HomeMy WebLinkAboutMedical Compliance, Inc. Electronic Claims Submission Service Agreement -1996 10 15
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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,
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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.
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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.
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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.
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Attest: ", - .
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roved as to form and legality: