HomeMy WebLinkAboutCC Resolution 9171 (Third Party Billing Services)RESOLUTION NO. 9171
A RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF SAN RAFAEL AUTHORIZING THE CITY MANAGER TO
EXECUTE AN AGREEMENT WITH ALLIED INFORMATION
AND SERVICES CORPORATION FOR THIRD PARTY
BILLING SERVICES FOR THE SAN RAFAEL FIRE
DEPARTMENT
WHEREAS, the City of San Rafael Fire Department has the
equipment and personnel available for the provision of paramedic
services in the City, and such service availability is funded
through the paramedic special tax; and
WHEREAS, medical insurance providers cover all or a portion of
paramedic transport service provided to their insureds; and
WHEREAS, the City by its paramedic tax ordinance is permitted
to charge fees; and
WHEREAS, the City's Fire Department can realize additional
revenue to maintain and increase its level or service to the
community through the implementation of billing the insurers of
users of paramedic transport services;
NOW, THEREFORE, BE IT RESOLVED, that the City Council of the
City of San Rafael, does hereby authorize the City Manager to
execute an agreement with Allied Information and Services
Corporation of Alameda, California, for the provision of Third
Party Billing Services for the Fire Department paramedic transport
service, subject to the review and approval of the City Attorney.
I, Jeanne M. Leoncini, clerk of the City of San Rafael, hereby
certify that the foregoing Resolution was duly and regularly
introduced and adopted at a regular meeting of the City Council
of said City held on Tuesday, the 5th day of July, 1994 by the
following vote, to wit:
AYES: COUNCILMEMBERS: Heller, Thayer, Zappetini & Mayor Boro
NOES: COUNCILMEMBERS: None
ABSENT: COUNCILMEMBERS: Cohen
JEA "A/ .t.%1L
. LEONCINI; City C erk
ORIGINAL
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BILLING AGREEMENT
THIS AGREEMENT entered into this 5th day of July, 1994, by and between the City of San Rafael, an
entity organized and existing under the Laws of the State of California, hereafter referred to as "CITY,
and, Allied Information & Services Corp. doing business at 2490 Mariner Square Loop, Alameda, CA
94501 hereafter referred to as "CONTRACTOR".
The CITY and CONTRACTOR hereby agree as follows:
1. SCOPE OF SERVICES
Contractor agrees to perform all those services described in Exhibit "A", attached hereto and
made a part thereof, in accordance with the terms and conditions stated herein.
In order to permit Contractor to render the services required hereunder, CITY shall, at its
expense and in a timely manner, provide such information in CITY's possession concerning the scope
of services as Contractor may require from time to time.
2. PAYMENT
For the services referred to in paragraph 1 herein, CITY will pay Contractor a total amount not
to exceed 11.0 percent of revenue collections on accounts processed after the inception of this
agreement. CITY shall make payments to Contractor in accordance with the provisions described in
Exhibit "B", attached hereto and made a part hereof.
3. TERM IVA �e w
The term of this Agreement shall begin on 7/ 94 and end on 7,x//96. The CITY's Authorized
Representative may extend the term of this contract for two years by giving written notice.
b. Either party may terminate this Agreement upon ( 90 ) days prior written notice to the other
if the other party has substantially failed to fulfill its obligations under this Agreement, in a timely
manner, through no fault of the terminating party. CITY may terminate this agreement without cause
upon ( 90 ) days prior written notice to Contractor. A written notice shall be deemed served upon
sending said notice in a postage paid envelope addressed to the other party to this Agreement and
depositing the same with the United States Post Office with postage paid. For purposes of this
Agreement, all notices to the CITY shall be addressed as follows:
"City of San Rafael"
(Fire Department)
(Attn: Chief Robert Marcucci)
1039 C Street
San Rafael, CA 94901
For the purposes of this Agreement, all notices to Contractor shall be addressed as follows:
Mr. Art Crowe, Vice President
Allied Information & Services Corp.
