HomeMy WebLinkAboutDocumentation_Regular_Tab 12K_4/10/1997 , ..„
• Memo
To: Thomas G. Bradford, Village irri-r
From: James M. Weinand, Fire Chi:
Date: March 31, 1997 •
Re: EMS Billing Contract
• Attached hereto is a contract to be executed for medical transport billing service. This
contract with Medical Claims Processors Group has been reviewed by John. C.
Randolph, Village Attorney, and his comment are also attached.
•
The Medical Claims Processors Group has been highly recommended for their medical
billing services. As a matter of fact, they are doing all of Palm Beach County Fire
Rescue's medical billing also. They are a local company based in Jupiter, and are
more than qualified to handle this type of insurance billing for us.
The last time I had to hire this type of service to perform EMS billing was in 1990. At
that time, the going rate was $6.10 per patient transported. The Medical Claims
Processors Group is giving us an outstanding price of $4.25 per person transported. In
this price, they are providing billing to the responsible party for payment, balance billing
to the patients, and the are also providing us with the necessary documentation
records for financial reporting.
During the course of the transport, the paramedic obtains all the necessary
documentation, signatures, and insurance cards to provide this billing. This data is
then turned over to the Medical Claims Processors Group which in turn will perform all
the billing services. All funds are mailed directly to the Fire Department and reported to
the billing agency weekly on a financial receipt ledger. This transaction builds in a
check and balance system for accountability of funds.
Originally, I anticipated Fire-Rescue staff to perform these billing procedures, but at the
rate provided by the Medical Claims Processors Group, it is more advantageous to hire
this outside agency to perform this service.
If you see appropriate, please forward this contract to the next Village Council Meeting
for their consideration on this matter. If you have any questions or concerns on this
matter, please do not hesitate to contact me.
J M W/cm
depthead\033197
V . - ._ 1 . _ fu1SLC1
•
JONES, FOSTER, JOHNSTON & STUBBS, P.
ATTORNEYS AND COUNSELORS •
FLAGLER CENTER TOWER
•
SOS SOUTHFLAGLER DRIVE Vrl `c .. ifflce
LARRY B.ArrxArmER MADE B.KxENmety ELEVENTH FLOOR HioulY P.LILIENTHAL
CARL ANGESDPP MICHAE.T.Cuuxz 1902-1982
M.TRAM BxAaarn lour B.McCR. , WEST PALM BEACH FLORIDA 3340 l
Hairy Allison Johnston
CUY C.BRoormc SCO r L.McMuuRx 1895-1983
JOYCEA CormAY DAVID PRATT P.O.Box 3475 R.Bruce lanes
MAaaAazr L.COOPER Jo,w C.RAimoirn WEST PALM BEACH,FL 33402-3475 1904-1988
EDWARD DIAz STEVEN 1.Actium (561)659-3000 Phil C.Wolfe
REBECCA G.DOANE PA.SAofl 1933-1991
DAODE.DEzrax D.CuLvERSeanc111 FAX:(561)832-1454
Ci maionult S.DOia SIDNEY A STUBBS Retired
• H.Mumma.EAsrRY Aurtr R.TOMLINSON WRITERS DIRECT LINE: William A.Foster
Scorr G.HAwi@m Joni S.DUMPER
'rHoax nt M.HarnY Baler R.WA7oeAN Of Counsel
Pit S.Haar H.ADAMS WEAVER Jack A.Ptisoo
HARRYA Jcaueiox B USA S.&Baru
•
February 28, 1997 VIA FAX: 575-6203
James M. Weinand, Fire Chief
Village of Tequesta
Department of Fire-Rescue
Post Office Box 3273
Tequesta, Florida 33469
RE: Village of Tequesta
EMS Billing Contract
Our File No. 13153 . 1
Dear Chief Weinand:
As you can see I have made some major amendments to the draft
contract referenced above. Basically, I have just reorganized the
contract, except that ' as to paragraph 8, I have amended the
contract so as to allow termination without cause, and I have
deleted language previously included in paragraph 22 .
Please contact me if you have any questions or comments .
Sincerely,
JONES, FOSTER, JOHNSTON & STUBBS, P.A.
rl `_
John C. Randolph
JCR\ssm SIGNED IN- THE
Enclosure ABSENCE OF JOHN C.
cc: Thomas G. Bradford, Village Manager RANDOLPH TO
EXPEDITE DELIVERY
. RESOLUTION NO. 18-96/97
A RESOLUTION OF THE VILLAGE COUNCIL OF THE
VILLAGE OF TEQUESTA, PALM BEACH COUNTY,
FLORIDA, APPROVING A CONTRACT BETWEEN THE
VILLAGE OF TEQUESTA AND MEDICAL CLAIMS
PROCESSORS GROUP, INC. FOR FIRE-RESCUE EMS
TRANSPORT BILLING AND AUTHORIZING THE
VILLAGE MANAGER TO EXECUTE THE SAME ON
BEHALF OF THE VILLAGE.
Hi
NOW, THEREFORE, BE IT RESOLVED BY THE VILLAGE COUNCIL OF THE
!; VILLAGE OF TEQUESTA, PALM BEACH COUNTY, FLORIDA, AS FOLLOWS:
!d Section 1. The Contract between the Village of Tequesta and
Medical Claims Processors Group, Inc. for Fire-Rescue EMS
Transport Billing, attached hereto as Exhibit "A" and
li incorporated by reference .as a part of this Resolution, is
hereby approved and the Village Manager of the Village of
Tequesta is authorized to execute the same on behalf of the
Village of Tequesta.
