,” the employee
relates. “Well, it did. What am I supposed to do?”
“IT’S CRAZY that I have to call doctors and
explain that although my insurance will pay in full, I need to make payments of
$100 a month to stop my bills going to collections,” said Eric, an employee who asked that his last name not be used.
“I HAVE doctors chasing me around because the
State is taking so long to pay the bills,” said Alexander Schilling, Director of the Research Service Facility-Mass
Spectrometry, Metabolomics, and Proteomics, in the Research Resources Center.
“Clearly, if doctors are pursuing collection, my credit rating may be damaged
due to the State’s irresponsibility.”
ALTHOUGH UIC employees are holding up their end of
the benefits bargain, the Illinois General Assembly is reneging on its
commitments, Schilling said. “I paid my premium; they should pay the bills once
they agree to cover them,” he continued. “Doctors who provide good, timely
medical treatment do not deserve to have cowardly politicians try and balance
the State’s books on their backs.”
ONE HOSPITAL employee who wanted to remain
anonymous said she has paid some of her children’s dental bills up front “just
to keep in good standing with my dentist, who has been very patient in
waiting,” she said. “The turnaround time for payment has been as much as 200
days.”
ROBERT E. LARSON, Assistant Director for Architectural Services
in the Office for Capital Programs, said he paid a bill for an ER visit to
avoid having it sent to collections. “My dentist now wants cash up front from
patients with our State dental insurance,” he added, describing another
situation State employees are facing: healthcare providers’ demands for payment
at the time of services.
Patients, produce the
cash
NICK ARDINGER’S dentist was paid for his last checkup
and cleaning just before Ardinger arrived for his next visit…six months later.
“As a result, my dentist now requires us to pay the whole amount and get
reimbursed ourselves,” said Ardinger, Assistant Director for Marketing, Campus Housing.
OVER THE decade in which Darlene Peters’ family has been visiting its dentist, “he has been
very willing to provide services and wait for reimbursement from our insurance
company,” said the former employee in Interventional Radiology. “That all came
to an end last summer when I became my family’s primary insurer.
“WHEN A family of five goes to the dentist
and gets the routine cleaning, X-rays, fluoride, etc., it can be very
expensive,” Peters continued. “I was shocked to learn the bill was close to
$3,000 after a few fillings were added. When the dental office contacted our
insurer and found out the payment would take almost nine months, they asked me
to pay up front. This was obviously a shock to me.”
FRUSTRATED BY endless delays in payment, some
providers have even closed the door to State-provided insurance. “My
primary-care physician stopped accepting my insurance because he could not
afford to wait,” said an employee who wished to remain anonymous. “This reduces
the likelihood of my using his services, since I essentially would have to
become a claims specialist to file the claims myself.”
SLOW PAYMENTS also translate into interest charges
for some patients, a circumstance that Joan
Johnson, Financial Aid Counselor in the Office of Student Financial Assistance,
finds unfair. “I was surprised to find that my family is charged interest on
our dental statements, because there are always outstanding charges hung up in
the bill payment rotation with Delta Dental,” she said.
“BECAUSE OF this backlog in charges, we pay a
combination of uncovered fees and interest on the charges delayed by late
insurance payments. That causes us to pay more for dental services, and that’s
not right.”
Rendering FSA tax savings
useless
JENNIFER ROWAN, Assistant to the Director in the Office
of Research Services, noted that extreme delays in payment also make it
impossible for employees to take advantage of the pretax savings in their FSAs.
“Because it takes CIGNA so long to pay, the flexible spending year has usually
ended,” she explained.
“EXAMPLE: I go to the doctor in April, and they
pay my doctor the following February. Since the service took place the previous
April, it falls into that year’s flexible spending period, but I can’t submit
my portion of the charges to the FSA since I received the final amount I owe
outside of the service year.”
CINDY LEDONNE, Assistant Director of the Clinical Performance
Center in the Department of Medical Education, had several substantial bills
processed so late that she couldn’t retrieve money from her FSA for it. “I had
to cover it with post-tax dollars, and that can add up pretty quickly,” LeDonne
said. “After five years of employment, this situation
has added up to several hundred dollars I've had to pay in taxes--money that
should have been spent on living expenses and not taxes. It's very frustrating
and there are no signs of improvement.”
VIVIANA KABABBE-THOMPSON, Academic Advisor in the Department of
Kinesiology and Nutrition, has seen a six-month plus delay in payment of her
dental bills, and watched as her annual physical took 11 months to be paid.
Still, she counts herself among the lucky ones. Kababbe-Thompson is in good
health—“I don’t expect any large costs, but feel bad for others who might have
more health issues and as a result have larger issues with bills and planning
for bills,” she said—and she has the option of switching to her husband’s
insurance.
THOUGH IT will cost the couple more in
insurance costs, “I hope to change insurance plans to my husband’s, which is
reliable and hopefully less complicated,” she said.
MEANWHILE, UIC employees without the option of using
their spouses’ or partners’ insurance struggle on, wondering when—and if—their
healthcare bills will be resolved.
“I WONDER if it’s even worth it for us to have
insurance?” said Carol Fendt, Co-Director
and Senior Researcher, PRAIRIE Group, who has more than once waited in excess
of six months for reimbursement. “Why am I paying monthly for a service I’m not
receiving, and, with the state of our State, for which I’m likely not going to
receive reimbursement?
