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HomeMy WebLinkAboutMedical Compliance, Inc. Electronic Claims Submission Service Agreement -1996 10 15 . ~';-=~~'f"~ . ELECTRONIC CLAIMS SUBMISSION SERVICE AGREEMENT This Electronic Claims Submission Service Agreement ("Agreement") is entered into this l.5ih day of OCI6C1.t.'f2- . 1996, by and between Medical Compliance, Inc. ('~iIling Center"), a Florida corporation, and the City of Winter Springs, Florida ("City"), a Florida municipal corporation. WITNESSETH: WHEREAS, City is desirous of retaining Billing Center to process and submit City's claims for ambulance services to insurance companies; and WHEREAS, Billing Center for compensation and consideration set forth in this Agreement will process, submit and collect funds owing City for ambulance services; and WHEREAS, Billing Center agrees to abide by and comply with all covenants set forth herein and with all applicable Florida law, NOW, THEREFORE, the parties do agree as follows, ; , 1. Claims Processing Services. 1.1 Billing Center will pick up all claims information from the City of Winter Springs Fire Chief or his designee on a weekly basis, unless other arrangements have been made and agreed upon by both parties. 1.2 Billing Center will electronically process and submit the City's claims to the corresponding insurance companies and provide a computer generated report verifying their receipt by the insurance companies. City shall owe compensation to Billing Center only for primary claims, and shall not be responsible or liable for additional compensation to Billing Center for secondary claims. 1.3 Billing Center shall supply the City monthly reports which shall contain Electronic Verification Reports, Patient Aging, Accounts Receivable Report, Practice Analysis Reports, Insurance Analysis Reports, Insurance documentation consisting of follow up, patient documentation on calls and collections and any and other information available concerning the claims filed during the month preceding the monthly report. 1.4 Billing Center will deposit collected funds into the City's bank account within two days of receipt of same. Billing Center shall provide City with validated deposit slips on a weekly basis. City shall provide Billing Center with pre- printed deposit slips. , 2. Compensation 2.1 City shall pay to Billing Center for the services described in section (1) herein the per claim rate of 5.5% of the collected amount. This rate shall be in effect for twelve (12) months from the date hereof with an option for extension for up to four (4) additional years. The invoices are to be billed on a monthly basis. 3. Term of Agreement 3. 1 This agreement shall be for a term of one (1) year provided however that it may be terminated by the City upon the submission of a (30) days written notice to Billing Center. 3.2 The City shall have the option to extend this Agreement for up to four (4) additional years. 3.3 The City agrees to a thirty (30) day trial period during which the right to terminate this agreement shall be waived. 4. Code of Ethics and Debt Collection Practices. 4.1 Billing Center maintains and operates under a "Code of Ethics" to insure the integrity and confidentiality of City and patients. A copy of this code is attached hereto and incorporated herein by reference. 4.2 Billing Center convenants agrees that it shall comply with, keep and following the guidelines, laws and regulations set forth in Chapter 559, Florida Statutes, and that it shall not violate Florida Statues 559.72 prohibiting certain practices in collecting consumer debts nor violate any other provisions of the Florida Statutes concerning consumer or commercial collection. Billing Center warrants that it is aware of and fully knowledgeable of the laws regarding collection practices set forth in Florida Statutes Chapter 559 and warrants that it shall at all times remain knowledgeable of the laws set forth therein and any amendments thereto. 4.3 The violation by Billing Center of either the Code of Ethics or any provision of Florida Statues Chapter 559 shall be grounds for City's immediate termination of this Agreement upon Billing Center's receipt of notice from City without the thirty (30) day waiting period. . , . 5. Indemnification 5.1 The City of Winter Springs, it's officers and employees shall not be deemed to assume any liability for the acts, omissions, and negligence of Billing Center, it's officers and employees. Billing Center shall indemnify and hold the City and it's officers and employees harmless from any and all liability, claims, cause of action, costs or expenses either direct or indirect including attorneys fees incurred as a result of or arising under this Agreement or the provision of services hereunder. 6. Insurance 6.1 Billing Center shall be responsible for maintaining a general liability insurance policy covering all actions taken by Billing Center in connection with either it's duties under this agreement or it's relationship with the City of Winter Springs. The general liability policy shall have a minimum coverage of One Million Dollars ($1,000,000.00) per occurrence and One Million Dollars ($1,000,000,00) aggregate. Billing Center shall name City as an additional insured on all insurance policies obtained. Billing Center shall provide the City a Certificate of Insurance on the aforementioned policy immediately upon execution of this Agreement. 7. Assignability This agreement is not assignable by either party. 8. Severablility: Florida Law Ifany part of this Agreement is adjudged invalid, all other parts herein shall remain valid and enforceable. Florida law shall govern this Lease Agreement. IN WITNESS WHEREOF, the parties hereto have signed by their duly authorized officers as of the day and year set forth above. CITY OF WINTER SPRINGS, FLORIDA MEDICAL COMPLIANCE, INC. BY:~ Attest: ", - . BY&:''' ~JwjW~ AU : Iiiu;N'~~ roved as to form and legality: