news release

ADMINASTAR FEDERAL PRAISED FOR AMBULANCE EFFORTS IN KENTUCKY

Anthem Subsidiary Recognized by Kentucky Ambulance Providers Association
and American Ambulance Association for Solving Claims Issues

Indianapolis, Ind. – October 3, 2002 – AdminaStar Federal (AdminaStar) announced today that it received an award from the Kentucky Ambulance Providers Association (KAPA) at the Kentucky Emergency Medical Services Conference in Owensboro, KY. The award was presented to External Affairs Representative Lindy Lady in recognition of AdminaStar’s efforts in working with ambulance providers. The decision to recognize AdminaStar came, in part, as a result of the American Ambulance Association (AAA) citing AdminaStar Federal as a model for “best practices” which could be shared with other Medicare contractors.

Two years ago, AdminaStar faced some concerns from Kentucky ambulance providers about claims processing and the claims appeal process. AdminaStar began an aggressive campaign to educate the ambulance provider community on how to submit accurate claims, as well as about how claims are tracked by AdminaStar. Working with KAPA, AdminaStar undertook a high-level strategic approach to reviewing its claims and appeals processes, working closely with the Centers for Medicare & Medicaid Services (CMS).

“We seek to have good working relationships with KAPA and now work directly with them on their conferences. We also do everything we can to assist them with education.” said Lindy Lady. Lady was recognized by KAPA as the key component in strengthening the AdminaStar-KAPA relationship.

“Effective planning and wide-open communications with the state association have been key to our success. Face to face meetings are important, because meeting the people involved in an issue and working together to find positive resolutions to problems helps to strengthen the relationship.”

Michael T. Swift, KAPA President, has glowing comments about AdminaStar and Lady. “Lindy has done an outstanding job working with ambulance providers. Kentucky and Indiana were given national recognition by the American Ambulance Association (during the AAA’s annual convention, in St. Louis, MO) on how to solve problems -- a lot of that has to do with Lindy Lady and the work she has done and we appreciate her efforts.” Swift lauded Lady’s “hands on” approach, “Now we have a provider carrier program. It has a name and face we can put together, and Lindy works hard to resolve issues. She tells it like it is and is very straightforward. If she does not have an answer, she gets one.”

AdminaStar Federal President Mike McCarron echoed Swift’s sentiment. “Lindy was the one on the firing line, not just monthly, weekly, or daily, but hourly. She handled the calls and the concerns of providers, congressional offices and the media. She did an outstanding job in helping all concerned in creating a viable resolution to the entire ambulance claims process.”

The resolution to the Kentucky ambulance claim issues was tackled from several levels. CMS offered advance payments to a selected group of providers who had money tied up in the appeals backlog. This action, combined with enhanced provider education, streamlining claims processing and re-engineering medical review policies, allowed AdminaStar to positively affect the entire claims process. CMS also secured additional funding for AdminaStar to relieve the appeals backlog.

The main part of the strategy was to provide education to all interested groups, including congressional offices, provider groups and professional organizations. They were kept informed about key issues via several sources, including a monthly newsletter, quarterly provider bulletins, and website updates. The most effective exchange of information came through the creation of a dedicated special unit whose goal was to focus strictly on ambulance claims and on issues requiring immediate provider education or process changes.

Lady feels that this way of expediting issues has been extremely successful, “We address issues immediately. If KAPA finds out information before we do, they share it, and that has kept issues from becoming problems. Each of us is a partner in maintaining a smooth process for everyone involved.”

AdminaStar Federal administers Medicare contracts for the Centers for Medicare & Medicaid Services (CMS). CMS, an agency of the Department of Health & Human Services, serves 40 million Medicare beneficiaries and 1 million providers throughout the United States, Guam, Puerto Rico and other U.S. territories.