HomeMy WebLinkAboutR-2003-040 Advanced Data Processing Fire Billing final RESOLUTION NO. 2003-040
• A RESOLUTION OF THE CITY OF DANIA BEACH, FLORIDA
AUTHORIZING THE CITY MANAGER TO ENTER INTO AN
AGREEMENT WITH ADVANCED DATA PROCESSING, INC. AND
THE CITY OF DANIA BEACH, RETROACTIVE TO OCTOBER 1,
2002, FOR MEDICAL TRANSPORTATION BILLING SERVICES,
UNDER CONTRACT WITH THE CITY OF HALLANDALE BEACH;
WITHOUT COMPETITIVE BIDDING AND WITHOUT
ADVERTISEMENT FOR BIDS; PROVIDING FOR CONFLICTS;
FURTHER, PROVIDING FOR AN EFFECTIVE DATE
WHEREAS, the Charter of the City of Dania Beach, Part III, Article 3, Section 4,
Subsection (J), authorizes the City Manager to purchase supplies, services, equipment
and materials for the city government in amounts in excess of $15,000.00 without
competitive bidding and without advertisement for bids if he is authorized to do so in
advance by a resolution adopted by the City Commission and if such purchases are
made pursuant to a competitive bid obtained within the last twelve (12) months by other
governmental agencies such as the Federal Government, State of Florida or a Florida
county or municipality, and
WHEREAS, the City Manager has determined that medical transport billing
services can be obtained at the least cost to the City by contracting with Advanced Data
Processing, Inc., 520 NW 165 Street Road, Suite 201, Miami, Florida 33169, under
contract between the City of Hallandale Beach and Advanced Data Processing, Inc.,
executed on the 1st day of September, 2002, a copy of which is attached hereto and
made a part hereof.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE
CITY OF DANIA BEACH, FLORIDA:
Section 1. That the contract with Advanced Data Processing, Inc., and the City
of Dania Beach for transport billing services shall be retroactive to October 1, 2002, is
hereby approved and the appropriate city officials are hereby authorized to execute
same.
Section 2. That all resolutions or parts of resolutions in conflict with this
resolution are repealed to the extent of such conflict.
1 RESOLUTION NO. 2003-040
Section 3. That this resolution shall be in force and take effect immediately upon
• its passage and adoption.
PASSED and ADOPTED this 25th day of March , 2003.
BOB ANTON
MAYOR-COMMISSIONER
AT ES :
ROLL CALL:
ARLENE JO N ON COMMISSIONER CHUNN - YES
CITY CLERK COMMISSIONER FLURY - YES
COMMISSIONER MIKES - YES
VICE MAYOR MCELYEA — YES
MAYOR ANTON - YES
APPROVED AS TO FO AND CORRECTNESS:
BY:
THbMA8'J.,AN8Mo
CITY ATTORNEY
2 RESOLUTION NO. 2003-040
CITY OF DANIA BEACH a
FIRE - RESCUE DEPARTMENT
INTER-OFFICE MEMORANDUM
TO: Ivan Pato, City Manager
FROM: Kenneth Land, Fire Chief
RE: Medical Transport Billing
DATE: March 20, 2003
Attached hereto is information relating to medical transport fees submitted by ADP
(Advanced Data Processing, Inc.). This company continues to be utilized by several
fire-rescue departments in the tri-county area (Dade, Broward and Palm Beach) and has
active contracts with 17 local (Broward County) fire-rescue departments, a list of which is
attached hereto.
• We have negotiated a contract that runs for three years with two (2) twelve (12) month
extensions, at the same fee which works out to be seven percent (7%) of the amount
collected. In fiscal year 2001/2002, ADP collected $465,298.87 at a cost to us of
$35,870.21. ADP continues to service only fire-rescue departments. In addition to the
foregoing ADP has also offered to include now required privacy act information to each
patient at a cost not to exceed $200.00 per month. Considering that they are absorbing
all expenses attendant to furnishing this notice (printing, envelope stuffing, postage,
etc.,) I feel it is cost effective to pay them for this additional service.
We have been extremely pleased with every aspect of our association with this
company; therefore, I recommend that we execute the contract pursuant to the terms
and conditions set forth therein and as highlighted above.
If you have any questions relating to the above, please do not hesitate to contact me.
KL:clb
attachments
•
ADVANCED
520 NW 165 Street Road Phone 305 459 0653
Suite 201 Fax 305 521 0778
Miami,FL 33169
DATA PROCESSING,, INC.
March 18,2003
Capt. Bruce Caruso, EMS Coordinator
CITY OF DANIA BEACH EMS
102 West Dania Beach Boulevard
Dania Beach,FL 33004
Dear Captain Caruso:
Subject:Contract Piggyback
Enclosed are the copy of our agreement with the City of Hallandale Beach and a draft of a
"Piggyback" Contract wherein another municipality having even greater volume used the same
agreement. This letter hereby serves as authorization for the City to effectively "camp-on" or
"piggyback"this in-force agreement.
The draft agreement has a modification that is being adopted by most all clients as is required by
HIPAA regulations. The modification, identified in Section 11 as Exhibit A, refers to the Business
Associate Addendum. In addition we have added, again for HIPAA compliance purposes, the
provision in Section 4 to provide a copy of the HIPAA Privacy Notice to each patient billed to be
included in the first invoice sent.The charge for this is computed on a monthly-billed basis.
Should you have any questions,please feel free to call me.We continue to value the City of Dania
Beach as one of our longstanding clients.
Sincerely,
D V Passaro
VP Marketing/Operations
Advanced Data Processing,Inc.
0
653
SuiteNW 165 Street Road Phone 305 521 0778
Suite 201 Fax 305 521 0778
a ADVANCED Miami,FL 33169 Email adpdhartung@bellsouth.net
0 DATA PROCESSING, INC.
March 19, 2003
Dear Capt. Caruso:
1U1j'ecBroward CIIemlift
Below is the list of clients who we serve in the Broward area:
Broward County
Cooper City
Coral Springs
Dania Beach
Davie
Deerfield Beach
Ft Lauderdale
Hallandale Beach
Lauderdale Lakes
Lauderhill
Lighthouse Point
Margate
North Lauderdale
Oakland Park
Plantation
Pompano Beach
Tamarac
Sincerely,
D V Passaro
Vice President, Business Development
•
AGREEMENT BETWEEN
THE CITY OF DANIA BEACH
AND
ADVANCED DATA PROCESSING. INC.
FOR RESCUE AMBULANCE BILLING & RELATED PROFESSIONAL SERVICES.
THIS AGREEMENT, hereinafter "AGREEMENT", made and entered into this 26"' day
of March, 2003 by and between CITY OF DANIA BEACH, a political subdivision of the
State of Florida, with principal offices located at 100 West Dania Beach Boulevard,
Dania Beach, Florida 33004, hereinafter referred to as the "CITY", and Advanced Data
Processing, Inc., a Delaware Corporation, authorized to do business in Florida, with
principal offices located at 520 NW 165 Street, Suite 201, Miami, Florida 33169,
hereinafter referred to as the "CONTRACTOR".
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 CITY 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 `CITY OF DANIA BEACH' or via
"Locked-Box" facility as directed by the CITY.
3. TIME OF PERFORMANCE. This Contract shall be effective for a three-year
period retroactive from October 1. 2002 through September 30, 2005, under the
terms and conditions contained herein unless otherwise terminated. The CITY 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.
4. COMPENSATION AND METHOD OF PAYMENT. The CITY reserves the right
to request changes in the services within the general scope of the Contract to be
performed upon mutual written agreement by the CITY and CONTRACTOR which
shall specify the change ordered and the adjustment of time and compensation
required therefore.
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.
1
The CONTRACTOR shall provide to the CITY a monthly invoice representing
fees to be paid by City 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), Section 4 Paragraph 3, 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. Two hundred dollars ($200.00) per
month for providing billed patient required HIPAA-compliant Privacy Notice
included with first patient invoice sent.
The CITY shall issue a check for the amount invoiced, minus any disputed
amount, within thirty (30) days of receipt and acceptance of the invoice.
The CITY shall bear the cost of any and all Lock-box services and it is hereby noted
that Dania Beach does not require this service at this time. However, if at any time in
the future, the City chooses to use a Lock-box bank service, the CONTRACTOR shall
provide to the CITY monthly an amount of two hundred ($200.00) dollars towards the
CITY'S banking and administrative costs in the form of a discount against
CONTRACTOR'S monthly fees as stated above. 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 CITY 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 in writing.
6. DATA TO BE FURNISHED BY CITY. The CITY 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 CITY will not be disclosed to any party
without the CITY's prior approval.
7. INDEPENDENT CONTRACTORS. The CONTRACTOR is an independent
contractor and not an employee or agent of the CITY 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 CITY 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 CITY; and insurance filings and
related forms. The CONTRACTOR has no authority to sign any
document that imposes any liability on the CITY.
The CONTRACTOR shall retain full control over the employment, direction,
compensation and discharge of all persons assisting in the performance of service by
2
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 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
CITY 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), that may issue thereon.
9. INSURANCE. The CONTRACTOR shall maintain the following insurance
coverage:
1) Workers' Compensation Insurance in compliance with Florida Statutes, Chapter
440 and applicable Federal Acts as they may be amended from time to time;
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;
5) Professional liability coverage in the amount of$500,000.
Where applicable all coverage above shall be amended with CITY OF DANIA BEACH
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 CITY by
certified mail. Prior to commencing work, the CONTRACTOR shall provide CITY 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.
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 CITY, including all rights therein of
whatever kind except as may otherwise be provided hereinafter.
11. ATTACHMENTS. The following named attachments are made an integral part of
this Agreement:
3
A. Business Associate Addendum (Exhibit A attached hereto and made a part
hereof)
B. Scope of Work (Exhibit B attached hereto and made a part hereof)
C. Proposal presented to CITY OF DANIA BEACH by Advanced Data Processing
dated March 8, 2003 (Exhibit C attached hereto and made a part hereof)
D. Contract between Advanced Data Processing, Inc. and the City of Hallandale
Beach dated September 1, 2002 (Exhibit D attached hereto and made a part
hereof)
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. During the time of this agreement the CITY may terminate this
Agreement either for convenience or for default after first giving to CONTRACTOR
thirty (30) days written notice.
For cases of default, the CONTRACTOR shall be given opportunity to cure'fhe default
within the thirty (30) day period. In the event the acts constituting default are a
violation of law, CONTRACTOR shall be subject to immediate termination of contract.
Upon termination for any cause, the CONTRACTOR shall submit an invoice(s) to the
CITY in an amount(s) representing fees for services actually performed or
obligations incurred up to the date of effective termination for which the
CONTRACTOR has not been previously compensated. Upon payment of all sums
found due, the CITY shall be under no further obligation to the CONTRACTOR,
financial or otherwise.
13. UNCONTROLLABLE FORCES. Neither the CITY 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,
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 Broward County, Florida which shall be
deemed proper jurisdiction and venue for the action.
4
15. PIGGYBACK. It is hereby a precondition of any part of this Agreement that the
Terms of CONTRACTOR's Agreement with the City of Hallandale Beach (dated
September 1, 2002) shall be extended to the CITY including any modifications,
amendments or exclusions for the term of referenced agreement. Effectively, this
allows the CITY to piggyback the agreement with the City of Hallandale Beach.
Where the Current Agreement conflicts with the Terms of the Piggyback Agreement,
the Terms of the Current Agreement shall prevail.
15 (a). MOST FAVORED CUSTOMER. The CONTRACTOR agrees to extend the City
the most favorable terms extended to any similar customer or client. Similar client
shall mean another city, within Broward County, having a population less than 80,000.
The CONTRACTOR shall be responsible for notifying the CITY of any such changes
and providing the option to accept such favorable terms. The CITY shall exercise its
right to such option by either amending or revising this Agreement by mutual
consent and notifying the CONTRACTOR of such amendment or revision to the
Agreement.
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 written consent by the CITY.
17. NOTICES. Delivered or mailed to such party at their respective addresses as
follows:
To the CITY:
Capt. Bruce Caruso, EMS Coordinator
CITY OF DANIA BEACH EMS
100 West Dania Beach Boulevard
Dania Beach, FL 33004
Phone #954-924-3725
To the CONTRACTOR:
Darryl Hartung
Senior Manager
Advanced Data Processing, Inc.
520 NW 165 Street Road, Suite 201
Miami, Florida 33169
18. REPESENTATION AND WARRANTY. CONTRACTOR represents that it has
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.
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 or implied representations, inducements or
understandings of any kind or nature.
5
IN WITNESS OF THE FOREGOING, the City has caused this Agreement to
be signed by its Mayor-Commissioner, City Manager, attested by the City Clerk with
the corporate seal of the City of Dania Beach, and the Contractor and Administrator
have executed this Agreement effective as of the date set forth above.
CITY: CITY OF DANIA BEACH,
a Fl ri unicipa Corporation
ATTEST:
'('CHARLENE HNSON Bbi A14TON
CITY CLE MAYO O SSIONER
Dated '
rvAu,4Yro
CITY AGE
Dated:
M W-_,Ip 3--o6
APPROVED FOR FORM D
CORRECTNESS:
BY: ' /�
THOMAS ANS R
CITY ATTORNEY
CONTRACTOR:
ADVANCED DA ROCESSING. INC.
By:
5HAMON
PRESIDENT
CORPORATE SEAL(If Applicable):
STATE OF FLORIDA
COUNTY OF DADE
BEFORE ME, an officer duly authorized by law to administer oaths and take
acknowledgments, personally appeared Doug Shamon, as President of Advanced
Data Processing, Inc., a Delaware corporation, authorized to do business in Florida,
and he acknowledged execution of the foregoing Agreement for the use and
purposes mentioned in it and that the instrument is the act and deed of the
Contractor.
IN WITNESS OF THE FOREGOI G, I Piave set my hand and official seal at in
the State and County aforesaid on t / T�"' 2003.
NOTARIAL SEAL:
�o0P1Y PU., Darryl M.Hartung Notary P blic, State of Florida it Large
RC=mxssion#DD12664G
c`. l spires Jane 17,2005 D / y �L�✓0.r�.1 ✓
Bonded Tb=
in i tic BondiugCR,Lm
6
Exhibit A
Business Associate Addendum
Advanced Data Processing, Inc. the "Business Associate" (hereinafter referred
to as "ADPI") and City of Dania Beach (hereinafter referred to as Dania Beach)
hereby amend the Agreement entered into on March , 2003, ("the Agreement")
by adding the following additional language to the Agreement.
1. ADPI shall carry out its obligations under this Addendum in compliance with
the privacy regulations pursuant to Public Law 104-191 of August 21, 1996, .
known as the Health Insurance Portability and Accountability Act of 1996,
Subtitle F—Administrative Simplification, Sections 261, et seq., as amended
("HIPAA"), to protect the privacy of any personally identifiable protected
health information ("PHI") that is collected, processed or learned as a result of
the Billing Services provided hereunder. In conformity therewith, ADPI
agrees that it will:
a. Not use or further disclose PHI except as permitted under this Addendum or
required by law;
b. Use appropriate safeguards to prevent use or disclosure of PHI except as
permitted by this Addendum;
c. To mitigate, to the extent practicable, any harmful effect that is known to ADPI
of a use or disclosure of PHI by ADPI in violation of this Addendum;
d. Report to Dania Beach any use or disclosure of PHI not provided for by this
Addendum of which ADPI becomes aware;
e. Ensure that any agents or subcontractors to whom ADPI provides PHI, or who
have access to PHI, agree to the same restrictions and conditions that apply to
ADPI with respect to such PHI;
f. Make PHI available to Dania Beach and to the individual who has a right of
access as required under HIPAA within 30 days of the request by Dania Beach
regarding the individual;
g. Incorporate any amendments to PHI when notified to do so by Dania Beach;
h. Provide an accounting of all uses or disclosures of PHI made by ADPI as
required under the HIPAA privacy rule within sixty (60) days;
i. Make their internal practices, books and records relating to the use and
disclosure of PHI available to the Secretary of the Department of Health and
Human Services for purposes of determining ADPI's and Dania Beach's
compliance with HIPAA; and
i
Exhibit A Page 1 of 2
j. At the termination of the Agreement, return or destroy all PHI received from,
or created or received by ADPI on behalf of Dania Beach, and if return is
infeasible, the protections of this Addendum will extend to such PHI.
