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HomeMy WebLinkAbout2022-04-05; City Council; ; Professional Services Agreement with Wittman Enterprises LLC to Provide Ambulance Billing Services(i S~~fi R~port Meeting Date: To: From: Staff Contact: April 5, 2022 Mayor and City Council Scott Chadwick, City Manager Cheryl Gerhardt, Finance Manager cheryl.gerhardt@carlsbadca.gov, 442-339-2468 CA Review CKM Subject: Professional Services Agreement with Wittman Enterprises LLC to Provide Ambulance Billing Services Districts: All Recommended Action Adopt a resolution approving and authorizing the Mayor to execute a professional services agreement with Wittman Enterprises LLC to provide billing and collection services for ambulance transport and related services operated by the City of Carlsbad Fire Department. Executive Summary/Discussion Firefighter/paramedics in the Fire Department provide necessary basic and advanced life support ambulance services to citizens, visitors and businesses within the City of Carlsbad limits and outside these boundaries, as defined by applicable mutual aid and automatic aid agreements with neighboring jurisdictions. In fiscal year 2020-2021, Fire Department paramedics transported approximately 5,470 patients and billed $6.5 million for ambulance services, for which approximately $3.3 million was collected. (The difference is due to Medicare, Medi-Cal and other contractual write-downs. Outsourcing ambulance billing services allows for quicker collection of payments, improved management reporting and provides better expertise in the government regulations and laws associated with paramedic services and ambulance transport. The city's current contract is expiring April 21, 2022. Proposals were received from two firms. The proposals were evaluated by a joint Fire/Finance selection team. Using a best value evaluation process, the top vendor was identified. The firms were evaluated on approach to the scope of work, price, responsiveness to specifications, project team experience and client references. Based on these criteria, the team is recommending the contract be awarded to Wittman Enterprises LLC. Wittman Enterprises is a full services medical and collection company and has been our provider since 2015. The company also provides services for many other San Diego County cities and agencies. This allows for a high understanding of local demographics and how to bill customers for calls outside the city limits. April 5, 2022 Item #6 Page 1 of 15 Fiscal Analysis Funds for ambulance billing services were approved by the City Council and budgeted in the General Fund for this current fiscal year. Funds for the next fiscal year will be included as part of the FY 2022-23 budget. Next Steps The City Manager or designee will execute the professional services agreement with Wittman Enterprises LLC. Environmental Evaluation This action does not constitute a "project" within the meaning of the California Environmental Quality Act under California Public Resources Code Section 21065 in that it has no potential to cause either a direct physical change in the environment, or a reasonably foreseea ble indirect physical change in the environment. Therefore, it does not require environmental review. Public Notification This item was noticed in keeping with the state's Ralph M. Brown Act and was available for public viewing and review at least 72 hours before the scheduled meeting date. Exhibits 1. City Council resolution April 5, 2022 Item #6 Page 2 of 15 RESOLUTION NO. 2022-084 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CARLSBAD, CALIFORNIA, APPROVING AND AUTHORIZING THE MAYOR TO EXECUTE A PROFESSIONAL SERVICES AGREEMENT WITH WITTMAN ENTERPRISES LLC TO PROVIDE BILLING AND COLLECTION SERVICES FOR AMBULANCE TRANSPORT AND RELATED SERVICES OPERATED BY THE CITY OF CARLSBAD FIRE DEPARTMENT Exhibit 1 WHEREAS, there is a need to contract for billing and collection services for ambulance transport and related services operated by the City of Carlsbad Fire Department; and WHEREAS, requests for proposals from ambulance billing and collection services firms have been solicited, accepted, and evaluated; and WHEREAS, Wittman Enterprises, LLC has been determined to provide the necessary services at the best value to the city; and WHEREAS, sufficient funds are available in the current 2021-22 Operating Budget to fund the contract for the current fiscal year; and WHEREAS, funds for future fiscal years will be included as part of the budgets for those fiscal years. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Carlsbad, California, as follows: 1. The above recitations are true and correct. 2. The firm of Wittman Enterprises, LLC is selected to perform ambulance billing and collection services. 