2490 Mariner Sq. Loop Suite 220
Alameda, California 94501
c. If either party terminates this Agreement before the Contractor completes the services in
Exhibit "A", in addition to any other rights and remedies provided by law or under this Agreement,
Contractor shall be entitled to compensation for services performed hereunder, through and including
the date of termination, but not to exceed the payment according to the rate specified in Exhibit "B".
Contractor shall also be entitled to all reasonable costs incurred in connection with such services. In
no event will the amount paid exceed the full amount in paragraph 2 of this agreement.
4. INDEMNIFICATION
Contractor agrees to release, indemnify, hold harmless, and defend CITY, its officers, agents,
and employees from and against any and all claims, demands, liability, lawsuits, or other actions for
damage or injury to persons or property arising out of or in any way connected with the Contractor's
operations under this Agreement, or the performance of this Agreement by Contractor or its officers,
employees, partners, directors, or agents.
INSURANCE
a. The Contractor shall maintain comprehensive general liability, automobile liability, and (if
any licensed professional performs services under this agreement) professional liability insurance
policies in the minimum amount of $1,000,000.00 to cover any claims arising out of Contractor's
performance of services under this Agreement. Said insurance, except professional liability shall name
the CITY, its officers, agents, and employees as additional insureds. All said insurance policies shall
provide that the insurance carrier shall not cancel, terminate or otherwise modify the terms and
conditions of said policies except upon thirty (30) days prior written notice to the CITY; shall be
evidenced by the original Certificate of Insurance attached to an endorsement in the form of Exhibit "C"
or the insurance carrier's standard form endorsement in the form of Exhibit "C" or the insurance
carrier's standard form endorsement evidencing coverage, and shall be approved as to form and
sufficiency by City of San Rafael City Attorney. Forward all insurance documents to City Attorney's
Office.
b. If Contractor employs any person, it shall carry worker's compensation insurance and shall
provide a certificate of insurance to the CITY. The Worker's Compensation insurance shall provide that
the insurance carrier shall not cancel, terminate or otherwise modify the terms and conditions of said
insurance except upon thirty (30) days prior written notice to the CITY; shall provide for a waiver of any
right of subrogation against CITY to the extent permitted by law; and shall be approved as to form and
sufficiency by the City Attorney. Forward all insurance documents to City Attorney's Office, City of
San Rafael.
6. CONFORMITY WITH LAW AND SAFETY
a. Contractor shall observe and comply with all applicable laws, ordinances, codes and
regulations of governmental agencies, including federal, state, municipal and local governing bodies,
having jurisdiction over the scope of services or any part hereof, including all provisions of the
Occupation Safety and Health Act of 1979 and all amendments thereto, and all applicable federal,
state, municipal and local safety regulations. All services performed by Contractor must be in
accordance with these laws, ordinances, codes, and regulations. Contractor shall indemnify and save
CITY harmless from any and all liability, fines, penalties and consequences from any noncompliance or
violations of such laws, ordinances, codes, and regulations.
b. Accidents: If a death, serious personal injury, or substantial property damage occurs in
connection with the performance of this Agreement, Contractor shall immediately notify the CITY by
telephone. Contractor shall promptly submit to CITY a written report, in such form as may be required
by CITY, of all accidents which occur in connection with this Agreement. This report must include the
following information: (1) name and address of the injured or deceased person(s), (2) name and
address of Contractor's subcontractor, if any, (3) name and address of Contractor's liability insurance
carrier, and (4) a detailed description of accident and whether any of CITY's equipment, tools or
material were involved.
7. AFFIRMATIVE ACTION
Contractor hereby agrees to comply with the provisions of CITY's policies regarding affirmative
action as amended from time to time. Contractor shall not in any manner discriminate against any
individual or entity based upon race, sex, color, religion, or national origin.
8. INDEPENDENT CONTRACTOR
For the purposes of this Agreement and at all times during the term of this Agreement,
Contractor shall be an independent contractor and not an employee of the CITY. The CITY shall not
have the right to control when, where and how the service is rendered, but shall have the right to
specify the results of the service rendered pursuant to this Agreement. Contractor hereby certifies that
his taxpayer identification number is: 94-3087401. Contractor must pay the state and federal
government all state and federal income and other taxes due.