2. The specific uses and disclosures of PHI that may be made by ADPI on behalf
of Dania Beach include:
a. The preparation of invoices to patients, carriers, insurers and others
responsible for payment or reimbursement of the services provided by Dania
Beach to its patients;
b. Preparation of reminder notices and documents pertaining to collections of
overdue accounts;
c. The submission of supporting documentation to carriers, insurers and other
payers to substantiate the health care services provided by Dania Beach to its
patients or to appeal denials of payment for same;
d. Uses required for the proper management of ADPI as business associate; and
e. Other uses or disclosures of PHI as permitted by the HIPAA privacy rule.
3. Notwithstanding any other provisions of this Addendum, the Agreement may
be terminated by Dania Beach if ADPI has violated a term or provision of this
Addendum pertaining to ADPI's material obligations under the HIPAA privacy
rule, or if ADPI engages in conduct which would, if committed by Dania
Beach, result in a violation of the HIPAA privacy rule by Dania Beach.
Exhibit A Page 2 of 2
0 ADVANCED Exhibit "E"
DATA PROCESSING, INC.
o so 0
Advanced Data Processing's Services
NOTE: The following are general descriptions of services performed and specific
aspects of our process. Our processes are continually refined in many aspects including
the betterment of procedures, software, and methods. We reserve the right to make
such changes in the normal course of business.
Advanced Data Processing will utilize collected billing information provided by Dania
Beach as the basis for:
Billing to and collecting from the transported individual, Medicare,
Medicaid, insurance companies, or other appropriate third party
payors for services provided by Dania Beach to the patient and
maintaining incident-based accounting to assist in this process.
Preparing the required management and financial reports including
information on delinquent accounts for the client's analysis of the
services provided.
® Advanced Data Processing will perform all services with the principal goals of:
Recovering the greatest amount of fees in the shortest viable time,
Collecting the greatest total amount with minimized cost to recover,
Adhering to and meeting all compliance regulations for Medicare,
Medicaid, Federal, State and local laws.
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.
Advanced Data Processing, Inc.
Scope of Services i
Critical Service Elements
Billing & Collection
Proprietary systems, procedures and techniques
High collection rates and cash flow within compliance regulations
Hospital arrangements to obtain/verify patient insurance and contact information.
Electronic submission of Medicare, Medicaid & insurance claims to decrease
payment cycle.
Customer Service
Provide customer-relation inquiry services.
State-of-art call center with ACD call handling.
Facilitate all customer calls through a dedicated "800" toll-free exchange.
Web-based Internet facility for patient-provided insurance info.
Provide a designated liaison for patient/payor concerns.
Reporting
Provide timely comprehensive reports facilitating all required aspects of
monitoring, evaluating, auditing and managing the services provided.
® Appropriate accounting procedures for reconciling all deposits, receivables
(including credit card payments & federal EFT payments), billings, patient
accounts, adjustments & refunds.
Comprehensive refund request documentation substantiating each refund
processed.
Compliance & Confidentiality
Ensure that all required documentation and agreements with payors (e.g.
Medicare, Medicaid, Champus, etc.) are filed and maintained.
Client is kept apprised of important changes to industry regulations,
Utilize most up-to-date knowledge and information with regard to coding
procedures, assigning of ICD-9 diagnostic codes,
Ensure compliance with applicable Federal, State, and local regulations.
Advanced Data Processing, Inc.
Scope of Services - 2 -
HIPAA Compliance
Provide consultation and informative legal briefings on HIPAA issues relating to
billing and collections,
Ensure HIPAA compliant transactions,
Confidentiality of any record of care or treatment of patients,
Facilitate proper security and shred confidential information in addition to all
disposed materials containing such proprietary information.
Facilitate provision of Privacy Notices.
Ensure HIPAA compliant Business Associate Agreements.
Client Training
Provide up-to-date training on compliance, regulatory, documentation & fees
issues.
Specific Services
Transport information is provided to us as follows:
Either paper or electronic format.
Paper runsheets are batched and mailed to us on a regular timely basis.
Electronic format are transmitted at regular intervals into a secure FTP site
provision under our direction.
The electronic information transmitted contains a facsimile of a transport run
sheet for each transport to be billed. These are provided in a batch, the count for
which is accounted for and reconciled with the county.
The billing related information provided in each electronic run report is processed into
our system and passed through an edit phase where automated screening for errors and
inconsistencies is performed. Upon scrutiny, verification and correction (where
necessary), the information passes an update phase where it is updated into our patient
accounting database.
Once updated, invoices or health claims are generated for all accounts. Invoices contain,
in addition to accurate charges for services provided by the county's EMS, requests for
patient insurance information and instruction on how to provide such information
(including how to submit such information simply via our web site facility).
Advanced Data Processing, Inc.
Scope of Services - 3 -
Our system also enters a "linking-phase"which provides information (including
insurances) about same patients updated who were previously updated and billed by our
system. This enables us to prepare and submit insurance claims where valid insurance
• information already exists.
Our system prints "hospital insurance request sheets"providing all patient demographic
and insurance data we have on file. This information list is sorted,by hospital and is
provided to our hospital specialists for verification against hospital-provided data.
The hospital information is researched both on initial placements of the transports and
again five months after transport date. The information is obtained via several methods;
Field specialists using hospital-provided terminal access,
Resident specialists located at our facilities who are provided remote access to
the hospital data,
Paid arrangements with hospital personnel who obtain information at the hospital
under hospital authorization,
Electronic verification and interface with databases,
Fax-back arrangements with the hospital business office.
Insurance claims are filed where valid insurance information is provided as soon as it is
received, whether from initial run sheet, hospital face sheet, linking information,
hospital/field data acquisition or, direct patient provision.
® Necessary copies of run sheet information are attached to the claim where required.
All required coding and ICD-9 information is affixed to the claim before submission.
Medicare, Medicaid and Private Insurance Claims are submitted electronically,
transmitted to the appropriate intermediary and are also submitted in paper form as
required.
Auditing of claims is performed in many cases before submission of the claim.
Rebilling is performed up to six times at regular intervals (cycle billing) of about 35 days.
Insurance companies not yet showing payment are contacted at appropriate intervals to
ensure payment.
Patient contact is made where clarification of insurance information is necessary.
At five months hospital information is searched again for all accounts not yet paid.
Unpaid accounts are submitted to an eligibility verification database service at our cost.
Advanced Data Processing, Inc.
Scope of Services - 4 -
Collection Philosophy
Advanced Data Processing prides itself in developing operations methods and systems
support tailored specifically to EMS billing and collections requirements. Our
methods and systems are refined to provide maximum efficiency in the collection of your
receivables. We are focused on our client's success and strive to improve their cash
flow through constant innovation and providing the highest service levels attainable with
professionalism with respect to both the client and the community.
In addition, because our sole focus is serving municipalities performing EMS billing and
collections, we provide clients the following distinct benefits:
o 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 tried-and-proven
solutions. Since all of our computer programming is done 'in-house', we have
the ability to immediately modify our computer programs to continually
improve our collections system and processes. We 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.
s Advanced technologies are deployed in key areas of our process where
their increased reliability and efficiency are enhancements to our operations
in the following areas:
• High-speed scanning to high-density optical storage for
maintaining runsheet images whether provided to us in paper or
electronic format. This allows us to retrieve these images to support
refiling of claims and internal auditing of accounts billed.
Increased customer service efficiency and all telecommunications
facilitated by T1 communications facilities and PBX facilities
providing Auto Call Distribution (ACD) with City/County
transporting and caller ID automatically displayed to
answering customer service agent.
All of our systems are tied together via a 350MHz interfacility LAN
network allowing access and inter-system transfer of information.
We employ high-speed fax machines and fax-server systems to
facilitate high volume of fax information in the most efficient manner
possible.
a Hospital support provides a principal ingredient in effectively maximizing our
collection success by having access to medical insurance records from the
transported hospitals. Please note that we perform this with redundancy and
timing critical in obtaining correct information.
i
Advanced Data Processing, Inc.
Scope of Services - 5 -
e Electronic Claims Processing of Medicare, Medicaid & many other
carriers claims are processed by us and submitted electronically to
ensure accurate and fast collections with the following distinctions:
As the first EMS service company in Florida to electronically file
Medicaid claims, we continually stay abreast of changes in
insurance submission standards and upgrade our capabilities as
such changes require.
We were 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
facilities and information updates.
We maintain logs of all insurance transmissions and a copy of the
confirmation receipt sent by the carrier.
♦ Automated patient linking -When a new patient is entered into the
system, the system first determines if the patient has been previously
transported. The database is searched for Medicare, Medicaid, and Private
Insurance information. If we find this information in our history file, we
immediately use this information to process a claim, thus eliminating the
time needed to research patient information.
♦ Automated payor monitoring & claim resubmission is performed on all
claims having been filed to insurance payors identifying those not yet paid.
These claims are flagged and automatically resubmitted.
♦ Effective patient statements are provided in an "easy-to-read",
comprehensive statement/invoice to all patients with the following features:
Courtesy return-payment envelope included for convenience.
Clear, concise description of all charges and payments.
A request on the statement for the patients' Medicare and/or
Medicaid number is clearly indicated.
Special annotation including our toll-free 800 number and our
web- site for providing patient insurance information.
The reverse side of the statement has clearly marked entry blocks
for information needed to file private insurance claims.
We optionally accommodate our clients with inserts to include in
our statement mailing such as questionnaires, comment cards,
notices, etc.
e Comprehensive & timely reports provide "just-the-right" information
developed over years of working with our clients. We send our reports within
Advanced Data Processing, Inc.
Scope of Services _ g _
24 hours of receiving the last day of the month's receivables. Our clients
generally get their reports no later than the 15`h of the following month.
• e Address Correction is performed 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
information, we check these patients electronically against the U.S. Post
Office's National Change of Address (NCOA) files, whose records are
updated quarterly.
Processing New Transports
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 collections. Advanced Data Processing will
determine the optimum method for information transfer, employing electronic or
communications methods as feasible. Information will be received, entered and
maintained on our data processing system to assist in our process. All information will
be treated as confidential in compliance with HIPAA Privacy Rules.
Manual data entry is keyed in at the most rapid and reliable manner possible. Advanced
Data Processing has maintained its original expertise in bulk data entry and data
processing therefore consequently has an advantage in the ability to process large
volumes of input data such as patient incident & demographics as well as payment
processing.
All data received is entered into the system's database within 1 to 5 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:
Automated "front-end edits",
"Patient-linkage", and
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
incomplete address, conflicting social security & date-of-birth information
with 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. If the information cannot be found through the two methods
listed above, recovery specialists conduct manual reviews.
•
Advanced Data Processing, Inc.
Scope of Services - 7 -
Scanning & Records Processing
All transport runsheets, whether paper or electronic submissions are processed as an
image into our scanning system. These images are maintained on-line and stored on
optical WORM media. The images can then be retrieved and printed by our personnel.
In most cases this eliminates our need to re-request runsheets.
On a special incident basis, requests for records (e.g. run.reports) will be forwarded to
EMS for processing & response regardless of the 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.
We maintain all payment records for the period specified by the county. These records
are kept intact with copies of Explanation of Benefits (EOBs) that 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 County upon request. All records are considered the property of City of
Dania Beach and will be turned over upon completion or termination of the contract.
Accounts Receivable
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 either corrected immediately or corrected after
obtaining valid information from a number of sources. In many cases we utilize on-line
verification, where our system automatically communicates multiple records to the
insurance carrier and obtains from the carrier the correct filing identification. In other
cases, telephone calling and/or hospital interrogation is employed.
• Claim generation & mailing - Bills will be submitted immediately upon completion of
input, verification and editing of the supplied billing information (generally within 1-3 days
of receipt), and mailed or communicated to patients/payors.
Electronic claim submission - Bills for which we transmit electronically are sent in
batch form, directly to the carrier providing payment. Processing by the carrier occurs
within approximately 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. 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
Advanced Data Processing, Inc.
Scope of Services - 8 -
Medicare, Medicaid and other carrier
Internet information systems
• Patient 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).
Billing and Insurance Forms
Advanced Data Processing utilizes its own designed invoice/statement form to mail to
self-pay patients/payors. It also includes the patients account number simplifying the
posting process. The following are featured in our statements:
Courtesy return-payment envelope included for convenience.
Clear, concise description of all charges and payments.
A request on the statement for the patients' Medicare and/or Medicaid
number is clearly indicated.
Special annotation including our toll-free 800 number and our web-site
for providing patient insurance information.
The reverse side of the statement has clearly marked entry blocks for
information needed to file private insurance claims.
We optionally accommodate our clients with inserts to include in our
statement mailing such as questionnaires, comment cards, notices, etc.
We employ a standard HCFA 1500 form for submitting paper claims to insurance
companies that do not accept electronic submissions or, where mitigating circumstance
does not permit electronic filing (e.g. correspondence is included, run reports must be
provided). All other filing is done electronically where applicable.
All forms are printed using OCR A format, which accommodates most processing
facilities for electronically processing our forms.
Advanced Data Processing, Inc.
Scope of Services - 9 -
Patient Invoice - Sample (reduced size)
Note: Patient data obscured to protect confidentiality.
STATEMENT
pqTE 2i08/96
CITY OF TAMPA - REV-FIN-EMS ACCOUNT
315 E KE:NNEriY 05OC NUMBER 024-01
'TAMPA, rL 33602 I
LOJ AMOUNT PAD S
UR PHONE NUMBER I5... 800-213-6199
MAKE CHECKS PAYABLE INU.S.DOLLARS TO:
I rIIhC - 60302- -01 CIT'Y OF 'I-AMI A - REV•-FTN-•EMS
96" OWL- PL 315 E KENNEDY 050C2
TAMPA, FL 33635 I TAMPA, FL 33602
I L I
J
TO INSURE PROPER CREDIT TO YOUR ACCOUNT-PLEASE DETACH AND RETURN THIS STAB WITH YOUR CHECK
PATIENT NAME: MIKE PLACE OF SEA: S J H
PHONE NUMBER: a 13-.
REFERRING DR.:
.. •:'X•k ....�A4 a�'.��,:�".�`'°,�...v�'flE.SG' PTIC?tID�.�FILY.N�, ..�"•�'"..ti� '�»�.��` .�`1k� wf
1/20/96 FIRE RESCUE TRANSPORT 170.00
MILEAGE. CHARGE 6.0 0 E 5.00 30.00
MEDICATION/SF'.HANDLE 62.00
WE f'ILEI YOUR INSURANCE CLAIM. F11.11- HIAVE REC[IVED NO FAYmENT
UP, ONLY fF1E PARTIAL PAYMENT INDICATED ABOVE.
THE BALtNCE SHOWN IS DUE AND PAYABLE BY YOU. THANK OU
PR'O'FECT YOUR VALUAFILE CREDIT STATUS.
IF YOU 1AVE INSURANCE, PLEASE CALL US. DO N11'1' :MEND C SH.
SI LISTF:: TIENE SEGURQ, POR FAVOR DE LL.AMARNOS.
PAY
TNIS 262.00
AMOUNT
PRIM YOUR MEDICARE NUMBER HERE ME ICAID
PRIM YOUR HOME PHONE NL"ER HERE BUfiNESS PHONE•
IF YOU HAVE INSURANCE OR PARTICIPATE IN ANY PROGRAM WHICH WILL PAY FOR
THESE SERVICES.PLEASE COMPLETE AND SIGN THE REVERSE SIDE OF THIS BILL AND
RETURN IN THE ENCLOSED ENVELOPE. ACCOUNT �24-O 1
IF THERE IS ANY PROBLEM REGARDING THE PAYMENT OF THIS BILL.CONTACT OUR
OFFICE AT( 600-213-619Y )WITHIN 5 DAYS TO MAKE ARRANGEMENM NUM ER
REASE SHOW ACCOUNT NUMBER ON ALL CHECKS.
IMPORTANT YOU MUST SIGN REVERSE SIDE TO RECEIVE INSURANCE PAYMENT
Advanced Data Processing, Inc.
Scope of Services - 10 -
Patient Invoice (back) - Sample (reduced size)
1.PATIENTS NAME(First Name,Mlddle Initial.Last Name) 2.PATIENT'S DATE OF BIRTH 3.INSURED'S NAME(First Name,Middle Inur,Last Name)
a.EMPLOYER'S NAME 6 ADDRESS S.PATIENT'S SEX 6.INSUREC'S I.D.POLICY OR CERTIFICATE NUMBER
MALE �FEMALE
7.PATIENTS RELATIONSHIP TO INS 8.INSURED'S G ROUP NO.(Or Grouo Name)
TELEPHONE NO: elf Soouse Child Other
9.OTHER HER HEALTH INSURANCE COVERAG E•Enter 10.WAS CONDITION RELATED TO II.INSURANCE COMPANy•S NAME 6 ADDRESS
Name o1 Policy no
loer and Plan Name and Address antl A PATIENTS EMPLOYMENT i Pulicy or Medical Assistance Numbe,
.
YES No
B.ACCIDENT
i
AUTO OTHER
12.PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE(Read Before Signing)1 au tnorire 13. I Authorlre Payment of Medical Benefits to Uncenlgned
;he Release of any Medical Information Necessary to Process INS Claim and F dueft Pay. Physician or Supplier for Se—co described oelow.
ment of Medicare Benefits Either to Myself or to the Party who Acce Pts AfSigninent Below.
SIGN/FIRMA: DATE: SIGN/FIRMA(Insured or AulhdrltedSPer-ri's.
SIGN/FIRMA: SIGN/FIRMA:
ALL OF THE ABOVE INFORMATION MUST BE COMPLETED IN FULL BEFORE RETURNING
AUTHORIZATION AND ASSIGNMENT
MEDICARE PAYMENTS: A patient's signature requests that payment be made and authorizes release of medical
information necessary to pay the claim. If patient has other health insurance coverage the patient's signature
authorizes releasing of the information to the insurer or agency shown. In assigned cases,the physician agrees to
accept the charge determination of the Medicare carrier as the full charge,and the patient is responsible only for
the deductable,coinsurance, and noncoverea services. Coinsurance and the deducible are based upon the charge
determination of the carrier•if this is less than the charge submitted.
MEDICARE RECIPIENT ONLY:
I certify that I am a recipient of the Medicaid.Title XIX program,and request that payment of authorized benefits be made
on my behalf. I authorize you to make available to the Florida Division of Family Services any requested information con-
cerning medical• insurance, and financial records relating to my treatment. 1 hereby certify all health insurance shall be
assigned to you for services provided.
INSURANCE ASSIGNMENT:
I hereby assign insurance benefits on all insurance policies otherwise payable to me for this treatment I authorize you to
submit insurance claims to insurance companies and to apply insurance proceeds to my bill and to make refunds to insurance
companies if refunds are due,under the provision of such insurance policies.
Advanced Data Processing, Inc.
Scope of Services
HCFA form
Note: Patient data obscured to protect confidentiality.
PLEASE AMFRTCAN I.NS
DO
TTAPOLE 1235 CORM.._ WAY
IN THIS „UITE #102
AREA MIAMI, FI- 33145 i
U
r-M
PICA HEALTH INSURANCE CLAIM FORM PICA
1. MEDICARE MEDICAID CHAMPUS CHAMPVA GROUP FECA OTHER IS.INSUREDS I.D.NUMBER (FOR PROGRAM IN ITEM 1)
HEALTH PLAN BLK LUNG
(MedweM) (Maa'kaMM1 (Sponear'eSSNJ (VA Fag. (S,WwID) E71 (SSN) (IDS 589. )
2.PATIENTS NAME(Last Name,Finn Name,Midtlb Inaw) 3.PATIENT'S BIRTH DATE SEX 11 {.INSUREDS NAME(Last tlMrle,FM Namq Mlddb mmm)
2nd PER_ U5� 00 9 /1 M F F PER.
FOLD 5.PATIENT'S ADDRESS(No.,S"60 8.PATIENT RELATIONSHIP TO INSURED 7.INSUREDS ADDRESS(NO.,S"W) -.
14. . SW . _ sou g s-El CnwE an«0 1.4 SW 6 ST #L
CITY STATE S.PATIENT STATUS CITY STATE
MIAMI FL sln9wi� MaMedo -0 MIAMI FL F
ZIP CODE TELEPHONE Unduda Area Co* ZIP CODE TELEPHONE(INCLUDE AREA CODE)
33135 (30-) 285- EmpfryW FVIITYM Part•ne» 33135 (305) 2 -
SalOeM � Sttldere LL
9.OTHER INSURED'S NAME(Lae Name.Fart Name,Meddle Initial) 10.IS PATIENTS CONDITION RELATED TO: 11.INSUREDS POLICY GROUP OR FECA NUMBER Z
POL#9 509 4 - o
W '
a.OTHER INSUREDS POLICY OR GROUP NUMBER e.EMPLOYMENT?(CURRENT OR PREVIOUS) a.INSUREDS DATE OF BIRTH SEX cc
YES )END V:7 DLO /1 MEl, F❑ Z
a.OTHER INSURED'S DATE Of BIRTH SEX 0.AUTO ACCIDENT? PLACE(St") 0.EMPLOYER'S NAME OR SCHOOL NAME e
MM OD YY
M F DYES ONO I I 2
Q
a EMPLOYER'S NAME OR SCHOOL NAME c.OTHER ACCIDENT? a INSURANCE PLAN NAME OR PROGRAM NAME
❑YES ❑NO F
0.INSURANCE PLAN NAME OR PROGRAM NAME 10d.RESERVED FOR LOCAL USE d IS THERE ANOTHER HEALTH BENEFIT PLAN? a
YES NO NYW loam to NO MMON a ftem 9 a-d
RE"BACK OF FORM BEFORE COMPLETING A SIGINP4 n"FORM- 13,INSUREDS OR AUTHOR=PERSONS SIGNATURE I a1m Grew
12.PATIENTS OR AUTHORIZED PERSON'S SIGNATURE IauM=S FIG mease 9f any memcm a-edormaw rwe"Mry prytneradnla11 Ber1MM to 9r w4wo rrd O"iman W&Wier ra
to PmCaM nil dale.I alu WOO haymern of pwammem Wafte1Ner t9 mYso f pb the Palo SmD am"anow m MaeI dMorbad De19M.
bab- SIGNATURE ON FILE W/PROVIDER 3/08/95 SIGNATURE ON FILE W/PROVIDER.
SIGNED DATE SIGNED
•4.l DATE OF�C•URRENT: ILLNESS(IRM ymm)OR 15.IF PATIENT HAS HAD SAME OR SIMILAR ILLNESS. 16.DATES PATIENT UNABLE TO WORK N CURRENTCUP OCATICI
111 "" `+•�' c INJURYANCH PORpto GIVE FIRST DATE MM l OD i YY
PREGN MM I DD i YY MM DD I YY
FOLD I FROM I TO
17.NAME OF REFERRING PHYSICIAN OR OTHER SOURCE 17.I.D.NUMBER OF REFERRING PHYSICIAN i&HOSPITALIZATION DATES RELATED TO CURRENT SERVICES
MM I DO I W MM DD I YY
FROM TO
,S.RESERVED FOR LOCAL USE 20.OUT&DE LAD? $CHARGES
YES NO
21.DIAGNOSIS OR NATURE OF ILLNESS OR INJURY.jRELATE ITEMS 123 OR 4 TO ITEM 24E BY LINE) 22.M ID RESUBM18610N ORIGINAL REP NO
IIAUTO VS AUTO 3 LACF_RATION� C ODE
E
23.PRIOR AUTHORIZATION NUMBER
2.1-.- 4.
