HomeMy WebLinkAbout2000 10 23 Consent C Emergency Medical Transport System
Date: 10232000
This was moved to the Regular Agenda on
10/23/00 but due to time constraints, this Item
was not heard on 10/23/00.
COMMISSION AGENDA
ITEM C
CONSENT X
INFORMA TIONAL
PUBLIC HEARING
REGULAR
October 23. 2000 MGR rlDEPT .--.:;~
Meeting Authorization
REQUEST: Fire Department requesting authorization to extend a term contract
for Billing Services for the Emergency Medical Transport System.
PURPOSE: The purpose of this Commission item is to gain authority for the City Manager to
extend a term contract with Medical Claims Processors Group, Inc. for Billing &
Collection Services for the Fire Department Emergency Medical Transport
System at a cost of3.82% of the amount collected.
CONSIDERA TIONS:
On September 13, 1999 the City Commission approved a one-year term contract
extension with Medical Claims Processors Group, Inc. for billing and collection services
for the Fire Department Emergency Medical Transport System at a cost of3.82% of the
amount collected. The contract contained a provision to allow the City the option to
extend this contract for up to three (3) additional years past the expiration date of
September 30, 2000.
The Fire Department and Finance Department request the City Commission consider
extending the contract for one additional year. The contract renewal would be from
October 1, 2000 through September 30,2001 and would permit an additional two (2)
years of extensions if the City should so desire.
October 23, 2000
Consent Agenda Item "C"
Page 2
Since assuming the contract from Regional Emergency Services, LP., Medical Claims
Processors Group, Inc. has performed as expected. During the twenty-four (24) months
of their contract they have billed out $426,452 and collected $233,721, which amounts to
a 55% collection rate. This collection rate does not include any adjustments or write-offs
for uncollectable amounts of Medicare, or Medicaid reimbursements. We will continue to
monitor the progress and anticipate an increase in collections to the expected collection
rate of 60% to 70% of billed services.
Last year when the Agenda item was presented to the City Commission, Medical Claims
Processing Group had a collection rate of 48% and have increased their collections by 7%
as originally projected. As experienced with the three (3) prior billing companies,
insurance, Medicare, and Medicaid claims take some time to catch-up when you change
billing companies. This causes delay in payments until all the changes take place and
historically take a few months for the companies to achieve a stable collection rate.
Payments within the last year have improved and it is anticipated to improve over the
next year. The chart below reflects collection rates of entities in Central Florida that
provide medical transport. The rates represent all collections through the end of calendar
year 1999.
ENTITY COLLECTION RA TE
Altamonte Springs Fire Department 67%
Casselberry Fire Department 67%
Longwood Fire Department No Report
Oviedo Fire Department 70%
Kissimmee Fire Department 60%
Sanford Fire Department 58%
Seminole County Fire Department 55%
St. Cloud Fire Department 66%
Winter Park Fire Department 61%
Winter Springs Fire Department 60%
October 23, 2000
Consent Agenda Item "C"
Page 3
The billing service provider is required to invoice the responsible party for Emergency
Medical Transport of the patient to the Hospital by the Winter Springs Fire Department.
The agreement will allow Medical Claims Processors Group, Inc., of Jupiter, Florida, to
bill the established transport fee at the maximum reimbursable rate as established by
Medicare plus mileage. The City of Winter Springs shall pay to the Billing Center for
services a rate of3.82% of the collected amount.
Bids for this service were publicized and were opened on July 29, 1997 under Bid # Y7-
190-HF of the Board of County Commissioners of Orange County, Florida. The Board
awarded a contract to Medical Claims Processors Group, Inc. for billing services. The
City of Winter Park, Sanford, Altamonte Springs, and Seminole County have also
contracted under the same terms and conditions.
Medical Claims Processors Group, Inc. has agreed to convey the prices, terms, and
conditions of their bid with Orange County, to the City of Winter Springs, as outlined in
the City of Winter Springs Fire Department, Term Contract No. 98-01, Billing and
Collection Services for Fire Department Emergency Medical Transport.
The City Attorney had originally approved the Term Contract between the City of Winter
Springs Fire Department and Medical Claims Processors Group, Inc. as to form and
legality when presented in October 1998.
FUNDING:
This service is budgeted in the 2000/2001 fiscal year in the Medical Transport Special
Revenue Fund, Billing Services Costs Line Code No. 53410 at a projected expense of
$6,000.
October 23, 2000
Consent Agenda Item "C"
Page 4
RECOMMENDATION:
It is recommended that the City Manager be authorized to enter into a term contract with
Medical Claims Processors Group, Inc. for Billing & Collection Services for Fire
Department Emergency Medical Transport System at a cost of 3.82% of the collected
amount.
IMPLEMENTATION SCHEDULE:
The agreement would become effective October 1, 2000.
ATTACHMENTS:
1. City of Winter Springs Fire Department, Term Contract No. 98-01
COMMISSION ACTION:
MEDICAL CLAIMS PROCESSORS GROUP INC
Fire Rescue Division
POBox 8063
Jupiter, FL 33468-8068
(561) 747-5755 PH
(561) 743-3359 FX
September 29, 2000
Chief Timothy Lallathin
Winter Springs Fire Rescue Department
102 N. Moss Road
Winter Springs, FL 32708
RE: CONTRACT RENEWAL
Dear Chief Lallathin:
Please be informed that it is the desire of Medical Claims Processors Group, Inc.
to renew its contract with Winter Springs Fire Rescue Department under the same
terms, conditions and price of the initial contract effective beginning October 1, 1998. A
copy of this contract has been attached hereto in its entirety and made a part of this
approval and acceptance.
Indicated below are two locations for approval and acceptance by the City of
Winter Springs and Medical Claims Processors Group, Inc. I have already executed on
behalf of Medical Claims Processors Group, Inc. and, after execution by the City
Manager, I would request that a conformed copy of this letter be forwarded to me so
that we may have an exact copy for our flie.
Medical Claims Processors Group, Inc. wishes to thank Winter Springs Fire
Rescue Department for the opportunity to perform your EMS transport billing. We
look forward to our continuing relationship with Winter Springs Fire Rescue and all of
its rme representatives.
erly, rJ~J~
APPROVED AND ACCEPTED
Elaine C. Hines
Administrator
B
sso s Group, Inc.
ate: ()q!d.Ci 1.8.000
City of Winter Springs
By:
City Manager
Date:
letters-ech .doc
ATTACHMENT: ONE
CITY OF WINTER SPRINGS FIRE DEPARTMENT
TERM CONTRACT NO. 98-91
Billing & Collection Services for Fire Department Emergency Medical Transport
TO: Medical Claims Processors Group, Inc.
P.O. Box 8063
Jupiter, FL 33468-8063
This is to inform you that the City of Winter Springs hereby enters into a Term Contract subject
to the following:
TERMS AND CONDITIONS
1. Acceptance:
This contract is our acceptance of your offer to operate as an Agency for the patient billing
and collection services of the Emergency Medical Services of the City of Winter Springs,
Florida Fire Department. It is subject to all terms and conditions herein.
2. Term of Contract:
2.1 This is a term contract for the time period specified herein. It is entered into for the sole
purpose of purchasing services which are covered by this contract. The City is not obligated
to purchase any minimum amount of service, unless otherwise stipulated in the contract.
2.2 This contract shall be effective beginning October I, 1998, and shall remain in effect
through September 30, 1999.
2.3 Thirty (30) days prior to the expiration date listed in section 2.2, the City shall advise
the Agency of its intentions regarding the possible extension of the contract. The City shall
have the option to extend this contract for up to four (4) additional years past the expiration
date listed.above, and any extension pursuant to section 2.3.
2.4 Both parties agree to a trial period of no more than ninety (90) days during which the
right to terminate the contract shall be suspended except as permitted under Paragraph 4.3.
2.5 The Agency will deposit collected funds into the City's designated bank account on the
same day as they are received. In addition, the Agency shall provide the City with validated
bank deposit slips on a weekly basis. It will be the responsibility of the City to provide the
agency with preprinted deposit slips.
Page 10f7
3. Compensation
3.1 The City shall pay the Agency for the services described in section (1) herein 3.82% of
the amount collected. This rate shall be in effect for twelve (12) months from the date
hereof with an option for an extension for up to four (4) additional years at the same rate of
3.82% collection rate. In addition, the City shall compensate the Agency at a rate of5.5%
for any revenue generated by the Agency on all acCOWlts which were previously assigned to
prior vendor. All payments by the City will be made in accordance with the "Florida Prompt
Payment Act".
4. Code of Ethics and Debt Collection Practices
4.1 The Agency shall maintain and operate under a "Code of Ethics" to insure integrity and
confidentiality of the City and patients. A copy of this code is attached and incorporated
herein by reference.
4.2 The Agency covenants and agrees that it shall comply with, keep and follow the
guidelines, laws and regulations set forth in Chapter 599, Florida Statutes, and that it shall.
not violate Florida Statute 559.72 prohibiting certain practices concerning consumer or
commercial collection, and all other laws, rules and regulations concerning commercial
collections. The Agency warrants that it is aware of and fully lmowledgeable of the laws
regarding collection practices including those set forth in Florida Statutes Chapter 559 and
warrants that it shall at all times remain lmowledgeable of the laws set forth therein and any
amendments thereto, and any successor laws, rules and regulations pertaining thereto.
