Coach of the Quarter – Jessica DelCastillo

Jessica DelCastillo, an accounting manager, has been with Palmetto GBA since 2008. She is a great asset to the Chief Financial Officer (CFO) reporting team. Jessica is a positive, supportive, focused, and open-minded leader who is always willing to share her knowledge with her staff. She takes the time to understand all projects from multiple angles so that she can best support her team to accomplish their goals. As a manager, she holds her team to a standard that is attainable but still allows for growth. Jessica encourages everyone to bring their ideas and process improvements to the table. Jessica's team says it best, "She is a positive and encouraging light in our department."

Team of the Quarter – Medicare Secondary Payer (MSP) Hospital Audit Team

The MSP hospital audit team is a group of individuals that constantly and consistently work toward their goals. They understand the Centers for Medicare & Medicaid Services (CMS) measures and what must be done to meet them. Each team member is assigned to certain hospitals throughout the year to complete audits for Palmetto GBA’s JJ and JM A/B MAC contracts. A total of 67 hospitals are assigned annually. The audit team is responsible for planning the audits and following each audit to completion.

An audit is a multi-step, detailed process including pre-audit planning, a virtual entrance conference, a review of admissions and billing processes, and an exit conference to discuss findings and provide education. A final assessment is completed, which includes recommendations followed by a review to ensure all actions were completed.

The MSP Hospital Audit Team conducts a review of 10% of the hospitals in each state yearly.

During August 2021, the auditors were required to complete all audits for the JJ contract’s year-end. The team completed all the work on time. JJ Option Year 3 was successfully closed out with no missed measures.

The MSP hospital audit team cares about their jobs and the output of their work and will do whatever may be necessary to attain success.

Team Members: Stacey Jenkins, Freyda Sherard, Dekita Thompson, Linda Williams, and Kisha Wilson

Process Improvement of the Quarter – A/B MAC FTE Requirements

Pre-Implementation: Before the JN A/B MAC solicitation, the MAC business proposal cost spreadsheets included the hours, rates, and costs for each Statement of Work (SOW) code within the workbooks.

Post Implementation: With the more recent CMS A/B MAC solicitations, the requirements include modifying the old cost templates and adding a full-time employees (FTE) column for all SOW codes within the workbook. In addition, cells had to be added for all indirect hours and FTEs for the four overhead pools, Other Direct Charges (ODCs), and G&A throughout every tab of the workbook. The sum formulas needed updating to include these new values. The recent Request for Proposal (RFP) templates also required a different color-coding format than we had been using. To ensure the correct number of direct and indirect FTEs, a reconciliation was included at the bottom of the spreadsheets and used the original FTE column to tie the direct FTEs.

These time-consuming changes were well worth it. Now, a set of preformatted cost templates offers time and cost savings for future A/B MAC proposals.

July Associate of the Month: Cindy Turner

Cindy Turner, an Accounting II Technician has worked for Palmetto GBA for over 12 years. Cindy is very hard-working, devoted, and has a strong willingness to help others. She brings a high level of excellence and customer service to the team by multi-tasking effectively and understanding projects and goals. Cindy wears many hats in the banking, Electronic Funds Transfer (EFT), and disbursements areas and excels in her role. She is an excellent example of what it means to be a team player. 

August Associate of the Month: Krystal Cato

Krystal Cato, an Accountant I, is one of the highest performers in the Financial Appeals department. She consistently exceeds expectations in her daily processing and is always willing to assist others. During August, Krystal successfully processed over 110 Administrative Law Judge (ALJ) decisions for the JM A/B MAC contract which is nearly three times the volume typically processed during a month. She always provides feedback during the training process for new associates and brings areas of concern to management's attention so that every member of the team can be trained appropriately. Krystal has a go-get-them attitude and is determined to perform work to the best possible standard.

September Associate of the Month: Savannah Tolonese

Savannah Tolonese, an Accountant II, is an employee any team would be fortunate to have. She consistently proves to be a contributing staff member by remaining productive, efficient, and professional. She actively completes impromptu requests as if routine and positively impacts the company’s strategic plan throughout various assignments. By utilizing effective listening skills and respecting the ideas and concerns of others, she leads her peers humbly and effectively.