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I City of Santa Ana Response to Request for Proposal (l2PP) Medical Services Review 2/g/y5 <br />t <br />t <br />Assurance of excellent clinic performance issues, as needed <br />• Periodic reports documenting the results of OCCLI-Med's work <br />QA3fees that the City would pay directly to the medical clinic, but without all the hassle of dealing with <br />"MEDICAL BILLING INVOICES" Occu-Med began its Clinic Bill Review service in 2006 as part of its <br />service to ITT, a company charged with deployin; employees to Iraq, Kuwait, Qatar and Afghanistan for <br />various major federal projects in that region. We have evaluated more over 100,000 clinic invoices for <br />pre -placement exams over this span of time and have been absolutely appalled at our findings: a) more <br />than 9217c of these clinic invoices were initially sub initted wltll inaccuracies (wrong charges for tests not <br />performed, charges for unnecessary testing performed, duplicate billings); and b) much worse is the fact <br />that nearly all of the incorrect invoices were inaccurate in Favor of the clinic, <br />OCCn-Med requires the submission of an accurate Invoice for payment—at which point we immediately <br />submit payment to the clinic. We submit our invoice to the City as a single fee (as negotiated) for an <br />exam— as the City's request au• invoice "ill also Include a list of itemized charges, however, the charges <br />wil I always add up to the pre -agreed negotiated fee. Clients have informed its that this "bill review" <br />set -vice alone has literally saved days of staff time. Another client, upon learning of this billing trend, <br />audited the previous year's invoices and was able to obtain a refund of more than $3,000 For exams <br />performed. <br />On the first day of each month, Occu-Med will submit an invoice to the City for the prior month's <br />medical services and examinations. Our invoices will be Itemized by the date of service, name of person <br />examined, type of physical performed, itemized charges For each type of physical (if applicable), a <br />subtotal for each person examined, and a total of charges for the month being billed. <br />Our knowledge of the precise medical exam components that are of value for each specific job class <br />(eliminating useless, improper and overly expensive medical tests), our ability to negotiate fair and <br />reasonable charges from providers for medical exams, our national buying power for laboratory services <br />(blood chemistry panels and urine drug screens), and our careful auditing of clinic and laboratory charges <br />allow its to offer a vastly expanded array of services to out- clients for fees typically charged by their <br />medical provider forjust the medical examination and laboratory charges. <br />Occu-Med kill in -turn be able to submit clear and straightfonvard monthly invoices to the City (see <br />APPENDIX H). This stands in contrast to the amorphous and often incorrect invoices typically submitted <br />19 Occu-Med <br />