08/16/2000 Agreement
Cled( of 11Ie
Circul coun
Danny L. Kolhage
Phone: 805-292-3550 Fax: 805-295-3615
Memnrandum
To:
Reggie Paros, Director
Public Safety Division
From:
Isabel C. DeSantis,
Deputy Clerk ~ C; JY:
Thursday, August 31, 2000
Date:
At the Board of Governors' of Meeting on August 16, 2000, the contract between
Monroe County and A,.dvaAced Data Processing, Inc. for RescUe Ambulance Billing &
Related Professional Services, was approved.
Attached is a fully-executed duplicate original of the subject document for your
handling
Should you have any questions concerning this matter please feel free to contact
this office.
Copies: Finance
County Attorney
Ate
'''Ambulance Billing & Related Services"
CONTRACT # Date:
Page 1
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ADVANCED DATA PROCESSING. INC. ~('"),- :z
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FOR RESCUE AMBULANCE BilLING & RELATED PROFESSIONAL SERVtGES> "::"
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THIS CONTRACT, hereinafter "CONTRACT OR AGREEMENT", made and entered into
this ~day of September, 2000 by and between MONROE COUNTY, a political
subdivision of the State of Florida, with principal offices located at 490 63rd Street,
Marathon, Fl 33050, hereinafter referred to as the "COUNTY", and Advanced Data
Processing, Inc., a Florida Corporation with principal offices located at 520 NW 165
Street, Suite 201, Miami, Florida 33169, hereinafter referred to as the
"CONTRACTOR" ,
CONTRACT BETWEEN
THE COUNTY OF MONROE
AND
WITNESSETH:
WHEREAS, the parties hereto now wish to enter into an agreement, pursuant to
which the CONTRACTOR will render those professional services in connection with said
project as hereinafter provided;
NOW THEREFORE, the parties hereto agree as follows:
1. DEFINITION OF THE PROJECT. The objective of the project is to utilize the
services of the CONTRACTOR to provide the COUNTY with ambulance billing and
related services.
2. SCOPE OF SERVICES. The CONTRACTOR shall perform and carry out the work
tasks presented in CONTRACTOR'S Scope of Work (Exhibit A), as summarized herein,
All payments shall be paid directly to 'MONROE COUNTY BOARD OF COUNTY
COMMISIONERS' or via "locked-Box" facility as directed by the COUNTY,
3. TIME OF PERFORMANCE. This Contract shall be effective for a two-year period
from September 1, 2000 through August 31, 2002, under the terms and
conditions contained herein unless otherwise terminated, The COUNTY may, at its
option, renew this agreement for two (2) additional one (1) year terms under the then
in force terms and conditions by giving notice to CONTRACTOR at least sixty (60) days
prior to expiration of the current term. Monroe County's performance and obligation to
pay under this contract, is contingent upon an annual appropriation by the Board of
County Commission,
4. COMPENSATION AND METHOD OF PAYMENT. The COUNTY reserves the right to
request changes in the services within the general scope of the Contract to be
performed upon mutual agreement by the COUNTY and CONTRACTOR which shall
specify the change ordered and the adjustment of time and compensation required
therefore,
Agreement Page 1 of 6
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'''Ambulance Billing & Related Services"
CONTRACT # Date:
Page 2
Any services added to the scope of this Contract by a change order shall be
executed in compliance with all other applicable conditions of this Contract, No claim
for additional compensation or extension of time shall be recognized unless contained in
the duly executed change order,
The CONTRACTOR shall provide to the COUNTY a monthly invoice representing
fees for the services provided computed as:
Seven percent (7%) of all monies collected by CONTRACTOR, excluding
Medicaid accounts, during the previous month, Pursuant to Florida Statute 409,913(9),
CONTRACTOR will include in the same invoice an amount of $11.40 per Medicaid
account for providing all billing services related to such accounts processed in the
previous month. The COUNTY shall issue a check for the amount invoiced, minus any
disputed amount, within thirty (30) days of receipt and acceptance of the invoice,
The COUNTY shall bear the cost of any and all Lock-box services, All other costs
incurred by CONTRACTOR in the performance of services as specified herein (including,
but not limited to postage, materials, communications and phone costs and, other
operating costs) shall be borne by the CONTRACTOR,
5. REPORTS. The CONTRACTOR shall provide the COUNTY with status reports as set
forth in Exhibit A and other reports as mutually agreed, The CONTRACTOR shall also
provide changes to such reports and ad hoc report requests on a reasonable basis and
as mutually agreed,
6. DATA TO BE FURNISHED BY COUNTY. The COUNTY will make available to the
CONTRACTOR, for use in performance of services under this Contract, all available
reports, studies or any other materials in its possession that may be useful to the
CONTRACTOR, All material furnished by the COUNTY will not be disclosed to any
party without the COUNTY's prior approval.
7. INDEPENDENT CONTRACTORS. The CONTRACTOR is an independent contractor
and not an employee or agent of the COUNTY with the following exception':
To the extent necessary to fulfill its billing and collection efforts
under the Agreement, the CONTRACTOR is authorized to sign in an
administrative capacity for the COUNTY the following types of standard
forms and correspondences only: probate filings; letters to patients or
their representatives verifying that an account is paid in full; forms
verifying the tax-exempt status of the COUNTY; and insurance filings
and related forms. The CONTRACTOR has no authority to sign any
document that imposes any liability on the COUNTY.
The CONTRACTOR shall retain full control over the employment, direction,
compensation and discharge of all persons assisting in the performance of service by
CONTRACTOR. The CONTRACTOR shall be fully responsible for all matters relating to
payment of employees, including compliance with Social Security, withholding tax and
all other laws and regulations governing such matters, The CONTRACTOR shall be
Agreement Page 2 of6
'''Ambulance Billing & Related Services"
CONTRACT #
Page 3
Date:
responsible for its own acts and those of its agents and employees during the term of
this contract.
8. INDEMNIFICATION. The CONTRACTOR shall indemnify and hold the COUNTY
harmless from any and all claims, losses and causes of actions which may arise out of
the performance of this Agreement as a result of an act of negligence, of the
CONTRACTOR, its employees, agents, representatives, consultants, or its
SUBCONTRACTORS, The CONTRACTOR shall pay all claims and losses of any nature
whatsoever in connection therewith and shall pay all costs and judgements (including,
but not limited to, attorneys' fee and expenses and cost of defense provided on behalf
of the COUNTY), that may issue thereon, The above provisions shall survive the
termination of this Agreement and shall pertain to any occurrence during the term of
this Agreement, even though the claim may be made after the termination hereof,
Nothing contained herein is intended nor shall be construed to waive COUNTY's
rights and immunities under the common law or Florida Statutes 768,28, as amended
from time to time,
9. INSURANCE. The CONTRACTOR shall maintain the following insurance coverage:
1) Worker's Compensation Insurance in compliance with Florida Statutes, Chapter
440 and applicable Federal Acts as they may be amended from time to time; and
2) General Liability insurance in an amount no less than $1,000,000 per occurrence.
3) Coverage for business interruption, destruction of data processing equipment and
media, liabilities affecting accounts receivables, contracts and independent
contractors and, valuable documents in an amount no less than $100,000
aggregate;
4) Liability coverage for all vehicles whether owned, hired or used in the amount of
$500,000; and
5) Professional liability coverage in the amount of $500,000.
Where applicable all coverage above shall be amended with MONROE COUNTY BOARD
OF COUNTY COMMISSIONERS named as an additional insured. All of the policies of
insurance so required to be purchased and maintained shall contain a provision or
endorsement that the coverage afforded shall not be canceled, materially changed or
renewal refused until at least thirty (30) calendar days written notice has been given to
the COUNTY by certified mail. Prior to commencing work, the CONTRACTOR shall
provide COUNTY with certified copies of all insurance policies providing coverage as
required, Any indemnification provisions in this Agreement are separate and apart and
in no way limited by the insurance amounts stated above,
The liabilities of the CONTRACTOR under this Agreement shall survive and not be
terminated, reduced, or otherwise limited by any expiration or termination of insurance
coverages.
Agreement Page 30f6
"Ambulance Billing & Related Services"
CONTRACT #
Page 4
Date:
10. OWNERSHIP OF DOCUMENTS. CONTRACTOR shall be required to work in
harmony with other consultants relative to providing information requested in a timely
manner and in the specified form. The CONTRACTOR agrees that any and all
documents, records, disks, and electronic data produced in the performance of this
Agreement shall be the sole property of the COUNTY, including all rights therein of
whatever kind except as may otherwise be provided hereinafter. Failure to turn over
such documents within seven (7) days of when requested may be cause for the
COUNTY to withhold payments due CONTRACTOR or to enforce this clause by legal
remedies,
11. ATTACHMENTS. The following named attachments are made an integral part of
this Agreement:
A, Proposal presented to Monroe County EMS by Advanced Data Processing dated
July 6, 2000 (Exhibit A attached hereto and made a part hereof) which includes the
Contract with the City of Boca Raton (referenced herein as the "Piggyback"),
B, Public Entity Crime Statement and Sworn Ethics Clause
Where terms, conditions or scope of services stated in either this Agreement or the
above attachments conflict, this Agreement and any superceding Amendments thereof
shall prevail.
12. TERMINATION for CAUSE. During the time of this agreement the COUNTY may
terminate this Agreement after first giving to CONTRACTOR notice of default and
opportunity to cure the default within thirty (30) days after receipt of such notice. In
the event the acts constituting default are a violation of law, CONTRACTOR shall be
subject to immediate termination of contract, Notwithstanding the provisions above,
the COUNTY shall not have any right to cancel this contract without cause,
Upon termination, the CONTRACTOR shall submit an invoice(s) to the COUNTY in an
amount(s) that representing fees for services actually performed or obligations incurred
to the date of effective termination for which the CONTRACTOR has not been
previously compensated, Upon payment of all sums found due, the COUNTY shall be
under no further obligation to the CONTRACTOR, financial or otherwise.
13. UNCONTROLLABLE FORCES. Neither the COUNTY nor CONTRACTOR shall be
considered to be in default of this Agreement if delays in or failure of performance shall
be due to Uncontrollable Forces, the effect of which, by the exercise of reasonable
diligence, the non-performing party could not avoid, The term "Uncontrollable Forces"
shall mean any event which results in the prevention or delay of performance by a party
of its obligations under this Agreement and which is beyond the reasonable control of
the non-performing party, It includes, but is not limited to fire, flood, earthquakes,
storms, lightning, epidemic, war, riot, civil disturbance, sabotage, and governmental
actions.
Neither party shall, however, be excused from performance if non-performance is due
to forces that are preventable, removable, or remediable nor which the non-performing
party could have, with the exercise of reasonable diligence, prevented, prevented,
Agreement Page 4 of 6
. "Ambulance Billing & Related Services"
CONTRACT # Date:
Page 5
removed, or remedied with reasonable dispatch. The non-performing party shall, within
a reasonable time of being prevented or delayed from performance by an uncontrollable
force, give written notice to the other party describing the circumstances and
uncontrollable forces preventing continued performance of the obligations of this
Agreement,
14. JURISDICTION, VENUE and CHOICE OF LAW. All questions pertaining to the
validity and interpretations of this Contract shall be determined in accordance with the
laws of the State of Florida, Any legal action by either party against the other
concerning this agreement shall be filed in Monroe County, Florida, which shall be
deemed proper jurisdiction and venue for the action,
15. PIGGYBACK. It is hereby a precondition of any part of this Agreement that the
Most Favorable Terms of CONTRACTOR's Agreement with the City of Boca Raton
(dated March 17, 1999) shall be extended to the COUNTY including any modifications,
amendments or exclusions for the term of referenced agreement, Effectively, this
allows the COUNTY to piggyback the agreement with the City of Boca Raton,
16. ASSIGNMENT OF CONTRACT. The CONTRACTOR shall not sell, transfer, assign
or otherwise dispose of this Contract or any part thereof or work provided therein, or of
its right, title or interest therein, unless otherwise provided in the contract, without
express prior Gonsent by the COUNTY.
17. NOTICES. Delivered or mailed to such party at their respective addresses as
follows:
To the COUNTY:
Monroe County EMS
490 Sixty-Third Street
Marathon, FL 33050
Attn: Teresa Gorentz, Director
To the CONTRACTOR:
Paul Franzelas
Vice President
Advanced Data Processing, Inc.
520 NW 165 Street Road, Suite 201
Miami, Florida 33169
18. REPESENTATION AND WARRANTY. CONTRACTOR represents that they have
experience and agrees to follow all Federal, State and Local Laws including, but not
limited to, Public Records Laws and those laws and statutes applicable to
discrimination,
Agreement Page 5 of 6
"Rescue Ambulance Billing & Related Services"
CONTRACT # Date:
Page 6
19. ENTIRE CONTRACT. This Contract contains the entire agreement between the
parties, The CONTRACTOR represents that in entering into this Contract it has not
relied on any previous oral and/or implied representations, inducements or
understandings of any kind or nature.
IN WITNESS WHEREOF. the parties hereto have caused these presents to be executed on
the day and year first above written:
Mol'+iaOE COUNTY
SEAL
By:
Yvonne Harper, Chairperson
Lower and Middle Keys Fire
and Ambulance District
Board of Governors
Attest:~.JLQ.. ~~ D.C-.
Danny Kolhage. Clerk of the Court
'8 - l f.s>- 00
By:
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Agreement Page 6 of6
O,Yv~rY ~o~~~2E
(305) 294-4641
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BOARD OF COUNTY COMMISSIONERS
MAYOR Shirley Freeman, District 3
Mayor Pro tern George Neugent, District 2
Wilhelmina Harvey, District 1
Nora Williams, District 4
Mary Kay Reich, District 5
PUBLIC ENTITY CRIME STATEMENT
A person or affiliate who has been placed on the convicted vendor list following a
conviction for public entity crime may not submit a bid on a contract to provide
any goods or services to a public entity, may not submit a bid on a contract with a
public entity for the construction or repair of a public building or public work, may
not submit bids on leases of real property to public entity, may not be awarded or
perform work as a contractor, supplier, subcontractor, or consultant under a
contract with any public entity, and may not transact business with any public
entity in excess of the threshold amount provided in Section 287.017, for
CATEGORY TWO for a period of 36 months from the date of being placed on the
convicted vendor list.
Attachment: Ambulance Billing Services Contract of September 1, 2000
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FI.ORIDA
ETHICS CLAUSE
AdVa.",ced. T.:bfo.. t=f.c!:)c.es~i+l~.:...._warrants that he/it has not employed,
retained or otherwise had act on his/its behalf any former County officer
or employee in voliation of Section 2 of Ordinance No. 10-1990 or any
County officer or employee in violation of Section 3 of Ordinance No.
10-1990. For breach or violation of this provision the County may, in
its discretion, terminate this contract without liability and may also,
in its discretion, deduct from the contract or purchase price, or
otherwise recover, the full amount of any fee, commission, percentage,
gift, or consideration paid to the former Count
--~~
. (signatu
Da te : --..-:JMO ()
STATE OF
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COUNTY OF
PE~Y APP~ED BEFORE. ME, the undersigned authority,
_.1.- --bMz..~..____.________nn_ who, after first being sworn by
me,
affixed his/her signature (name of individual signing) in the space
2.ffk
pr~~' above on this __~L._____day of
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My commission expires:
~~y P,,~ YVETTE BLAIR. GAllES
~& If, COMMISSION # CC 718204
~ ~ ?! EXPIRES FEB 19, 2002
"'T~ BONDED THRU
OF f\.tI' ATLANTIC BONDING co., INC.
CERTIFICATE OF INSURANCE
This certifies that ~ STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
o STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
insures the following policyholder for the coverages indicated below:
Name of policyholder ADVANCED DATA PROCESSING INC.
Address of policyholder
520 NW 165TH STREET RD STE#201
MIAMI, FLA. 33169-6303
Location of operations
SAME
Description of operations BILLING & COLLECTION SYSTEMS
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
subiect to all the terms exclusions, and conditions of those policies. The limits of Iiabilitv shown may have been reduced bv any paid claims.
POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD LIMITS OF LIABILITY
Effective Date Expiration Date (at beqinninq of Dolicv Deriod)
Comprehensive BODILY INJURY AND
98485820-5B Business Liabilitv 03/06/00 03/06/01 PROPERTY DAMAGE
This insurance includes: ~ Products - Completed Operations
~ Contractual Liability
o Underground Hazard Coverage Each Occurrence $1.000,000
o Personal Injury
o Advertising Injury General Aggregate $2,000.000
o Explosion Hazard Coverage Products - Completed
o Collapse Hazard Coverage Operations Aggregate $2,000,000
o General Aggregate Limit applies to each project
0
0
EXCESS LIABILITY POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE
Effective Date EXDiration Date (Combined Single Limit)
o Umbrella Each Occurrence $
o Other 10/11/99 10/11/01 Aaareaate $
98KB72387F 04/06/00 04/06/01 Part 1 STATUTORY
Part 2 BODILY INJURY
Workers' Compensation
and Employers Liability Each Accident $100000
Disease Each Employee $100000
Disease - Policy Limit $ 500000
POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD LIMITS OF LIABILITY
Effective Date EXDiration Date (at beginning of policy period)
5553289A0159 AUTO 07/01/00 01/01/01 500/500/500
If any of the described policies are canceled before its
expiration date, State Farm will try to mail a written notice to
the certificate holder 3 0 days before cancellation. If,
however, we fail to mail such notice, no obligation or liability
will be imposed on State Farm or its agents or
representatives.
Name and Address of Certificate Holder
MONROE COUNTY BOCC
5100 COLLEGE ROAD RM # 203
KEY WEST, FLA.33040
ADDN INSD. MONROE COUNTY BOCC
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Title
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Signature of A orized Representative
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558-994 a 2-90 Printed in U,S.A.
Date
. Advanced Data Pnx:essing
Advanced Data Processing Phone 305 945 2260
520 NW 165 Street Road
Suite 201 Fax 305 945 6692
Miami, FL 33169 Email AOPadv@aol.com
July 6, 2000
MONROE COUNTY
Purchasing Office
5100 College Road, Public Service Bldg
Cross Wing Room #002
Stock Island, Key West, FL 33040
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Dear Purchasing and EMS Director:
~
Subject: EMS Billing & Collections Contract. Boca Raton Piggyback
This letter hereby serves as our authorization for you to "Piggyback" our contract with the City of Boca
Raton Agreement No. 99-006 adopted under Resolution No. 57-99 dated March 16111, 1999 to provide
same Billing and Collection Services for Emergency Medical Transports provided by Monroe County.
We therefore extend all most favorable terms and conditions of this agreement to Monroe County.
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Respectfully submitted,
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D V Passaro
VP Marketing/Operations
Advanced Data Processing
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Exhibit B - Fees
Pricing for all services shall be a monthly contingency fee of:
Seven (7%) percent of all monies collected in the previous month.
Price shall include but not be limited to all stationary, fax, farms, envelopes,
mailings, postage, and telecommunications/phone facilities/charges.
Price for services does not include the cost of "Lacked-box" service,
The "Locked-box" service selected shall be at the sole discretion of the
City and shall provide a secure postal address and box far receipt of all
correspondence (especially including all insurance and patient payments,
correspondence and benefits determination and denials. The "Locked-box"
service will on a daily basis perform the following:
· Open all mail (except clearly marked returned-mail).
· Make a copy of every check and attach copy with original document
accompanying each check.
· Deposit all receivables into designated City account.
· Prepare and provide a daily deposit slip totaling and accounting for all
receivables deposited for the identified day.
