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From YouTube: Clearwater Benefits Committee Meeting - March 8, 2023
Description
Watch the Clearwater Benefits Committee Meeting that took place on March 8, 2023.
A
We're
gonna
get
started
good
morning,
we're
going
to
get
started.
It
is
Wednesday
March,
8th
at
903
a.m,
and
this
is
our
birth
benefits
committee
meeting
of
2023
and
we
have
Sean
Fleming
and
Samantha
riccini.
Our
new
account
rep
here
today
to
walk
us
through
the
agenda.
We're
going
to
talk
about
the
claims,
experience,
the
navmd
analytical
reports,
the
clinic
RFP
and
then
we'll
have
some
open
discussion.
B
So
today
we're
gonna
go
through
claims.
Experience
we'll
talk
about
how
last
Pioneer
ended.
We
have
one
month
of
data
for
the
current
plan
there
and
then
we've
got
a
little
bit
more
detail
reporting
on
some
of
where
the
claims
costs
are
occurring.
Some
of
the
medical
conditions,
the
Pharmaceuticals,
so
we'll
take
a
look
at
all
of
that.
If
you
guys
won't
go
on
the
claims,
we'll
actually
start
on
page
two.
B
Oh
I'm,
sorry
so
go
through
her
real
quick
just
for
everybody.
That
said,
he
has
a
self-funded
medical
plan,
which
basically
means
the
city
pays
signal
to
administer
the
plan.
The
city
pays
for
the
bulk
of
the
costs
as
they
occur,
so
there's
a
small
fee,
that's
paid
to
Cigna
to
administer
the
plan
and
then
the
bulk
of
the
cost
that
comes
in
are
claims
which
the
city
pays
as
they
occur.
B
A
C
B
Able
to
catch
up
perfect,
so
I'm
gonna
go
up
and
load
columns
or
the
gold
Road
for
everybody,
and
just
talk
about
the
columns
real
quick.
So
after
the
date,
our
first
column
is
toenail
plan
funding.
So
that's
basically
the
the
rates
for
each
of
the
plan.
If
you
set
for
the
funding
multiply
by
the
number
of
improvements
in
each
year.
B
So
overall,
the
plan
funding
based
on
those
rates
for
2022
was
19.79
going
across.
So
of
that
19
really
70
million
820
000
Goods
to
Signature
administer
the
program.
I
would
like
to
point
that
out.
It's
a
relatively
small
percentage
of
the
overall
economy
that
our
next
column
is
reinsurance
or
stop
loss.
So
basically,
if
any
individual
has
a
claim
more
than
300
000
signal
picks
up
anything
under
300
000..
B
B
However,
if
you
go
to
that
Reserve
column
you'll
see
each
month,
obviously
almost
all
the
months
were
negative,
meaning
the
fundings
was
less
than
the
actual
expenses,
but
the
plan
received
back
just
shy
of
1.4
million
in
Partners
agreement.
So
that's
something
we
take
into
account
in
the
projections
so
that
you
know
the
rates
are
set
based
on
receiving
that.
So,
overall,
the
plan
finished
with
a
deficit
of
about
403
000
compared
to
those
but
and
then
on
the
far
right.
B
What
we
do
is
we
take
the
the
total
claim
usage
month
and
divide
it
by
the
number
of
employees
in
the
plan
that
way
as
enrollment
changes.
As
you
know,
we
have
new
hires
people
leave.
We
have
a
consistent
kind
of
Benchmark
number,
so
we'll
talk
about
that
in
a
second
looking
in
the
boxes
down
below.
So
basically,
the
plan
ran
about
two
percent
higher
than
expected.
B
C
B
Increase
in
pharmacist
claims
a
lot
of
that's
driven
by
a
couple
of
new
categories
of
drugs,
the
biggest
one,
even
though
it's
not
a
new
category,
is
in
the
diabetes
space.
There's
a
lot
of
people
that
are
on
a
generic
metformin,
which
spots
15
a
month
that
have
now
been
moved
through.
Some
of
these
brand
name
drugs.
All
you're
going
to
do
is
watch
a
sporting
event
on
TV
and
you'll,
see
one
of
the
ones,
that's
probably
on
that
list,
where
they
might
be
a
thousand
dollars
a
month.
B
B
We
have
one
month
of
data
for
2023.
We
did
increase
in
funding
period,
as
everybody
knows,
so
a
couple
things
we've
seen.
Medical
claims
are
actually
down
just
going
to
that
same
summary
box.
Although
we
only
have
one
month,
things
improved
quite
a
bit
in
January,
so
it
created
The
increased
funding.
They
plan
to
actually
have
a
surplus
for
the
month
of
January
of
about
two
hundred
thousand,
so
we
made
some
of
those
changes
last
year.
B
The
prevailing
kind
of
industry
thought
is
that
we're
a
little
bit
on
an
entail
end
of
the
code
with
backlogs.
So
when
everybody
didn't
get
care,
you
know
we
had
shortages
in
the
medical
community
in
terms
of
Staffing
in
terms
of
all
those
things
as
some
of
those
things,
a
lot
of
them
were
kind
of
talking
out
last
year,
because
people
were
getting
back,
facilities
were
open
and
up.
You
had
a
lot
of
elective
surgeries
that
have
been
put
off
during
the
pandemic,
so
that
only
essential
stuff
could
be
done.
B
So
a
lot
of
that
kind
of
came
back
last
year
is
the
theory.
So
when
you
look
at
a
lot
of
forecasts,
everybody
thinks
that
claims
will
hopefully
be
down
in
2023,
but
encountering
that
with
the
fact
that
we
have
inflation
and
levels
that
we've
never
seen
so
and
that
inflation,
not
only
does
it
affect
groceries
in
the
gas
pump,
but
it
affects
medical
Affair
as
well,
so
we're
in
this
inflationary
environment
where
everything's
impacted.
B
B
B
So
I
think
there's
a
number
of
things
that
come
into
play
with
that
not
having
all
the
groups
in
front
of
me.
I,
don't
know
how
many
groups
that
potentially,
is
you
know,
are
you
going
to
break
down
by
study
divisions
per
se?
You
know,
are
you
going
to
have
a
group
for
City
Attorney
office,
or
are
you
going
to
have
a
group
for
different
types
of
engineer?
You
know
so
I
would
need
to
I
guess
see
what
all
the
groups
are
and
what
that
structure
would
look
like.
B
B
B
You
get
to
a
point
general
rule
of
thumb
you
get
under
50
people,
you
start
having
issues
with
hip
and
protected
health
information,
because,
if
I
put
a
report
in
front
of
you
guys
as
a
committee,
Broken
Out
by
division
and
there's
a
department
with
six
people-
and
you
see
that
somebody
had
a
million
dollar
claim
and
you
go
well,
there's
six
people
in
there
and
I
see
that
Bob's
been
out
for
the
last
six
weeks.
He
must
be
the
million
dollar
claim,
that's
hurting
our
plan.
So
that's
one
issue
with
that.
B
B
Have
to
be
cautious
that
we're
looking
at
kind
of
valid
data
sets
in
that
and
that
we're
not
looking
at
you
know.
Oh
somebody
has
a
10
loss
ratio
one
year
and
a
500
loss
ratio
in
the
next
year.
So
there's
a
lot
of
things
that
would
have
to
be
discussed.
There
is
kind
of
what's
the
reason.
What
are
we
trying
to
accomplish?
B
Most
of
our
groups
do
not
break
out
most
groups
through
active
retiree
Cobra
unless
they
have
some
sort
of
structure
where
they
need
to
build
apartments
in
a
special
manner,
but
that's
pretty
rare
the
only
time
we
typically
see
that
is
colonies
where
there's
different
constitutionals
like
a
tax
collector
appraiser,
because
they
all
have
their
own
independent
budgets.
But
then
they
also
roll
up
into
one
budget,
so
they
have
to
bill
each
other
and
collect.
So
that's
typically,
the
only
thing
we
see
that
kind
of
structure.
B
So
I
think
where
you
have
to
be
cautious
in
that,
is
you
know
that
year-to-year
variability
and
and
what
are
you
going
to
act
on
with
that
data?
Are
you
going
to
hit
you
know,
bargaining
group,
a
with
a
30
increase
and
give
bargaining
group
b,
a
30
decrease
because
they
had
a
bad
year
and
then
what
happens
the
next
year?
So
again,
that's
why
most
people
don't
do
it.
B
All
right,
so,
if
everybody
has
this
book,
not
gonna,
not
gonna.
Put
you
this
week
with
this.
This
is
going
to
be
coming.
Cursory
I
love
going
through
a
student
I
have
a
general
an
employee
standing.
Where
are
some
money
is
actually
being
spent
and
going
so.
The
first
thing
I'll
say
about
this
is
there's
different
types
of
this
is
based
on
the
cities.
Act.
Four
claims
experience
for
2022,
but
there's
certain
fees
in
your
signal
program.
You
know
mental
health
doesn't
run
on
her
head
on
a
per
claim
basis.
B
It's
capitated,
which
means
there's
just
a
flat
fee.
So
some
of
the
pots
don't
pull
into
your
report
when
it's
on
the
actual
claim.
So,
if
you're
looking
and
going,
why
doesn't
a
match
up
with
b,
especially
the
finance
people,
and
they
will
not
match?
Is
the
only
thing
I'm
telling
you
so
I?
Don't
want
anyone
driving
themselves,
nuts
trying
to
make
them
match
because
they
will
not
page
two
is
just
kind
of
financial
overview
and
that
pretty
much
lines
up
with
summative
graphs
that
you've
seen
on
our
other
report.
B
The
difference
here
is
it's
going
to
be
based
on
the
month
of
the
claiming
covert,
meaning
the
day.
I
went
to
the
doctor,
the
one
this
other
page
that
we
could
review
is
based
on
today
in
this
act
claim
page
so
just
another
thing
what
it
won't
look
exactly
the
same
and
some
of
that,
because
sometimes
a
claim
occurs
by
the
time.
It
makes
a
way
to
put
the
system
they
could
get
paid
three
months
later.
So
it's
what
we
call
the
leg.
B
If
you
look
on
page
three,
you
don't
need
to
look
necessarily
in
kind
of
detail,
but
landlorded
the
trend
on
the
graph
and
it
kind
of
tells
us
what
those
of
us
getting
older
know,
which
is
our
claims
costs
increase
as
we
get
older
typically,
and
then
we
actually.
Obviously
we
thought
a
lot
less
employees
right
in
the
64
to
60
to
64
range
and
then
65,
plus
the
bulk
of
those
individuals,
have
moved
on
to
Medicare.
B
B
B
H5
is
just
kind
of
a
demographics
page
I'm
not
going
to
hit.
You
know
in
super
detail
on
that,
but
page
six,
a
couple
breakouts
the
graph
cut
in
the
left
tells
you
average
age
and
kind
of
breakout
of
the
employees
and
what
you'll
see
is
you
know
that
explaining
much
looks
like
that
spending
graph?
We
had
a
couple
Pages
ago
so
interesting
correlated
in
there
and
then,
as
you
go
to
the
right,
this
just
kind
of
breaks
out.
B
You
know
the
cost
brackets,
so
the
top
one
percent
of
claims
is
almost
is
more
than
a
third
of
the
plan
costs
and
we'll
look
at
that
in
a
little
bit
more
detail
of
mine
through
so
down
below
that.
If
you
look
current
12
months,
if
everybody's
in
that
ground
on
the
bottom,
it's
over
returns
to
the
right.
B
B
B
You're,
a
very
small
percentage
of
the
population
is
driving.
The
majority
of
the
plan.
Costs
I
always
like
to
point
that
out,
because
when
we
talk
about
plan
changes
that
are
the
examples,
I
say.
Oh
what?
If
we
raise
our
deductible
from
two
thousand
to
five
thousand
as
an
example?
Well,
people
will
say
that
should
save
us
10
or
15,
and
you
look
at
it
only
saves,
maybe
one
or
two
percent
well.
Why
is
that?
B
B
You
know
if
it
doesn't
affect
many
people,
it
doesn't
save
the
planet.
So
because
of
that,
that's
why
I
would
say
the
last
five
to
seven
years,
we've
had
a
lot
of
groups
that
really
haven't
raised
their
deductibles,
because
there's
not
that
much
benefit
you're
only
impact
in
a
very
small
percentage.
B
Seven
exist
right
breaks
down
some
of
those
numbers
that
we
had
in
a
little
bit
more
detail
again.
I,
don't
want
to
put
you
guys
to
sleep
with
too
many
Insurance
or
remember
to
what
I
do
always
kind
of
look
at
is
er
visits,
resulting
in
an
admission,
it's
actually
even
brewed
from
the
prior
12.