3. The professional services agreement with Wittman Enterprises, LLC (Attachment A) is approved and the Mayor is authorized execute it on behalf of the City of Carlsbad. PASSED, APPROVED AND ADOPTED at a Regular Meeting of the City Council of the City of Carlsbad on the 5th day of April 2022, by the following vote, to wit: AYES: NAYS: ABSENT: Hall, Blackburn, Bhat-Patel, Acosta, Norby. None. None. ~y' FAVIOLA MEDINA, City Clerk Services Manager (SEAL) DocuSign Envelope ID: 1ADBBFBC-4C69-46E7-88C0-77823C98AF18 Attachment A AGREEMENT FOR AMBULANCE BILLING AND COLLECTION SERVICES WITTMAN ENTERPRISES, LLC 7 -t-\r--- THIS AG~ EMENT is made and entered into as of the --'------day of ----~t-+--1 ~---' 2022, by and between the CITY OF CARLSBAD, a municipal corporation, (" ity"), and Wittman Enterprises, LLC , a Limited Liability Company, ("Contractor"). RECITALS A. City requires the professional services of a billing and collection Contractor that is experienced in the preparation of invoices for emergency ambulance transports being sent to private insurance companies, government agencies and patients; delinquent claim handling: receipts processing; monthly reporting; and other duties as defined under the Scope of Work. B. Contractor has the necessary experience in providing professional services and advice related to emergency ambulance transport billing and collection. C. Contractor has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the "Services") that are defined in attached Exhibit "A", which is incorporated by this reference in accordance with this Agreement's terms and conditions. 2. STANDARD OF PERFORMANCE While performing the Services, Contractor will exercise the reasonable professional care and skill customarily exercised by reputable members of Contractor's profession practicing in the Metropolitan Southern California Area, and will use reasonable diligence and best judgment while exercising its professional skill and expertise. 3. TERM The term of this Agreement will be effective for a period of five (5) years from the date first above written. The City Manager may amend the Agreement to extend it for two (2) additional one (1) year periods or parts thereof. Extensions will be based upon a satisfactory review of Contractor's performance, City needs, and appropriation of funds by the City Council. The parties will prepare a written amendment indicating the effective date and length of the extended Agreement. 4. TIME IS OF THE ESSENCE Time is of the essence for each and every provision of this Agreement. 5. COMPENSATION The total fee payable for the Services to be performed during the initial Agreement term will be 4.5% of net collections for transports, not to exceed two hundred thousand dollars ($200,000) per agreement year. No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. If the City elects to extend the Agreement, the amount shall not exceed two hundred thousand dollars ($200,000) per Agreement year. The City reserves the right to withhold a ten percent (10%) retention until City has accepted the work and/or Services specified in Exhibit "A". Incremental payments, if applicable, should be made as outlined in attached Exhibit "A". City Attorney Approved Version 6/12/18 April 5, 2022 Item #6 Page 5 of 15 DocuSign Envelope ID: 1ADBBFBC--4C69-46E7-88C0-77823C98AF18 6. STATUS OF CONTRACTOR Contractor will perform the Services in Contractor's own way as an independent contractor and in pursuit of Contractor's independent calling, and not as an employee of City. Contractor will be under control of City only as to the result to be accomplished, but will consult with City as necessary. The persons used by Contractor to provide services under this Agreement will not be considered employees of City for any purposes. The payment made to Contractor pursuant to the Agreement will be the full and complete compensation to which Contractor is entitled. City will not make any federal or state tax withholdings on behalf of Contractor or its agents, employees or subcontractors. City will not be required to pay any workers' compensation insurance or unemployment contributions on behalf of Contractor or its employees or subcontractors. Contractor agrees to indemnify City within thirty (30) days for any tax, retirement contribution, social security, overtime payment, unemployment payment or workers' compensation payment which City may be required to make on behalf of Contractor or any agent, employee, or subcontractor of Contractor for work done under this Agreement. At the City's election, City may deduct the indemnification amount from any balance owing to Contractor. 