4.3 A violation by the Agency of either the Code of Ethics or any provision of Florida
Statutes Chapter 559, or any other law, rule or regulation concerning commercial collections
shall be grounds for the City's immediate termination oftrus Agreement upon the Agency's
receipt of notice from the City, without the thirty (30) day waiting period. In addition, the
Agency agrees to comply with the Federal Debt Collection Practices Act set forth in 15 U.S.
Code Section 1692 (a) - (0), and that any violation of that Act will also be grounds for
immediate tennination of the contract.
4.4 Uncollectible accoWlt receivables will be written off after twelve (12) months from the
initial billing date. The City and the Agency will discuss this issue before any action is
taken to remove the set accoWlts. The City reserves right to make the final decision on the
accoWlts.
5. Indemnification
5.1 The City of Winter Springs, its officers and employees shall not be deemed to assume
any liability for the acts, omissions, and negligence of Agency, its officers and employees.
The Agency shall indemnify and hold the City and its officers and employees harmless from
any liability, claims, causes of action, costs or expenses either direct or indirect including
attorney's fees incurred as a result of, or arising Wlder, this contract or the provisions of
services hereWlder.
Page 20f7
5.2 The City shall be held harmless against all claims of bodily injury, sickness, disease,
death or personal injury or damage to property or loss of use resulting therefrom arising out
of performance of the contract, unless such claims are a direct result of the City's sole
negligence. The City shall also be held hannless against claims for financial loss with
respect to the provisions of or failure to provide professional or other services resulting in
professional, malpractice, or errors or omissions liability arising out of the contract, unless
such claims are a result of the City's sole negligence.
6. Insurance
6.1 The Agency shall be responsible for maintaining a general liability insurance policy.
covering all actions taken by the Agency in connection with either its duties under this
contract or its relationship with the City. The general liability policy shall have a minimum
coverage of One Million Dollars ($1,000,000) per occurrence and One Million Dollars
($1,000,000) aggregate. The Agency shall provide to City a Certificate of Insurance on the
aforementioned policy immediately upon execution oftms contract.
6.2 The insurance company and policy shall be in a form that is acceptable to the City. The
Agency shall notify the City at least thirty (30) days in advance of cancellation, non-renewal
or adverse change to the policy. New certificates of insurance are to be provided to the City
at least thirty (30) days prior to coverage renewals.
6.3 If requested by the City, complete copies of the insurance policies, forms and
endorsements will be furnished to the City within ten (10) days of written notice. The
receipt of certificates or other documentation of insurance or policies by the City, wmch
indicate less coverage than required, does not constitute a waiver by the City of Agency's
obligation to fulfill the insurance requirements.
7. Assignability
7.1 This contract is not assignable by either party.
8. Severability: Florida Law
8.1 If any part of this contract is adjudged invalid, all other parts herein shall remain validiand enforceable. Florida law shall govern this contract.
9. Scope of Services
9.1 The Scope of Services attached herein is expressly made a part of this contract.
Page 3 of7
10. Miscellaneous Provisions
10.1 Notices. Any notices pursuant to this agreement shall be provided in writing to:
City Manager
1126 East State Road 434
Winter Springs, FL 32708
Copies To:
City Clerk
1126 East State Road 434
Winter Springs, FL 32708
Agency:
Medical Claims Processors Group, Inc.
Elaine Hines, President
P.O. Box 8063
Jupiter, FL 33468-8063
IN WITNESS WHEREOF, the parties hereto have signed this contract by their duly authorized
officers as of the day and year set forth above.
CITY OF WINTER SPRINGS, FLORIDA
BY:~ 1rJ.1J11~ -
Attes?kr~.x?/~
MEDICAL CLAIMS PROCESSOR GROUP, INC.
BY:~~Va.W~(~)
Attest: tI~~xiIi1
Page 4 of7
CITY OF WINTER SPRINGS FIRE DEPARTMENT
BILLING AND COLLECTION SERVICES
SCOPE OF SERVICES
Winter Springs, Florida (City) desires to enter into a contract with an experienced and qualified
firm (Agency) to:
1. Provide billing and collection services for Emergency Medical Services treatment and
transport, as required on a case by case basis, with an emphasis on an accelerated turnaround
between services provided and payments received. The price bid or piggyback contract
herein shall include all expenses of billing and collection including, but not liri1ited to,
stationary, forms, envelopes and postage.
2. Provide reasonably necessary training to appropriate City Fire Department personnel
regarding the gathering of necessary information and proper completion ofrun tickets.
