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In the following Q&A, Fernando Veloz offers his perspective as a Hispanic individual and someone who works on the payer side of insurance claims and benefits. For Veloz, the stakeholders he works with are all saying the same thing, but the message delivery varies. And it will take a continued partnership from all stakeholders to navigate.
Today Veloz is with MS Administrative Services. He started off his experience with nine years at Blue Cross of Idaho, has worked as a CPA, was involved with Your Health Idaho and a number of other overlapping industry stakeholders.
This Q&A has been edited for length and clarity.
Going into COVID-19, how has this impacted ‘payers’?
COVID-19, and its effects, have been devastating for us all; we're all experiencing its impact, from the provider, community, the payer community and the individual side of things.
First quarter (of 2020), we were concerned with cases that dealt with emergency room visits, the typical cases, preventive health care (and) elective procedures. Then we started seeing COVID starting to spike.
We (Idaho and the nation) were faced with this lockdown situation...all of the procedures were actually halted in health and wellness visits, preventive care visits. Once COVID started hitting the third and fourth quarter, our claims started...surpassing the thresholds. It hit the benefit plans especially hard. A lot of this had to do with in-patient stays...ICU cases. These cases lasted anywhere from 15 to 30 days. And these are high-dollar claims. This contributed to claims utilization. Just to give you a definition of utilization, it's the charge for medical expenses responsible for increasing costs.
It was a payment process partnership of dealing with...