Office of the City Auditor

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Issued: January 2003

SUMMARY

The City of Austin contracts with a Third Party Administrator (TPA) to process and pay medical claims. $11.5 million was processed between February 1999 and February 2002. JI Companies took over in March 2002 to serve as the City's new Workers' Compensation TPA.

The Office of the City Auditor (OCA) hired a consultant to conduct an audit of claims to identify duplicate claims. The consultant found reasonable assurance that the program was not impaired by duplicate payment of workers' compensation claims. Prior to the audit, approximately $13,000 in duplicate payments had already been identified by the TPA, medical providers, and Human Resources staff and redeposited in the fund. The OCA consultant identified approximately one percent of the dollar value of the claims as potential duplicate payments that totaled nearly $136,000. Of those, detailed review confirmed $13,000 in duplicate claims; representing one tenth of one percent of total claims processed during the period reviewed. The City's Law department has begun collection procedures to recover these duplicated payments.

Click here to go to our audit request form to request a hard copy of this report (Report No. AU02307) or download the entire text of the Workers' Compensation audit (Size: 38 KB) in Adobe Acrobat. You will need Adobe's Acrobat Reader to view these files.

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