Key initiatives and enhancements from 2020
HBS by the Numbers–A Look at 2020 Infographic
We have embraced many
services and opting to find
solutions to serve our members
to the best of our ability.
Telehealth continues to surge as the safest way to receive medical care. The telehealth market in the United States is estimated to display staggering seven-fold growth by 2025, with 2020 seeing a 64.3% growth according to a recent analysis by Frost and Sullivan.
At the start of January 2020, the Christian Brothers Employee Benefit Trust (CBEBT) began allowing for telemedicine visits with your current providers that offer regularly scheduled visits via telehealth. We are excited to report that many participants have been able to take advantage of these types of visits to seek treatment and continue management of chronic conditions.
Telehealth visits (phone, video and other virtual visits), including behavioral health, will be covered as a regular office visit in accordance with benefit plan terms for providers who offer the service through two-way, live interactive telephone or digital video consultations or other methods allowed by applicable laws and regulations.
Since the pandemic hit, the CBEBT has seen a remarkable increase in telehealth visits, processing claims for over 50,000 telehealth visits. These visits range from mental health visits to chronic care maintenance.
Claims, Calls, and Communication
In 2020, HBS completed and delivered more than 700 renewals, along with a multitude of prospects, reports and special requests. Our customer care call center answered 173,742 calls for members of the Employee Benefit and Religious Medical Trusts, achieving a call quality rating of 98.8%.
More than 83,000 claims and over 10,000 pieces of correspondence
were scanned by our claims imaging team and our claims examiners processed nearly 794,000 claims in an average of 15 days, achieving a 99.81% on an internal quality audit.
In addition, recovering nearly $700,000 in overpayments on behalf of our Trusts, our recovery staff reviewed and adjusted more than 13,000 claims. The HCR staff
completed over 2,100 predeterminations and assisted the examiners and customer care agents on over 1,200 inquiries. In addition to orchestrating the myriad number of necessary transactions required for the timely delivery of monthly invoices to Trust members, the billing and eligibility team also responded to more than 8,500 inquiries regarding member benefits.
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HBS receives perfect score on audit
Each year, Aetna Signature Administrators conduct an extensive audit of the HBS division for procedural and processing accuracy in the areas of Claims and Customer Care/Service.
HBS reached a perfect score, garnering full points for each compliance category. Every facet of the business was measured including not only a review of claims against CBS payment policies and procedures, Aetna representatives also reviewed training and internal auditing programs, HIPAA compliance policies and procedures, fraud and abuse training, system capabilities, security and reporting and disaster recovery capabilities and policy.
In addition, the customer care department underwent an operational and performance audit, meriting a perfect score on all areas reviewed including staffing, training, HIPAA compliance and internal work flow processes.