24. A B C D E F G H I J K Z
FrDATE(S)OF SERVIC o Place Type PROCEDURES.SERVICES.OR SUPPLIES D�I,gS1$ RESERVED FOR O
MM OD YY MM OD V1' of d C E-Cnn Unuawl CIwmsamm CODE $CHARGES I MODIFIERUNITS F." E110 COB LOCAL USE Q
2
03I 08 I9S 0.1� 08I951 41 I A0322. SH E812 155b0 1 0
i ; z
2 03 03 95 103 08.,951 41 I A0380 SHj E R12 toss 1. W '
I J
j a
a
' I �
I �
I ! 4
5 to
Y
_ LL
S 25.FEDERAL TAX I.D.NUMBER SSN EN 2B.PATIENTS ACCOUNT NO. 27. PT ASSIGNMENTS 28.TOTAL CHARGE 2&AMOUNT PND 30.BALANCE DUE
8 596000:i75 1:4__ =01 YYES���i+o ) s 16580 $ 1, 0 s ih5: 80
4 31.SIGNATURE OF PHYSICIAN OR SUPPLIER 32.NAME AND ADDRESS OF FACILITY WHERE SERVICES WERE 33.PHYSICI W'S.SUPPLIER'S WILLING NAME•ADDRESS,ZIP CODE
tjcom?vratn@sta DEGREES
wVw1�.s J �tK1°`"F�I 1A�0e)HOSPITAL. C:�Ri 6bF FIRE RF-SCUE
Apply to to bill and we made a pan mereot.) 1611 NW 12 AVE, MIAMI FL DEPT 7533 •
CITY OF FIRE R1 FI- 33 1 95-7 5 33
6/08/95 •j0 5-5 1C)2
C; SIGNED DATE PING GRqA4•P
d' (APPROVED BY AMA COUNCIL ON MEDICAL SERVICE 8/88) PLEASE PRINT OR TYPE APPROVED OMS-0938.0009 FORM HCFA-151X1(12-90). FORM RRS-1500,
APPROVED OMB-121S-0=FORM OWCP'1500. APPROVED OM&0720.OW1(CHAMPUS)
Advanced Data Processing, Inc.
Scope of Services - 12 -
Collection Process
• 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 correspondences are made as representatives of your county.
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 re-billed up to six (6) times. Other cycles handle rebilling
of carriers and billing of secondary/tertiary payors. Medicare, Medicaid and private
insurance are billed immediately and given 45-60 days to pay before rebilling.
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. Insurance denials for reasons other than
those that can be resolved are converted to self or patient pay and begin regular cycle
billing. System checkpoints trap bills that would be in jeopardy of expiration due to
insurance filing limitations.
Secondary payors - All other payors, secondary 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.
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 allowable charge by Law) will require the
authorization of your County. Forms required for submission of claims and other forms
occasionally required by carriers and other payors will be completed and filed by us on
behalf of City of Dania Beach. 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 allows 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.
Advanced Data Processing, Inc.
Scope of Services - 13 -
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.
Account retention - We currently retain accounts for 12 months for all of the clients
we serve. We do this because we have proven that our system will find insurance
information on patients up to the 11th month for some insurance 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 alternate
Billing and A/R companies. In fact, many of our clients that use collection agencies have.
found that their collection company complains of having next-to-nothing to collect after
we're done processing the accounts.
Incurred Costs & Supplies — No incidental costs are hidden in our service 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 county may employ in special fashion. While we charge nothing
extra for.including these in our mailing, the county must provide the printed materials,
they require.
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 that a hardship exists. Such cases are submitted to EMS in
• writing for final resolution along with appropriate documentation (i.e. hospital
credit status, credit file information, activity file). Only upon instruction from EMS
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.
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.
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 county's responsibility).
The bank then receives all payments and processes them daily, directly providing
deposits to your account. Records of all payments or deposits are provided directly to
the county. Using this method, we do not directly handle any receivables. Only the
Explanation of Benefits (EOB) and copies of checks or 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.
Credit Card processing — We will facilitate acceptance of payment from patients via
major credit cards. We will not charge any additional fees for this processing, however,
• the county must absorb any fees incurred directly from the Credit Card companies.
Advanced Data Processing, Inc.
Scope of Services - 14 -
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 (i.e. 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. A specialist who, through either database searching and/or contact of
the original payor, obtains the necessary identification to properly post the item(s) marks
these items for research. 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.
Rebilling and payment arrangements - Rebilling will be performed for accounts
where partial payments are made or accounts where 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 secondary, refiling and
invoicing or rebilling customers.
Refunds and returned checks - Refunds are generally processed on a monthly
basis. Refund requests are presented to the county in a report format with supporting
documentation provided. Checks returned as NSF can be processed in a manner
determined by the county. 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.
Professional Billing/Accounting Procedures
Advanced Data Processing began as a provider of data processing based accounting
services as the founder and the current CEO and President 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.
It is worth noting here that we are one of very few companies that report collection
statistics in a "correct" manner. That is, we report receivables collected against the
month.within which the charge was originally billed. This is the only way to produce
p actual collection percentages. Other companies attempt to mask their performance by
Advanced Data Processing, Inc.
Scope of Services - 15 -
using what might seem to be simpler methods but, do not tell the truth about their
collections.
Because we have focused on performing billing and A/R Management for cities/counties,
we are quite 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.
Customer Communications
Phone service-Our collection ability is dependent on availability. Consequently, we
provide toll-free "800" numbers to our clients for both patient calling and calls from the
county personnel to us. We provide rotary capability to available lines using T1/PBX
technology giving improved call response and availability. Phone lines specific to
your customer requirements are allocated with the number clearly provided on all bills,
invoices and correspondence. The City/County transporting and caller ID are
automatically displayed to the answering customer service agent.
We absorb all phone costs as part of the basic service we provide.
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 and a local exchange/area code. Facilities and
attendants are provided to ensure calls are not blocked. Someone is available to answer
calls Monday thru Friday (excluding Holidays) from 8:30 a.m. to 5:00 p.m. Statistics on
phone activity are reviewed monthly to ensure proper level of phone availability is
maintained. Note: We reserve the right to adjust the calling times to accommodate
changes in business requirements or special considerations.
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 county and never 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.
Training & Continuing Education
Client Training - Using some of the finest multi-media tools to bring training
assistance to the EMS administration and staff, we provide education aids and
assistance in the essentials of providing key patient information (demographic, insurance
and medical) and proper billing-related documentation in the successful billing process.
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 customer service
telephone skills providing 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 calls in languages other than English. Our exceptional reporting system allows us
Advanced Data Processing, Inc.
Scope of Services - 16 -
to view the work completed by an individual for a given day. This also allows the
supervisor to review the work (specific accounts) on which an operator has worked. This
assists in training and on-going quality improvement.
Remote Communications
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 FTP/Internet Site maintained for us under
arrangement. We provide you a username and password for access and you can
deposit your information any time convenient to you.
Technical Data Format —We have provided this type service for a number of clients
supporting various data formats for their respective systems. We can coordinate with
your systems people for support of any format they might require or provide a sample of
formats we already support.
•
Advanced Data Processing, Inc.
Scope of Services - 17 -
ADVANCED
DATA PROCESSING, INC.
•
PROPOSAL FOR
EMS BILLING& A/R MANAGEMENT SERVICES
CITY 0""' F
=� r'a
'L IA EA" m n
DAN
-... .. - -
ATTENTION:
City of Dania Beach
Capt. Bruce Caruso, EMS Coord.
115 W. Dania Bch Blvd
Dania Beach FL 33004
PROPOSALFROM
Advanced Data Processing, Inc.
520 NW 165' Street, Suite 201
Miami, Florida 33169
800.226.1149 305.945.6692 FAX
Contact/Firm Liaison
Donald V. Passaro, Vice President
March 6,2003
�Il Jllll�
0 ADVANCED
DATA PROCESSING, INC.
March 3, 2003
City of Dania Beach
Capt. Bruce Caruso, EMS Coord.
115 W. Dania Bch Blvd
Dania Beach FL 33004
re: Response to Requirements for Emergency Medical Services Billing &A/R
Management
Dear Purchasing Director and Selection Committee:
Enclosed is Advanced Data Processing, Inc.'s proposal in response to your
requirements for"EMS Billing and A/R Management Services ". We appreciate the
opportunity to continue to meet your needs. We believe this response answers all
• requirements. Our solution provides you the finest available billing and collection
services for a county EMS organization such as those required by City of Dania
Beach. The content of this Proposal may be incorporated, in whole or part, into a written
contract for such services.
Advanced Data Processing has proudly served the Southeast with dedication and
excellence for over two decades. We have enjoyed healthy business growth and
long-term client relationships. We now serve 43 communities with a combined
population of over 8 million residents and a total of over half a million transports we bill
for per year. And, we have served Dania Beach since June of 1999 with excellence.
At Advanced Data Processing we do one thing ...we provide superior EMS billing
and collection services you can count on. We strive to provide the best client
service, collection experience, and patient support all with flawless compliance in
meeting healthcare regulations. Our size and specialization in EMS billing allows us to
make focused investments in technology, people and process that will greatly benefit our
clients.
We are committed to increasing collections, service levels, and compliance for our
clients.
