Railroad Medicare Brochure (PDF,2654KB) - Palmetto GBA

Along the way,we have brought aboutgreat innovationsIn 2009, our associates generated 62 process improvementideas and innovations. These innovations automatedprocesses, increased quality and efficiency of our operations,and improved our customer service. Collectively,these improvements generated significant cost savings inthe form of reduced labor hours, supply costs, workloadprocessing time, and potential cost of errors, penalties andprogram costs. These innovations resulted in a savings ofapproximately $314,000. Some highlights of the keyinnovations implemented in 2009:Interactive Voice Response (IVR)The Customer Service Center implemented an enhancementto the Interactive Voice Response (IVR) system thatreduced talk time and the number of calls handled byour CSRs. NPI and PTAN verification is now an automatedprocess through the IVR. The incoming call process was alsoenhanced to auto-populate the NPI/PTAN for the CSR whenthe call comes in from the IVR, providing more efficientservice to the providers and reducing the talk time for handlingcalls. This enhancement saves over $25,000 annually.Undeliverable Mail Processing System (UMPS)Our Operations area developed an automated mailprocessing system for undeliverable mail. This applicationscans, indexes, and archives all undeliverable mail returnedfrom the US Postal Service. The system also suppresses mailto ensure no additional mail is sent to the same incorrectaddress. By automating a formerly manual process, we areable to realize lower RRB contract administrative cost byensuring compliance with USPS postal requirements forbulk mail discounts.InnovationsTIMBA Grouping ApplicationThe Claims Operations and Provider Enrollment areascollaborated on a process to reduce the volumeof claims resulting from the NPI implementation.A grouping application was created to allow us togroup multiple claims having the same providerinformation and take like actions on the group ofclaims rather than having to process each claimindividually. The application also provides anautomated letter generating process for specificclaims processing guidelines, reducing the timeand cost of the prior manual process. Overall, thisinnovation enabled us to realize a reduction of theoverall staffing due to the reduction in manualprocessing required, an efficiency gain of 280%, anda cost savings of nearly $46,000 annually.Elimination of Cancelled ChecksDue to advances in technology and the eliminationof true cancelled checks after the passage of theCheck 21 legislation, high bank and storage feesto process, ship, and maintain hard copy imagereplacement documents are now unnecessary. Wereceived CMS approval to discontinue receivingcancelled checks allowing us significant savings onpaper storage costs and also to negotiate a lowerbank fee. Total annual savings for this processimprovement for 2009 is $79,187.72, and insubsequent years will be $89,046.76.Bank Clearing Scrub FileWe implemented a change to the incoming bankdata we receive to incorporate a file containingpurged and/or corrected bank errors. This improvementreduced time previously spent manuallyreconciling bank errors and preparing monthlyreconciliations as well as keying corrections to ourfinancial system. This innovation totals an annualsavings of $14,380.33.1099 B-NoticesEach year the IRS sends a mismatch file for allproviders we paid who are using a different tax idnumber or name. We are required to solicit updatedinformation from the providers and withhold 28%of their payments if they fail to respond. Due tothe unique nature of how the RRB provider file ispopulated with data from other Medicarecontractors, we developed additional steps to ourcurrent processes to ensure that we have the properinformation to match the IRS records. The Financeand RRB Provider Enrollment areas work togetherto update records and utilize additional IRS tools formatching. The work for these records have resultedin a significant reduction from the 2007 to 2008 taxyear, leaving only .07% of the total 1099 populationthat we mail. This process improvement result is apotential savings of $104,950 in potential penaltiesthe IRS could access.4 5