· Mail (daily) to Advanced Data Processing separated bundles of; copies of
checks attached to supporting documents, other correspondence and,
returned-mail along with deposit slip.
· Mail (daily) to City copies of checks and daily deposit slip.
· Mail (monthly) to City reconciliation of account.
Price shall include adjustment due to increase in cast far postage
according to the City's RFP (Section 2-2 E.).
Exhibit 8 Page 1
CEFHIFICr\ TE OF INSURANCE,
T":~ certifies that X STATE FARM FIRE AND CASUALTY COMPANY. Bloomington, Illinois
o STATE FARM GENERAL INSURANCE COMPANY. Bloomington, Illinois
in:.ures the following policyholder for the coverages indicated below:
Name of policyholder ADVANCED DATA PROCES SING
If
(-r'
Address of policyholder
520 165TH RD STE 201
MIAMI
FL 33169
Location cf operations
SAME
Description of operations ADDITIONAL INSURED: CITY OF BOCA RATON
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
subj eet to all the terms e:<c1usions, and conditions of those policies. The limits of Iiabilitv shown mav have been reduced by any paid claims.
POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD LIMITS OF LIABILITY
Effective Date Expiration Date (at beainnina of policy period)
Comprehensive BODILY INJURY AND
98 48 5820 Business Liabilitv 01/15/99 01/15/00 PROPERTY DAMAGE
! This insurance includes: X Products - Completed Operations ;/
I
i X Contractual Liability
, o Underground Hazard Coverage Each Occurrence $ t;00 000
,
, X Personal Injury
i
I X ,o..d'lertising Injury General Aggregate $ 1 000 000
I o Explosion Hazard Coverage Products - Completed
o Collapse Hazard Coverage Operations Aggregate $ 1 . 000 000
l o General Aggregate Limit applies to each project
0
0
POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE
EXCESS LIABILITY Effective Date Expiration Date (Combined Single Limit)
o Umbrella EiiCh Occurrence $
o Other Aaareaate $
Part 1 STATUTORY
98 CU 1862 04/04/98 04/04/99 Part 2 BODILY INJURY
Workers' Compensation
and Employers Liability Each Accident $100 000
Disease Each Employee $100 000
Disease - Policy Limit $ t;00 000
POLICY NUMBER POLICY PERIOD LIMITS OF LIABILITY
TYPE OF INSURANCE Effective Date Expiration Date (at beQinninQ of policy periodl
555 3289 59 D AUTO 01/01/99 07/01/99 500/500/500
WILL COVER NON OWNED AND
HIRED VEHICLES
. .
Name and Address of Certificate Holder
If any of the descnbed poliCies are canceled before its
expiration date, State Farm will try to mail a written notice to
the certificate holder 30 days before cancellation. If,
however, we fail to mail such notice, no obligation or liability
will be imposed on State J~r its agents or
rep sell ative . ~'---
rT~Y OF BOCA RATON
_ W PALMETTO PARK ROAD
oOCA RATON FL 33432
AGENT
Title
_03/04/99
_Date
B. Pattee
DADE COUNTY B
1307302810
'106
F600
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RESOLUTION NO. 57-9.9
.,
A RESOLUTION OF THE CITY OF SOCA RATON
AUTHORIZING THE MAYOR AND CITY CLERK TO
EXECUTE AN AGREEMENT WITH ADVANCED DATA
PROCESSING, INC., FOR THE PURPOSE OF PROVID-
ING EMERGENCY MEDICAL TRANSPORTATION BILL-
ING SERVICES.
WHEREAS, the City of Boca Raton has found it desirable to enter into an
agreement with Advanced Data Processing, Inc., for the purpose of providing emergency
medical transportation billing services; and
WHEREAS. such an agreement has been prepared and a copy thereof is attached
hereto; now therefore
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF BOCA
RATON:
That the Mayor and City Clerk be authorized to execute the agreement with
Advanced Data Processing, Inc., a copy of which is attached hereto:
PASSED AND ADOPTED by the City Council of the City of Boca Raton this K ~
day of '7u ~ , 1999,
CITY OF BOCA RATON, FLORIDA
ATTEST:
~~/~~-
/ Carol G. Hansori, Mayor
COUNOL VOTE
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HANSON
GLASS
ABRAMS
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THA~ _
IM1ELCHEL /
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AGREEMENT FOR PROFESSIONAL SERVICES
NO. 99-006
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THIS AGREEMENT made and entered into this /7 ti day of 'lnwrci .19 77,
by and between the City of Boca Raton. a municipal corporation of the State of Florida. hereinafter
referred co as CITY. and ADV ANCED DATA PROCESSING. INC. hereinafter referred to as
CONSULTANT:
WHEREAS, the CITY requir~s cen::l.in professional services in connc:ction \vith Medical Transportation
Billing Services; and. WHEREAS. the COl'oiSUL T ANT represems that it is capable and prepared to
render those services as hereinafter provided:
NOW THEREFORE, in consideration of the promises contained herein, the parties hereto agree as
follows:
ARTICLE 1 - EFFECTIVE DATE
The effective date of this Agreement shall be upon execution of the Agreement by the City of Boca Raton
and shall remain in effect for a three (3) year term with two (2) one year renewal options,
ARTICLE 2 - SERVICE TO BE PERFORMED BY CONSULTANT
The CONSULT ANT shall perform those services requested and authorized by the CITY pursuant to the
Ex.hibit "A" and the City's RFP 99-006 which are deemed as being attached hereto and made a part
thereof providing, however, that if there is any express or implied conflict or inconsistency with this
agreement the agreement shall always prevail, as may be specifically designated and additionally
authorized by the CITY. Such additional authorizations will be in the form of a Work Order, Each Work
Order will set forth a specific Scope of Services, amount of compensation and completion date and shall
be approved by resolution of the City Council before the work encompassed by such work order is
perfonned,
ARTICLE 3 - COMPENSATION
The CITY shall pay CONSULT ANT in accordance with Exhibit B, Fee Schedule, which is attached
hereto and incorporated by reference as part of this Agreement,
ARTICLE 4 - STANDARD OF CARE
CONSULTANT shall exercise the same degree of care, skill, and diligence in the performance of the
Services as is ordinarily provided by a CONSULT ANT offering services for local goverrunents in South
Florida, under similar circumstances and CONSULT ANT shall, at no additional cost to the CITY. re-
perform services which fail to satisfy the foregoing standard of care.
ARTICLE 5 - INDEMNIFICATION
The CONSULTANT hereby acknowledges and confirms that the proposal price includes
Indemnification/Hold Harmless. CONSULT ANT shall. in addition to any other obligation to indemnify
the CITY and to the fullest extent permitted by law, protect, defend, indemnify and hold h:l.rmless the
1
CITY, their agents, dected officials and employees from and against all claims. actions, liabilities. losses
(including economic losses), COSts arising out of any actual or alleged: a). Bodily injury, sickness. disease
or death. or injury co or des[~uction of tangible property including [he loss of use resulting therefrom, or
any ocher damage or loss arising oue of or resulting. or claimed to have resulted in whole or in part from
any actual or alleged act or omission of the CONS UL T ANT. any subconsultant. anyone directly or
indirectly employed by any of them. of anyone for whose acts any of them may be liable in the
perfonnance of the \VORK; or b). violation of law. starute, ordinance. governmental administration
crder, rule. regulation. or infringement of patem rights by CONSULTANT in the perfonn:mce of the
\Vork; or c). liens. claims or actions made by the CONSULTANT or any sub consultant under worke~3
comFensatlon acts: disability benetit acts. other employee bend'!c acts or ~ny stamtN)" bar. ,~.ny COSt of
expenses, including atromey's fees (including appellate. bankruptcy or patem counsel fees), incurred by
the CITY to enforce this a~reement shall be borne by the CONSULT ANT,
- .
Upon completion of all Services, obligations and duties provided for in this Agreement, or in the event of
termination of this Agreement for any reasons, the terms and conditions of this Article shall survive
indefinitely,
ARTICLE 6 - INDEPENDENT CONTRACTOR
CONS UL T ANT undertakes performance of the Services as an independent contractor and shall have
control of the work and the manner it is performed. CONSULT ANT shall work closely with the CITY in
performing Services under this Agreement.
ARTICLE 7 - COMPLIANCE WITH LAWS
I:; r~;"~'<Jrn:~nce of the Services, CONSULTANT will comply with applicable regulatory requirements
including federal, state, and local laws, rules regulations, orders, codes,criteria and standards,
ARTICLE 8 - INSURANCE
During the performance of the Services under this Agreement, CONSULTANT shall maintain the
following insurance polices, and provide originals or certified copies of all policies. and shall be written
by an insurance company authorized to do business in Florida.
WORKER' S COMPENSATION
The Consultant shall procure and maintain, for the life of this Contract/Agreement, Worker's
Compensation Insurance covering all employees with limits meeting all applicable state and federal laws,
This coverage shall include Employers' Liability with limits meeting all applicable state and federal laws,
This coverage shall extend to any subcontractorthat does not have their own Workers' Compensation and
Employer's Liability Insurance, Thirty (30) days notice of cancellation is required and must be provided
to the City of Boca Raton via Certified Mail.
COMPREHENSIVE GENERAL LIABILITY
The Consultant shall procure and maintain, for the life of th~s Contract/Agreement, Comprehensive
General Liability Insurance. This coverage shall be on an "Occurrence" basis. Coverage shall include
Premises and Operations; Independem Contractors' Products and Completed Operations and Contractual
Uability. This policy shall provide coverage for death. personal injury or property damage that could
arise directly or indirectly from the performance of this Agreement.
2
Th~ Minimum Limits of Coverag~ shall be 5500.000 per occurrence. Combined Single Limit for Bodily
Injury Liability and Property Da'mage Liability with a S 10.000 deductibl-:,
" ,
.
I
The City of Boca Raton must be named as an additional insured, The additional insured requirement is
waived if Owners and Contractors' Protective Coverage is also provided, or required, Thirty (30) days
written notice must be provided to the City of Boca Raton via Certified Mail in the event of cancellation.
BUS!NESS AUTOMOBILE LIABILITY
The Consultant shall procure and maintain, for the life of the Contractl Agreement, Business Automobile
Liability Insurance.
The minimum limits of coverage shall be $500,000 per occurrence, Combined Single Limit for Bodily
Injury Liability and Property Damage Liability. This coverage shall be an "Any Auto" or
.. Comprehensive Form" type policy,
In the event that the Consultant does not own any vehicles, we will accept hired and non-owned coverage
in the amounts listed above. In addition, we will require an affidavit signed by the Consultant indicating
the following:
does not own any vehicles.
"Company Name"
In the event we acquire any vehicles throughout the term of his Contract/Agreement,
agrees to purchase" Any Auto" or
"Company Name"
Comprehensive Form coverage as of the date of acquisition.
Consultant's Signature:
Thirty (30) days written notice must be provided to the City of Boca Raton via Certified Mail in the event
of cancellation,
SUPPLEMENT AL PROVISIONS
1. The insurance coverage and conditions afforded by these policies shall not be suspended,
voided, canceled or modified, except after thirty (30) days prior written notice by Certified Mail,
Return Receipt Requested, has been given to the City of Boca Raton's department that originated this
contract.
2. Certificates of Insurance meeting the specific required prOViSion specified within this
Contract/ Agreement shall be forwarded to the City of Boca Raton Department that originated the
contract, and approved prior to the start of any work or the possession of any city property.
ARTICLE 9 - CITY'S RESPONSIBILITIES
The CITY, during the term of this Agreement, shall:
3
r\. Provid~ the n~:essJ.ry patient information to the CONSULT Ai':T on a weekly b:lsis, for those
patients that have been transported by Fire-Rescue Services.
B. Comply with all Federal, State and local laws, rules and regulations as applicable to the
services being contracted for.
C, Agree to use the successful firm for all medical billings exclusively for the service
specifkd her~in. as long as the contract agreem::m is in force and the Consul~.lm is not in default of this
llgreemem.
D, ~1:!.ke reasonable effortS to obtain the proper billing address for all bi1i:!.b!~ p:ltients prior to
forwarding to the finn.
E. Pay the firm additional fees for any postage increases that may occur during the contract
period. However, this fee will only be the actual direct cost of increase.
F. Pay the CONSULTANT, in full payment of all work and services performed or rendered
hereunder, the amount of seven (7) percent of all sums collected, minus adjustments for overpayments,
bad checks and foreign currency exchange rates, The CONSULTANT shall submit an invoice to the
CITY on a monthly basis. The City shall pay the invoice in the manner allowed by the Florida Prom? t
Payment Act, Florida Statute 218.70, er. seq.
ARTICLE 10 - TERMINATION OF AGREEMENT
The obligation to continue Services under this Agreement may be terminated for cause by either party
upon seven (7) days' written notice of substantial failure by the other party to perform in accordance with
the terms hereof through no fault of the terminating party.
CITY shall have the right to terminate this Agreement or suspend performance thereof without cause for
the CITY's convenience upon fourteen (14) day's written notice to CONSULT ANT, and CONSULTANT
shall terminate or suspend performance of Services on a schedule acceptable to CITY. In the event of
temlination or suspension for CITY's convenience, CITY shall pay CONSULTANT for all Services
performed through the date of notice of termination or suspension,
ARTICLE 11 - NONDISCLOSURE OF PROPRIETARY INFORMATION
CONSULTANT shall consider all information provided by CITY and an reports, studies, calculations,
and other documentation resulting from the CONSULTANT's performance of the Services to be
proprietary unless such information is available from public sources, CONSULTANT shall not publish or
disclose proprietary information for any purpose other than the performance of the Services without the
prior written authorization of CITY or in response to legal process or orders of a court of competent
jurisdiction.
ARTICLE 12 - UNCONTROLLABLE FORCES
Neither the CITY nor CONSULTANT shall be considered to be in default of this Agreement if delays in
or failure of performance shall be due to Uncontrollable Forces, the effect of '.','hich, by the ex.ercise of
reasonable diligence, the non-performing party could not avoid. The term "Uncontrollable Forces" shall
mean any event which results in the prevencion or delay of performance by a party of its obligations under
4
this Agreement and which is beyond the reasonable control of the non-performing party. [t includ~s. but r-
is not limited to fire. tloed. earthquakes. stOm1S. Iighming. epidemic. war, riot, civil disturbance. \.
sabotage. and governmental actions.
Neither party shall. however. be excused from performance if nonperformance is due to forces which are
preventable. removable. or remediable and \vhich the non-performing party could have, with the exercise
of reasonabk diligence. prevented. removed. or remedied with reasonable disp:ltch, The non-performing
party shall. within a reasonable time of being prevented or delayed from performance by an
uncontrollable force, give written notice to the ocher pany d.::scribing che circumstances and ul1comroliJbl.::
forces preveming continued performance of the obligations of this Agreemem.
ARTICLE 13. GOVERNING LAW AND VENUE
This Agreement shall be governed by the laws of the State of Florida, Any and all legal action necessary
to enforce the Agreement will be held in Palm Beach County and the Agreement will be interpreted
according to the laws of Florida,
ARTICLE 14 - MISCELLANEOUS
14.1 Nonwaiver
A \'I~aiver by either CITY or CONSULTANT of any breach of this Agreement shall not be binding upon
the waiving party unless such waiver is in writing and signed by the parties to this agreement. In the
event of a written waiver, such a waiver shall not affect the waiving party's rights with respect to any
other or further breach, The making or acceptance of a payment by either party with knowledge of the
existence of a default or breach shall not operate or be construed to operate as a waiver of any subsequent
default or breach,
14,2 Severability
The invalidity, illegality. or unenforceability of any provision of this Agreement, or the occurrence of any
event rendering any portion or provision of this Agreement void, shall in no way affect the validity or
enforceability of any other portion or provision of the Agreement, Any void provision shall be deemed
severed from the Agreement and the balance of the Agreement shall be construed and enforced as if the
Agreement did not contain the particular portion or provision held to be void, The parties further agree to
reform the Agreement to replace any stricken provision with a valid provision that comes as close as
possible to the intent of the stricken provision,
The provisions of this section shall not prevent the entire Agreement from being void should a provision
which is of the essence of the Agreement be determined to be void.
Political Campaigns
During the term of this Agreement, the CONSULT ANT, or any employee or associate, shall not be
involved in any political campaign for a City of Boca Raton elective office, nor make financial
contributions to any such campaign,
ARTICLE 15 - INTEGRATION AND MODIFICATION
5
This Agreem~nt and any exhibits incorporated by reference in this agreemem. is adopted by the CITY and
CONSULT ANT as a tinaL complete and exclusive statement of the terms of the Agreemem between the
CITY and CONSULTANT. This Agreement supersedes all prior agreemems. comracts. proposals.
representations. negotiations. letters or other communications between the CITY and CONSULT ANT
pertaining to the Services. whether written or oral.
The Agreement may not be moditied unless such modifications are e~'idenced in writing signed by both
the CITY and CONSULTANT.
The follo\ving documents are made an integral pan of this Agreement:
A. RFP No. 99-006
B. Proposal dated December 9, 1998
In the event of any conflict or inconsistency between these documents and this agreement, the agreement
shall prevail.
ARTICLE 16 - SUCCESSORS AND ASSIGNS
The CITY and CONSULTANT each binds itself and its director. officers, partners, successors, executors.
administrators, assigns and legal representatives to the other parry to this Agreement and to the partners.
successors, executors, administrators, assigns, and legal representatives.
The Consultant may only assign, sell or pledge this agreement or it's interest therein if the Consultant first
receives the prior written consent of the City Commission, which may be reasonably withheld. Any
proposed assignee will have to sign an assumption agreement accepting this agreement's terms and
conditions in a form acceptable to the City,
ARTICLE 17 - CONTINGENT FEES
The CONSULT ANT warrants that it has not employed or retained any company or person, other than a
bona fide employee working solely for the CONSULTANT to solicit or secure this Agreement and that it
has not paid or agreed to pay any person, company, corporation, individual or firm. other than a bona
fide employee working solely for the CONSULT ANT, any fee, commission, percencage, gift or any other
consideration contingent upon or resulting from the award or making of this Agreement.
ARTICLE 18 - TRUTH-IN-NEGOTIATIONCERTIFICATE
Execution of this Agreement by the CONSULT ANT shall act as the execution of a truth-in-negotiation
certificate certifying that the wage rates and costs used to determine the compensation provided for in this
Agreement are accurate, complete and current as of the date of the Agreement and no higher than those
charged the CONSULTANTS most favored customer for the same or substantially similar service,
The said rates and cost shall be adjusted to exclude any significant sums should the CITY determine that
the rates ad costs were increased due to inaccurate, incomplete or noncurrent wage rates or due to
inaccurate representations of fees paid to outside consultants. The CITY shall exercise its rights under this
"Certificate" within one (1) year following payment.
ARTICLE 19 - OWNERSHIP OF DOCUMENTS
6
CONS UL T ANT shall be 'required to work in harmony with other consultants relative to providing (."
information requested in a timely manner and in the specitled form, Any a.nd all documents. records.
disks. original drawings. or other infomlation shall become the property of the CITY upon completion or
termination for ie's use and distribution as may be deemed appropriate by the CITY, Failure to turn over
such docum~nts with seven (7) days of when requested may be cause for the City to withhold any
payments dLl~ Consulcant or to enforce this clause by legal remedies.
ARTICLE 20 - NOTICE
Any notice. dem::.nd. communication. or request requir~d or permict~d hereunder shall be in \vririn2 and
delivered in person or sent by certified mail, postage prepaid as follows: . -
As To CITY
Bruce W. Silk, Chief
Fire/Rescue Services Department
City of Boca R'Jton
2333 West Glades Road
Boca Raton, Florida 33431
As To CONSULTANT:
Paul Franzelas, Vice President
Advanced Data Processing, Inc.
520 N.W. 165m Street, Suite 201
Miami, Florida 33169
Notices shall be effective when received at the address specified above. Changes in the respective
addresses to which such notice may be directed may be made from time to time by any party by written
notice to the other party, Facsimile is acceptable notice effective when received, however, facsimiles
received (i,e,; printed) after 5:00 p,ro, or on weekends or holidays, will be deemed received on the next
business day. The original of the notice must additionally be mailed as required herein,
Nothing contained in this Article shall be construed to restrict the transmission of routine communications
between representatives of CONSULTANT and CITY.
7
lL\' WITNESS WHEREOF, the City of Boca Raton, :It a regular meeting thereof. by action of the City
Council and directing the foregoing be adopted, has caused these presents to be signed by the Mayor,
and it's seal to be hereunto affixed. and ADV ANCED DATA PROCESSING, INC. has executed this
contract all as of the day and year first above written,
Wimess:
~(UL-
Approved as to Form and Legal Sufficiency:
BY:~' ~k,JJV\
City ttomey ... .j
CONSULT ANT
Attest:
(-Y~<<,~n~
---- COq)oratesecr.etary /
./'
~/",
(Seal)
Witness:
/7
~.,dr 4 ~~
q'\(\~ t9 \~, ~ g R~rN\.h~}11\'
Approved by City Council on m wr C/h I b
CITY OF BOCA RATON
~,.
; ~&
. . / 1~/ /, .
B'j~~t:Z/~. l 'i2.-J!d/'YU
~ CarolG.Hamon
Mayor,
Vg4
~~~re A'~r~
./'
Name:
\""' \ I\J ~ Cl ~ tJ?.e \ IlS
Title: ~R --e s \ ~ ~''-.l+
Prcsident(or other Duly Authorized Officer)
(Attilch ResolutionIBylawofauthorization i f not
President)
, 1999, Item # 3. r,
8
Exhibit A - Scope of Work
General Scope
Advanced Data Processing will perform all services with t:'e principal goals of:
f
= recovering the greatest amount of fees in the shortest possible time and,
= gieatest total amOU:lt with minimiz>::d cost to recover.
All services will be provided as stated in this Proposal. The specifics of such
services to be provided are addressed in the following subsections of this
proposal. The following are general services requested by the City, which will be
performed if awarded such contract
= Provide billing and collection services for Emergency Medical Services
transport, as required on a case by case basis, with emphasis on accelerated
turnaround between services provided and payment re::ei'led.
= The price bid herein shall include all expenses of billing and collection
including, but not limited to, stationary, fax, forms, envelopes, mailing, postage
and telecommunications/phone facilities/charges.
= Ensure that all required documentation and agreements with payors (e.g.
Medicare, Medicaid, Champus, etc.) are filed and maintained and that Fire
Rescue is kept apprised of important changes to industry regulations.
= Provide reasonably necessary training periodically to City Fire Rescue
personnel regarding the gathering of necessary information and proper
completion of run tickets. Advanced Data Processing in corroboration with other
municipalities has already put together a video-based training program for this
purpose.
= Provide prompt submission of Medicare, Medicaid and insurance claims
(within 72 hours) after receiving completed run ticket, which shall be Advanced
Data Processing's notice to commence the billing/collection service including
keeping logs confirming all electronic submissions. Secondary insurance
provider claims shall be submitted after the primary insurance provider has
paid. Advanced Data Processing shall follow-up on rejected and inactive
claims and establish payor remittance accounts and procedures.
= Utilize most up-to-date knowledge and information with regard to coding
procedures, assigning of ICD-9 diagnostic codes and proper preparation of
electronic and paper insurance filings to ensure compliance with applicable
Federal, State and local regulations.
Exhibit A Page 1
,
(
= Reconcile the number of transports collected with those transmitted to
Ad'lanced Data Processing and contact Fire Rescue to report any discrepa!ides.
Advanced Data Processing shall provide a designated liaison for
patient/payor concerns. This person shail be Ms, Bech Kaminer, Sr,
Collector.
Provide survey questionnaires or mail inserts to patients at the City's
request.
= Provide ail customer-related inquiry services and prepare additional
third-party claims or patient payment arrangements based on this information
exchange. Customer calls will be facilitated as local within Cit'j of Boca Raton
through a dedicated "SOO" toll-free exchange.
= Facilitate proper security of confidential information and proper
shredding of all disposed materials containing such proprietary information,
= Visit hospitals and/or establish with hospitals arrangement to
obtain/verify patient insurance and contact information.
= Respond promptly to the City and patients on requests for information or
records.
= Treatment as confidential any records of care or treatment of patients
solely for the purpose of processing and collecting claims and shall not release
any such information in any legal action, business dispute or competitive bidding
process.
= Use of proprietary systems, procedures or techniques as required to
achieve higher collection rates and improved cash flow. '
= Maintain appropriate accounting procedures for reconciling all deposits,
receivables, billings, patient accounts, adjustments & refunds.
= Provide timely comprehensive reports facilitating all required aspects of
monitoring, evaluating, auditing and managing the services provided and the
interface between Fire Rescue and Advanced Data Processing.
= Process refund requests providing Fire Rescue with documentation
substantiating each refund processed.
= Provide Fire Rescue all unpaid invoices along with the complete
processing history once collection efforts are exhausted.
= Convert all active and inactive files from the prior billing company and
maintain such records.
Exhibit A Page 2
, .
Specific Scope Compliance
Advanced Data Processing will provide the above general services with
specific compliance as requested by the City of Boca Raton in the RFP :
r....
t.o
= Assign billing patient numbers providing cross-reference to City of Boca
Raton assigned transport numbers.
= Responsible for obtaining all necessary rescue and insurance information.
= Provide accurate coding of proceduies and diagnosis and correlation of
rescue documentation.
= Annually make recommendations for fee schedule changes, regularly
advise on changes in statutes and industry regulations.
= Respond to all patients' requests and inquiries, either written or verbal.
= Negotiate and arrange modified payment schedules for individuals unable to
pay full amount when billed.
= Mail requested citizen satisfaction survey.
= Provide for facilities to permit dial-up access to our system to obtain
patient data and billing information.
= Maintain daily deposit control sheets and original documentation.
c
= Submit claims, process statements, post receivables, process refund
requests and submit reports within following specified timeframes and
frequencies:
· File claims & send an invoice to all self-pay patient/payors with return
envelope and address as specified by the City within five (5) days of receipt
of incident information, Provide prompt submission of Medicare, Medicaid
and insurance claims within 72 hours after receiving completed run ticket
. Process all third party reimbursements within one-week after receipt of
appropriate billing information from primary payor.
· Responsible for sending second notices at thirty-five days and third
notices at sixty-five days,
. Visit hospitals twice (if necessary) to obtain/verify patient insurance
and contact information.
. Respond within three (3) business days to the City and patients on
requests for information or records.
Exhibit A Page 3
· Provide specified management reports on monthly basis as identified and
prescribed by the City. Monthly reporting is produced after month
closing and provided to you no later than the 10th of each month, We
print the reports within 24 hours after rec~ivi:1g the last da:; of tr.a
month's receivables from the banI<.
. Provide monthly listing of accounts past due 1 SO-days or more,
. Provide Fire Rescue all unpaid invoices (upon request) along with the
com.:JI~te processing history once collection efforts are exhausted.
. Accounts are retained for a period of one-year.
. Process refund requests within the month following an overpayment.
Exhibit A Page 4
Rationale
The following section explains the approach to be taken. identifying its rationale and
distinguishing characteristics.
Advanced Data Processing prides itself in developing operations r71S:;-,:JC!s and
systems support tailored s/:ecifici.:/!/ ::) 5.\,i S ::.....:.: ,.:' ',:-:::;, .:>:.: :,'.:: ,;:..:: &r"j.::n :5.
Our methods and systems are refined to provide maximum efficiency in the collection
of your receivables In addition, because of our focus solely on serving municipalities
in the area of EMS billing and collections. we ha'/e pro'/ided so many of our municipal
clients at both the cit"j and county level the follo'l/ing distinct benefits:
Using some of the fi,:est multi-media tools to bring training assistance to the Fire
R:scue staff and 2Gministration in essentials of understanding the importance of key
patient information (demographic, insurance and medical) in the successful billing
process,
+ Standard and Ad Hoc reporting through our proprietary in-house
programming providing the essential information for management,
administration and accounting of the billing/collection process, Our IBM AS400 &
Pentium/PC environment provides state-of-the-art solutions. Our reports are not
only comprehensive and provide just-the-right information but, we send our
reports within 24 hours of receiving last day of the month's receivables. Our
clients generally get their reports within 1 to 4 working days of the month-end.
The following outlines some of the most important distinctions in how we provide
such superior services.
+ Hospital Support - The principal ingredient in effectively maximizing our
collection success is having access to medical insurance records from the
transported hospitals, Our company with your assistance will maintain a working
arrangement with all of the major hospitals in your area These hospitals will be
requested to provide a copy of their patient facesheets or patient demographic
and insurance information. The ER facilities will set up a holding tray for
facesheets, We send our personnel to the area hospitals to obtain up-to-
Exhibit A Page 5
date, validated patient insurance information. Some hospitals provide us
on-line access, others provide fax-back or a console on premises. Please
note that we perform this with redundancy and that timing is critical in
obtaining correct information, We do this at least twice and update our
sjstem, refiling as neceSS:lr/, For smaller hospitals. we will arrange to have
them provide us such information via fax or phone request. Advanced Data
Processing has served several municipalities in Florida and has already
established working relationships with a number of hospitals.