THE FOREGOING RESOLUTION WAS OFFERED by Councilmember
, who maved its adoption. The.mation was seconded
by Councilmember , and upon being put to a vote,
H the vote was as follows :
FOR ADOPTION AGAINST ADOPTION
The Mayor thereupon declared the Resolution duly passed and
adopted this 10th day of April, A.D. , 1997 . '
MAYOR OF TEQUESTA
Ron T. Mackail
ATTEST:
•
i Joann Manganiello
Village Clerk
wp60\res\18-97
L.\-1l1:5l1 • :\
CONTRACT FOR FIRE RESCUE EMS TRANSPORT BILLING
THIS CONTRACT entered into on this day of
1997, between VILLAGE OF TEQUESTA, hereinafter referred to as
"Tequesta" , and MEDICAL CLAIMS PROCESSORS GROUP, INC. , hereinafter
referred to as "MCPG" , for the purpose of providing insurance and
patient billing for all EMS transport services rendered by
Tequesta.
WHEREAS, the Village of Tequesta, is a municipal corporation,
incorporated within the State of Florida, which engages in EMS
transport services; and
WHEREAS, MCPG is a corporation incorporated in the State of
Florida established for the purpose of providing insurance and
patient billing; and
WHEREAS, the Village of Tequesta desires to contract with MCPG
for the purpose of providing insurance and patient billing for all
EMS transport services rendered by Tequesta.
NOW, THEREFORE, the parties hereto agree as follows :
1. The duties of MCPG which shall be performed on behalf of
the Village of Tequesta are as follows :
A. MCPG shall abide by all federal, state, county and local
laws, ordinances, rules and regulations that in any
manner affect the work it performs for the Village of
Tequesta.
B . MCPG shall provide Tequesta with a copy of all licenses
and insurance coverage certificates on an annual basis,
or earlier or upon more frequent intervals, upon request
of the Tequesta.
C. MCPG shall maintain complete documentation and records
associated with the work it performs for Tequesta and
shall return all documentation and records to Tequesta on
an annual basis, or earlier or upon more frequent
intervals, upon the request of Tequesta.
D. MCPG will perform all diagnosis and CPT coding, and any
other work required in order to submit insurance claims
and perform patient billing.
E . MCPG shall perform balance billing to the patient for any
balance remaining after collection of insurance benefits
as may be permitted and conform with insurance industry
and governmental rules and regulations .
F. MCPG shall prepare a bill for EMS services to be sent
immediately to all patients with no insurance coverage.
G. MCPG shall make no adjustments or write-offs on any
patient account until first consulting with Tequesta by
presenting the accounts for consideration and obtaining
written authorization on which accounts the adjustment or
write-off shall be made .
H. MCPG shall consult with Tequesta before making any
determination that a patient account is uncollectible .
I . MCPG will submit all claims electronically as permitted.
J. MCPG will follow up on all claim submissions, reviews
and/or appeals and patient billing.
K. MCPG shall provide Tequesta with financial reports on a
monthly basis to keep Tequesta advised of the status of
billing. The reports shall be forwarded the 15th of each
month. The reports to be provided shall be as follows :
a. Patient List
b . Monthly Payment List
c . Aged Trial Balance
d. Financial Analysis by Financial Class
e . Charges and Payments Statistical Report by
Financial Class
L. MCPG shall render Tequesta its Statement for Services
rendered the 1st of each month for the preceding month' s 1
work performed.
2 . The duties of the Village of Tequesta are as follows:
A. Tequesta will provide MCPG with all patient, insurance
and chief complaint information for all patients to whom
MCPG will be submitting insurance claims and performing
patient billing.
B . Tequesta will make available all billing information for
MCPG to pick up each Friday at the Fire Rescue office
located at 357 Tequesta Drive, Tequesta, Florida.
C. Tequesta shall keep MCPG advised of any patient payments
and insurance payments received by Tequesta by providing
a weekly Receipt Report with all insurance EOB sheets and
a copy of all patient checks attached.
D . Tequesta shall provide MCPG with all insurance
correspondence and patient correspondence so that MCPG
may be fully aware of the status of patient accounts and
the claims it has submitted and to respond to any
2
information being requested by patients and insurance
companies .
3 . In consideration of the above services to be performed by
MCPG for Tequesta, MCPG shall charge a unit price of $4 . 25 per
patient/unit .
4 . Payment of MCPG statements are due upon receipt and
Tequesta shall forward MCPG full payment within fifteen (15) days
of receipt of the statement .
5 . Should Tequesta be delinquent in payment of MCPG
statements, MCPG shall have the right to discontinue work for •
Tequesta until all fees have been paid in full to MCPG.
6 . All insurance benefits and patient payments shall be
directed to the Village of Tequesta at Post Office Box 3273,
Tequesta, Florida 33469-0273 .
7 . The term of the contact between Tequesta and MCPG shall
begin January 1, 1997, and end December 31, 1999 . MCPG fees shall
remain as set forth above for the period of the contract .
8 . This contract shall remain in effect until the expiration"
of the term or unless Tequesta or MCPG provides notice of
termination thirty (30) days prior to intent to terminate. In the
event of termination by either party, MCPG shall be entitled to all
fees for work performed up to the termination date.
The parties will abide by the above terms and conditions and
the above terms and conditions are hereby accepted, confirmed and
approved by:
MEDICAL CLAIMS PROCE SORS GROUP, INC.
By
Ela e C. Hine
Presient
VILLAGE OF TEQUESTA
By
Thomas G. Bradford
Village Manager
JCR\13153-01\MCPG.AGR
3