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QualCare reports large repricing savings on county medical bills through Nov. 30
Summary
A QualCare representative told the Middlesex County board the third-party administrator repriced 86 medical bills through Nov. 30, producing $148,665.99 in savings (65% of charges); 18 intakes were logged, 12 required further medical intervention and six were report-only.
Nicole, a QualCare representative, reported to the Middlesex County board that QualCare repriced 86 medical bills for November, producing substantial savings.
“So overall, the numbers are, really good for 2024. We've had a little bit of uptick in the, medical claims, but managing them, appropriately,” Nicole said. She told the board the report in the agenda packet begins on page 16 and that figures in the packet were through Nov. 30.
According to Nicole, total billed charges for the repriced claims were $229,221.17, allowable charges were $80,555.18, and the calculated savings were $148,665.99, a 65% reduction from billed charges. She also reported 18 total intakes for the month: 12 required additional medical intervention and six were recorded as report-only.
Commissioner Drews asked for a summary after Nicole finished; Nicole reiterated that the savings trend for the year was positive and that staff were tracking medical-claim trends on a weekly basis.
The board did not take formal action on the managed-care report; it was presented as the monthly savings and penetration report and placed on the record.