. Electronic Claims Processinq - Medicare, Medicaid & many other carrier
claims are processed by us and submitted e!ectronically to ensure accurate and
fast collections. As the first EMS service company in Florida to electronicaJiI file
Medicaid claims, we continually stay abreast of changes in insurance submission
standards and upgrade our capabilities as such changes require. We ware one
of the first service companies submitting claims to Medicare in the new "National
Standard Format" now supporting Claims Submission. Claims Status,
Remittance Advice and Electronic Funds Transfer, We have electronic access
via Internet to all Medicare & Medicaid 88S facilities and information updates.
We maintain logs of all insurance transmissions and a copy of the confirmation
receipt sent by the carrier. Claims not sent electronically are processed on paper
using HCFA-1500 forms or special forms provided by the carrier (occasionally
required).
. In-house ProQramminq & Advanced TechnoloQV - Since all of our computer
programming is done 'in-house', we have the ability to immediately modify our
computer programs to maintain the state-of-the-art in our collections system and
processes. Our expertise upon which the company was originally formed was
data processing and accounting based applications requiring custom
programming. This enables us to rapidly develop advancements and custom
tailor many aspects of our service unlike many of our competitors who employ
.off-the-shelf' or .canned" software packages. Such packages restrict the user
from changing database layouts, report definition, invoice formats and so forth.
We are virtually unrestricted in such facets. In addition, we employ PC-to-Host
transfer facilities that enable us to upload/download data to and from our AS400
host or even a customer system.
. Automated Patient Linkinq - When a new patient is entered into the system,
the first thing the system does is to determine if the patient has previously been
transported, The database is searched for Medicare numbers, Medicaid
numbers, and Private Insurance information. If we find this information in our
history file, we can immediately use this information to process a claim, thus
eliminating the time needed to research patient information, We call this our
'Patient Linkage Feature'.
+ Automated Payor MonitorinQ & Claim Resubmission - The system monitors
all claims having been filed to insurance payors identifying those not having yet
paid. These claims are flagged and automatically resubmitted. At a regular
interval a trace letter is sent to the responsible carrier if the claim has still not
been paid or response received.
+ Effective Statements - We provide an easy-reading, comprehensive
statement/invoice to all patients and include for convenience a courtesy
return-payment envelope, The front of the statement describes all charges and
Exhibit A Page 6
payments, A request on the statement for the patients' Medicare and/or
Medicaid number is clearly indicated. The reverse side of the statement has
clearly marked entry blocks for information needed to file private ins:Jrance
claims. We frequently accommodate our clients with inserts to include in O'Jr
statement mailing such as questionnaires. comment cards, notices, etc.
r-..
,
~
+ Skiptracinq - We use various methods of.Skiptracing to locate patients who
have left the area, or patients with invalid billing addresses and phone numbers.
For incorrect addresses returned to us by the Post Office, we attempt to obtain a
valid update from the hospital. If the hospital does not have better address
informa:ion, "''Ie check these patients electronicallv against the U.S. Post Office's
Nation<ll Change of Address (NCOA) files. whose records are updated
quartarly. All mailing list companies to keep their lists current use ti1e (NCOA)
files.
Exhibit A Page 7
Optimized Flow
The following diagram shows the major patient billilig cases a~d their flow of activities
employing the previously mentioned techniques to optimize the billing and collection
process. Obviously, the sooner that valid patient information is obtained the Quicker
and more assured is collection. Accordingly, in cases where less information is
initially provided, we do net dela" th-= billina crocess waitina for information. Instead,
a bill is generated as just one form of patient contact through which, oftentimes, the
patients themselves will fill-out the appropriate data on our easy-to-return billing form.
This data is used to update the patients' billing information and a new billing is
generated.
Excellent working relationships are maintained with the hospitals to obtain this
information and in some cases we provide updated information to the hospitals in
reciprocity. The best case should be noted is where the EMS attendants provide the
best information obtainable at the time up-front. Although this is sometimes not
practical and is understood, the described approach accommodates this in an optimal
way,
Diagram - Optimized flow
Case 1
Case 2
. no phon~
. \'~Iil.l ;lhen~
. no f~cesheet
ITem Hosp
PatieIH Data Pr()\'iclcu
. no 13ceshect
ITem Hasp
D:1ta DepelldC:llt Process
visit Hospibl
locate patient d~ta
visit Hospibl
upd~te patient dab
Exhibit A Page 8
Case 3
. v~1 id, p~one
InlO
. v~lid faceshcet
ITem Hosp
Patient Infonnation
We utiiize four methods for obtaining patient insurance in~ormation:
.
We utilize Inr:r;;-a,ior. piO'lice'= 'l/It:; the: iL," she:?: (& hospital facesheet, if
included). This is obtained in eith:, har.jccpy (which we key into our
system) or. via e!ectror.ic communication from yOlir facility to curs. We
provide BBS dial-in and we support E-mail transfer as well as most
standard media (6250 tape. QIC-BO tape, PC-diskette).
We send our personnel to the area hospitals to obtain up-to-date, validated
patient insurance information. Some hospitals provide us on-line access,
others provide fax-back or a console on premises. Please note that we
perform this with redundancy and that timing is critical in obtaining correct
information. We c::J {his at le3st {Wlce and I.:pdate our system, refiling as
necessary.
.,.~
i
.
.
We provide easy to fill out return mail form as an integral part of our invoice
statement for the patient/guarantor to provide insurance information. We
also directly contact the patient/guarantor where necessary to request such
information,
Our system provides a "patient-linkage~ feature allowing us to use
previously obtained insurance information, if the same patient has been
previously transported. If the system finds a "linkage" having valid data
from a previous transport, we immediately use this to file with their
insurance.
.
Hospital Support
The principal ingredient in effectively maximizing our collection success is having
access to medical insurance records from the transported hospitals, Our company
maintains a working arrangement with all of the major hospitals in your area. Most
hospitals will provide a copy of their patient facesheets or patient demographic and
insurance information. We understand the importance of rescue personnel
availability. Consequently, we have been able to make arrangements with most
hospitals to either hold the facesheets for us or to fax them to us, Where ER facilities
will set up a holding tray for facesheets, we will send our own personnel to retrieve
the facesheets. In addition, our personnel will retrieve required information from their
computers. For smaller hospitals, we will arrange to have them provide us such
information via fax or phone request. Advanced Data Processing as incumbent
vendor to your City has already established a working relationship with most
hospitals in y.our area:
. Bethesda Memorial
. Boca Raton Community
. Delray Community
. JFK Hospital
.. Holy Cross
. Palms West
. West Boca Med Center
. North Ridge Med Center
Ia Fair Oaks Hospital
II t'l Broward Med Center
The above list is already programmed into our system to submit claims for transport
to these facilities. (There may be other facilities to which you occasionally transport.
We also have those already in our system).
Exhibit A Page 9
Tasks
Advanced Data Processing will utilize collected billing information provided by the
City as the basis for:
o Billing to and collecting from the transported individual. Medicare. Medicaid,
insurance companies or, other appropriate third party payors for services
provided by the City and maintaining incident-based accounting to assist in this
process.
o Preparing the required management and financial reports including information
on delinquent accounts for the Cit'/s analysis of the services provided.
Advanced Data Processing will provide the following services:
o Mail an invoice to each transported individual at the current prevailing rate for
transportation services.
o File all insurance claim forms for all patients based upon information received
from the patient or obtained from research we perform at health care facilities,
o Provide required paperwork to Medicare, Medicaid, insurance companies or,
third party payors for claims, reviews, resubmission, provider agreements. and
other as required.
o Mail copies of invoices to patients. Medicare, Medicaid, insurance companies or,
other third party payors, when requested.
o Mail a series of follow-up invoices to patients and make patient contact as
necessary ,
ORe-file Medicare, Medicaid or insurance claims, as necessary to obtain payment.
o Record customer payments from lock box collections.
o Prepare periodic management/financial reports,
o Negotiate and agree upon modified payout schedules within City-established
guidelines for those individuals unable to remit the full initial-billed amount.
o Notify the City of past due accounts by providing a listing of such accounts and
pertinent detail.
o Transition open balance accounts from previous billing agent and process for
collection.
o Any other services agreed to between the parties, in order to effectively
collect all fees,
Electronic Claims
Bills for which we transmit via Electronic Communications are sent in batch form
directly to the carrier providing payment orocessinq by the carrier within
aooroximatel'l 15 days after receipt. Transmission to Medicare employs the most up-
to-date National Standard Format and utilizes Medicare's "Medigap" feature to the
greatest extent possible. This feature provided by Medicare automatically forwards
Exhibit A Page 10
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secondary payor information to the supplemental insurance carrier ensuring faster
payment of the 20% not paid by Medicare. In conjunction with our use of electronic
claims processing we support and utilize the following facilities:
.. Electronic Transmission Logs
.. Electronic Claims Status
. Electronic Reject Status
+ Electronic Remittance Notification
.. Electronic Funds Transfer
+ Medicare, Medicaid and other carrier Internet and
BSS information systems
Other carriers are billed via paper HCFA-1500 forms and sent directly to the
appropriate insurance carrier.
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Patient Signature - All indicators on insurance claims for identifying patient
signature authorization and signature on file are appropriately set. Signatures are
obtained where absolutely necessary. However, rescue medical and transport
services are legally viewed as an extension of the hospital/ER facility. Signature
authorization obtained by these facilities for treatment applies. In addition, our patient
invoice form has a place for providing insurance information and signature
authorization.
Insurance Reviews - All insurance denials or problem mail are reviewed within 1-3
days of receipt. Wherever these problems can be resolved by phone call they are
immediately addressed. All others are processed within the prescribed timeframe
providing all appropriate documentation including EOBs, denial letter, run report or
corrected information requested by the carrier, All applicable regulations are adhered
to especially those of Medicare and Medicaid. .
Accounts Receivable
Merging Accounts - We are able to merge current open accounts from the current
billing system at your option. If we take on these accounts. we will do so with review
of the account determining the appropriate action to be taken (e.g. refiling, review,
rebill, write-off) advising you of status.