3. Provide prompt submission of Medicare, Medicaid and insurance claims within ten (10)
business days after receiving the completed run ticket, which shall be the Agency's notice to
commence the billing/collection service. Secondary insurance provider claims shall be
submitted within ten (10) business days after the primary insurance provider has paid or
otherwise completed its processing of the claim. The Agency shall follow-up promptly on
rejected and inactive claims and establish payer remittance accounts and procedures.
4. Reconcile the number of transports collected with those transmitted to the Agency. The
Agency shall contact the Fire Department within twenty-four (24) hours of receipt to report
any discrepancies.
5. Agency shall provide a designed liaison for patient/payer concerns.
6. Provide survey questionnaires to patients at the City's request.
7. Provide all customer related inquiry services and prepare additional third party claims based
on this information exchange. Customer calls will be facilitated as local within metropolitan
Orlando or through an "800" exchange.
8. Implement a collection system involving a minimum of three invoices and a follow-up
campaign of up to ten (10) telephone attempts to collect all private pay accounts with
outstanding balances, including required co-payments and deductibles assessed by Medicare,
Medicaid, HMO's or private insurance. Records of telephone calls and contacts shall be
maintained and any payment on an account shall reset this cycle. The Agency shall make an
attempt to locate the correct address for all returned mail to include up to three (3) attempts.
The City reserves the right to approve the invoice format.
9. Attempt to collect all balances due for services rendered as well as attempt to assess patient's
ability to repay the debt and, if necessary, extend time payments, all subject to such policy
Page 5 of7
guidelines as the City may establish.
10. All requests for refunds will be forwarded to the City for any possible reconciliation. Refund
requests will be forwarded to the City on a weekly basis. It will be the responsibility of the
City to issue any refunds to clients.
11. The Agency shall provide to the City all unpaid invoices along with the complete processing
history once collection efforts described herein are exhausted. At the termination of the
agreement the Agency shall turn over all existing information in its possession concerning
then existing unpaid accounts to the City. Such information shall be transmitted by an
electronic medium (magnetic tape or diskette) reasonably acceptable to the City.
12. The Agency shall provide sufficient personnel to process all billing/run tickets in a timely,
efficient and effective manner and shall respond promptly to the City and patients on requests
for information or records.
13. Agency shall use any confidential records of care or treatment of patients solely for the
pwpose of processing and collecting claims and shall not release any such information in any
legal action, business dispute or competitive bidding process other than disputes with the
City over billing services.
14. Any procedures described in this scope of services represents a minimum effort required by
the City of the Agency and shall not limit the Agency's use of its proprietary accounts
receivable and billing and collections systems, including modifications as required by major
provider groups, or its usual and customary practices. This agreement shall require a
minimum standard of 60% collection success rate. The successful collection rate will be
calculated on a quarterly basis and reflect the percentage based upon what is billed versus
what is actually collected before any other action is taken on the account. The Agency will
be responsible for the amount of potential revenue that falls below the 60% minimum.
Payment difference must be made before the end of each fiscal year or may be removed from
any fees paid by the City for said services.
15. Accounts are subject to being reviewed by the City, and being available during normal
working hours to authorized City personnel. A listing of those personnel shall be provided
by the City.
16. The Agency, or its representative, must be licensed as a Health Claims Adjuster by the State
of Florida.
17. The City reserves the right to terminate this contract after a thirty (30) day written
notification to the Agency.
18. The Agency will be able to work previously billed accounts and be expected to collect on
accounts. The City agrees to compensate Agency 5.5% ofthe amount collected for these
accounts. A separate account shall be established to track these accounts.
Page 6 on
19. The City agrees to work with the Agency to provide the required run information to best
facilitate the billing process.
20. The Agency agrees to notify the City when refund to a client is required. The City will be
responsible for mailing all refund payments. The City will advise the Agency of all accounts
created and provide copies of payments made to same.
21. The following reports shall be prepared and submitted by the Agency for review by the City.
All discrepancies shall be brought to the attention of the Agency within ten (10) working
days.
Reports
Patient Accounts/Run Number Cross Reference
End of Month Report Totals Confirmation
Transport Billed Run Number and Invoice Number
Accounts Receivable! Aged Trial Balance
Payments by Deposit/Collection Report
Run Ticketffransport Tracking Report Corrections
Patient Account and Claim Follow up
Adjustment Report
Deposit Total Confirmation
Daily Cash Receipt Recap by Deposit
Collections by Payee Group
Page 7 of7
Frequency
Monthly
Monthly
Monthly
Monthly
Wee1dy/Monthly
Monthly
Upon Request
Monthly
Daily/Monthly
Daily/Monthly
Monthly