CINICO boss confirms AIS no longer processing claims

| 15/03/2016 | 7 Comments
Cayman News Service

Cayman Islands Hospital

(CNS): The CEO of the government-owned insurance company, CINICO, confirmed that it is no longer using AIS Cayman Ltd or its Jamaican parent company, AIS, to verify and clear payments for its clients at the Cayman Islands Hospital. Lonny Tibbetts told CNS that, following a request for proposals in 2013, the payment systems are now being handled by a Michigan-based company, ABS-Automated Benefit Solutions, which is the network access provider to UnitedHealthcare, which operates out of Minnesota.

The former chair of the Health Services Authority, Canover Watson, was convicted last month for corruption and sentenced to seven years in jail. During the trial it was revealed that he and his friend, Jeffrey Webb, a convicted fraudster in the FIFA scandal, were the beneficial owners of AIS Cayman Ltd, which won the HSA payment system contract.

The AIS contract cost the Cayman Islands treasury millions of dollars, but as well as becoming the centre of the HSA corruption scandal, the system itself never worked properly.

Tibbetts said that on 1 January 2014, ABS began amalgamating the processed HSA claims from AIS Cayman, as well as processing the non-AIS claims that CINICO deals with, such as other providers in the private sector, claims for treatment in Jamaica and the US, plus claims that need to be reimbursed where CINICO clients have paid upfront for medical care.

“In the middle to late part of 2014, the Cayman Islands Health Services Authority and CINICO informed AIS that we would be reducing the use of their services and limiting the groups processed to the SHIC (Standard Health Insurance Contract) Group only. In response to this, AIS ceased the processing of all claims for CINICO and the CIHSA on 5 December 2014,” he said. “ABS, per the original contract executed in December 2013 with CINICO assumed the processing of the CIHSA claims for no extra cost to CINICO or the CIHSA. This produced an approximate savings of CI$ 2.1M per year for both entities,” he added, confirming that CINICO has not used AIS for any claims processing or any other services since 4 December 2014.

Tags: , , , ,

Category: Health

Comments (7)

Trackback URL | Comments RSS Feed

  1. Anonymous says:

    Approximately 2.1M savings a year for each entity?? It appears that the claims process and payment function is outsourced to overseas companies – which begs the question WHY?? Also the savings stated need to be justified with a comprehensive explanation as to how these savings were in fact realized. “ABS is the network access provider to UnitedHealthcare” (ref: first para of the article). How many services are provided by offshore third party administration companies is another question which answer begs WHY??




    0



    0
    • Anonymous says:

      The tone of this story, tells the real truth. Believe in anything outside Cayman and blame locals for any shortfalls. Two crooks don’t justify building a prison




      0



      0
    • Anonymous says:

      Get on your phone and call Cinico CEO Lonny Tibbetts and ask him. He is a brilliant man with more degrees than a thermometer, he is very approachable. I had questions once, I called got me an appointment and he was the most intelligent person I ever talked to in this country.




      0



      0
  2. Anonymous says:

    Does this mean that the cosmetic surgery will now stop being paid for by CINICO?




    0



    0
  3. Anonymous says:

    They are a bunch of jokers up there.




    0



    0
  4. Anonymous says:

    Can’t understand why I was told today that I owed the GTH nearly $200 for a routine procedure that should have been paid off long ago by the insurance – until I looked at the bill I requested (first time I’d laid eyes on it) and saw that it was only billed to the insurance co. 10 days ago. The procedure took place at the beginning of September 2015. What are they doing at that place??




    0



    0
  5. Anonymous says:

    I know Conowa must be wex! Thats another 2.1million that he could have gotten!!




    0



    0

Please include your email address in the form below if you are using your real name. You can use a pseudonym, with or without leaving an email address, or just leave the form blank to be "Anonymous". All comments will be moderated before they are published. Please read the CNS Comment Policy at the top of this page.

%d bloggers like this: