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HomeMy WebLinkAbout25C - PARAMEDIC BILLINGREQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: JUNE 1, 2009 TITLE: AGREEMENT FOR PARAMEDIC BILLING ~ ~ _} ~~ ~,~ / / ~/ fem.: CITY MANAGER RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVED ^ As Recommended ^ As Amended ^ Ordinance on 1 S` Reading ^ Ordinance on 2"d Reading ^ Implementing Resolution ^ Set Public Hearing For CONTINUED TO FILE NUMBER Authorize the City Manager and Clerk of the Council to execute the attached agreement with Wittman Enterprises, LLC, to provide Paramedic/EMS billing and collection services for the City of Santa Ana Fire Department for an initial three-year term, with the option to amend for one two-year term, at a rate of 6.3 percent of net collection, subject to non-substantive changes approved by the City Manager and City Attorney. DISCUSSION In January 2009, the Fire Department issued a Request for Proposal (RFP) for paramedic/EMS ambulance billing and collection services. Fourteen companies submitted proposals, which were reviewed and evaluated by Fire Department staff. The top four proposals were then reviewed by fire managers, who concurred with the selection of Wittman Enterprises. Wittman Enterprises has provided excellent paramedic/EMS ambulance billing and collection services, to the department since 1994. The Fire Department recommends approving an initial three-year agreement, with one two-year amendment, with Wittman Enterprises, base on their submitted Request for Proposal. 25C-1 Y ~ Agreement for Paramedic Billing June 1, 2009 Page 2 FISCAL IMPACT Funds are available in the FY 2009/10 Fire Department, Fire Suppression, Contract Services - Professional account (account no. 0111533062300). APPROVED AS TO FUNDS AND ACCOUNTS: ~A~~ G(i Marc Martin Fire Chief Fire Department Francisco Gutierrez Executive Director Finance & Management Services Agency 25C-2 STANDARD CONSULTANT AGREEMENT THIS AGREEMENT, made and entered into this 1St day of June, 2009 by and between Wittman Enterprises, LLC, a California Limited Liability Company (hereinafter "Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"). RECITALS A. The City desires to retain a consultant having special skill in providing ambulance and paramedic billing and collection services for the City's Emergency Medical Services Program. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall provide EMS billing and collection services as set forth in Exhibit A, attached to this Agreement and incorporated by reference. 2. COMPENSATION City agrees to pay, and Consultant agrees to accept as total payment for its services a fee equal to 6.3% of net collections obtained by Consultant. If at any time during the term of this Agreement, City implements ePCR, Consultant payment will be reduced to 6.0% of net collections obtained. Consultant shall bill for Emergency Medical Services at the rates established by City Council Resolution. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing collections received by City, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 25C-3 3. TERM This Agreement shall commence on July 1, 2009 and terminate on June 30, 2012, unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended for one additional two-year term upon a writing executed by the Fire Chief and the City Attorney for the City and by Consultant. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. b. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by 25C-4 reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 7. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 8. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, California 92702-1988 telefacsimile (714) 647-6956 With courtesy copies to: Fire Chief City of Santa Ana 1439 S. Broadway (M-80) Santa Ana, California 92702 telefacsimile (714) 647-5779 25C-5 and City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6515 To Consultant: .Wittman Enterprises 21 Blue Sky Court, Suite A Sacramento, California 95828 telefacsimile: (916) 381-5047 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by telefacsimile, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 25C-6 12. TERMINATION This Agreement may be terminated by either party upon ninety (90) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Fire Chief may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 13. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. JURISDICTION -VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of her inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall 25C-7 indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. c. Consultant agrees that, notwithstanding the existence of any dispute between the parties, insofar as possible under the terms of this Agreement, each party will continue to perform the obligations required of it during the continuation of any such dispute, unless enjoined or prohibited by any court. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: PATRICIA E. HEALY Clerk of the Council APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney By: Laura Sheedy Assistant City Attorney CITY OF SANTA ANA: DAVID N. REAM City Manager WITTMAN ENTERPRISES CORRINE WITTMAN-WONG Chief-Executive Officer Tax ID# In r~0 ~ 7QD~r 25C-8 EXHIBIT A SCOPE OF SERVICES 25C-9 ?1 Blue Sky Court, Suite A iaccarpento, GA 95828 360.906.6552 phone X16.381.5047 fax vebilllwebillems.com ~wvw webillems.com j-- ''~ Wittman Enterprises, LLC ro~_ ~ ~~F+r:i~~ 1 .r n;~Gnr,c dil,'n; '(_or,; r ~ .~~ --, ( r..tr 1~ r < tcz Request for Proposal Paramedic/Medical Billing and Collection Services EXCELLENCE together we achieve the extraordinary. 25C-10 !iiltmua Erve~rprisets, !_L(~ 3.1 SCOPE OF SERVICES \~ ittularl I~ntcl~}~ri,cc~ I.I.C~ mots and 'gill continue t~~ cscccd the (~it~~> cxpcctati~~ns. ~~`c arc dc.iicatc~i to the ~~roduction of ~lualit~ ser~icc to the Cite, and demonstrate this commitnr nt ~~ith ~nu~uir.~~ tr,linin~` and u}~~i~Itill~ ~~f aalt: ~l l;is is acc~~ni}~li~h~•d h~~ h~>th cuntiliu~,i!~ in-hc~usc cruse lralllin~. all<l hV~ fa~ln~' a~1~ai]Iil~,!~ i1j lllll~l~~t <~U<llll~' lralnln~' In ;11~ ;iti~l~~l~ ~)t hl~hnEt ]~SU~S ,iIld lli~;1~i11t1~ `~e1'`.lce. ~~~t ;lIC Il f~;lli JCr\ll'C E~ll~lnt' l)j~t1C~' ~Sllil CL11~11'ilt~\ V~UI"~ '.1ith lh~ l~l(t C1Il~j niullll'le l~.~l~ hr~~~"Ide?'~. ~'~ ~ ~t~111 Ci~l7tllltle tip ~~I'irilde [he ~~ItV~ 11"!lh eXCc11cI11 ~crV~1CC U~In~' Ollr (11'~~\eIl !1}ellli?d~ ;itl' ie~el\ili,! alld )~l"~~~C~~In,~ fry FZ ~, ~ rill IZecet~ll~. ~l~l'I'cs~)i~lldenec anci lOr r.'(1'.C`, tt':_ ;;,; !n.t.\lliiu[I; I~` :; C~1!;lt`l!rsCnlell:. • I'(`K~s arc date st~un~~cd and counted in double custody. ~l~he~~ arc re~~ic~ced 1«r completenes>. coded fi,r data cntr~. entered. and hilled ~~ iihin three «orkin~r dais. • l~~uh Iyeccl}its al'C uaCC slam}?~~~ and CltUlllel~ 711 double CIISit7d`,'. ~ hc'Se are ~~OSted IO i`atlent ai;C~tulli~ '~~It}lin t?ne da~~ ;;nd n~)jl~icall!?ils ~?f ih~~~ Ill~~nl~ al'C C~~)i)rl~~~ IU ~Ull t i:I fay ur enulil un a dai1~ basis. • .~%1 ~~;1\cl'~ ~~11cIhC1' 1'Clll]al'~ UI' ~C~Undal'~ arc hIl~cil eleclr~~IllCal~\ qtr (111 ~?aO~I'. and t~~tl~t~~cd u~~ on until tilil ali~t~~ed reilnbulscmellt is achic~c~1. • ~_~11I" cll~tU1111Jed !nV [)1Ce5 alKi 1Ct(el:~ ikl~~ ~?~' C~eSI~~I1Cl~ ~J?l'CIf1C~1~~V (f11' lhC' ~ 1?`w~. • \i~ttn~all l:nte!-hriscs. I.LC com}Tics ~~~ith all certifications. licenses. and 'a»~; as the~~ .~erta111 tt~ Ihl~ 1'etih(1n~e. • 11c prtt•~ ide a muitiullje ;~,~ rc~~orts i~~r ~~,ur financial and statistical needs. Uur ~f~c~~ialt~ t?n_[~el,Ial;a rc~,urts .u nu additional cost and may be pruduccd at a 111 ('til]et1tS nUll~e. • i)cdicated and trained stain is iu~mediatcl~ a~ailablc to ~~our need;. C itr r f .Sururr inu Fire DePrrrtm~n7 25C-11 lf'itunun Frrtrrpri+rs. L!_C` 3.1.1 ~hIZ:~\SFl~:lt OF ('1"C1' 1NFOlt~1:~"I'!O\ Uc~cumenrs Confirmed and Screened fur Completeness ~~ '- .:.~~~~ l!Il' ~ Ili ~ ir~ IZ ~ at'C ~~;ljt' ~t:I111P:~1. L~~t1n;CC~ In U~7Cihlc ~l7~It~Ci`• ;1nu the IlllI77beI" '~~::.',:.( I~ ~~flli~~: AID ~~: ?I;c LIt~•; 1'CIZ ~ ,lI'c dent tip l~llr I):1[It I:ntl``• Irrodulalon U8pa1'llllent ~ II::C ttl~_ fill' C~'\ t:'~\~~1 It?1~ ~~1lIIpiGIc'n~'i5 .11'¢~l ~l>llld `~1llh tllc' aI?h1't~prlate Ie~cl C!1 Ser\lCe, pa~~el' lull i~iilli:)11 cc~nd;llU;l 11ilhln -~i; I„JIII'~ i~l Icc~thl. I'( IZ ~ If?a1 ha\~ il~Ct1;I aeCl1I'1[~ nlllllbl'I's ;il'l' }7C~f:e~I itJi' ~Icd1-CaI ~I1~~!lf~l~lt~' ~1~~ LiSill~~ II]~ 1IC~7-<<lI CIIlIlI1C 1Ct1tiCC1YI~111 S_~'i[~Ill liri~? I)f~lc'+~ t)lll 711 t1?CC11aI~;iA. I':It1lfll al~i~Unt> ~V~1tII hYf1;2IC lll~ll'-"anCe 1nI0[lllalloll 0111 bllltil ~~UI ll1lIllC:halcl~~. II assurance information is n~+t a~<Iilahle on the PCR or b~ means of our research. then the patients ~LC:?illll i~ i~~I lll) a1i' I)1'1\a1e I'lllli]~~. :~ I)II~711t ~~III ICJ thal ~atll'lll ;~ a~S~) Ill~i~IC \11~~7111 ~1 E1C)UC Ol ~~cc~iht ~,I~the P~'R. In ~Jrder tiJ r~Illain true w ccn'rect bi(lin_zproccsscs• ~~~c iull~• audit ~~"~ ofall ~.rih~ th:~:I are ?~illcd f~~r !h~ r'tt ai tl.~ time ~~i~"auI ~nn'~~. Research ~lethuds '~~~it:man Enterprises. Li.C has ~arici~ of processes and resources in place to iolk>~~-up on ::cc~~urlts :hat ha~~r inadequate billing information. These resources include but arc nut limited ,. • ' ~~~ c,i~%ip Cudr~treet directories for ubtainin~ Ibis>in~.:iucompletc addresses • 1. ~~ C~t':lccurint.(_~om fc>: tra~iu~~ mail returns • t~~~Iltactin~_ I:AIS lli~.'isi<~n ;t~ I~~~at~• Il~is~in,~ inf~~rmatic~u i~rrm I~un R~h~>rts • ~ C~nla~Un~~ I'~~CI~ ln~ IIC?~I?IIaI Ii~l' IIl1~5l1IL 1nCt)Ill})~C1C hlllln~~ IIlIi?I'n1al1C?II • ~ i'll?aCilIl~ patlclll ~ I:111llI.~ IllelT]ber~ IC~~I' l?lllln~~ or in~llralllc 1[lll1rl11filli~n • \1,Ii!in~ inquire It~rms t« the patient. O'er the past tiftecn ~~cars ~~~e have established a ~aood rapport ~~ith the: ~it_~''s r~cei~~in~ hr>spitals that cnah?c u~ t:~ req~~Iest the f~~liu«in~ int~Jrmatiun ii•necded: • h,sul~.Inc~ inti?rmation inclu~lin~~ hillin_~ address. phone numbers. and member ~,r subscriber identification number • ~lc;,iicarc yr .Vedi-(_'al ill:i~rnultion includin~s - social ecurit~ numhcrs and dau of birth (~urrcllt address. phone number and crnplo~er inli~rrnation I~~r the patient. • ~:i~r[':~llc Cirnlacls ~~!' f;eaI'eil felall\e i address orph~~ne IlIil:Iber lnii7rmatiun is requested pia i~as ur phone call to the financial attire of the hospital. Reyuests are made ~~eekl~ and come back to us in a timel~~ manner. If• no information is recei~~ed, accounts arc handle: iIl ~ICCOrdance ~',~ith the Cite'; guidelines. City ujS:vrt:r Auu Fire Dc/~rrrtrr~rnr 25C-12 li7tnnrur f,irtdrpri.c~~s. I.LC .1si~nment :~utharization ln;!udt:d on .III in~~ilices and ;rltementc Inaileti out b~- \~'ittman Lrterprises. LLC for the Cite is :~~~ .I;~i~,nnlcnt of benetit autl~IOriiati~~n that is mandator~~ for \9edicare billing. I1~ the :i~nattlre is n~~t r~btained at the time of service b_ the field cre~~s. uc ~tiill relea,e the in~~oice to the patient ~h'.' ~~.~InplClti)n. 11 1~ llllpi7rtailt it) nl~tt' that I'e~t.'asc o~ bl~~lnf! IO ~,]«h~~ll'C 1~ nC~l pCRIlliIC(.~ ~~1thOUI the ~3~'Ila1t11'e i1t lh:' p'a11eI1L deS1~~IlalCd ~?UBCC~Iiin Uf v~7llle~~ll IItC11I1'.3llt?n 1h:I1 Iht: ~latti[Ilt IS Ilt~l ,.1~1: ', c, ;i;~n. It~ ;he (icf~i cI'e~~~ :Ire nt~t rec~tlircd to t~htain the i,,n.ItIII't: or ~.~itne~~ the patient- I:i,1l`I':lt`. t~~ ~i~I; at llnl'.' i~~ ~~1't~IC~. U111111~ ill1~~ 1~7C1'C~1111 ~?i11I1?Cn1 ~~I~~ bC Si ~`11t1~aIlllV ~~~]~A~~~i, ?.1.Z-x.1.5 B11_LI~(; Fl~1C"h[U\S, Rh:COIZU ~I:~I1~TI:A:1\('I~:, 1'Htllll 1':1R'll~ ('L,V ~I, :~1I) CliOSS IZEE'I~:RI?\C'l~: OI~ 1':1'fll~:ti-1' :~000l ~-Tti ~ut~plies and Equipment \~~rl~aan C:nicrprises. I.LC provides all supplies. ec}uipment. and se:r~~ices neccssu"~ to perform I;1: t1'~ ;~JOil~ ~): the 1~~ 1' aI ilU addltli~llal cU~t It? IIIe ~~lt~. ~Up(?IIe~. e~lUlplne111. and sei'V'1cC~ Iil: ~U~.l~ ''Ill :31.e nl~i lllllited tl~' • :~Il eoll](lUlCl' hal'd\\aCC atld CottVV~a!'C IIcCeSSaI'~ Itl I?extol"m aCeUCalel\ anal etflClentlV~ the ~~roresses as described in this IZI~N - - • ~~ll 111,1I11n!~ ti'i'ill.ti. hl~lli?`~ !oi'[I1S. III~UraI1Ce foi"I?l~, ilen tol'm~, Gild ell~elopC> Il:'l'C~sart to 'eI'IOI'll? the billlll~ tnllltlQll~ • 1n~~ prlstage neccssar~ to mail l'~illin,~ or information to patients. insurance companies. ?rd }?arties, iuld attorney s • \~~Ii'abilit~ ~,1~ CI national tali i-ree S(}0 number for patient>. the Cite, insurance c~.?Inpani<,. uttorne~ ~ ,' paI-ties to call for information or discussion ofaecount status h:lectronic Killing of C'laimti ~~s .~ matter rt' ctnu"sc. 1~~itnnar, f:ntcrpriscs. LLC electronicall.. hi11 the ('it~-> \ledicare and ~1cd;-Cal claim; resultin in p,nlnrnt in 1-l da~~s iuld ., dais respecti~eJ~. ('alifornia is unique in its munber of~ ~leaicare and ~icdi-Cal ] i\1O pa~~ers. Vl'hen ~~e recei~~e a trip indicating 'Medicare i)r \Iedi-Cal cu~cra~ac. ~~e ~erit~~ this infilnllation throu~,h rizctrunic ~eriticatilm ;~"stcma in order t~l he certain ~,~'hillin~~ corrcrtl~. the first time. ~hhesc claims are transmitted tiai;~ usin~~ :1\SI, the forlllat s.t f~~I"th under the EIII'_1.1 rettuirements. Cin• o/ Smrla Ana Firr Drpurbnrrrr 25C-13 if itrm:ui Fnrc~rprisz.~. LL(' lle also c;lectrunicall~~ hill i«r the City. all yualitied primary and secondary insurance sources, ~~~i~rl;ers' compensation. health maintenance ~n~gani~ations, third part~~ liability- henetit programs. a;xl el f-insurance programs. Those ~~~ho do not quality are billed im paper. 13itlin;~ and ~ cril'ication of pelf Yap ~lccountti ~lil'~e~~ !1't~Ill the .An1erl~,In ~~Ul~~'e1Ut's :1s~O~lllUUn indlcalc Ihat pall~'llts a€'~ nl~)re nli>tl~~alell tU n;;; ;1 5~:1'~i11Cnt iri!111 .l !e~ephUlle ut~l r:Ilhcr t~l;p; llpeated ~UI~~ChI?Il I1l~Il~es. lluvvc1cI', thl,'v ~1;:•: ~ii~,:.~ll Ifl: In~~~l .td1li>illli ~'1 CjlCell\~"11C~~ ~rUnl a Cl)nlhlnallUn l1~ Ih~~C t11~1? n1~d1111125. ~~~~ }r.I. ~ iuur.d this t~~ he true t11r~nl~h the hers~~nal attention ~~~i~~rn to oIn- cfi~nt and their patients. C);,r ?ir;t call t~~ a nri~ate acc;~unt ~ICCUrs immcdiatch al'tcr data cntr~ ui the incident into the s~;t;nl. lllis ~.~~cri?icati«n~' call a11o~1~~ us to dcterllline if the patient has insurance ~n~ ally special cirrunlstances that ~~ill nlakc it dit'iicult to pad the hill in a reasonable amount of tine. phis earl~~ cstahlishnlent u1 ccuuact ~~ith th,; paticnt i; ccr~ henciicial.:At this point h.Intllin~~ ~~f Idle ;;~~l~Ulll heC~~li1C~ \~I't ill~ll\IdUaIIL..I ~~~ haA~' lt~Und 11:11 ~~lll~ ~As(~'ill UI In~ul~ei, >1.i1~'1?lent, ll~'~In~lllClle~ la)IIC~.'~. aP,il In~l^~IdUal letters In Cl`nl,an~tit~!1 ',1lll? ?elcph(?ne tollo~'. tIh llas f~cen mutt <ucccssi~ul. 1 ul(c~~~-up procedures used t~~ elicit pa~Inent include a data lilt ~~t.Ihiisrcd 1~~~r each p,Iticnt li~om ~~~hich inCormatiun re~~ardin,~ the transport. billing and pa~mcnt ~a11 hC i'.C~Jrt.eil all~l relCleA'e~l, and patlellt Inl~)1"nlllll(~I1 e11I1 bC Ilpdaled. ~~~ p4ltlents lllaV' he IYl'~I'~ileed ~?~ ]iallle. date l~l ~c'I'`."ICe, Ineldetlt nUlnhel'. 1"UIl IlUttll?C]', st~Cllll ~eCUi"it~~ IlU[I1bC'T', alld ll1s.~ ?1~~' id~nlEl i I:Ii1I1 Iilinlbel's. `.fee Iabl~ i)I1 pa~,?C 1 ~ It?I' a Sample blll sehedlllC. 13i1linr~ and ~'crilication of Insurance :lccountc and 7~hird Yarn Y•~~ c-•, _All nst:r;Incc :u~d third part~~ pa~~er iufin~mation pro~~ided at the time ~,t~ input is ~erilied ~rilh ~~h~~11e 1.1!l~ (1n-Mile aC~:s~ (~~ !IIiUI":1n1'~' ~cfI11p1:nICs Is iIt111/Cd 1vheI'e (~fiCrcd. t)UI 1'rl~l'eS~ tal iden!i':~~ ir.~~ Ih~ ~•r,rr«t l,a~~r tur a pati~tlt~; clail~~ bcl~~~re it i~ ~<<n billed hay ke}?t cur percentage ~~1~ incorrect billin~~s lo~~. Uur Customer Ser~~ice Representati~~es. in the e~cnt ul~ incorrect insurance inlifnnati~nl. ~~ ill c~~ntact hnspital>. and if necessar~~. the paticnt it~r the corrections to t1lli1 I11101'malt~~n. 13ankrunCc~ and Litigation ~~ccouni~ \1~hcn n~~tificd of a personal hanl:ruptc~ all billing acti~it~ ~~ill cease. lnivrmation ~~ill be noted itl the ~SCC:7!.Int ;ind ll?ll~~~tied lik?Ili~l~_\. ~)n~. n(JTIIICatIUn (~~ dlil'har~'~ i~I ~jc',hE iS made l~lc; :1CCllUilt It~~iusle.l 1u _; %eil~ C~;1l;lliee. l:i the ease t~l j~l't)h;ll~ CIrCUmSlanCeS, ~\e ~~ill llle a l'rellltUl~ S Clallll <<~ pr,~tect t1u• Cit:'s interests. ~V"hell an account is identiticd as a litigation ease it is Ilagged ~~ith ~i SheC1~1C pa?~ S~IUrCe. att01'IIC~ lllll~I'IIY1Uh^ ]~ added tl,) the 3CC11U11I, a IICII 1S gent tl? the paUCnl i attorne~~ Iu be signed h~ both the patient and the attorne~~, and the patient billing is put on hold. C'ip o).Santu:frtaFireDepurtrr~enr 25C-14 iI'ittmun F.ntrrpriscs, LLC' '~•~~lrn requests for information arc sent in, thcr~ are re~~ie~~~ed for compliance ~~ith 1IlP:~:a. -~t!nrnc~~ requests ran no lon~~er he all encompassing. but must he spcciTic. Thee must also inclu~ic :- medical release signed h~~ the patient. The exception to this is a subpoena li-om the col.rt. l~ullo~~-up on lien accounts occur c~cr~ 6(i da~~s to verii~~ that all in1ol-Ination is current ~:nu ~~urrect. and insure that ~~~hen a settlement is reached the Cite ~~~ill recei~~e the mono due on the account in a timel~~ manlier, Our computer program t~~nrrates in~~oices oI1 demand. laclitatiu~~~ a ~~nc-day turn ar~~unc~ on an~~ subpoena request that may be made. ~Vorkcrs' Cumpcnsation Claimti \V"iitmal~ l~:ntrrprises. LLC bills all ~~~orkcl's~ compensation insurers. ~~'hen needed. "Green I i~~n~~ paprr~~ork ~~~ill he filled out and sent to the Cite for the appropriate signatures. ~'~~ittma^ 1~:II'rrnrisLs, LLC.' complies ~~ith 1i`orkcrs Compensations Rttlrs and regulations. It~'ollu~~-up on Open accounts ~~'e ~olle~.~ up on all City accounts insurin~a the maximum legal reimbursement for our clients. I~ollo~~~-up procedures used to elicit pa}~ment include a customised billin~~ schedule ~~~ith multiple im~uires and telepliorle contact ~a~ith the patient. the patient's responsible part~~, or their insurance coll~p;u~~~. :~ data file is established for each paticllt from ~~°hich information regarding the traL`~ht~11, h)llln~, ;Ind l?il~meIll :;ail be re,rol'dcd alld f'i;II'1C~c'.d. alld patient ln~o1'I17aU011 ran bc; uj~~latcd. .As ;;atcd. under _l~rlii~,,,~ acre! !"t-riliculinit o~'1'~~Ij~l'u~~.Icc~I~unis~~ page 1~. pie have 1t)Und that our ~~stcnl of~ in~~oiccs. statcments_ delinqucnr~ notices. and indi~~idual letters in conjunction ~~~ith telephone follo~~~ up has been Most successful. I=urther, the sult~care autornaticall~~ up~Iates each indi~'idual account detailing date, change. or billin~a function. :ill llistor~' and noted entries arc "~~rite protrcted~~ so no alterations call be made. In the course of billin~~ for the Cite. patients are identified ~~~ho do not ha~~e insin'ance. Ii~ these }~~atirnts arc unable to make one pa~-Inent in full, the~~ are oI'fcred pa~mcnt arrangements that ran he m.-dc on a monthly. hi-monthl~~. or ~~eckl~~ basis. :1 custcnner ser~~icr rcprescntativc sees up th~:..Iinl~ f'~I~" ~~iihin the s~strm and an initial letter i, sent to the patient outlining the pa~~Il~ent arrangements. ~I~hc patient signs the arran~aement and returns it ~~ith the first pa~~mcrlt. Follo~~- up appropriate to the arrangement ensures timel~~ patiment and a statement and cll~~elopc arc released after each pa~`ment is rerei~~ed. "phe minimum "Time Pay'" amount accepted b~ the Cite is ~~~'- h~I~~Iilcnt arrangements ~~~ith a lo«~er amount must he submitted in ~lciting for the Cit~~'s re~'ie~~ . :~Il "Time Pae~~ accounts must be paid off within I near of the date of service. In addition to the ""Time Pay" option ~l~ittman T:ntel-prises. LLC takes credit card payment inn behalf ul~ the Cite. Patients arc atilt to pro~~iile credit card information through correspondence to us, o~ cr the phi->ne or ~~ia the "Patient I'ortal.'- City of Santa Ana Firr Drpartmrtrr E• 25C-15 tf ittnaur Litn•rprisrs, r_LC Customised Billing For•m5 •rnd Follo~c-up 1 otters `.t~itt•,nan f:nterpries. I.I.C has cusutmi~ed the pri~~ate hill schedule to rcl7ect the Cit~~'s needs. `l~h~ hilfin, ~ehedule corks in conjunction ~~ith our billing program that tracka accounts I'e~~'1A~lI`I.' and ~l~~l~.',Il> ~i~i71 iii (t LiP~tUI11~I ~~I~\ll'l' 12~~~I~CS~Ili:2U\~' ~i~I" Illa}~11.,,? ti)~I1+11 Ll~~ ~all~. 11~ ~~ii~', hillin~ ~~h~~3u1~ i, :I t~~~flu«~: action Timing - - ~ Ir711)1C'(~rClli'1 ! I . _ - - -- -~.~ ------- _ _- --- E _ _~_.-- I ~~Ill `Iat~lllelll 31/ Ihrt ~ -_~ fiend 1'al 1)ue ,'\ithee -{~ Uirt's tien,i ~~inal Request \otice ±~(ll)crt., "--~---- - ln~~itice~ cunutin fields t~ur specialized Iltr~sa~_~~s and i~a)ment instructions. ~~'~ I~ultill any c~i~thc r:~ a _. _ ~~ .., ..... .. 1'.L°~. ~ ~ :::I;'. 'lj, tr, :dlji:il`a .:~ tl:~ .:~~l-etc ..,.:ill'l::J. ~~. ~:(1\:dC I ~~[:1 ~_ 'Ii.~.'~i.'~i- 1~,~`, i~~' I~~,!1-C~~Ilt~i(il~~ t~ li~i-j t~1;At Ire .1~_l. ~ ~,.~ I ] Iy Mate t~~~ c;ich c~.rliecu~n sltuatlon. _l part ~~~f l~uilo~~-uh. these letters can he scheduled to address a Iaarticular circunlstanee. l-his estcnds that t~crsonal touch to the collection process. Our computer program has fields tilled «ith nest ~,f kill inlin~nlaUon. as ~cc:'tl as enlplo~•~er data. so that reaching the patient its famil~~ I11Cn:I?el'~ (~11' ;id~lltloilai 3nil)CInalluri Is ~lleCesj(11I, f'.r~n1eI11 1~1'000'SSlri he Cit.. ~s p ,'~l;lellti arc •,~.-hat ~~~c call "1)ca~i C'aall": they Ire recei~ ~~', at the ~'it~ ~~here copies Llt I;T.Id~ a:ld ihcr. lUi'ltarded tU ll~. I he~c pa~~llll'ntS alY Ihe'Il poslCil tl1 the proper ~I~C(tUt11 ~cllhln or,~' ~ia~ Il~~tin~~ tII, ;~~In~c~ oi~ the pa~nl~nt. .~11 ~har~~~s_ pa~nlent,. ~an~l adjusullrntappli~d to a p:nic:,t-, ,I~cuunt are retained as a permanent record of that patient's medical histor~_ Tull pa~n~ents potted that result in a zero hafanrc ~~ill require no further aetion. ~~'hcn a paI-tial pa~mcnl is nwde it «ill be posted and the balance transferred w the nest appropriate pac source. I'ur csample a Medicare pa~~ment ~~~ill he posted kith the appropriate ~~rite do~cns and the p,Iticn;'~ ;~~mainin,,~ ~t~~';, rc;ponsibilit~ is thin transierred f~~r hillin~~ to the >cctmdar~ insuran~t i~r to ~~ri~ate biliin~~ directl~~ to the patient. 1-uture correspondence and follel~~-up is ~~~nlplct~.i b~ a C'ustonler Scr~-ice Representative regardless oCprit~alc ur secondar~~ insurance billing. City ojS'artta ,a r+u Fire Daparrmrrr! 25C-16 It'itt»u1n Enttaprisrs, LLC 4~ e ~;oulci like to offer the Cite a cost say ink option. 