“I’M BEGINNING to think I’ll see healthcare reform
before I see the State pay its bills.”
With significant
interest
THE STATE does pay its bills—but so late that
it has to pay interest, too.
“THE FACT that the State is in fact paying 9%
interest on the delayed payments concerns me also as a taxpayer,” Schilling
said. “It would clearly be cheaper for the State to at least float a bond
(easily at less than 3% yield in today's bond market) to clear the backlog
rather than pay such an exorbitant interest rate. It isn't just employees who
suffer—it’s the taxpayers also.
“CLEARING THE backlog does not solve the budget
shortfall going forward, but at least it clarifies the problem to one of
ongoing expenses and revenue and saves the taxpayers some money right now,”
Schilling concluded.
APAC Meetings Scheduled
ALL
APs are invited to
the monthly APAC meeting at 12:30 p.m. on the second Wednesday of the month.
Meetings are held either in Room 5175 of the College of Medicine Research
Building, 909 S. Wolcott, or Room 2750 of University Hall on the East Campus. Next
meeting is Feb. 13 in Room 5175 of the College of Medicine Research Building.
For information, call (312) 996-0306.
BENEFIT BEAT
ARE YOU an AP who also is a UIC student, or do
you have a dependent who is a UIC student? Then contact the Office of Special
Scholarship Programs (OSSP). See http://www.uic.edu/depts/oaa/ssp/.
OSSP
ASSISTS current UIC undergraduate and professional
school students in searching and applying for nationally competitive
scholarships, fellowships, and external scholarship awards. The office provides
information about available awards, advice on application preparation, and
assistance throughout the scholarship application process. The office’s services are available to current UIC
undergraduates and graduate/professional students only.
THE
OFFICE does not
simply provide a list of awards. OSSP helps people present themselves clearly
and effectively for awards that best suit their needs. The office can offer
guidance on communication about academic achievement, co-curricular
involvement, life experiences, and financial need. Individuals are welcome at
any point in their degree program, and are encouraged to plan ahead to prepare
the strongest possible scholarship applications.
FOR
MORE information,
contact OSSP at 2506 University Hall, 601 S. Morgan St. (MC 115), Chicago, IL
60607, (312) 355-2477, fax (312) 355-1233. Director Beth Powers can be contacted at bpowers@uic.edu.
AP RESOURCE SPOTLIGHT
REGISTRATION
IS available for instructor-led learning opportunities from UIC Human
Resources Organizational Effectiveness in February:
BUSINESS
WRITING Fundamentals is a three-hour course for employees interested in a
refresher on basic writing rules. This course is full of activities designed to
provide guidelines for planning, organizing, drafting, and editing documents.
Target audience: All UIC employees. Friday, Feb. 8, 9:30 a.m. to 12:30 p.m.
STRUCTURED
BEHAVIORAL Interviewing is packed with information for those who hire to apply
immediately in their effort to select best-fit job candidates. Target audience:
Employees responsible for conducting job interviews. Monday Feb. 11, 1:30 to
4:30 p.m.
CUSTOMER
SERVICE Fundamentals discusses the elements of good customer service that can
make a difference in the workplace. The interactive, instructor-led course
explores the impact of customer service at UIC and provides information on
actions that can be taken to exceed customer expectations. Target audience: All UIC employees. Friday, Feb. 22, 9:30 a.m.
to 12:30 p.m.
RESULTS
ORIENTED Communication is a half-day course designed to provide tools and
techniques to encourage communication that will position managers to achieve
results in the workplace. During this session, building credibility, delivering
clear and concise guidance to teams, and focusing on the end goal before
crafting messages will be explored. Target Audience: Supervisors, managers, and
those wishing to enhance their communication skills to achieve targeted results
in the workplace. Tuesday, Feb. 26, 9:30 a.m. to 12:30 p.m.
LEADERSHIP
ESSENTIALS is a two-day workshop designed to provide new managers and
supervisors with information required to function in their role more
effectively. Cost: $200. Target audience: Supervisors and managers. Wednesday,
Feb. 13, & Wednesday, Feb. 20, 9 a.m. to 5 p.m.
REGISTER
FOR the above sessions by visiting the MyCareer website:
www.uic.edu/depts/hr/mycareer/. Select UIC Training Providers on the left
navigation menu and select view listings under UIC-HR for all courses
provided by Human Resources and Organizational Effectiveness, and then click
the register/view link under the course name to register.
THE CONTINUING CRISIS
 |
| Ralph Martire, executive director of the Center for Tax and Budget Accountability, offered a pension fix idea. |
HERE’S AN actual, honest-to-goodness pension
fix. See Crain’s Chicago Business, Jan.
16: http://www.chicagobusiness.com/article/20130116/OPINION/130119858/heres-an-actual-honest-to-goodness-pension-fix.
Vol. 6, No. 1 January 2013
ISSN 1946-1860
Editor: William S. Bike
Staff: Lucia Gonzalez, Gail Mansfield, Monica M. Walk
Vice Chair: Ahlam Al-Kodmany
Chair: Michael Moss
Secretary: Mary Berta
Treasurer: Virginia Buglio
Web Chair: Jeff Alcantar
Web Chair: Jeff Alcantar
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