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HomeMy WebLinkAboutMedical Claims Processors Group, Inc. Term Contract No. 98-01 Renewal -1999 08 17 ~ ~ . MEDICALCLAIMS PROCESSORS GROUP, INC. CONSULTANTS & MANAGEMENT DIVISIONS: Fll'TIENT ADVOCATE ESTATE & LITIGATION CLAIM APPEALS PROVIDER CLAIMS & BILUNG MAIUNG ADDRESS: P.O. BOX e083. JUP~.FL3346e-8063 LOCATION: 725 N. HIGHWAY I><lA SUITE 6403 .JUPfTCR. FL 33477 581-747~5 PHONE 581.:t'43-3359 MX August 24, 1999 Winter Springs Fire Rescue Department Chief Tim Lallathin 102 N. Moss Road Winter Springs, Florida 32708 Dear Chief Lallathin: This letter comes in follow-up to our meeting of August 17, 1999 and discussion of the renewal of contract #98-01 "Billing and Collection Services for Fire Department Emergency Medical Transport." Please be informed that it is the desire of Medical Claims Processors Group, Inc. to renew the contract with Winter Springs Fire Rescue Department under the same terms and 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 acceptance. I have indicated below two (2) locations for acceptance and approval by Winter Springs Fire Rescue and Medical Claims Processors Group, Inc. I have executed the approval and acceptance and request tbat Medical Claims Processors Group, Inc. be forwarded a conformed copy of this acceptance and approval after executed by your Town Manager so that we may have an exact copy for our file. Medical Claims Processors Group, Inc. thanks Winter Springs Fire Rescue for the opportunity to provide our services for your EMS transport billing and look forward to the continuance of our good working relationship. Cordially, APPROVED & ACCEPTED Elaine C. Hines, Administrator Date: ){ / d 4, jqc; I I ECH:dcm Enclosure City of Winter Springs By: il~M 11A'~ 9fy Manager -.f' Date: l' -' J ( '- CZ i CITY OF WINTER SPRINGS FIRE DEP j\RTMENT TERM CONTRACT NO. 98-01 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 1, 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 1 of? " i - j 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 harmless 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. Irlsurance 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 of this 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 ofinsurance 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, which 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 ofthis contract is adjudged invalid, all other parts herein shall remain valid and 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 of? . .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:/1l#1J. rl1~ ... AIre~?A.~?/~ MEDICAL CLAIMS PROCESSOR GROUP, INC. By:J.fb~LJa.W.(~,~) Alresl: ~~4 Page 4 of? CITYi 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 co!lection 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 limited 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 of run tickets. 3. Provide prompt submission of Medicare, Medicaid and insurance claims within ten(lO) 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 oftelephone 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 of? guidelines as the City may establish. i J 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 ofthe 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 purpose 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 of7 . I I. 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 s~e. 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 Weekly/Monthly Monthly Upon Request Monthly Daily/Monthly Daily/Monthly Monthly