1~ ittman 1~:nterprises, 1.1_C is capable oC directly recci~~in~~ pa}mcnts on behalf of the Cite. This includes all corres}x~ndence. EO}3's_ patient letter>. and rep}nests. This ~~~inlld eliminate the need for Cite personnel to make copies of p~I~,nent ini~~umatiun and process correspondence. Pa~•ments ~~~ould he posted within 1 dad ui~ rcc~i;?t tin. th~~ I:unlic~ deposited into the C'it~ hank account. :1 c~?p~ of~the deposit slip «uuld he f21\~~ or emailed to the l".'it~~ de,i~;nat~a rcpres~ntati~~e the samz day. In c~~mplianc< «ith ~1~d:cam rules. u e «ill maintain deposit ri~,hts o1~1~ . Refunds ~1'hr accuuuu rccei~able deparllnent thoroughly researches all credit balances. ~~'e require insurallci companies to request refunds in ~yriting befz~re ~~~e rcec?mmend release of am liulds. Resolution ui~ all credits ~~ill ht completed ~~ithin ~U calendar da~~s from the date the account refleea the credit balal:ce. Resolution may include initiation of a refund packet. recrnlp packet. tra:I~l~er ~~r funds, or ~~rite-oil~re~'ersal. x111 requests are forwarded to the ('ity fur approval ~~~ith detailed reports and dOe11111e11ta11Un. Record Maintenance 1'~'itin,~jn {~.nterprises. LLC' rnainiains the City~s records in accordance, with the ~~enerally acce;~;ed ,tccc~untin~.; principles (~~~A}'~~. 1~'ittman }:nterprises. I.I,C retains all re~i~rds on site l~~r se~~en ~ para. Patlelll Care Reports and all con~cspondence arc scanned il~to au electronic sti~r:I_~e s~,te;n daily. ~fhis sti,ra~a~ system is a~,liiable to all personnel insurillL ~as~~ r~trir~~al ut~ IP.t~11'Inatl~~a lUl' ;; A;irtl't~ tit (llll"poses knl'~Udln~? 1'CC1U~Sl5 tOr Intl~I'Ill<SII(1n hV lI1~L11'~illC~ l'~ll]1pI1111~~ ur aaorne~ ~l~11e s~5tem is h,lcked up on a dail~~ basis to ensure it is secured. Llcctronic PCR~s arc st~~red as PI)l~ files fir easy retri<<~al.:~Il computer-~~enerated information is a~~ailable to access at an~~ given moment. ~l'ittman I-:nterprises, LI_C' agrees that all acci?unt files are the property o~~the ('it~~ and will relinquish them w the Cite at the termination of the contract. 'Coll-Free 'Celerzhone ~t~'ittman I~:nter}rises. LLC~s Custottlcl° Service Rcprescntatiyes are available B:UU am tc> ~l: ~U pm f~~r ease contort h~ the C'it~ ~s patients. ~)Llr national toll-free QUO-number has nnlltiple lines a~~aifal~le ±i>r patients. clients, insurance companies. attorrn~s. and third parties to tail for inturrrltion ur discussion ni account status. ~)ur atno ans~yering system moves the Cit~~'s patielas t~~ a Customer >er~~ice Representati~ e faster alid snore accuratel~~ than a manual system. In addition to our 8OU-number. 1~'itunan Enterprises. LI.C has developed a "Patient Portal.'. This secure ~~ehsitc ~,~i~~es patients ?4 hour access to us. Patients are able to email questions and submit tltcir insurance or pa~~ment information to us. Questions are responded to within 24 hours oi~ receipt. City' o(Snrrtu Arru /7n+ peprrrunent 1~ 25C-17 ii'itnnuu F.rai~rprisics, l.1.(' 1!'lonitorin~ of Itegulator-~~ and Reimbursement Changes ~~ittman I~:ntcrprises. I.LC semis out updates to the City regardin~~ regulator~~ changes ~~ia email. Management staf-f is mailable to ans~~er any questions that the Cite may have regarding these chan~~es ~~r any' other aspects ol- compliance. 1\'e ha~'e at our disposal the tools necessary to }~rt~~ i~'.e t};urough and complete rate and reimbursement an~il~'sis fir the 9ledicare Fee Schedule Irnplementatiun flan. ~l~hcsc fouls arc updated regularly' «~ith an~~ chan~~es to the contents of-the ticdicarc hn>ces~~ so the intcarit.,~ of am' anal~~sis is maintained. '1'rainin:! of 5ta1.1' I:mhiu~~ee~ are subiect to an initial Dour ~~ eck trainin~z period in ~~~hich they gain kno~~'(edgc of thL cumptiter sl'steui- hu~~~ to gather insurance information. avid ho~~- to na~~igate our billing sc~it~~;uc. In addition, all Customer Ser~~ice IZepresentati~~es ha~~e continuous customer ser~~ice training. I-:ach ne~~ emplo~~ee has a 9U-da~~ period ~~-here 100 percent oI~ his or her «~ork is audited 1~~r accuracy. }oh kno~~lcd~~c. and hrotcssionalism. «~~ continuously train our sta11- thro~<<~h ~u~~nth;~ tal-f- inectin~; that co~~~r a ~~ariet~~ ul~ tupi~ from ~ledicarc I~rainin~a to C~.i~trn~er Sc~r~, ice issues t)~ar Medicare and :'~~ledi-Cal Specialists. as ~~ell as the Re~emic :assurance ~7~cam. are updated pia email ~~f any ch~in~aes that ma~~ be implemented. ~f~his intorulation is passed on through the rnontlil~ staff mccti~i~~ c>r if needed the~~ arc passed on inim~diatel}~ pia dcpartm~nt memos. 1~~1an~~~~tntont Staticmeets on a «~ekl~~ basis to discuss an~~ industry' or go~'el-~unent pa_~~er chan~ues that ha~c occurred arul the hest course of action for implementation. :ail iieparu»ents ha~c a company' manual that outlines each indi~~idua] client-s contacts, pulicies- a~xi ~peciSic r~ccd It i~ updated on a regi_ilar basis. Our rnanageu~ent stat-f participates in on- ~oin,.! ccrtificutcd training ~,n management and customer scr~ice. ~'~~e helier~e that education is the key tip prop iding excellent ser~'ice to our clients. Re~'enur I•:nhancement 'I'rainin ~~'itu»an Enterprises. I.LC is a~'ailable to pro~~idc rc~-cnue enhancement training! l«r the Cite. ~~'~ asu ~~tli:r documentation u-airting fir field personnel. phis is helpful in maintaining compliance ~l~ith ~ao~~crnn~ental requirement, and helps in the building ot-a partnership bct~~~en the (iel~l cre~~~; and the hillin~~ office. Cin~ ojSarrlu.gna FireDeprrrtment f9 25C-18 H7tbnnn Enrerprises. (.LC' 1.1pd~-ted and Current Technoiog~~ ~~~ittnuln hnterprises, L[.C' is dedicated to maintaining and updating our technolog~~ to nlcet the in;~ustries needs. Our I'I~ department is continuousl~~ on the Eook out for the newest soft~~-are and h~Ir~i~~,u-e ,~~ailahle makin~~ sure ~~~~:Ire kept up to date ~~~itll all the latest technology. Our l~l d.;~;:rtnlcn! a(~,I ret~eiyes ~~Il~~uin~~ update to our hillin~> Scattt~~arc a t i~ ~i~~~cl~~p~~i b~ atn scl=t~~;lre y~ndor- Intcr--al and h:~ternal Audits ~~'ittman l~:nterprises. LI.C keep; accurate and up-ta-date records of~ all bills. pa~~ments, and curres,x~ndcncc related to billing functions to ensure a positive outcome to an~~ Audit. ~'~'ittnlan I~nterprises. I.,I.C is ilpen Auld encourages the City and its authorised repmsentatives to inspect and ~uldit all data anti records rclatin,~ ul ow• performance under the corltract. A~~e ~~ill be at the (`it~~; disposal durin.~ any audit procedures, insuring immedi.lte compliance with raluests for In~~rnwu~>:;. l2outi-><e ~`leetin~~s \\'ittman E=nterprises. I,LC' is happy to meet Stith the Citv~s personnel to discuss special or future needs an~i changes. ~~t~e are available to aUelld meetings b~~ teleconference or in person. ~l~llla,~eln~111 staff is also ~lyailable during regular business hours if the Cite should have an~~ du~stion~ or problems that need inunediate attention. The successful partnership that we lraye ~•stublihcd enable, us tip obtain rnaximunl Ic>'al reillillurscnlent on all the Cit~~~sacrounts. If~:lertrouic _~cccss to Il~cords ~'~'ittlnan Enterprises. LLC o11~rs cumpuler access via a soured login that is pass~yord protected. ~cces5 is ~~rant~d only to the. Cite personnel ~~~ith authorization to yie~c such information and is strictly finlited tip the City's information. _<~11 patients ma~~ h~ referenced by name. date of~ scr~-ice. illci~ient and run rnlmher. Uur billing software system allots for a clear and tractable audit trait for initial contact verification. billin~~ notification and phone contact. It also, updates each individual account dctailin~z date. change. or billing filnetion. :~fl history and noted enU-its are '~~~rite protected~~ so no alterations can be made. .~~ record ofall char~.:es is maintained. a cell :1~ a ~l~nll`lele 1>a~ llletl[ hlSltll'~ . ~t~ht C'it~ has accts, to monitor. audit. reyie~y. examine, or study the methods, procedures, and reslllls of our billing and colfectiims at all times via its own "Client Partal." Access to individual patient accounts as well as standard and customized '7ea1 time" reports is a~~°ailablc ?-}l7 within this ~yebsite. C'1n~ nf'Sruua 9na Fire Departntenr ~~ 25C-19 I! ittrnirn F.rrt<~rprisr'+. !.L( 13ilin~ual Staff ~1 ~tunalt l:nterprise~. LI.~ ha, sacral Spanish-speaking C~usu~mer Scr~ic< }~epresentati~~e~ in h+~tll mana~,emrnt and n~~n-nlana~~Inelit Ix,siti<~ns. ~[~his c;nabl~s patients to hI~-e tf~~ hi~~flest du.ilit~ ,~1- scr~ icr a~ailablc at the hi~~h~st le~~~l. A'~~ittman Ent~rpriscs. I,l_C zl~c~ has ~mhl~~~res ~~1~.~> >h,:Ii. AIr~n__. l'llinese. and ~~lctna111eSc. IC ~I patient sparks ,I lan,atla~,:e ~~Itel-~ ~~~ Flo n~~t h:I~,c an cmhlo~~~ u~aifablc. ~~~ utiliic Langua<~c Ling ~er~ir~s to ~~,~er am lan~aua~es that cru:I;,~t ~. I`T+~~ idd intcrrlali~ . (~t>mpliunre ~~ith C'ounh~, State, and Federal Lams \1 ii:r.:I;I I~ntcTt~ri~c~. L[.C is iII c+~mplctc C'ount~, titatc. Federal. ~ \iS. and I IIP:~:A rcgulati~~n ~~~:nhiiallcc. 1'r.Iri~ audits :Ire pcrtormcd to insure that ~IUr hillin~_ ;cr`<~ice remains in ~umhletr C+~:Ilp1L}IICC, lhtls pTOtecUn~ i?t1T ~:helli~. :~lOn,.? 1\lt}1 IhOS~ atldll~, ~1LlT ~Upcl'\1sO('~ pct-IOrlll ~pOl ;nl~#its ~,n ::II cmplo~~ees to insure their under-standin~_ :mii thcr~t~~rc their e~,mpliunc~ ~~itl~ tlll Ir~al. state. and l«ieral la~~~s. Further. ~~~~ ensure compliance ~~ith these lasts h. continually ~~!i 1.1;:~ ~~lJ'a~I'~.:~ ;S~ t+i ;111 ,!Ill.l'~Il~~~ t~7~it I]IIS\ ~lpl)1'~. ~~ ~ :i~1'~ lU ~+)Cillnll~ lU :1Li1lI~ h`. ;ln\ C1,~j~llC:ll'l~ t~lllln(lnCeti (~j the ~ 1i`, C'om~iiancc to IiIP:~.~ ~~ ittmar. I~-:~terhri~cs. LLC~ ha i'Ti~~ac~ and Securit~~ Officers ~~ho insure that all 1ill':1:1 policies in~+~l~in~, pri~ac~ ;ind s~curin arc 1:~Ilo~ced. l~he~ ha~c rccci~ed and i~ft~rcd t~, our clients' CVte11~1~ ~ tr:Unln~_' lhrllU~~I7 ~~lllif;,'.1'~ ~rt'Sc;nI~~I ~V' t}lc ~ tlllf~)I'IllFi :~117ht1I'1nC~ .-~ti~(l~lallOR. ~~ }~!'~?V~Ide aCCCS~ lip Intl'I'11C1 TCSill1CCC~ tOI' C(71ltlntling edUCatIOTl ~~Itl1 Te~1aTd l(~ aI1V' Chall_L'eS that m.!_, d~~ plc>I~ ~,~ith E III'.A:~ (a~~. ~~ e ~h~~s~ the C>>_1 i<Ir I I1P.~:~ trainin hecaue that ~>r ~alli~.:I<,n'; att~n-n~~.. l~ol~~ and l.ardn~r. h,l~l the ,greatest f'amiliarit~ ~~itll ('alilornia La~~. IIII':A.~ i-C~UIaUUIls I'e~IU;Ce a~ihcTCncc tU Jlate Ia1eS ]t Il~i?Te ~U'lCi. ~~aIIIOTIlIa pl'I\acA~ Iat~~s aTe aln~~l:,' thi' I11O~1 ~lI'ln~~~nl In tI1C I13U<~II. I I1C1'~IOrl'. AV~t' t3ri: C~1"laln tI77:lt OUT ~~1CptS Iirl' n131nIa11111] c+~nlpii;Incc ~~ith all l~cdcr.il and State mandates.:-~11 cmplo~~ecs 1'rum the Atana~~emcnt Ic~cl uI ciericai h:I~c Tecci~c~i extensi~c trainin~~ under the ~litlin~um \eccss<ir~~ Rule. .~~11 Pr«t~ct~d l Icalth Infi~rmation is secured per 1 III'.-\A rc~3uiren~ents at the ~lc>se uI~ each buill~; ~ia~ . At'c ha~c a I3usincss _~ssociatc :A+~rcelr.cnt ~~ith the City-. t;o~ e-•n~tient Nay er Compliance ~V'itunan l:ntcrpriscs. LL~~ is in c~~mplcte compliance ~~ith all ~~~,~~ernment pa~~T~. Uur ~lcdicar~ compliance I~r<+gram has been in place for sc~~cral ~~ears and is updated on a rc~~uiar basis to comply ~~ith eurrcnt la~~. Lhl~~id \e~ins has been retained as inu- Medicare compliance oi'ficer ~incc the be~~innin~~ oi'this process. City ojSarrta Ana Fire D~~tartmart 25C-20 II"Htnran fintrr/ni.crc. LLC ~•1r_ Ae~~ins ~~as tormali~~ the Pmsident ui~ the CaliT~~I~lia :ambulance :~ssuciatiiln. ser~~es as a m~Inh~r ~~t~ the ~lmericarl :~mbulancc :1sociatiun lteimburscmcnt Co-unlittcc. a-ld is a Former l~ ~~~uti~c ~~icr 1'resid~nt oi~ the :~illel'i~an :lmbiilance :~~UClallllll. Our relationship «ith ~1r. \u~ir~ insures that ~~c adhere t~~ all aspects ui \ledicarc la~~- I3c perfurlns ~eari~ audit, to insure that ~,ar hillir:= >cr~ ice rcm.Iin in c~~mplct~ c~~nlpliancc. thw protcctin~ uur clicnta. III' llll:l'1lal ~C)Illphatll'e ~l)n1lnlllCe Ille2ls Iln a ~IUai'teI'l~ bads I(1 rl'~'IC~~ anV ~Iedlcare I~~Ues UI' IlL~'• :I'.;i~rilT.ali~;l. I~III"Il1c:'. ABC ellslll"~ Ct)lll(?IIall~e ~\Ith ~7i?