ATTORNEYS FEES
If any action at law or inequity is brought to enforce or interpret the provisions of this
Agreement, the prevailing party shall be entitled to reasonable attorney's fees in addition to any other
relief to which it may be entitled.
10. GOVERNING LAW
This Agreement shall be Governed by the laws of the State of California.
11. AMENDMENTS
The terms and conditions of this Agreement shall not be altered or otherwise modified except
upon a duly executed written amendment to this agreement.
12. ENTIRE AGREEMENT
a. The terms and conditions of this Agreement and all exhibits attached hereto or documents
expressly incorporated by reference therein represent the entire Agreement between the parties hereto
with respect to the subject matter hereof, and this Agreement shall supersede any and all other prior
agreements regarding the subject matter between the CITY and Contractor, either oral or in writing.
No other agreement, statement, or promise relating to the subject matter of this Agreement shall be
valid or binding except upon a duly executed written amendment to this Agreement.
b. Should any conflicts arise between the terms and conditions of this Agreement and the
terms and conditions of any exhibits attached hereto or documents expressly incorporated therein, the
terms and conditions of this Agreement shall control.
13. CONFLICT OF INTEREST PROHIBITED
Neither Contractor nor any person who is an employee, officer, director, partner, or member of
Contractor shall have served as either an elected officer, an employee, or a Board, Committee or
Commission Member of City. Contractor shall comply with City's conflict of interest code.
14. OWNERSHIP AND ACCESS TO DOCUMENTS
Contractor agrees to return to CITY upon termination of this Agreement and in the same
condition as received, all documents, drawings, photographs and other written or graphic material,
however produced, received from CITY, its contractors or agents, and used by Contractor in the
performance of its services hereunder. All work papers, drawings, internal memoranda of any kind,
photographs and any written or graphic material, however produced prepared by Contractor in
connection with its performance of services hereunder, shall be and shall remain after termination of
this Agreement, the property of Contractor and may be used by Contractor for any purpose
whatsoever. However, the previous sentence shall not apply if the CITY or Contractor terminates this
contract before the Contractor completes all the services required under Paragraph 1. In this case, the
latest set of draft documents shall be and remain the property of the CITY.
Contractor agrees to allow City's representative access to review and copy all documents,
drawings, photographs, and other written or graphic material, however produced, upon reasonable
notice, during regular business hours.
15. NON -ASSIGNMENT
Contractor shall not assign any of its duties or responsibilities to any other person or entity
without prior written consent of City.
16. RECORDS AND AUDIT
Contractor shall maintain all records related to its performance under this Agreement, and shall
make such records available to City for inspection and/or audit upon reasonable notice.
17. WAIVER
City's acceptance of work or payment by City for that work, under this Agreement, shall not
constitute a waiver by City of any of the provisions of this Agreement. City's waiver of any breach of
this Agreement shall not constitute waiver of any other provision or/of a subsequent breach.
IN WITNESS WHEREOF, the CITY and Contractor have executed this agreement through their duly
authorized representatives as of this date first above written.
CITY OF SAN RAFAEL
Pamela J. Nicolai
Title: City Manager
ATTEST:
By:up,,,,�
U Jeanne—M. 'Leoncini
Title: City Clerk
APPRO RM:
By:
Gary T. Ragghianti
Title: City Attorney
CONT CTOR
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By:
Tax I.D. No.
Incorporates (N)o
Subject of Contract:
Title
Exhibit "A"
SCOPE OF SERVICES
1). Statement of Work: This documents the CITY's and Contractor's mutual understanding of the
scope and magnitude of the project.
a.) Outline of authorized work:
The Contractor will produce statements and invoicing (billing) for all qualified ambulance
transportation with corresponding completed ambulance report forms. The Contractor will
produce cumulative and detailed accounts receivable reports in generally accepted accounting
format. Invoicing and/or reports will be produced on a monthly basis or in such other time
frame as is mutually agreed. The Contractor will not be the depository for monies received as
a result of the invoicing. The Contractor will provide all necessary personnel, tools, equipment
and product necessary for producing the invoicing and reports.
The Contractor will review and make recommendations, for change, if necessary, with respect
to the current ambulance report form(s) content, data collection procedures and billing
amounts for ambulance related services.
b.) Obiective(s):
The objective of this project is to maximize and make timely the collection of revenue due from
the provision of ambulance transportation and services provided by the City of San Rafael Fire
Department. Further, it is to provide for the review of and improvement(s) in the overall
ambulance billing process.
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c). Project organization:
The basic project organization is;
The Contractor's project manager in cooperation with the designated CITY person will provide
and oversee an integrated billing process for ambulance service(s). Through the use of in-
house and field staff the Contractor will process the ambulance report forms through a data
processing system in order to produce invoicing and corresponding report(s). Through
additional in-house staff the Contractor will post all monies received by the CITY and produce
the necessary balance billing, account registers and accounting documents as outlined.
d). Project Staffinq:
Staffing for the project will be the responsibility of the Contractor. THE CITY will provide
sufficient liaison personnel time in order that the ambulance report information is received by
the Contractor on a daily basis. Please see the attached organization chart for the numbers of
persons and corresponding positions.
e). Deliverables:
The Contractor will produce and cause delivery of all invoices, statements and reports as
required. (Please see attached list of reports.) In addition, the Contractor will provide the CITY
with a report on its review of the ambulance report form(s), billing amounts and other items the
Contractor believes will improve the billing process for ambulance service. This report will be
provided to the CITY no later than sixty (60) days after the beginning of the contract. The
Contractor will provide demographic reports on the accounts and corresponding billing
classifications. All reports due will be produced and provided to the CITY by the fifteenth
(15th) of the month following the month of service. This reporting will begin after the first
month of the beginning of the Contract.
2.) Action Steps:
The following is an outline of steps to be taken by the Contractor and the CITY.
a.) The CITY, on a routine basis, will collect and place in trip number order all ambulance
report forms for the previous days service.
b.) On a routine basis the Contractor will pick up and screen the ambulance report forms
for billing information and forward them to the Contractor's data processing staff.
C.) The Contractor's data input staff will input all pertinent data to the Contractor's data
processing system.
d.) The Contractor's in-house staff will process the accounts and produce statements,
invoices and reports as required.
e.) The CITY will receive all payments due and forward facsimiles (photocopies) of the
payment information to the Contractor's personnel for account update on a daily basis.
f.) The Contractor will post or credit the monies received by the CITY on account and
produce all corresponding reports and balance billing.
g.) The Contractor will process all third party payor billing forms as needed.
h.) The Contractor will meet as needed with the CITY staff (Project Director) or at least
monthly to discuss the project's process and to review the project's reports.
3.) Review Points:
a.) The Contractor will review all demographic data and make recommendations for
change in billing procedures If necessary.
4.) Departmental Participation:
a.) The CITY will provide a billing liaison person to Allied's Billing Personnel on a daily
basis during normal business hours.
E
Reports Ustinq
f. Monthly listing of all accounts established in the system. The listing will include the following;
- Alpha order by Patient name
- Account Number
- Date of Service
- Total Charges
2. Quarterly Aged Trial Balance
3. Monthly Collection Report(s) (Detail)
4. Monthly production & management report(s) showing;
- Number of accounts
- Number of payments received
- Number of accounts returned by the CITY for cancellation
- Total accounts aged by days
- Percentage of Collections by financial classification
- Any other information deemed necessary by the CITY
5. Quarterly pre -collection or delinquency report(s) showing accounts;
- returned for other collection process in alpha order.
iK
Exhibit "B"
SCHEDULE OF RATE(S) FOR SERVICE
- 8.5 percent of all cash receipts for the billing portion of this project.
- For the provision of the "Pen -Based" system, an additional 2.5 percent of all cash receipts will be
applied totalling 11.0 percent.
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