You
had
72..
B
So
that's
a
lot
of
er
visits
that
ended
up
with
somebody
in
the
hospital.
In
the
last
12
months
you
only
had
48,
so
that's
a
pretty
significant
reduction
there,
which
is
good.
We
had
less
MRIs
substantially
less
physical
therapy
visits.
I.
Think
that's
I
did
the
fact
that
2021
and
early
2022,
you
had
a
lot
of
those
elective
surgeries
that
were
probably
put
off
but
Orthopedics.
So
you
have
a
lot
more
physical
therapy
with
some
of
those
items
and
then
we
also
have
Behavioral
Health.
B
We
had
a
pretty
decent
reduction
in
Behavioral
Health
visit.
We
saw
a
spike
on
a
post
pandemic
early
a
lot
of
people
struggling
with
the
pandemic.
So
we've
seen
a
little
bit
of
a
balance
there
for
the
page,
8
just
breaks
out
your
top
providers,
so
Morton
Plant
Hospital
of
18.8
million
days.
In
that
period,
3.2
million
went
to
Morton
Plant.
So
that's
where
a
lot
of
your
people
are
going
the
next
one,
a
CREDO
that
is
the
high
cost
specialty
medications
that
have
to
be
filled
through
signal.
B
C
B
C
B
Bit
of
its
relevance
in
the
discussion,
but
this
reporting
breaks
out
and
take
this
all
with
a
grain
of
salt.
It
breaks
out
what
they
call
avoidable
ER,
which
is
basically
you
know,
should
have
been
able
to
get
somewhere
else.
You
know
regarding
an
Urgent
Care
gone
to
the
Health
Center
and
just
gives
you
an
idea
of
some
of
the
reasons.
So
you
know
you
had
11
ER
visits
for
an
acute
respiratory
infection
so
getting
to
those
people
and
making
sure
they
know
that
you
know.
B
There's
Urgent
Care,
there's
some
of
those
things
these
Standalone
er's
I,
think
are
not
helping
because
people
don't
associate
them
as
a
hospital
like
I
think
they
just
want
to
talk
about
today.
Right,
yeah
people
don't
think
of
that
as
a
hospital,
but
when
it
gets
built,
it's
getting
filled
just
like
any
of
the
other
hospitals
and
you're
paying
the
same
cost
and
then
the
bottom
page
is
what
they
consider
unnecessary
ER.
So
that
was
completely
shouldn't
have
gone
to
the
ER.
B
C
A
B
So
this
gives
you
an
idea
of
kind
of
what
the
major,
what
would
you
call
chronic
conditions
are
impacting
employees
so
you'll
see.
If
you
look
by
member
Health,
the
top
one
is
hyper
detention
which
is
high
of
11th
manager.
You
have
596
members
on
the
plan
that
have
had
a
diagnosis
of
a
high
blood
pressure
104
with
heart
disease.
B
B
B
So,
as
you
guys
will
see
on
the
top
left
top
20
RX
conditions-
and
you
look
at
that
graph-
that
pretty
much
tells
you
know
everything
you
need
to
know
how
much
of
an
outlier
diabetes
is.
So
that's
our
biggest
single
Cloud
driver
that
applied.
You
know
things
like
omada
and
some
of
those
things
you
know
we've
been
promoting
psoriasis
is
over
two.
B
So
years
ago
we
didn't
have
a
category
for
psoriasis
on
any
of
these
reports,
what
they
found
over
time
when
you
look
at
the
kind
of
autoimmune
class,
which
is
your
rheumatoid
arthritis
and
some
of
those
things
they
found
in
a
lot
of
conditions
like
Crohn's,
ulcerative,
colitis,
psoriasis,
rheumatoid,
arthritis,
they're,
all
kind
of
generally
caused
by
a
similar
autoimmune.
So
they
found
that
the
humerus
and
the
emeralds
which
they
originally
used
just
for
rheumatoid
arthritis,
were
very
effective
in
these
other
categories.
B
B
B
C
B
From
that
it
might
be
like
well,
it's
okay,
if
I
skip
it
for
a
couple
of
days,
and
it's
actually
that's
when
for
some
conditions
you
end
up
at
the
most
risk,
so
the
real
benefit
of
mail
order
is,
if
it
shows
up
in
people's
door,
you
don't
skip
it.
You
know
they
don't
skip
a
blood
thinner
and
then
end
up
in
the
hospital
and
or
have
a
stroke
or
a
heart
attack.
So
that's
really
the
bigger
benefit
of
mail
order.
It
is
cheaper.
B
So
it's
a
it's
a
win
in
that
regard,
but
when
you
talk
to
any
doctor
kind
of
anything
with
the
plans
when
they
look
at
the
data,
it's
the
compliance
is
the
biggest
benefit
when
it
shows
up
so
on.
The
right
is
a
breakout
of
your
spend
on
how
much
is
spent
or
generics
versus
brand,
so
84
of
the
costs
going
towards
brand
name
drugs
and
only
15
go
towards
generic.
Now
we
don't
have
the
number
in
here,
but
the
last
time
I
looked
doing.
B
B
B
However,
there
is
and
I
was
in
the
gym
yesterday
morning
and
there
was
a
big
report
on
there's
a
couple.
Others
I
can't
remember
all
the
names
offhand
they're
dieting
these
meds
and
they're,
finding
that
when
people
take
them
they
are
very
effective
at
Weight,
Loss
and
but
now
there's
all
these
reports
out.
Thank
you,
Kardashian
yeah.
Now,
there's
all
these
reports
out
that
people
are
having
crazy
side
effects
when
they're
taking
this
but
they're,
not
actually
diabetic.
You
know
it
hasn't
been
out
that
long.
B
So
the
reason
I
say
that
is
I
pretty
much.
If
I'll
go
to
a
meeting
these
days
where
an
employee
hasn't
asked
HR,
oh
can
I
get
a
zombie
on
the
plan
because
my
doctor
said
it
would
be
a
great
way
for
me
to
lose
weight.
So
it's
a
very
growing
Trend
most
plants
are
typically
excluding
it
if
it's
solely
for
the
purpose
of
weight
loss.
B
So
if
you
need
the
crime
Syria,
because
you're
diabetic
or
one
of
those
things
it
is
covered,
but
I
just
bring
that
up
in
case
any
employees
in
a
group
say:
I
want
that
and
I
think
it
will
be
interesting
to
see
over
the
next
six
to
12
months,
because
now
there's
a
lot
of
warnings
coming
out.
It
seems
like
where
people
like,
hey,
you
really
shouldn't
be
making
this,
for
you
know
just
to
lose
weight
and
I,
don't
know
you
know.
We've
had
a
couple
of
these
fads
over
the
years.
B
I
remember
25
years
ago,
I,
don't
know
if
you
guys
remember
what
it
was
spend,
then
all
right,
you
know
everybody
running
to
give
fencing
and
then
they
were
dying
with
artifacts
and
all
that
and
I.
There
was
a
guy
that
worked
for
my
dad
that
did
it.
You
know
he
lost
a
bunch
of
weight,
but
then
he
just
he
lived
the
next
five
years,
like
in
total
fear
like
was
his
heart
and
a
stop.
B
You
know
because
he
had
been
on
this
med,
so
you
know
I
think
it
had
to
balance
that,
but
that's
just
kind
of
where
the
industry's
at
with
it
I
just
couldn't
pronounce
it
to
anybody.
Anybody
talks
about
that
page
19
is
the
bigger
brand
following
right.
So
page
20.,
this
is
the
drugs.
We
can
do
a
separate
report
that
this
shows
the
cost
per
square,
because
some
of
these
drugs
are
eight
ten
thousand
dollars
a
script
when
you
start
to
look
at
them.
B
But
what
I
do
you
know
kind
of
like
to
point
out
and
they're
all
saying
in
an
offensive
manner,
but
we
hear
people
all
the
time.
Oh,
our
co-pays
are
too
high.
Our
Pharmacy
plan.
Isn't
that
good
and
all
those
things
well
like
these
nine
individuals
on
new
marriage
is
to
give
you
an
idea
to
plan
and
pay
the
516
000
dollars
and
the
members
combine
a
two
thousand
the
next
one
down.
You
know
three
members
getting
stolara
combined
paid
540
and
the
plan
paid
400
000.
B
I
understand,
like
you,
know,
everybody.
Nobody
wants
to
see
anything
going
up,
but
I
do
think
it's
good
to
have
sort
of
that
perspective
of
how
much
the
plan
is
actually
picking
up
on
some
of
these
things
and
a
50
copay
or
a
thirty
dollar
copay
seems
burdensome.