~CI']1117CnI paA~ci's I'1 C~?nllnllm4ll~ ~ciuruin~~ ourscl~es thr~,u~ah ;~mit~ar: hru~~id~d b~~ '~1e~licarc. A1~di-(',IL anal Industl"~ .~~~~~~i'.llk~:a. l)LIl' ~ t1Sl~~nlei' 1eI'~l~e 1ilptl"~~1~('C~ 111~~I1]L~l' ~iI`;~~i U1 a~~ lei(}~l1t~Ile call> Iliade IUI' ~111:1:?l~ CI~S,IC;lI1Ce, and .11'1 a~i~lltll~ndl ~''0o t)I aCCl1Un1 III~CIl'lllall(~11 chan~_es ihal I'eslllted lronl C~'le}~Ili~ne calls and C~)I'I'c'~Dt~nd~il~C, al'e ;IUdlte.~i for ,il'~U1";ICS. Calls and Curresnondence ~~ 1~Ei]liUi ~~.illCt'pI'11C~• i.l,~ pI"l>ce~scs I~1C ~~liA $ IIICilIIIIII,~ Calls alld C(~CCCtitI(tind~nCC 1!` :1 ?IIl?e~V', hr(~fCSSI~~Pa~. :1114 CC~UI'TeUll~ :11,}17ner. ~ DUI' ~ llSll)I1leC ~CI",'iCC ti,Ipc1~\ ltii~l'S IIli~111I~~1' l (}`~ a ~~j ~lll telcph~~lle Cads lllade li)I' ~Illaht~ a~SUCa11C::. :~-1 adChllonal ~`0i, itj a~COUnI Illl(~I"mat-c?n ChanLCS that resulted from telephone calls and cnl--"espi~ndence an audit,d 1~ur accuracy . ~~ ~ ,~!C,l~~ C~lll Ci~111i,illCd C~~illllllllTlelll l~> ll'C3l l}le ~ It~'~,~ C~)111fI1Ut11(\~ V1~Ilh resl?eCl alld CI~ITt~?;1»ti~tl 111 the III~ItIa~~~C[I1~17I ~~~ ;I(11fiUIa!]C~ hll~lll~~. (?U]' I)~I'~U[]2il allCIlllt>l1 li? ~C~all aIl(I iI';I~1~~I1~ il:Ill~j~lIlL~ t~I ~~all~llll f?;'t~ I"CSU~tti~I I!I ;IIC I11~1X11111Ut1 allllltlllt l~f I"Clltl~lli'~<Illl]II 3II(~\t'C~j ~~Ilil~' n~aint.Iinin~~ the ctili~s ~~~• hair ~lc~m~~n~trated in ~Iur ~~~u-> t~l~ser~~ice. Customer s~r~~ice i; cur r.u;r,bcr Inc ,zual ut ~V'ittnrln Enterprises. I.LC. Claim :~pncals ~~~itt-nttn Interpriscs. I.EC' has become "armeil'• ~~ith ertensi~~e trainin~z that clarified the ~1h1^~;lllt~llti ~?f (a~1tUl'llla IlliUrallC~ ~alTlc'Ci. :~ti ,1 rt;Sl1I1 l`I Ihl~ Ir~lllllll~~ ~~~C h~IVC I)lll ~illO aCll(~il ~~lil' ..lZe~ ePlle .>»Ilr,It?CC ~ Canl.•~ l heA liili)~1 the apphCable >tCTIOIIs (~I tl]e ~nl)S }scene :~(.T. ltl~lil';ln~. C~~de~_ ;llld ilcahh and ~alel~ ~l>des, a11d CIUi)le lhelll l\hen ilCl7landnl!'_ paAll~elll I1'llnl illsurallc:. 1hc~• alst~ file complaints ~~ith the Dcpal-tnlcnt ui~ ~l:Ina~,;;~1 C•arc: ~~h~~ ~~o~ern 1I~IO•s. ~~~hen an insurance conlpan~ is nun-compliant. This kno~t~led~;e has helped us obtain con"eci ;~a.~ r.;ent G-u-n ~~ncc ditiieult rarricrs such .IS Health het, one; ot~ the lamest in Calil~>rnia. They al,~, :<ppcal claims. demand ha~~menl. ~~ith interest ii~ applicable, li-om am~ non-co-llplia-u insur.:nc~• comp~ul~. ~1~orkers' C~>mp and insurance companies are challen~~ed ~ti~hen claims are clenied ~n~ underpaid. Denials are nu? ,imply ..accepted.'- City nJ.Sunur.anu Firr Depurnrrent 25C-21 {47ttrnrrn l:rarrpri~~~c, L.LC' 3.1.6 Reports ~~ ituuan Enterprises. f.I.C ~n~o~idcs 13nancial. stabsticul and iiseal reports i~t all i~illin~,~ ~~ursu~Int tc~ i;cner:ill~ Accepted .~cwuutilY13 1'I-incip(~s tC;:1:1P1 i»I a Inol~thl~'. qual-tcrl~- and annual basis. ~u ~~~ r,yacsted h~ the City. lccunullated r<<emle reports i~rr the: ~~it~ are sent on a ntonthl~~ ha~i~. (1aI' rcprri~ art detailed and ;.I:~ ter read. Keporu can he pru~ ided hard ~~{~~~- ;mailed, or a~~ailablc inn r~ur ~~ehsite fir reu-ie~al. S:unt{le Ilet~orts The I~,II~~~~in~ is :I amplil7~~ ul~ ~l<< rr}~orls ~~z prcl~id~ t~, ti1~ Cite al~,n~, ~~ith ;olne that pan b~ !'cifaesle~, Zit a ll1i~Il~el]1S ll~~11t;C. ~ hose I'eporl~ clrV'eI' i~ilr ablilll ti? aCCOUnl for aetai~ed ~'fCCfl~ttI'C. ~'cdi-Ca!. Aiembersl-~ip. and 13ad l~eht ~~rite uit~s ol~an~ t~pc :Ind to track re~~emle h. pcrii~d: r'ihl'( .~lil'1'i'1 i lci~~'l ~lll-fie' f)et<lli or 111i1]lllat'~ salt bC rllll L~\ dale i>f~ ~CI~V'1CC. E~a1~~1- 4J 1' ~dltCll[ OI- C~~ll;i?111C11iUi7 litc'IL' 01. { lekei ~iirteA~ aCc' Used lU ptt~~lde lll~i)rllli]UUIl sUeh as Illllllbt°r of aCC~lUnt II'.~~ll!lcii !l1`c` the ~~'~teli) In a_?~ en Itl(~Ilth and 1~:Y~e1- 1711\. ~ }IIS Inft~i-mdtlt~lt 0:117 rC i1Sed Iii `~ CI'1~~ that .:ll tickets ent ha~~e been recei~~ed and t<~r projection of~re~cnuc. - 1 C'111' ItJ 1)U(i 1~Z~'l'i'171i~' i177i( .~Jill;tl..;C771('111 .SlfilJillll{"; l~l'jh)1'Li ll~c l~cal t:~ f)utc Rej~iu-t i~r~,~~,i.ies a snai~shot o:-the last t~~el~e months at a!1~ ~_i~en Ume. i~his 1.'}~~''f'; i~~;ers ii~ta~> in 11t~ ~atei~~riCi. li ;.~>~~ re~ICi:t~ the C111~'Uln1 l'i)~ICCUUn '~lt~', t~Ut~1 1?riliJ an~~ n- '.ir ~~e '.`,~~!~ e-ln~_rMh 1?Cl'1i~~i. The ~lana~aem~nt tiumnlar~ rc~~i,rt i run b~ fiscal year. It ~~ri~~i~1es an ac:r~~untin~~ b~ financial cias~s i~i~t~~ta( trips and dollars billed each month. ~~ith a eumulati~c ~~ear-to-date trackin~~. [t also [~rU'.!~~L•~ ..Ill a~Ci?Untl11~~ i?f tt~C ~~i>~~:Ii'ti I-~~C1V~cij Ci1C}1 Inillltl) b_~ tlna11C13~ e~il~~ A~lth ~3 ~UIIlU~~itl~'~ ~e~u-to-dale U~aekine. ft'~,tif17~1' i~,~?ui'1 fh~~ r~~iln:d r~~~~,rt 1i,t.~ ~,aticnt name. u'ip date. run rnunher. incident number. and the amount to h~• r~~.uni~d. llt~itir'tlt_~'irln;~~11t Li~Lir~~ ~1h~ Ali~cthl~~ Cash f:eceipts Journal lists patient Warne. paler, date ol- ser~~ice, pa~~ment. :c>ntractual ~~rite do~~ns, ~~rite-off, refunds. anti re~enuc adjusuilcnts b~ deposit date lire cacl: f?atient. Citr~ of Surrru 1 era Pier Drpurtrrerru 25C-22 14inmuu Fntrrpris~~s, LL( ~1 i'l! i'1(1 .~! f)3I771C11't' «~tl~ lfal'}~ iCe(>Un1 ~?~~ Indl~'IdUal pa~~eI' IIlC)U~IIl~~ .1CCOlllll »~11~] Cl [1:1~~II]~Ill ~~21I1 aill~ iOlal aI1101I11T r«(lcctcd and halancc rcmainin. irr;;;r, -a._. 5 ~ 1Z .A~~in~ - Uetail ~,r Summary. b~ -Drip Date i,date i~f scnice). Patient. ~~r Pa~cr. The report can h. "15I:"111/~d ll± IC:1C}~ a .