DALLAS, May 13 /PRNewswire/ -- TrailBlazer Health Enterprises, LLC (TrailBlazer) saved Medicare over $952.8 million through payment safeguard activities during the fiscal year ending Sept. 30, 2003.
All Medicare contractors are required to develop programs that reduce the claims payment error rate in the Medicare program. TrailBlazer saved or prevented unnecessary payments of $952.8 million in federal tax dollars, compared to $832.3 million in fiscal year 2002.
"TrailBlazer conducts multiple corrective and pre-emptive actions to ensure that Medicare claims are paid correctly," said Barbara Harvey, vice president of program integrity. "We use enhanced technology for claims review, sophisticated data analysis to avoid inappropriate payments, and education to physician groups about documentation requirements to help reduce the payment error rate."
TrailBlazer's cost savings can be broken out in the following ways: * Medicare secondary payer - Ensures the proper insurer pays before Medicare does: $267.4 million saved. * Medical review of claims - Identifies billed services that are deemed not medically necessary or appropriate: $685.4 million saved.
Medicare provides health coverage to people over age 65 and the permanently disabled. A subsidiary of BlueCross BlueShield of South Carolina, TrailBlazer is the Medicare Part A fiscal intermediary for Texas, New Mexico and Colorado, and the Medicare Part B carrier for Texas, Maryland, Delaware, the District of Columbia and Virginia.
TrailBlazer also is the regional processor for the freestanding rural health clinic community and national Indian Health Service providers of Medicare services. The company is a specialized regional processor of End Stage Renal Disease services for Arkansas, Louisiana, New Mexico, Oklahoma, Colorado and Texas, and is the single intermediary for several national dialysis and skilled nursing facility chain providers.
Headquartered in Dallas, Texas, TrailBlazer provided claims processing, customer service and other administrative services for more than 4 million Medicare beneficiaries in FY 2003 TrailBlazer processed over 98.5 million Medicare claims and paid $15.5 billion in Medicare benefits. TrailBlazer has over 1,700 employees in Texas, Maryland, New Mexico and Virginia.
TrailBlazer Health Enterprises, LLCCONTACT: Elizabeth Hammond of TrailBlazer Health Enterprises, LLC,+1-803-264-4626, or Elizabeth.Hammond@bcbssc.com
