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P a c i f i c Working Groups Chief, Program Operations 2008 TAOP Conference Seoul, Korea Today’s Challenges, Tomorrow’s Solutions.

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Presentation on theme: "P a c i f i c Working Groups Chief, Program Operations 2008 TAOP Conference Seoul, Korea Today’s Challenges, Tomorrow’s Solutions."— Presentation transcript:

1 P a c i f i c Working Groups Chief, Program Operations 2008 TAOP Conference Seoul, Korea Today’s Challenges, Tomorrow’s Solutions

2 P a c i f i c Issues Philippines [Claims, Satellite Office] Korea Satellite Office ANG & AFR MTF Big Rocks

3 P a c i f i c Philippines Fraud & Certification Retiree Support PSO: DoS Mandates –Limit NSPS personnel –Security of resources & people PSO Location [Clark Air Base, VA, or Embassy] Support at PSO [Computer systems, housekeeping, etc.]

4 P a c i f i c 4 Issue: Cost are out of Control

5 P a c i f i c Fraud/Abuse Schemes Misrepresenting services provided Misrepresenting provider of services Billing for services not rendered Grossly inflated charges Claims for services not medically necessary Disguising noncovered services as covered Waiving cost shares and deductibles.

6 P a c i f i c Discussion and Recommendations

7 P a c i f i c Korea Satellite Office

8 P a c i f i c ANG & AFR

9 P a c i f i c MTF Big Rocks CHCS Registration/Enrollments –Beneficiary Addresses –Enrolled to PCMs [File & Table] Claims Accuracy & Currency Marketing Customer Service


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