WITTMAN ENTERPRISES, LLC HIPAA BUSINESS ASSOCIATE AGREEMENT -2009

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Wittman Enterprises, LLC 3.1.1 TRANSFER OF CITY INFORMATION Documents Confirmed and Screened for Com leteness Upon receipt, the City's PCR's are date stamped, counted in double custody and the number received is verified All of the City's PCR's are sent to our Data Entry Production Department where they are reviewed for completeness and coded with the appropriate level of service, payer and patient condition within 48 hours of receipt. PCR's that have social security numbers are checked for Medi -Cal eligibility by using the Medi -Cal online verification system and billed out immediately. Patient accounts with private insurance information are billed out immediately. If insurance information is not available on the PCR or by means of our research, then the patient's account is set up for private billing. A phone call to that patient is also made within 72 hours of receipt of the PCR. In order to remain true to correct billing processes, we fully audit 35% of all trips that are billed for the City at the time of data entry. Research Methods Wittman Enterprises, LLC has variety of processes and resources in place to follow -up on accounts that have inadequate billing information. These resources include but are not limited to: • Use of Zip Code /Street directories for obtaining missing /incomplete addresses • Use of Accurint.Com for tracing mail returns • Contacting EMS Division to locate missing information from Run Reports • Contacting receiving hospital for missing /incomplete billing information • Contacting patient's family members for billing or insurance information • Mailing inquiry forms to the patient. Over the past fifteen years we have established a good rapport with the city's receiving hospitals that enable us to request the following information if needed: • Insurance information including billing address, phone numbers, and member or subscriber identification number • Medicare or Medi -Cal information including — social security numbers and date of birth • Current address, phone number and employer information for the patient, • Alternate contacts or nearest relative's address or phone number Information is requested via fax or phone call to the financial office of the hospital. Requests are made weekly and come back to us in a timely manner. If no information is received, accounts are handled in accordance with the City's guidelines. City of Santa Ana Fire Department 13