7. SUBCONTRACTING Contractor will not subcontract any portion of the Services without prior written approval of City. If Contractor subcontracts any of the Services, Contractor will be fully responsible to City for the acts and omissions of Contractor's subcontractor and of the persons either directly or indirectly employed by the subcontractor, as Contractor is for the acts and omissions of persons directly employed by Contractor. Nothing contained in this Agreement will create any contractual relationship between any subcontractor of Contractor and City. Contractor will be responsible for payment of subcontractors. Contractor will bind every subcontractor and every subcontractor of a subcontractor by the terms of this Agreement applicable to Contractor's work unless specifically noted to the contrary in the subcontract and approved in writing by City. 8. OTHER CONTRACTORS The City reserves the right to employ other Contractors in connection with the Services. 9. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney's fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City's self-administered workers' compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. 10. INSURANCE Contractor will obtain and maintain for the duration of the Agreement and any and all amendments, insurance against claims for injuries to persons or damage to property which may arise out of or in connection with performance of the services by Contractor or Contractor's agents, representatives, employees or subcontractors. The insurance will be obtained from an insurance carrier admitted and authorized to do business in the State of California. The insurance carrier is required to have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California's List of Approved Surplus Line Insurers (LASLI) with a rating City Attorney Approved Version 6/12/18 April 5, 2022 2 Item #6 Page 6 of 15 DocuSign Envelope ID: 1ADBBFBC-4C69-46E7-88C0-77823C98AF18 in the latest Best's Key Rating Guide of at least "A:X"; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. 10.1 Coverage and Limits. Contractor will maintain the types of coverage and minimum limits indicated below, unless the Risk Manager or City Manager approves a lower amount. These minimum amounts of coverage will not constitute any limitations or cap on Contractor's indemnification obligations under this Agreement. City, its officers, agents and employees make no representation that the limits of the insurance specified to be carried by Contractor pursuant to this Agreement are adequate to protect Contractor. If Contractor believes that any required insurance coverage is inadequate, Contractor will obtain such additional insurance coverage, as Contractor deems adequate, at Contractor's sole expense. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. 10.1.1 Commercial General Liability (CGL) Insurance. Insurance written on an "occurrence" basis, including personal & advertising injury, with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this projecUlocation or the general aggregate limit shall be twice the required occurrence limit. 10.1.2 Automobile Liability. (if the use of an automobile is involved for Contractor's work for City). $2,000,000 combined single-limit per accident for bodily injury and property damage. 10.1.3 Workers' Compensation and Employer's Liability. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation will not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. 10.1.4 Professional Liability. Errors and omissions liability appropriate to Contractor's profession with limits of not less than $1,000,000 per claim. Coverage must be maintained for a period of five years following the date of completion of the work. 10.2 Additional Provisions. Contractor will ensure that the policies of insurance required under this Agreement contain, or are endorsed to contain, the following provisions: 10.2.1 The City will be named as an additional insured on Commercial General Liability which shall provide primary coverage to the City. 10.2.2 Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims-made coverage. 10.2.3 This insurance will be in force during the life of the Agreement and any extensions of it and will not be canceled without thirty (30) days prior written notice to City sent by certified mail pursuant to the Notice provisions of this Agreement. 10.3 Providing Certificates of Insurance and Endorsements. Prior to City's execution of this Agreement, Contractor will furnish certificates of insurance and endorsements to City. 10.4 Failure to Maintain Coverage. If Contractor fails to maintain any of these insurance coverages, then City will have the option to declare Contractor in breach, or may purchase replacement insurance or pay the premiums that are due on existing policies in order to maintain the required coverages. Contractor is responsible for any payments made by City to obtain or maintain insurance and City may collect these payments from Contractor or deduct the amount paid from any sums due Contractor under this Agreement. City Attorney Approved Version 6/12/18 April 5, 2022 3 Item #6 Page 7 of 15 DocuSign Envelope ID: 1ADBBFBC-4C69-46E7-88C0-77823C98AF18 10.5 Submission of Insurance Policies. City reserves the right to require, at any time, complete and certified copies of any or all required insurance policies and endorsements. 