Data collection & entry - All information pertaining to patients/payors for accounts
under our billing/collection whether hard copy or electronic form will be obtained from
your office for the purpose of assisting in their collection. Advanced Data Processing
will determine the optimum method for information transfer employing electronic or
Exhibit A Page 11
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co:nmuniCCii::Or.:.: ;-. ;.::tnod3 as feasible. Information wi!! then be entered and
maintained on G:Jr data processing system to ass,ist in this process. All information
wi!! be treated as proprietary.
Manual data entry is keyed in the most rapid and reliable manner possible. Advanced
Data Processing has maintained its original expertise in bulk data entry and data
processing and consequently has an advantage in the ability to process large
volumes of input data such as patient incident & demogra;::hics as well as payment
processing.
All data received is entered into the system's database within three (3) days after
receipt. It is then passed on for immediate verification and bill generation.
Information Verification - All processed patient incident and billing/payor
information is processed for first stage verification using three methods; 1)
automated "front-end edits", 2) "patient-linkage" and, 3) manual review by
insurance recovery specialists.
Automated "front-end edits" look for certain inconsistencies in information that can be
flagged and corrected. Items ranging from complete address, social security & date-
of-birth to insurance IDs are checked by the system and flagged either for correction
or hospital verification.
As previously described, when a new patient is entered into the system, our system's
"Patient-Linkage" feature determines if the patient has previously been transported.
The database is then searched for valid Medicare numbers, Medicaid numbers, and
Private Insurance information on which payments have been processed. If we find .
this information in our history file, we can immediately use this information to process
a claim, thus eliminating the time needed to research patient information.
Beyond even these two automated methods used to filter perhaps otherwise "lost" or
delayed collections (especially from commercial and Federal payors), we also employ
manual methods to further screen the entered fresh billing information. Our insurance
recovery specialists review each bill for claim processing. In many cases we can spot
invalid insurance information or incomplete data that would result in a rejected claim.
This information is corrected either immediately or, after obtaining valid information
from a number of sources. In many cases we utilize on-line verification where our
Exhibit A Page 12
system automatically, communicates multiple records to the insurance carrier and
obtains from the carrier the correct filing identifica~ion. In other cases, telephone
calling and/or hospital interrogation is employed.
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Carrier coordination - All coordination and correspondence with insurance carriers
will be maintained. We will make every effort to collect all legally collectible amounts
writing off only those amounts required by law. Settlements and adjustments (other
than Medicare/Medicaid write-offs due to maximum a~lowable charge by Law) will
require the authorization or you; organization. Forms required for submission of
c1a:ms and other forms occasionally required by carriers and other payors will be
completed and filed by us on behalf of the City. We strictly adhere to all insurance
regulations regarding claim submission and recovery especially those of Federal and
State programs. Utilizing electronic filing and the Medigap and Medicaid Crossover
facilities allow us to increase efficiency in obtaining secondary payments. However,
we also review all primary payments for possible manual secondary filing
requirements doing so wherever possible,
Other amounts - Our insurance processors are trained to take appropriate billing
action to obtain payment for other amounts not paid by the insurance carrier
deductibles, co-payments, etc.). Using remittance advice and EOB information we
will bill the patient for all applicable coinsurance, deductible and non-covered
amounts.
Account aging - Account activity is maintained and reflected on reports provided
which show daily activity for the month and aging of receivables. Accounts updated
with valid payments are re-aged showing payment status as current. All accounts are
summarized monthly and are reflected within categories showing their status as
either current, 30, 60, 90, or 120 days. We utilize this information to focus OUr inquiry,
rebilling and collection efforts on a routine basis. While we are able to provide you
with a review of 180-day accounts with potential return of them to the City, we
currently perform for all of our clients retaining accounts for 12 months. We do this
because we have proven that our system will find insurance information on patients
up to the 11 th month for some insurances and collect a significant amount of money
that, in most cases, collection agents would not have collected. And. we provide such
service at our same basic rate, far lower than that charged by ccliectio:l agent:;, In
fact. many of OUr clients who also use a collection agency (such as Brevard County)
ExhibitA Page 13
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have found that, their collection company complains of having next-to-nothing to
collect on after we're done wit:' the accounts.
Incurred Costs & Supplies - No incident31 costs are hlcden in our s~;"ice pricing.
We provide all forms, reports, statements, envelopes, postage, phone service, etc. at
no additional cost. Operating costs such as personnel, software, etc. are all borne by
Advanced Data Processing. The only exception to this is special questionnaires,
surveys, or forms the City may employ in special fashion, v"hile we charge nothing
extra for including these in our mailing, the City must provide the printed materials
they require,
Third Party Billing
Transmission to Medicare employs the most up-to-date National Standard Format
and utilizes Medicare's "Medigap. feature to the greatest extent possible, This feature
automatically forwards secondary payor information to the supplemental insurance
carrier ensuring faster payment of the 20% not paid by Medicare. All other
secondaries to Medicare are manually filed immediately after receipt and posting of
the Medicare payment. Other third party payors (especially where ,auto insurance and
private insurance is applicable) are filed sequentially to avoid unnecessary refunds
and are filed using proper coordination of benefits.
Hardship Cases
Occasionally, after all insurance avenues are checked including State Medicaid and
local HRS or municipal programs; having found no method of payment for an
individual, we may find hardship to exist. Such cases are submitted to Fire Rescue in
writing for final resolution along with appropriate documentation (Le. hospital credit
status, credit file information, activity file). Only upon instruction from Fire Rescue will
we write-off any amounts or make any adjustments to a bill. This includes when a
patient disputes mileage, oxygen, special handling charges or even the bill itself.
Case Files
We currently process manual hardcopy and electronic format for our clients. While
we can continue to process your claims in hardcopy form, we will welcome the
opportunity to assist you in electronically transmitting your information to our 885,
which we provide our clients for customer data transFer.
Exhibit A Page 14
Non-Deliverable Return Mail
All non-deliverable return mail is processed for obtaining forwarding address, zip
code correction, address correction, etc. Returned mail is processed generally within
1-2 weeks.
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Billing
Bill generation & mailing - BiBs will be orinted immediatel'! upon completion of
input, verification and editing of the supplied biiiing information (generally within 1-3
days of receipt) and mailed or communicated to patients/payors. Bills for which we
transmit electronically are sent in batch form directly to the carrier providing payment
processinq bv the carrier within aporoximatelv 15 days after receipt. Transmission to
Medicare employs the most up-to-date National Standard Format and utilizes
Medicare's "Medigap" feature to the greatest extent possible. This feature provided
by Medicare automatically forwards secondary payor information to the supplemental
insurance carrier ensuring faster payment of the 20% not paid by Medicare. Other
carriers are billed via paper HCFA-1500 forms and sent directly to the appropriate
insurance carrier. Because of the overall volume we process, we are able to batch
forms to more popular carriers obtaining faster bulk processing.
Self-mailing invoices - Bills to self-pays are printed on a pre-printed invoice and
sent in a double window envelope containing a convenient self-mailer. The invoice
sent also has a convenient place for the patient to return updated insurance
information, which is used to refile on the behalf of the patient. The following figures
provide an example of a completed patient bill and paper insurance claim (bill).
Patient/payor data verification - The information collected throughout the process
will be verified on a case-by-case basis and updated as required for the purpose of
establishing contact with the patient/payor,
Follow-up & multiple notices - Phone contact will be made on a routine basis to
follow-up on notices sent without response or for payments not received. In certain
cases, multiple contacts will be made. In no way will harassment be used to force
payment. All phone conversations and correspondence are made as a representative
of the client.
Exhibit A Page 15
Cycle billing - Several cycles are managed by our system to produce maximum
collections. Regular (monthly) cycle billing is performed on self-pay accounts and
accounts showing a patient pay balance. These cycles handle routine invoicing for
payment arrangements as well as generation of dunning messages for slow or no-
pay accounts. Patient invoices are rebilled up to six (6) times. Other cycles handle
rebilling of carriers and billing of secondary/tertiary payors. Medicare, Medicaid and
private insurance are billed immediat;ly and given 45-60 days to pay before rebilling.
Insurance denials for reasons other than those that can be resolved are converted to
self or pati;nt pay and begin regular cycle billing. System checkpoint3 trap bil!s that
would be in jeopardy of expiration due to insurance filing limitations.
Exhibit A Page 16
Deposits
Receivables processing - Statements, bills, and electronic claims will be marked
with payment address of your choice. It is recommended that a "locked-box"
arrangement with the bank of your choice be used (cost for this service is the City's
responsibility). The bank then receives all payments and processes them daily
directly providing deposits to your account. Records of all payments/deposits are
provided directly to the City. Using this method, we do not directly handle any
receivables, Only the Exp!3nation of Benefits (EOB), and copies of checks/money
orders are sent to us along with any correspondence (denials, problems, &. requests
for further information). Receivables are generally posted within the same day we
receive them, Receivables will be itemized and reconciled against daily bank
deposits on a monthly closing basis and provided to you in a comprehensive report
format.
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Receipt Posting
Payment processing - All payments will be processed upon receipt from the lock-
box facility and posted to the correct patient account (generally within 1-2 days of
receipt, never to exceed 7 days). Individual patient accounts are maintained showing
all payment amounts, check or money order number (if applicable) and date of
payment and balance owed. Information will be used for the purpose of either
rebilling, follow-up or closing of the account.
Unidentified payments - On occasion payments are received for which the identity
is obscure or not immediately known (Le. account number missing or incorrect, name
provided is different than that originally filed, etc.), In these cases the receivable is
processed to a suspense account so that processed receivables balance against the
bank statement. These item are marked for research by a specialist who, through
either database searching andor contact of the original payor, obtains the necessary
identification to properly post the item(s). Once the correct patient account has been
located, a transfer is made from the suspense account to the appropriate patient
account. A documentation trail is provided for such transfers.
AR Reconciliation - All accounts will be reconciled to reflect accurate balances
outstanding against payments received and posted. Write-offs will also be posted
where your office has provided prior agreement.