We are pleased and fortunate to have an excellent team at Advanced Data Processing
that is dedicated and committed to client service. We are confident that you will find our
proposal properly meets your requirements and positions City of Dania Beach with the
best service and value.
Respectfully submitted,
Vice ?resident
Don Passaro
•
ADVANCED
DATA PROCESSING, INC.
, o e •
Introduction and Executive Overview
Section 1. Qualifications & Experience
History & Background
Organization & Personnel
References
Section 2. Scope of Services
Requested Services
Advanced Data Processing's Services
Collection Philosophy
Processing New Transports
Collection Process
Customer Communication
iSection 3. Reports & Technical Information
Reports
Computer System Information
Section 4. Compliance & Quality
Compliance Program
HIPAA Compliance
Section 5. Fees & Affidavits
Fee Proposal
General Proposal Statements
•
ADVANCED
DATA PROCESSING, INC.
Enclosed is Advanced Data Processing Inc.'s response to your requirements for "EMS
Billing and A/R Management". We appreciate the opportunity to respond to your
needs. This section provides an overview of our proposal.
Experience
Our company, Advanced Data Processing, with two decades serving EMS clients, has
demonstrated its exclusive commitment to providing such service at the county level. We
have expanded our operations; now serving 43 cities/counties. We are currently billing
for approximately 500,000 EMS patient accounts annually, consisting of many
clients exceeding 10,000 annual transports and a large number of clients with
transports exceeding 30,000 annual transports per year. This demonstrates our
ability to successfully handle the size of account City of Dania Beach is offering.
Considerable experience and history has been focused exclusively on EMS Billing and
Collections for city and county rescue organizations. In many cases, specialized
solutions have been constructed to unique county requirements.
• Mission
Advanced Data Processing's mission is to create increasing value to our customers and
in their business through the use of the best possible technology, well-trained personnel,
efficient medical billing processes while presenting our passion to serve customers'
needs.
Keys to Success
Two fundamental objectives to meeting our client's needs are:
1. Timely capture and correctly bill for all services. and
2. Employ proper follow up tactics realizing the cash potential from these claims.
We strive to follow six key strategies to successfully meet our objectives. They are:
•
Advanced Data Processing, Inc.
Introduction _ i _
• Submit clean claims
• File claims in a timely manner to the proper payers
• Define and control effective exception processing techniques
Understand client dynamics and needs
• Manage people effectively resulting in successful task
completion
• Use technology to eliminate human intervention in
transaction processing.
These strategies will drive quality, competitiveness, our client satisfaction and client
retention.
Advanced Technology
We use key technologies to continually improve our processes, such as:
ACD and PBX communications software to allow our customer
service personnel to more efficiently handle the considerable
volume of patient�calls in a courteous and effective manner.
Web-based hosting and FTP capabilities to facilitate patient-
provided insurance information via the internet, client transfer of
runsheet data and, access to e-version monthly reports and refund
data to help automate the refund process for finance organizations.
> Substantial investment in imaging systems with on-line optical
storage meeting legal records management requirements for
maintaining copies of transport run-sheets and receivables
(EOBs). At no increase in cost to our clients, we have nearly
eliminated their labor costs for often required additional copies of
runsheets.
High-capacity T1 digital communications to provide dedicated
toll-free and local-area calling for client's patients.
Continually enhanced proprietary, in-house developed, core
software platform running on a "tried and proven," IBM AS/400
environment thereby controlling our own destiny and improving our
operational process.
Provide Software-based mobile solutions for integration of Field
Operations with the billing and dispatch operations
Advanced Data Processing, Inc.
Introduction - 2 -
Process
Advanced Data Processing's process is demonstrated as the most
• successful in the business through its customer satisfaction and delivery in
terms of both quality and level of service. Our quality of service is exemplified in
our billing forms and reports, the methods we employ, and the way in which our
personnel conduct themselves on behalf of our clients, your county. In addition,
we demonstrate "going-the-extra-mile" with our double-verification of patient
information through our hospital liaison programs, sending trained people to
obtain updated and validated insurance information from hospitals. And, our
customized training provides our clients key understanding of how to improve
their field data. Our level of service is superior in collection levels both as a
percentage of billing and in the cash flow we have produced for our clients.
Personnel & Experience
Advanced Data Processing's key personnel represent a significant
experience base; our senior management team has over 40 years combined
experience in Medical and EMS billing. Supervisory personnel have over 10
years in the field and since we have been in business over 20 years, we have _-
retained many data entry and billing personnel resulting in over 10 years
experience.
Billing System Integration
Since Advanced Data Processing has based its core process on proprietary, in-
house software, we develop custom interfaces to handle the extract of billing-
related data from other vendors' field data reporting systems. We have
developed such interfaces for our clients for a number of vendors' systems.
Compliance & Commitment
In selecting the right vendor for your EMS billing and A/R Management, the most
important issues come to the forefront ... compliance and commitment.
Advanced Data Processing continues to put significant resources into
establishing and maintaining a corporate compliance program including
involving a renowned legal counsel in writing the "Compliance Guide for Third-
Party Billing Companies" for the Office of the Inspector General. In addition, we
have recently retained a legal counsel with renowned specialists in ambulance
transportation law and regulatory issues. We have also enclosed a sample of our
newsletter "The EMS Informant" demonstrating just one aspect of how our
compliance program communicates important compliance information to our
clients. We recently sponsored a HIPAA seminar put on by Page, Wolfberg and
Wirth, a leading legal attorney specialized in Emergency Medical Services, for all
our clients. This is just one more example of how we communicate important
information and our commitment to our clients.
Fees Proposed
We believe this proposal response answers all requirements with an offer to
provide City of Dania Beach the finest, most reliable, credible, and
® responsible billing and collection services available.
Advanced Data Processing, Inc.
Introduction _ 3 _
Advanced Data Processing has proposed to City of Dania Beach a superior
set of services to meet their needs, and... we offer them at an extremely
competitive price.
We offer the following for services and options requested by the County for
the following price:
For all Billing and A/R Management Services (without Field Data System)
of collections computed by incident month.
Price includes all postage, invoices, billing forms, envelopes. reports
Plus, Optional service:
--. — for maiiing of County's Privacy Notice to each patient to comply
with new HIPAA reguiations.
We believe this indicates both an aggressive desire to win the county's business
balanced with a fair appraisal and assessment for a job to be well done. As such we
appreciate the opportunity to provide you services with which you will be more-than-
satisfied.
Advanced Data Processing, Inc.
Introduction - 4 -
SeSe ecirvwerVle
Experience & Proven Track Record
Over two decades serving cities and counties in the Southeast
' Specific focus on only EMS Billing and A/R Management for cities/counties,
' Provide demonstrably superior level of service & collections,
Currently billing/collecting for 43 cities/counties
Affirmative Action Employer providing job opportunities for over 100 people
in the Southeast.
Now billing over 500,000, transports annually,
' Excellent client retention and satisfaction.
Demonstrated Superior Philosophy
Timely capture and correct billing for all services with proper follow-up
through:
' Clean & timely claims,
Filing to proper payers using electronic submission where possible,
• Effective exception processing techniques,
' Understanding customer dynamics & requirements,
' Effective people and task management,
Use of advanced technology eliminating human intervention in transaction
processing,
"Going-the-extra-mile" through our hospital liaison programs and our double-
verification of patient information.
Resulting in:
' Greater service satisfaction and customer retention,
' Greatest collections within compliance limits in both percentage of billing and
cash flow,
Measurable & repeatable collection performance,
Superior quality of service shown in methods employed, billing forms, reports
produced, and personnel conduct on behalf of our clients.
Advanced Data Processing, Inc.
Introduction - 5 -
Advanced Technology
Increased commitment through continued investment in technology and expertise
especially in the following areas:
Use of IBM AS/400 System "tried-and-proven" methods and technology,
' Proprietary systems software & development,
' Networked-PC environment linked to AS/400 Back-end, Internet & other on-line
facilities,
' Expansive Nortel PBX with AutoCall Distribution (ACD) technology for most-
efficient handling of patient calls,
' T1 high-speed digital communications,
' On-line access to participating hospital facilities with executed and
maintained confidentiality agreements
Toil-free (800) numbers dedicated to client's patient calls,
' Web-based Internet access (www.emsclaims.com) for patient to provide
insurance info,
Web-based FTP site for secure transfer and exchange of electronic transports
data, end-of-month reports, and refund data
' Optical-based imaging system for maintaining up to 500GB or several years of
on-line run sheet & receivables images,
' High-speed faxes and fax server systems,
3 Maintain reserve capacity in our systems, facilities and people to handle new
clients without disruption to operations
Industry Knowledge & Compliance
Providing "rock-solid" stability and assurance through:
' Staying abreast of and informing our clients on changes in insurance
processing and health care regulations,
' HIPAA- compliant security consciousness with security-monitored access and
high volume shredding of discarded HRS forms, Run Reports and Patient
Data, and maintained Business Associate Agreements
' Membership in American Ambulance Association & Healthcare Business
Management Association (HBMA),
' Attendance of all major Medicare & Medicaid seminars for Ambulance
Transportation Billing,
Advanced Data Processing, Inc.
Introduction - g -
' Retention of one of industry's most reputable legal consultants to develop
full-compliance program,
' Retention of legal compliance counsel Page, Wolfberg & Wirth, LLC.
ambulance transportation specialists for on-going advisement,
' Support for Electronic Funds Transfer, Claims Status & Remittance
Notification, Hospital Database & Insurance Verification Access.
Client Communications & Training
' Produced and hosted off-site seminars for updating clients on Fee Schedule
changes, implementation/compliance considerations, and HIPAA issues at
no cost to clients
' Developed specialized in-house and client training for compliance
' Produced industry-focused newsletter for assisting our clients in maintaining
compliance
Pricing
' Superior services offered at an extremely competitive price.
Advanced Data Processing, Inc.
Introduction - 7 -
® -CONTRACT BETWEEN
HALLANDALE BEACH
AND
ADVANCED DATA PROCESSING. INC.
FOR RESCUE AMBULANCE BILLING & RELATED PROFEjSIONAL SERVICES.
THIS AGREEMENT, hereinafter"AGREEMENT", made and entered into this 1 day of
September 2002 by and between HALLANDALE BEACH, a political
subdivision of the State of Florida, with principal offices located ai 400 South Federal
Highway, Hallandale Beach, FL 33009, hereinafter referred to as the "CITY', and
Advanced Data Processing, Inc., a Florida Corporation with principal offices located at
520 NW 165 Street, Suite 201, Miami, Flo1 ida 33159 y,
, I lereil lal W r elel 1 Cd to as U 1C
"CONTRACTOR".
WIT NESSE T H:
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 PIa10JEV I. The objeCuve of the project Is to utilize the
services of the CONTRACTOR to provide the CITY 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 'CITY OF HALLANDALE BEACH' or via "Locked-
Box'facility as directed by the CITY.
3. TIME OF PERFORMANCE. This Contract shall be effective for a three-year period
fromOctober 1, 2002 through September 30, 2VV5, ullder the t2 rms and conditions
s
contained herein unless otherwise terminated. The CITY 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.
A. f%^ILASAT1 1N AND METHOD OF PAYMEN T. The CI i( reserves the right to
request changes in the services within the general scope of the Contract to be
performed upon mutual agreement by the CITY and CONTRACTOR which shall specify
le change VI dCl CU QI IIU t1 le adjustment UI Lirl a al IU l,.ompel satiol l r equir eU tl ler efor e.
. 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
aaC;ili0r,a1 Gull Pal�satiion or a'AA6nlsio r, jai t1111C 511 Cal ii b8 rcivgl 11L6U -i1 Mess c:0i Bali led 111 i ie
dju y executed crier lge order.
.-
Mt�tCClf:e:lt ^c7tyC I Ui 0
The CONTRACTOR shall provide to the CITY 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),
Section 4 Paragraph 3, CONTRACTOR will include in the same invoice an amount of
$11.40 per Medicaid account for providing all billing services related to such accounts
paid in the previous month. The CITY shall issue a check for the amount invoiced, minus
any disputed amount, within thirty (30) days of receipt and acceptance of the invoice.
The CITY shall bear the cost of any and all Lock-box services. CONTRACTOR shall
provide to the CITY monthly an amount of two hundred ($200.00) dollars towards the
CITY's banking and administrative costs in the form of a discount against
CONTRACTOR' monthly fees as stated above.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 CITY 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 CITY. The CITY 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 CITY will not be disclosed to any party
without the CITY's prior approval.
7. INDEPENDENT CONTRACTORS. The CONTRACTOR is an independent contractor
and not an employee or agent of the CITY with the following exception:
To the extent necessary to fulfill its billing and collection efforts
under the Agreement, the CONTRACTOR is authorized to sign for the
CITY in an administrative capacity only 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 CITY; and insurance filings and
related forms. The CONTRACTOR has -no authority to sign any
document that imposes any liability on the CITY.
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
responsible for its own acts and those of its agents and employees during the term of
this contract.
8. INDEIVINIFICAT;ON. The CONTRACTOR shall indemnify, hold harmless and
save the CITY from any and all claims, losses, liabilities and causes of actions which
may arise out of the performance of this Agreement as a result of an awl of negligence or
Agreernerit Page 2 of 6
willful misconduct of the CONTRACTOR, its subcontractors, or agents. The
CONTRACTOR shall pay all claims and losses of any nature whatsoever in connection
therewith and shall pay all costs and judgments which may issue thereon, including, but
not limited to, attorneys'fee and expenses.
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 CITY's rights and immunities under the common law or Section
768.28, Florida Statutes, 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 CITY OFHALLANDALE
BEACH 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 CITY by certified mail. Prior to
commencing work, the CONTRACTOR shall provide CITY 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.
-.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 specked form. The CONTRACTOR agrees that any and all
documents, records, disks, and electronic data produced in the performance of this
Agreement shalt be the sole property of the CITY, including all rights therein of whatever
kind except as may otherwise be provided hereinafter.
Agreement Page 3 of 6
11. ATTACHMENTS. The following named attachments are made an integral part of
this Agreement:
A. Proposal presented to CITY OF HALLANDALE BEACH by Advanced Data
Processing dated August 4, 1999 (Exhibit A attached hereto and made a part
hereof)
B. Scope of Work (Exhibit A attached hereto and made a part hereof)
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. The CITY may terminate this Agreement at any time
and for any cause, but not limited to, default by the CONTRACTOR or for circumstances
beyond the control of the CONTRACTOR, upon written notice to the CONTRACTOR.
Upon termination, the CONTRACTOR shall submit an invoice to the CITY in an amount
that represents the fees for services actually performed or obligations incurred for which
the CONTRACTOR has not been previously compensated to the date of effective
termination. Upon payment of the sum found due, the CITY shall be under no further
obligation to the'CONTRACTOR, financial or otherwise.
13. UNCONTROLLABLE FORCES. Neither the CITY 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,
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.
s
Agreement Page 4 of 6
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 Broward County, Florida which shall be deemed proper
jurisdiction and venue for the action.
15. MOST FAVORED CUSTOMER. The CONTRACTOR agrees to extend to the CITY
the most favorable terms extended to any similar customer or client Similar client shall
mean another city, within Broward County, having a population less than 80,000. The
CONTRACTOR shall be responsible for notifying the CITY of any such changes and
providing the option to accept such favorable terms. The CITY shall exercise its Oght.to
such option by either amending or revising this Agreement by mutual consent and
notifying the CONTRACTOR of.such amendment or revision to the Agreement
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 consent by the CITY.
17. NOTICES. Delivered or mailed to such party at their respective addresses as
follows:
To the CITY:
Mark Antonio, Assistant City Manager
• Hallandale Beach
400 South Federal Highway
Hallandale Beach, FL 33009
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.
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.
Agreement Page 5 of 6
IN WITNESS OF THE FOREGOING, the City has caused this Agreement to be
signed by the City Manager, attested by the City Clerk with the corporate seal of the City
of Hallandale Beach, and the Contractor and Administrator have executed this
Agreement effective as of the date set forth above.
CONTRACTOR: CRY:
Aqvanceed Data P cessing. C. City of Hallandale Beach,
a Florida Municipal Co oration
By:
PAUL RANZELAS By:
VICE PRESIDENT Charity Pape
INTERIM CITY MANAGER
Approved as to F nn and Sufficiency
By:
Mark Goldstein
City Attorney
ATTEST:
L:
CITY cL
Agreement Page 6 of 6