11. BUSINESS LICENSE Contractor will obtain and maintain a City of Carlsbad Business License for the term of the Agreement, as may be amended from time-to-time. 12. ACCOUNTING RECORDS Contractor will maintain complete and accurate records with respect to costs incurred under this Agreement. All records will be clearly identifiable. Contractor will allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of records and any other documents created pursuant to this Agreement. Contractor will allow inspection of all work, data, documents, proceedings, and activities related to the Agreement for a period of t hree (3) years from the date of final payment under this Agreement. 13. OWNERSHIP OF DOCUMENTS All work product produced by Contractor or its agents, employees, and subcontractors pursuant to this Agreement is the property of City. In the event this Agreement is terminated, all work product produced by Contractor or its agents, employees and subcontractors pursuant to this Agreement will be delivered at once to City. Contractor will have the right to make one (1) copy of the work product for Contractor's records. 14. COPYRIGHTS Contractor agrees that all copyrights that arise from the services will be vested in City and Contractor relinquishes all claims to the copyrights in favor of City. 15. NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement. For City For Contractor Name Cheryl Gerhardt Name Corinne Wittman-Wong Title Finance Manager Title CEO --------------- Department Finance ----------Address 11093 Sun Center Drive. City of Carlsbad Rancho Cordova, CA Address 1635 Faraday Ave. Phone No. 916-669-4608 Carlsbad, CA 92008 Email cwittmanwong@webillems.com Phone No. 442-339-2468 Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 16. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests in all categories. YesD No ■ City Attorney Approved Version 6/12/18 April 5, 2022 4 Item #6 Page 8 of 15 OocuSign Envelope ID: 1ADBBFBC-4C69-46E7-88C0-77823C98AF1 8 17. GENERAL COMPLIANCE WITH LAWS Contractor will keep fully informed of federal, state and local laws and ordinances and regulations which in any manner affect those employed by Contractor, or in any way affect the performance of the Services by Contractor. Contractor will at all times observe and comply with these laws, ordinances, and regulations and will be responsible for the compliance of Contractor's services with all applicable laws, ordinances and regulations. Contractor will be aware of the requirements of the Immigration Reform and Control Act of 1986 and will comply with those requirements, including, but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors and consultants whose services are required by this Agreement. 18. DISCRIMINATION AND HARASSMENT PROHIBITED Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment. 19. DISPUTE RESOLUTION If a dispute should arise regarding the performance of the Services the following procedure will be used to resolve any questions of fact or interpretation not otherwise settled by agreement between the parties. Representatives of Contractor or City will reduce such questions, and their respective views, to writing. A copy of such documented dispute will be forwarded to both parties involved along with recommended methods of resolution, which would be of benefit to both parties. The representative receiving the letter will reply to the letter along with a recommended method of resolution within ten (10) business days. If the resolution thus obtained is unsatisfactory to the aggrieved party, a letter outlining the disputes will be forwarded to the City Manager. The City Manager will consider the facts and solutions recommended by each party and may then opt to direct a solution to the problem. In such cases, the action of the City Manager will be binding upon the parties involved, although nothing in this procedure will prohibit the parties from seeking remedies available to them at law. 20. TERMINATION In the event of the Contractor's failure to prosecute, deliver, or perform the Services, City may terminate this Agreement for nonperformance by notifying Contractor by certified mail of the termination. If City decides to abandon or indefinitely postpone the work or services contemplated by this Agreement, City may terminate this Agreement upon written notice to Contractor. Upon notification of termination, Contractor has five (5) business days to deliver any documents owned by City and all work in progress to City address contained in this Agreement. City will make a determination of fact based upon the work product delivered to City and of the percentage of work that Contractor has performed which is usable and of worth to City in having the Agreement completed. Based upon that finding City will determine the final payment of the Agreement. Either party upon tendering thirty (30) days written notice to the other party may terminate this Agreement. In this event and upon request of City, Contractor will assemble the work product and put it in order for proper filing and closing and deliver it to City. Contractor will be paid for work performed to the termination date; however, the total will not exceed the lump sum fee payable under this Agreement. City will make the final determination as to the portions of tasks completed and the compensation to be made. 21. COVENANTS AGAINST CONTINGENT FEES Contractor warrants that Contractor has not employed or retained any company or person, other than a bona fide employee working for Contractor, to solicit or secure this Agreement, and that Contractor has not paid or agreed to pay any company or person, other than a bona fide City Attorney Approved Version 6/12/18 April 5, 2022 5 Item #6 Page 9 of 15 OocuSign Envelope ID: 1ADBBFBC-4C69-46E7-88C0-77823C98AF18 employee, any fee, comm1ss1on, percentage, brokerage fee, gift, or any other consideration contingent upon, or resulting from, the award or making of this Agreement. For breach or violation of this warranty, City will have the right to annul this Agreement without liability, or, in its discretion, to deduct from the Agreement price or consideration, or otherwise recover, the full amount of the fee, commission, percentage, brokerage fees, gift, or contingent fee. 22. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees that any Agreement claim submitted to City must be asserted as part of the Agreement process as set forth in this Agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that if a false claim is submitted to City, it may be considered fraud and Contractor may be subject to criminal prosecution. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act applies to this Agreement and, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of information. If City seeks to recover penalties pursuant to the False Claims Act, it is entitled to recover its litigation costs, including attorney's fees. Contractor acknowledges that the filing of a false claim may subject Contractor to an administrative debarment proceeding as the result of which Contractor may be prevented to act as a Contractor on any public work or improvement for a period of up to five (5) years. Contractor acknowledges debarment by another jurisdiction is grounds for City to terminate this Agreement. 23. JURISDICTION AND VENUE Any action at law or in equity brought by either of the parties for the purpose of enforcing a right or rights provided for by this Agreement will be tried in a court of competent jurisdiction in the County of San Diego, State of California, and the parties waive all provisions of law providing for a change of venue in these proceedings to any other county. 24. SUCCESSORS AND ASSIGNS It is mutually understood and agreed that this Agreement will be binding upon City and Contractor and their respective successors. Neither this Agreement nor any part of it nor any monies due or to become due under it may be assigned by Contractor without the prior consent of City, which shall not be unreasonably withheld. 25. ENTIRE AGREEMENT This Agreement, together with any other written document referred to or contemplated by it, along with the purchase order for this Agreement and its provisions, embody the entire Agreement and understanding between the parties relating to the subject matter of it. In case of conflict, the terms of the Agreement supersede the purchase order. Neither this Agreement nor any of its provisions may be amended, modified, waived or discharged except in a writing signed by both parties. Ill Ill /II /II April 5, 2022 6 City Attorney Approved Version 6/12/18 Item #6 Page 10 of 15 OocuSign Envelope ID: 1ADBBFBC-4C69-46E7-88C0-77823C98AF18 26. AUTHORITY The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR By: (sign here) Corinne Wittman-Wong, CEO (print name/title) By: (sign here) Walter Imboden, PresidenUCFO (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California May r ATTEST: FAVIOLA MEDINA City Clerk Services Manager If required by City, proper notarial acknowledgment of execution by contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups. Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY: {jLJ.,it, ~-~ Assistant City Attorney City Attorney Approved Version 6/12/18 April 5, 2022 7 Item #6 Page 11 of 15 DocuSign Envelope ID: 1ADBBFBC-4C69-46E7-88C0-77823C98AF18 EXHIBIT "A" SCOPE OF SERVICES The city currently uses World Advancement of Technology for Emergency Medical Services (EMS) and Rescue (W.A.T.E.R)(www.wateronscene.com) software system for data collection. The city is currently reviewing proposals for a new electronic patient care records (ePCR) system. It will be the responsibility of the CONTRACTOR to modify its billing system to capture the necessary data generated from W .A.T.E.R. or the new ePCR system, if implemented. The CONTRACTOR will receive and interpret accurately the patient charges in accordance with the city policies regarding charges and ePCRs via a secure website. The CONTRACTOR will obtain the appropriate software to provide a compatible interface with the City of Carlsbad ePCR system and for entering this data into the CONTRACTOR'S system. The CONTRACTOR will review each ePCR generated by the City of Carlsbad for content to accomplish the following: (a) Check for discrepancies to ensure the number of ePCRs received match the number of transports, against medical advice (AMAs), releases and transported by other units (e.g., BLS downgrade, or Zone Move- up/Boundary Drop). (b) Insure that the appropriate fee schedule has been selected and the documentation to support the fees is present. (c) Assign the appropriate billing code based on the documentation treatment and chief complaint of the patient. (d) Review reports that require any other ancillary charges required by the city. All ePCRs are sent to the billing company. This includes AMA's or "dry runs ." This population is included in the Fire Department Customer Survey. Additionally, the total number of patient encounters is recorded each month. It is further stratified by ALS/BLS/AMA/Treat & Release. The CONTRACTOR will interface with the San Diego Health Connect (HIE) aka "hub" to obtain demographic/billing/and outcome data as it is available. CONTRACTOR will sort ePCR's in numerical/date order as well as sort all the "paperwork" in a systematic order for billing organization and future accessibility. CONTRACTOR will provide a link to the City of Carlsbad Customer Satisfaction Survey on every patient invoice in the manner prescribed by the Fire Department. In addition, the CONTRACTOR will mail a set number of paper surveys every month. The survey contents may be modified at any time during the contract at the discretion of the Fire Department staff. CONTRACTOR will mail the City of Carlsbad HIPAA Notice of Patient Privacy Practices to every patient. To the extent possible, the CONTRACTOR will provide electronic claims processing and filings to all insurance carriers. The first invoice will be dated no later than (2) business days after the ePCR is sent to the CONTRACTOR via the secured website. The second City Attorney Approved Version 6/12/18 April 5, 2022 8 Item #6 Page 12 of 15 DocuSign Envelope ID: 1ADBBFBC-4C69-46E7-88C0-77823C98AF18 notice will be sent to the patient or responsible party thirty (30) days after the second notice has been mailed to the patient's insurance carrier. CONTRACTOR will obtain "Assignment Authorization" also called "Lifetime Signature" which allows CMS to pay the provider directly. Once the ePCRs are received by the CONTRACTOR, all customer contact, including notices, mailing, bankruptcy filings, and miscellaneous requests and inquiries, will be the sole responsibility of the CONTRACTOR. This includes: fil ing insurance claims for accounts in collections, reviewing account status with collections contractor and the city as required or requested, reviewing and handling phone calls for patients with accounts placed in collections, and posting and forwarding payments received for patients with accounts placed in collections. CONTRACTOR will provide all monthly finance, billing, receivable and aging reports including: Collection profiles for each month dating back to the beginning of the contract, status of all accounts by payer-mix for the current month and total in the system, aging report by payer-mix, detail for current month reports, transport log, monthly write-offs (detailed as contractual and bad debt), refund reports including refunds pending, detail of monthly receipts, and any additional reports that the city may need formatted to fit the specified requirements. CONTRACTOR'S method of obtaining billing information shall not impose additional reporting requirements upon the Carlsbad Fire Department personnel. Contractor will use current reporting methods (ambulance run reports and drugs and supply summary sheets) or another method acceptable to the City of Carlsbad EMS Manager. CONTRACTOR will bill patient within two (2) working days of receiving account with complete and correct demographic and incident information. Initial invoices will be mailed out within two (2) working days of receipt of fully completed and accurate paramedic run reports. At least three (3) additional notices will be mailed on unpaid accounts on a schedule to be determined prior to award of contract. CONTRACTOR will bill patient's insurance companies and handle all third party claims, inquiries and generate Medicare and