2018-09-19 Merit Appeals Board Minutes

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Merit Appeals Board September 19, 2018 MS. NAMAHOE: —use a TPA, a third party—that’s what their bread and butter is to do these— MR. BRILHANTE: Third party adjustors/administrator. MS. NAMAHOE: Third party administrator to do the adjustments, the claims, and whatnot— which is their area of expertise. So, we’re using—never mind. I’m just, I’m amazed that you’re not doing a TPA for all of it. MR. BRILHANTE: We—I would like to do a TPA for all of it. There’s a issue with privatization because these positions have historically done that job. We can’t just take those jobs away from our County employees. MS. NAMAHOE: But they’re not menial jobs, though. They’re areas of— MR. BRILHANTE: But we do have claims adjustors who perform the exact same. MS. NAMAHOE: Okay. MR. BRILHANTE: So, that’s kind of the—so, we met and we engaged through Corp. Counsel, we were able to get these 2 departments just because their numbers were so high—and we could show them that it was a—there’s this overflow of work, we needed the TPA to come in to remove the work—some of the workflow so that their people—the—these civil servants could then perform at a reasonable level or— CHR. NAHUINA: Sure. MR. BRILHANTE: —management level. MS. NAMAHOE: The reason— MR. BRILHANTE: —(inaudible) workload level. MS. NAMAHOE: The reason I bring the question up is because part of what a TPA does as a firm is they have a network side of the house to make sure that the doctors understand—we’re good for our money, we’re going to pay for it within the next (inaudible) 10 business days. Right? ‘Cause doctors have to pay their bills, too. And that’s one of the reasons why doctors don’t like to take work comp. MR. CHILLINGWORTH: Right. MS. NAMAHOE: Right now, I’m having a blon—my mind is blown. We’ve never had this discussion before, but I didn’t know this. Page 16