But
when
you
really
look
at
you
know,
what's
being
paid
by
the
plan,
it's
you
think
about.
You
know
these
30
people
pay
probably
less
than
two
hundred
dollars
and
the
plan
picked
up.
B
And
then
page
21
video,
we
always
like
to
just
keep
an
eye
on
on
Imaging
I,
think
there's
some
of
their
industry
wisely.
There's
too
many
tests
being
Britain,
because
doctors
are
afraid
of
getting
sued.
You
know
you're
going
for
a
headache.
20
years
ago
we
said
here's
the
mask
button
and
let
us
know
what
happens
now.
We
send
you,
for
you
know
a
thousand
dollar
CAT
scan
to
make
sure
you
know
just
so
we
don't
get
sued
and
the
link.
B
B
C
B
So
that
so
those
those
scripts
are
all
direct,
so
he's
a
health
center,
but
what
we,
what
we
do
is
we
run
through
a
zero
cost
claim
so
that
we
have
to
count
on
like
scripts
being
filled
and
some
of
those
things.
So
we
get
that
audit
on
the
pharmacy.
We
run
it
through
at
zero
o'clock,
so
it
goes
in,
but
there's.
C
B
One
of
the
reasons
we
did
that,
just
so
you
know,
I
was
like
Alliance
like
Cigna,
has
programs
as
an
example
and
the
health
center
programs
too.
We
wanted
them
to
be
able
to
see
as
an
example
like
building
Outreach
calls.
Let's
say
somebody
didn't
take
hadn't
taken
their
diabetes,
they
haven't
filled
their
diabetes
script
for
six
months.
They'll
make
an
Outreach
call
and
say:
Hey,
you
know,
is
it?
Can
you
not
afford
it?
Can
you
do
that?
We
didn't
want
them
making
calls
when
you
were
getting
it
at
the
health
center.
B
B
B
B
Okay,
so
I
would
just
suggest
anybody.
That's
considering
that
talk
to
somebody
that
really
knows
Medicare
to
see
if
that's
actually
the
best.
You
know,
there's
different
rules
when
you're
active,
if
you
have
both,
which
yeah
that
I'm
pretty
familiar
with
but
I,
don't
know
if
you're
I
don't
know
if
Medicare
has
any
like.
If
you
have
health
insurance
available
to
you
and
you
choose
to
take
Medicare
I,
don't
know
if
that
impacts.
Anything
it
may
not.
A
B
B
I
think
we
told
you
all
last
year,
but
it's
been
a
it's
been
a
number
of
years
since
we've
been
to
Health
Center,
there's
no
major
ongoing
concerns,
or
anything
in
that.
So
we
are
working
on
RFP
for
the
health
center
that
will
go
out
and
have
those
people,
that's
nothing
to
do
with
this
satisfaction
or
anything
along
those
lines,
just
having
a
benefit
since
I
think
it
was
16..
B
So
originally
The,
Five-Year
window
kind
of
came
up
during
the
pandemic,
and
you
know
we
didn't
feel
nobody
felt.
It
was
in
the
best
interest
employees
here
at
the
city
to
potentially
have
any
concerns
or
disruption
with
that
during
that
time.
So,
and
that
is
on
our
agenda.
Is
there
anything
that
anyone
else
wants
to
talk
about
ask
about.
C
B
C
B
I
don't
have
anyone
that
is
like
direct
contracted
with
BayCare
or
kind
of
the
clinic
type
scope
of
services.
We
have
probably
across
all
of
our
clients,
I
think
there's
about
28
groups
running
clinics.
We
have
a
couple
that
have
you
know:
I'll
call
Paul
Cigna,
you
know
ever
North
for
this
Clinic
like
Kerry,
to
see
some
of
those
I'll
call
those
like
your
traditional
Clinic
providers.
We
have
a
couple
that
are
using
like
a
local
doctor
group,
not
many.
B
It's
only
two
or
three
that
have
done
that
type
of
arrangement,
there's
pros
and
cons.
You
know
some
people
like
that
they're
just
mobile
and
they
can
call
the
owner
and
say
hey.
We
got
a
problem
at
the
clinic.
The
flip
side
of
that,
though,
is
they
typically
don't
have
the
symptoms.