Exhibit A Page 17
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Rebilling and payment arrangements - Rebilling will be performed for accounts
where partial payments are made or accounts w~ere regular payments have been
arranged. Details of such arrangements will be noted on the account. Receivables
are processed and posted to individual accounts at which time the status of the
account is updated. These updates control the way in which the account must be
subsequently processed ranging from closing ,paid-in-full accounts to filing
secondarj, reflling and invoicing or rebilling customers.
Refunds and returned checks - Refunds are ~enerally processed on a monthly
basis. Refund requests are presented to the City in a report format with support:ng
documentation provided. Checks returned as NSF can be processed in a manner
determined by the City. Generally, the bank provides a copy of the check and, we will
attempt to collect the amount directly from the customer. Posting adjustments are
made accordingly as a reversal entry and reflected on the month-end reporting.
Reporting - All collections activity will be summarized and posted on a monthly
basis. Reports are provided by the 10th of each month, Specific reports provided are
identified in a later section.
Audit
Because we have focused on performing billing and collecting for municipalities, we
are most familiar with the requirements for their audits and can fully comply with such
requests. In fact, because of such familiarity we can often assist in providing insight
to help correct discrepancies and errors. We will cooperate with all such reasonable
requests for audit.
Professional Billing/Accounting Procedures
Advanced Data Processing began as a provider of data processing .based accounting
services as one of the founders holds an Accounting degree. All processes are
performed using generally accepted accounting methods and principles
(GAAP). Receivables including Electronic Funds Transfers are balanced against
bank deposits to assist your accounting department in reconciling their accounts.
This ensures efficient and accurate billing, collection and account management
reconciling to all payments, patient accounts, deposits, refunds, adjustments, billing
placements and statistics.
Exhibit A Page 18
It is wer c" notmg here that we are one o~ very few companies that report collection
statistics in a correct manner, That is, we reoort receivables collected aaainst the
month within which the charae was oriainallv billed. This is the only way to produce
actual collection percentages. Other companies attempt to mask their performance
using what seem to be simpler methods.
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Maintenance of Records
We maintain all payment recoids for the period specified by the City. These records
are kept intact with copies of Explanation of Benefits (:::085) th",t accompany most
insurance payments. These are filed by cash receipt date and kept in chronological
sequence along with deposit reconciliation. Copies of specific documents can be
provided to the City upon request. All records are considered the property of City of
Soca Raton and will be turned over upon completion or termination of the contract.
Patient Calls
Phone service - Our collection ability is dependent on availability. Consequently, we
provide toll-free "SOO. numbers to our clients for both patient calling and calls from
the City personnel to us. We will not only provide three toll-free lines but will also
provide rotary capability to available lines improving call response times and
availability. Phone lines specific to your customer requirements will be allocated with
the number clearly provided on all bills, invoices and correspondence, Included will
be a facility providing toll-free access. We absorb all phone costs as part of the basic
service we provide,
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Support & availability - Phone lines specific to your customer requirements will be
allocated with the number clearly provided on all bills and invoices. Included will be a
facility providing toll-free access, Facilities and attendants are provided to ensure
calls are not blocked, Rather, someone is available to answer calls Monday thru
Friday (excluding Holidays) from 8:00 a.m. to 5:00 p.m. In addition, we have people
calling self-pays/no-pays two nights a week until 8 p.m. and on most Saturdays 'til
2.pm.. Statistics on phone activity are reviewed monthly to ensure proper level of
phone availability is maintained.
Facilities and attendants are provided to ensure calls are not blocked. Rather,
someone is available to answer calls Monday thru Friday (excluding Holidays) from
Exhibit A Page 19
8:00 a.m. to 5:00 p.m. Statistics on phone activity are reviewed monthly to ensure
proper level of phone availability is maintained.
Customer Communications
Philosophy - Our client history shows "We are focused on our client's success
improving their cash flow through constant innovation yet proven means and,
providing the highest service levels attainable with professional respect by both the
client and the community."
Advanced Data Processing conducts all written and verbal communication always in
the most professional manner. We emphasize helpfulness towards the customer and
respect referencing ourselves as a representative of your organization and ~ as
collectors or, in any way that might be interpreted as intimidating or threatening.
Multi-ethnic operators are employed to facilitate most frequent language
requirements. In addition, difficult calls are passed to a supervisor more skilled in
handling irate callers, special insurance issues, taxpayer questions, etc. A significant
aspect of our ability to achieve high collection levels is our customer service
perspective.
Records
On a special incident basis requests for records (e.g. run report) will be forwarded to
Fire Rescue for processing & response regardless of source of request (i.e.
insurance, patient, attorney, etc.). In the case of insurance requests, we might expect
you would have us forward the information to the insurance carrier for claims
processing. Alternatively, we could provide you with the appropriate filing material for
your forwarding. If you desire, we can accommodate billing the requester/patient
special handling charges for obtaining copies of records,
Education
Client Training - Using some of the finest multi-media tools to bring training
assistance to the Fire Rescue staff and administration we provide education aids
and assistance in essentials of understanding the importance of key patient
information (demographic, insurance and medical) in the successful billing process.
We have produced a training video especially for this purpose.
Exhibit A Page 20
Attendant Training - Advanced Data Processing provides training and a stable
environment for its attendants. They are skilled in 'understanding all aspects of
insurance applicable to EMS transport billing so as to be helpful toward the customer
and efficient in processing charges and insurance claims, They are also trained in
how to provide maximum assistance to the customer and when to transfer the call to
a supervisor for handling difficult situations, We maintain a multi-ethnic staff to handle
caiis in languages other than English, Our exception reporting system allows us to
view ~he work completed by an individual for a given day. This allows the supervisor
to review the work (specific accounts) on which an operator has worked. This assists
in training and on-going qualitj improvement.
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Exhibit A Page 21
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Remote Acces::;
Information Download - We provide access to our system facilities for the purpose
of electronically sending us your transport data and billing information. This access is
convenient and easy to use via an FTPllnter:iet Site maintained for us under
arrangement. We provide you a username and password ror access and you can
deposit your information any time convenient to you.
Technical Data FOimat - We have provided t;,is type service for a number of clients
supporting various data fOima~s for their respective sJs~ems. INs can coordinate with
your systems people for support of any format the} might require or provide a sample
of formats we already support.
Exhibit A Page 22
Reports - Management Information
Advanced Data Processing prides in providing essential statistics in concise
easy-to-understand format. These reports provide our client with the same
insight we use to manage and increase the efficiency of their collections.
Monthly reporting is produced after month closing and provided to you no later
than the 10th of each month, We print the reports within 24 hours after
receiving the last day of the month's receivables from the bank, All reporting
will be in the manner as requested by the City. The following 2ie major reports we
produce as a sam;Jle for the City's evaluation:
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o Collection Statistics - Summary
o Collection Statistics - by Payor Class
o Collection Statistics - Gross/Net Computation
o Account activity - Monthly Billing Report (Charges)
o Account activity - Monthly Payment Report (Receivables)
o Billing & Collections - Summary to Date, Monthly Running
o Accounts Receivable - Summary
o Monthly Refund Schedule
o Insurance Report - # of Bills with Outstanding Balance by Class
In addition to the above reports, Advanced Data Processing will provide the following:
· All account numbers will be cross-referenced to City's incident numbering,
· Other reports as requested by the City.
Ad Hoc Reports
Advanced Data Processing prides in providing essential statistics in concise easy-to-
understand format. However, we do understand that special requirements come up
on occasion. In response to such situations, we can provide ad hoc reporting either
from the AS400 environment or in the PC environment without limitation since we are
on our own proprietary software.
Exhibit A Page 23
Reports - Management Information (cont'd)
The following section provides a brief explanation of major reports provided and concludes
with an example of each, Samples are provided (as shown in the proposal submission) are
not necessarily complete nor are they all live data. Confidential information such as names,
contact and 10 information is obscured to protect confidentiality.
1, Collection Statistics. Summary
Provides a running month summary of charge, payment and adjustments f.Jr the closing
month period showing gross and net collection percentages for each period. Summari:es
totals for each type activity and computes average collections for both gross and riet.
Note: All payment activity is reflected against the original month billed in order to
reflect true collection percentages.
2, Collection Statistics. by Payor Class
Provides a running month summary for the closing month period of collections by Payor
Class (Self.Pay, Medicare, Medicaid, and Private Insurance). The report also shows for
each running month the mix or, % of total collected against that month's billings for each
class. Also shows # of accounts billed and total # of accounts. Summarizes total amounts
collected by class and % of total.
3. Collection Statistics - Gross/Net Computation
Shows overall monthly computation of gross collection percentages providing # of
accounts billed and accounts not billable. Total amounts are summarized.
4, Account activity - Monthly Billing Report (Charges)
Shows all billing (new charges) processed alpha sorted by Last Name and summarized
total billing for period.
S, Account activity. Monthly Payment Report (Receivables)
Provides a batch oriented listing of all payments processed including check number and
type of payment (self pay, Medicare, Medicaid, private insurance). Report reconciles
against bank deposit and ties back to EOB detail for secondary filing, refund processing
and adjustments.
6. Billing & Collections - Summary to Date, Monthly Running
Show receivables as applied to "original billed month".
7. Accounts Receivable. Summary
Provide summary for period ending of Accounts Receivable showing gross billing,
payments received/processed, reflected write-ofts and adjustments, reversals and ending
balance.
Exhibit A Page 24
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8, Monthly Refuna Schedule
Report provides by account detail of associated payments reflecting an overpayment and
necessary refund to be processed. . .
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9. Insurance Report - # of Bills with Outstanding Balance by Class
Provides summary showing by running (billed) month the number of patient bills having
an outstanding balance. Shows balance and number of bills outstanding by class,
10. Payment Report - % of Bills Showing Payment
Provides for each billing month total patients, number having made no payments,
number and percentage having made payment
Exhibit A Page 25