~~~eC! ~i~ pay Cr ~!1' pay eI'~ aild .~alC I"an~~e .~i:(ir(~~ ~lc'UtJl'1 Un-1)emalld rep~~rt> arc our,pecialt~. at nn additional char~,c. Uur hillin~ soit~~arc collects and tra~k~ :: numher of data elements u~hether input or elcetronicall~~ do~~~nloaded. Such reports are readily a~~aiiat~le i7rl-line t~or the City's re~ic~~ and can comain ~9onth I~.nd and "Kcal ~(~itnc'- ir,i~~rnr.Iti~~n. Cit1' njSanra Anu Fire Uepurnnent 25C-23 r.~ifl;.... ... ~~i r,' .mac. _!.i 3.1.' tipcciul:~ccuunts Discounts, fi:~r~lship, ana Uther Policies The C'it~~s poli,:ics arc ~~~cll established and apple t« all residents and business o~~-Ilea ~~~ithin the Cite !inut~. 1IIC Cite ~_locs not ol~Cer diseuunting ~~f~ aII~ hind. .ill hardship re~~uests are sent ~~it11 the :~}~pro}~ri.Itc ~ubaantiatin~~ d~~rum~ntatiun t~I the Cite i~>I~ r~~~i~~~~. A~'~ are then notified ul~ the a~cision alld ~l?I~~~~I:'d t11;1t dc:ISlon i'~11 It? the pallelll. :~1~ prU~Cdlli'eti a1'e ~1Jteil In v(~~II~ Ci~mpan~ iE~c'~1111'? and ~~e ~~ill c~~ntinuc Iu li>llu~,~ all ~~uidelines that hay ~ been cslabiished. ~ubscriptiun Yro~~ranl the ('it.. ul' Santa .Ana ha; a Paramedic Membership pro~~ram. _~~Il accounts are ~~erified fur mcn7b~r~ilip pri~u- to data cntr~. ~~erilication of a patients metnhership is done ? ~~a~s. If~ the membcrsilip i, paid through the eater bill ~.~c cali the Cite of Santa .-~na 1'~ater llepartment and usin~a the paticllt'; address. date of scrcicc, and the uanlc on that the «~ater bill «e ~~crif~~ rlramcdic_c~~.cra ....:: I1~1~ i~`, ;a: ~I.~l:~;'~~Sli]` ~. It I11C pa'ti~nl p~1., ~ lltr 1110 nlelnb~l'~illp i~il an ;}nnUai ba~15 V1e CtI~C); the Paramccii~ AIcmhcl'ship book the Cite t~ro~~ides tip us. If the patient is not ur: ~}~c fist but insitit tha; t}~e~• arc un the ~earl~ pru~aranl ..e call the C'it~~ to ~cril~ membership. Patient :IC~~~unt~ ;h.It du nut ha~c inurance information Iistccl arc researched through a phone call to Il1C ~?:IIICRI. ;k~~~~lta~ ~~7l7tael t?1' Clll Injl?I'ina11~~11 ieTlel~ ~cnl Ili the ]~atiCnt. ~)Ilc;l al~ lllSllraIl~e ~~d11ll~Il1S ha~~~ been rccci~, cd. ~i c do ni~I hill the patient or ca11 them. the balance is ~~-ritten off to the membership pro_ram. II~ tflc member due: not ha~~e an~~ or other insurance, the balance is ~~ritten ot1~ to the III.I'.il`~f~hl~~~ i~!'~~~I';llll. l~ the patlellt 41a~ I1hI a V~a~ld lllelllbel" O11 the date Uf >e1'V'ICe. t\e COnllntle I~) bl~~ the pl;ticni accor~lin~~l~,. Dispute 12esolution The resolution of disputes is perfurrl3ed in accordance ~~ith the Cite and HiP_~.1 ~auidelitle. ~~~ittman I-;nt~rpri;«. l.l.l' ha; ~a~~~•lui,cd~Ind ~~ill mailltain a ,a~~ud rap~wrt ~~ith the City's ;tali. ~~orkin~a cloel~ ~~~it~ them to !ind a ~~uick :Ind cc~uita6le resolution t~> all patient dispute,. ~~'}Iile ~~e rccci~< and make over ] U.U(~(i cads per ~~~erk our Customer Ser~~ice [Zeprescntati~~es £It ~1~ittnrln Enterprises, I.I.C Ire a~~are that ~~~~~ represent the City's interest ~~~hen respondin~a to inquiries from patients. insurance c~~~I:nal~ics. att~~rnc~ • and ethers. Customer ~Crv ice Kepresentati~es process all in~utnin~~ mail. insul-anc~ 1~;(?f3',, and patient di~put~s. \~'~ are often ab}c to dispel an~~ concerns or disputes regarding cllarge ~s ithout imul~~ing City perwnncl, h~~„c~cr. ~,~~ itnmcdi~Iteh notif~~ the (~it~ ofan~~ patient care cumpfaints. .'n'..':icrtt:..;na r.. ~ .`~2J;:;rtrree~ 25C-24 ~!~innr,:r: Errt~rnr~..~s .-,.. 3.1.8 llelinyucnt :accounts X111 accounts that are bein~~ written oil to collections are sent electronie~rll~' to the Cit~~'s collection a~~enc~. _1cc~runts c,in he pufleci ti-on. collections ~~~ithin ~U dais of relerral.:111 collection ytrcatiorls ~n~c rei~,~r~•~i to a~r~° Citl~~. collection a~~ene~~. I3efi~re ari account can be recc~n~mendcd i~~r rei~erral the iullu~~~in~~ ;~r~~c.~lur~s mu,t hay ~ been hcri~orn~td: • 13111 ~~hedule has fern completed • t ~tiliration of all appropriate follo~~-up letters • :\ltcrnate contacts hay e been used • :~tlempts ttr locate con~ect address and telephone number ~~ith the 1laincs Uirector~'. ~~'hite Pa~es.com and :-'lccurint.Cim1 • 1 lospital contacted lur better inl~rrmation • Itledi-Cal ~li~~ibilit~ r~-~~riii~~l <' i n :;' Snnlu : irta ~'rrr U~~•purtment .i ~ 25C-25 ~ .r:lf:.f l: :'.lli i'I':..~ ..:.I . PRICING ~~ h~ Cii~ Ilas rcalii.L~i the hi~~hcst }~o~~ihle r~~~~nuc frt~rn i~ur cfti~rt~. 11~e ~ir~ pleased tc~ be .I part c~f :h~ C'ii~'s ,uccc~s and ~t~e ~,~~ish t~~ continue a~ ~~our t~illin~ went. ~~'e hclic~~c ~~~~ have a ,tame i;~~:ul~iati~~rl t~~~r a mutualf~ ~ati~f~actor~ l~,n~~-tcrn~ r~lati~>nshi}~. ~:~h~• a~3~ic~1 in~,~I-i~~~~In~nt; to ~.~tlr kn~,~~.l~~l~~~ al~~l t~chllical .jhilitic~ ha~c ~nhancc~i cur ~:hilit~~ tc~ ~~a,tilr,I~ '.u }rut i~lc an~3 ~•~c~c,l the cx~~cllent ~cr~~ice the Cite has ~~>n~c t~> expect. ~~~~ ot~ttr <>ur hilinl_ :cr~icc, at the t~~l}o~~inh rate: 6.3'%~ - Paper PCIZ"• G.Oiu - lI' at and Illllc ~iurin<z the contract tht ~'it~ .~htains ~PC'K capabiliti~, ~ 1;}1~I' ;I'~'CnCI~'~ InltA Ci)nl~ ltl A~IIh :I i~R~~?' ~Cl'. }~Ut ~~~C a~~ t}1C (~lt~ til C1~17~ICiCr that It 1~ t~tlr ~~}'':rwna: lltc"Illil'~i'.~~ `:}al't ~1'~at:°~ I}7C InCI'Ca~C~} {1:~cllU~: any} ~111~~ `.~L' ha~~ ,. }~1'l)\t'.n 1't~~)I'~ UI E~eatin~ thc~ cun~pctiti~~n h~ at Ira~t 1O°~, un collections. ire bclic~~e the C'it~ ~~il] continue t~~ net I'l~~i~C in~~'n].' '.Ait}1 ~~lll' 3l'1'\ Il~~. 1~ C Str(?nl~f~ C11~~?Iir21h~ the ~_ lIV' lU .OI1taCt i)Ur rCtC'rCnll'S. ~)nCC ~C~If ;1;I~'~' `.l?U tAlii ~~~' :I>~llr~~l (hat ~~hat VAC tilalC In i)Ur 1'CSpOn;c 1~ ]1ot ]ll~t ~~!]1tlt~ ~~ ~~~hat ~~C >aV' ~~, ~ ~ic~ i ~ hat ~~< :ICtuall~. Rio. 25C-26