You
know
for
online
scheduling
for
a
lot
of
those
different
things.
B
So
you
take
a
little
bit,
you
know
pro
and
con
there
and
they
typically
don't
have
as
as
strong
of
access
to
Pharmaceuticals
as
the
bigger
companies
are
going
to
have
so
there's
some
trade-offs
there.
You
know
you
get
a
little
smaller
operation,
but
not
necessarily
you
know
you
potentially
lose
some
of
the
services.
B
So
a
lot
of
our
groups
have
a
concern
that
if
I'm
partnering
with
a
hospital
system
to
run
my
health
center,
that
they're
incentive
is
going
to
be
to
actually
push
people
to
the
hospitals,
a
higher
cost
facilities.
Some
of
those
things
now,
that's
actually
concern
I've,
never
had
anyone.
Do
it
so
I
can't
say
that
I
have
never
had
anyone
partner
with
a
hospital
system.
So
I
can't
say
that
there's
any
evidence
that
oh
that's
happened,
that's
just
more
of
a
concern
that
people
have
is
that's
where
their
highest
revenue
is.
B
So
what
are
you
going
to
do
to
ensure
to
me
that
I'm
not
going
to
see
you
know
my
claims
at
Morton's
plan
which
were
three
million
or
whatever
it
would
is
you
know
if
I
put
in
a
health,
you
know
Clinic
with
one
of
those
or
a
chance
in
general.
Even
that
is
that,
like
then,
all
of
a
sudden
last
year,
I
spent
a
million
dollars
at
that
hospital,
and
this
year
I
spend
four
everybody's
going
to
look
and
say:
Well
why'd
you
go
into
entrepreneurship,
go
down
there
just
so.
B
Those
are
concerns
that
I
think
are
valid
and
have
to
be
looked
at.
You
could
probably
structure
a
contract
with
some
guarantees,
but
that
would
take
some
time,
I
think
and
somebody
that
really
knows.
Hospital
billing
like
actually
go
through
and
write
a
contract
that
would
protect
you
because
there's
a
lot
of
practices
in
the
hospital
billing,
where
you
could
kind
of
bury
a
lot
of
costs.
So
that
would
be
a
concern.
Is
we
don't
want
to
save
money
on
the
clinic
and
see
our
Hospital
claims.
B
So
and
one
thing
we
are
I,
don't
know
if
anything
will
change,
but
one
thing
we
are
going
to
ask
about
in
England.
Rmp
is
a
possibility
of
maybe
adding
some
of
the
occupational
and
workers.
You
know
what
can
different
vendors
do
doesn't
mean
we're
necessarily
going
to
move
any
of
that
to
the
clinic,
but
in
that
process
we
want
them
to
really
outline
whether
different
options
are.
We
have
a
number
of
groups
that
is
an
example,
run
all
their
occupational
exams
through
the
health
center.
B
They
haven't
really
a
high
cost
with
them.
So
you
know,
if
there's
you
know,
if
you
know
your
guys
departments
aren't
happy
with
the
current
structure.
Is
that
hey
we
can?
We
can
look
at
moving
this
in-house
or
doing
that,
so
it's
just
some
more
exploring.
It
doesn't
mean
anything's
going
to
change.
B
You
know
it's
just
something
that
we're
you
know
look
at,
and
maybe
it's
not
even
the
occupational
exam.
Maybe
it's
week
it's
in
first
reported
an
injury,
Center
and
produce
the
workers.
You
know
claim
instead
of
like
some
of
those
things.
So
this
is
something
that
we're
going
to
explore
in
that
honor
it.
But
nobody,
nobody,
panic
than
anything
or
I
know
certain
things
are
negotiated
and
all
those
things
it's
just
something
we
want
to
have
them
explain
what
their
capabilities
are
and
you
could
have
a
vendor.
B
That's
the
best
vendor
in
the
world.
Everything
you
want
on
the
medical
and
they
say
we
don't
touch
any
of
that
stuff.
Yeah
we're
not
going
to
touch
it
and
you
know
I
would
never
recommend
somebody
give
up
something
they'd
like
or
something
that
is
really
good.
On
the
medical
side,
because
that's
primary
focus,
but
it's
just
something
we
want
to
look
at.
A
B
B
So
yeah,
so
that's
a
no!