Medi-Cal claims. The ability to electronically generate billings to CMS is required . CONTRACTOR will provide analysis of collection rates (defined as billing minus contractual write-offs) and percentage of accounts released to a third party collection agency for the period of July 1, 2022 to June 30, 2023 and each fiscal year after that. CONTRACTOR guarantees the confidentiality, security and safety of all files, documents, computer files, etc. . City Attorney Approved Version 6/12/18 April 5, 2022 9 Item #6 Page 13 of 15 DocuSign Envelope ID: 1ADBBFBC-4C69-46E7-88C0-77823C98AF18 CONTRACTOR will meet federal/state guidelines for CMS programs and will conform in all respects to all federal, state and local laws, ordinances and regulations, including all HIPM requirements regarding protected health information (PHI). CONTRACTOR is the custodian of billing records. Subpoenas for billing records will be directed to the CONTRACTOR, not the city. CONTRACTOR will, as custodian of records, respond to records requests and provide a HIPM compliant method for the transmission of records to patients, their legal representatives or legal subpoena requests. The patient invoice must contain a message stating "All checks must be made payable to the City of Carlsbad ." CONTRACTOR will provide all invoices and related forms with remittance advice. All envelopes must indicate Address Correction Requested. CONTRACTOR will provide postage for the mailing of all correspondence for the billing operation. The city will provide the CONTRACTOR the customer survey instruments and the HIPM Notice of Patient Privacy brochure. CONTRACTOR will individualize collection demand notices in a form and method to be acceptable to the City of Carlsbad Finance Director. After an account's complete bill schedule has been run, and the account has aged to 90 days beyond the date of the first mailed invoice, cash accounts are to be referred to the city's approved collection agency for either write-off or for further action by the collection agency. CONTRACTOR will agree to employ courteous business procedures as to maintain the city's goodwill. CONTRACTOR, when turning over a complaint regarding fees or services to the city, will turn over billing notes and history of the claim to date when sending the complaint to the EMS Manager. CONTRACTOR'S Customer Service Representatives will be available at a minimum 8:00 AM -4:30 PM, Pacific Time, Monday through Friday, excluding major holidays via a toll- free telephone number. Spanish speaking representatives will be available to assist the city's Spanish-speaking population. CONTRACTOR will meet periodically with the City of Carlsbad staff at staffs request to discuss all services and to provide initial training, as well as follow up training. The CONTRACTOR will provide ongoing training as the City of Carlsbad deems necessary due to industry regulation changes, trends noted, changes in Medicare and Medi-Cal rates, product software changes, etc. City Attorney Approved Version 6/12/18 April 5, 2022 10 Item #6 Page 14 of 15 DocuSign Envelope ID: 1ADBBFBC-4C69-46E7-88C0-77823C98AF18 CONTRACTOR will meet periodically at city staff's request to help city staff determine and analyze the city's fee structure. CONTRACTOR will respond to information requests as part of an ambulance fee and first-responder fee feasibility study. CONTRACTOR will maintain accurate records of all correspondence, documents, accounting records, transactions and other relative evidence. All records will be made available to the City of Carlsbad for review upon request. CONTRACTOR will comply with all federal and state requirements with regards to record retention. CONTRACTOR will work with all government programs to seek reimbursement. CONTRACTOR will provide response for data fields within the CMS Medicare Ground Ambulance Data Collection System that can be extracted from ePCR and billing records. CONTRACTOR will maintain a HIPAA Business Associate Agreement with the city and be both knowledgeable and compliant in both the HIPAA Privacy and Final Security Rules. Any settlement of principal or charges must be agreed upon in writing between the Contractor and the Designated City Representative prior to acceptance. CONTRACTOR will have designated one high-level contact person to communicate with the Fire Department. This individual will then communicate internally with CONTRACTOR'S staff conveying the needs and expectations of the city to avoid the city having to communicate with multiple people. CONTRACTOR will have its high-level administrative staff review any contract or agreement that the city needs to take action on prior to sending it to the city for action. The CONTRACTOR will be aware of what fields the city is exempt from as a governmental agency. City Attorney Approved Version 6/12/18 April 5, 2022 11 Item #6 Page 15 of 15