1st Amendment & Extension 05/20/2009
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DA TE:
June 4, 2009
TO:
Fire Chief James Callahan
Fire-Rescue Department
FROM:
Camille Dubroff
Isabel C. DeSantis, D. C. ~kQ/rV1vO
A TTN:
At the May 20, 2009, Board of Governor's the following was approved:
Extension and Amendment No. 1 between Board of Governors, Fire and Ambulance
District 1 of Monroe County, Florida and Advanced Data Processing, Inc. to provide rescue
ambulance billing and related professional services extending the term from June 1, 1009
through May 31, 2010, amending Section B2 to amend the time frame that accounts are sent to
collection, amending Section B3 to clarify modified payments and settlement requests, amending
Section C 1 to clarify re- filing of claims, and amending Section G to add two additional monthly
reports.
Enclosed is a duplicate original of the above-mentioned for your handling. Should you
have any questions please do not hesitate to contact this office.
cc: County Attorney
Finance
File J
EXTENSION AND AMENDMENT NUMBER 1
TO THE AGREEMENT BETWEEN
MONROE COUNTY, FLORIDA AND
ADVANCED DATA PROCESSING, INC.
This Extension and Amendment Number 1 ("Amendment 1") is made and entered into this ~ day
of June, 2009, by and between Monroe County, Florida, a political subdivision of the State of Florida
("COUNTY") and Advanced Data Processing, Inc., a corporation organized and doing business in the
State of Florida ("CONTRACTOR").
WITNESSETH:
WHEREAS, the parties hereto entered into an agreement dated April 20, 2005 ("Agreement")
to provide rescue ambulance billing and related professional services; and
WHEREAS, said Agreement provided an option under Article 1 for the COUNTY to renew the
contract for two additional one year terms: and
WHEREAS, the COUNTY has elected to exercise said option for the continuation of rescue
ambulance billing and related professional services; and
WHEREAS, the parties desire to amend Attachment A of the Agreement in order to clarify the
Scope of Work;
NOW, THEREFORE, the parties agree as follows:
1. The COUNTY elects to renew the contract for the one additional second year pursuant
to Article 1 of the agreement entered April 20, 2005.
2. The effective date of this renewal is June 1, 2009 and shall extend through May 31,
2010.
3. Attachment A of the Agreement shall be amended in Section B2 as follows:
B. Patient Billing
2. CONTRACTOR shall provide all self pay patients with a comprehensive
statement/invoice including a courtesy return payment envelope. The front of the
statement shall describe all charges and payments. The reverse side of the statement
shall have clearly marked entry blocks for information needed to file private insurance
claims. CONTRACTOR shall file claims and send an invoice to all self-pay
patient/payors with return envelope and address as specified by MONROE COUNTY
within five (5) days of receipt of incident information. Subsequent invoices to self-pay
patient/payors will be sent at thirty-five (35) day intervals, up to a maximum of six
InVOIces.
CONTRACTOR shall send one initial statement/invoice to a patient for whom
Medicare, Medicaid, or private insurance (payor) information is available when an
account is filed to the insurance company. These statements will be mailed at 45 days
from filing the insurance claim. Thereafter, CONTRACTOR will send a maximum of
six invoices to payor.
1
In the course of time that the six invoices are sent to patient/payor and payment in full
has not yet been received, CONTRACTOR shall provide follow-up on rejected and
inactive claims and establish payor remittance accounts and procedures. In the case of
patients for whom payor information is available, CONTRACTOR at that time shall
resume sending invoices to patient and shall, within fourteen (14) days of receiving a
final decision from the payor, send a maximum of five (5) additional invoices to the
patient every thirty-five (35) days thereafter in an attempt to collect the claim.
Effective October 1, 2009, unless insurance, Medicare, Medicaid or secondary insurance
payment is pending, CONTRACTOR shall on a monthly basis send all eligible accounts
that have not had activity for 210 days or more from the date of service a Pre-Collection
Letter. These accounts have thirty (30) days to respond to the CONTRACTOR. Once
the thirty (30) days have expired, the CONTRACTOR shall send MONROE COUNTY
a list of all accounts along with a complete processing history once collection efforts are
exhausted. These uncollectible accounts will be forwarded by the CONTRACTOR onto
a third party collection agency named by MONROE COUNTY for further attempts at
collecting.
4. Attachment A of the Agreement shall be amended in Section B3 as follows:
B. Patient Billing
3. CONTRACTOR shall negotiate and arrange modified payment schedules for patients
unable to pay the full amount when billed. CONTRACTOR shall not reduce the amount
owed and shall not negotiate settlements. All settlement requests shall be forwarded to
the COUNTY for review, processing and BOARD approval.
5. Attachment A of the Agreement shall be amended in Section Cl as follows:
C. Patient Filing
1. CONTRACTOR shall file all insurance claim forms for all patients based upon
information received from Run Report and research performed by CONTRACTOR.
CONTRACTOR shall provide prompt submission of required paperwork to Medicare,
Medicaid, Insurance Companies or Third Party Payers for claims, reviews,
resubmission, provider agreements and other as required within 72 hours after receiving
the requested "Run Report" from MONROE COUNTY, provided that accurate and
complete insurance and patient demographic information is provided on the Run Report.
CONTRACTOR shall submit secondary insurance provider claims after the primary
insurance provider has paid within 30 days after receipt of payment from primary
insurer. Upon receipt of notice of claim denial, requirement for additional information,
Explanation of Benefits reflecting underpaYment or other notice requiring submission of
documents to the third party provider CONTRACTOR shall within 45 days re-file
Medicare, Medicaid, or Insurance claims to obtain payment. CONTRACTOR shall
maintain responsibility for obtaining missing or incomplete insurance information.
CONTRACTOR shall process all third party reimbursements within one week after
receipt of appropriate billing information from primary payor.
6. Attachment A of the Agreement shall be amended in Section G to include two
additional reports as follows:
G. Monthlv Reports
2
15. Aging Report: On a monthly basis, CONTRACTOR shall provide a report which
lists patients' accounts receivable amounts by age to alert the COUNTY of any slow
paying patients.
16. Timeliness of Billing Reoort: On a monthly basis, CONTRACTOR shall provide a
report which lists the number of times invoices were sent to each patient. This report
will be used by the COUNTY to verify compliance with Attachment A Section B2 of
the Agreement. It is recognized by COUNTY that if an account is pending payment, the
patient may not yet have received the maximum number of invoices.
7. All other terms and conditions of the contract dated April 20, 2005 shall remain in full
force and effect.
In all other respects, the provisions of the contract between the parties dated April 20, 2005, not
inconsistent herewith shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have caused this Amendment 1 to be executed the day
and the year first above written.
(SEAL)
\ \
\
Board of Governors, Monroe County, FL
Jbak)~. ~
~.,.I!. 't>~,e4J-.
Mayor/Chairman
Date:
5/.2 0/09
,
ATTEST:
Danny L. Kolhage, Clerk
BY:~
Repres atlve for
Advanced Data Processing" rc.
Witness: ~"''1l. f1-n-);,..,.J...
Date: 1h'1 J/; J-O{) r
ANT ~~t!r"5!l]~ANEV
3