So
typically
what
you
will
typically,
what
you
will
do
is
you'll
need
to
have
an
occupational
provider,
and
that's
you
know,
kind
of
to
that
point.
We
have
to
look
at
all
the
data
and
the
occupational
to
even
see
if
that
would
move
what
most
of
the
clinics
do,
though,
when
they
do
that
is
they
have
a
separate
EMR
system
and
they
actually
separate
the
occupation
on
the
medical
so
that
there
is
so
that
those
records
aren't
funded.
B
C
B
B
You
an
example
so
Charlotte
accounting
they
run
their
workers
on
a
personal
report
of
inquiry
for
the
health
center.
However,
as
you
guys
know,
not
all
workers
comp
claims
are
potentially
you
know
low
enough
level
of
severity
that
they
can
write
some
out
to
go
to
an
ER
or
some
have
to
go
to,
so
they
still
have
other
resources.
B
B
C
B
Yeah
anyway,
it's
just
something:
we're
looking
at
I
think
it
is
not
a
primary
purpose
by
any
means,
the
primary
focus
is
the
medical
care
and
all
that
and
yeah
yeah
I.
Think
too,
from
a
point
of
having
the
committee,
you
guys
have
concerns
about
that
or
anything
because
that's
definitely
something
that
we
want
to
know.
You
know
I
mean
I.
B
I
know
this
from
all
the
groups
we
work
with
and
what
Live
Scan
does
I
mean
we
would
never
probably
come
in
and
recommend
that
probably
just
replace,
because
I
know
the
way
people
are
attached
to
lifestan.
I
know
the
benefit
of
the
year-over-year
report
so
like
to
me:
it's
not
like.
Oh,
we
want
to
come
in
and
make
Life
Scan
out
of
save
a
couple
dollars,
not
by
any
means
you
know,
but
you
know
if
we
can
take.
B
You
know
a
bunch
of
you
know
every
time
that
workers
comp
claim
is,
and
it
affects
your
modification
memory
that
affects
your
periods.
So
if
there's
certain
claims
that
really
aren't
costing
that
much
that
are
very
minor
and
we
can
run
them
through
the
clinic
and
not
have
a
cost
and
not
have
all
those
things,
that's
going
to
help
everybody
by
the
road.
B
C
B
B
We've
seen
huge
huge
changes
either
way.
Dental
I
think
what
has
happened
in
Dental
kind
of
industry-wide
is
a
large
number
of
dentists
have
gone
to
sort
of
this
practice
of
I
will
process
your
insurance
claim,
but
I'm
not
taking
any
network,
and
that's
really
that's
becoming
very
common,
for
you
know,
excuse
the
terminology,
but
for
the
good
dentists,
because
they're
Asian
clothes
is
so
high
that
every
single
Scott
is
federal.
So
the
way
that
Rihanna
started
looking
at
it
is
all
filed.
My
patients
claim
and
get
them
the
money.
B
B
So
that's
what
we've
seen
in
Dental
I
don't
know
that
you
will
see
that
change
unless
we
go
into
a
significant
recession
and
we
start
seeing
people
cut
back
that
maybe
you'll
see
Dennis
and
say
I
need
to
go
to
network
as
far
as
the
dhmo
networks.
You
know
those
have
been
challenged
for
a
number
of
years.
B
You
know
the
typically
a
lot
of
those
practices
are
more
of
a
stepping
stone
for
business
to
starting
their
own
practice
and
kind
of
getting
where
they
walk
in
so
you've
always
seen
the
dhmos
much
more
limited
to
your
retail
change.
You
may
not
know
which
dentist
you're
getting,
and
we
haven't
seen
that
change
really
all
that
much
so
you
know
we've
seen
if
we've
seen
anything
we've
seen
more
on
today's
shift
to
PBO
plans.
B
B
Added
cost,
you
know
it
might
be
10
15
a
month,
but
if
you
are
actually
going
to
the
dentist
twice
a
year
and
getting
your
that
money
is
going
to
come
back
to
you
ultimately
like
that
plan
is
going
to
be
worth
it
yeah.
If
you
pay
for
that
plan
and
you
never
go
it's
just
for
emergencies,
that's
a
little
bit
tougher
discussion,
but
you
know
I
think
the
PPO.
You
pay
a
little
bit
more,
but
you
will
get
your
money
back
if
you're
going.