HomeMy WebLinkAboutSystems Design West LLC - Ambulance Billing ServicesSERVICES AGREEMENT
AMBULANCE BILLING SERVICES
THIS AGREEMENT is made and entered into between the City of Pasco, a Washington
Municipal Corporation, hereinafter referred to as "City", and Systems Design West LLC,
hereinafter referred to as "Vendor" on the 2'? day o - 40,Pvj+al.% _, 201 Zo,
RF.CITAI.S
WHEREAS, the City desires to have certain services and/or tasks performed as set forth
below requiring specialized skills, training, equipment, and other supportive capabilities; and
WHEREAS, the Vendor represents that it is qualified and possesses sufficient skills,
experience, equipment, and necessary capabilities, including technical and professional expertise,
when required, to perform the services and/or tasks as set forth in this Agreement upon which the
City is relying.
NOW, THEREFORE, in consideration of the mutual covenants, and performances
contained herein, the parties agree as follows:
1. Scone of Services. The Vendor shall perform such services and accomplish such tasks,
including the furnishing of all labor, materials, facilities and equipment necessary for full
performance thereof, as identified and designated as Vendor's Responsibilities throughout
this Agreement, and as more particularly described in Scope of Work detailed in Exhibit
A, attached hereto and incorporated herein (the "Project"). Along with EMS Billing and
Collections Procedure in Exhibit B.
2. Term. This Project shall begin on the execution date listed above and will continue for
three (3) years with an option to extend for an additional year.
3. Compensation and Payment.
3.1 Payment for services provided hereunder shall be made following the performance
of such services. Such payment shall be full compensation for work performed or
services rendered, and for all labor, materials, supplies, equipment, and incidentals
necessary to complete the Project.
3.2 No payment shall be made for any services rendered by the Vendor except for
services identified and set forth in this Agreement except as may be authorized by
a written supplemental agreement approved by the City.
3.3 The City shall pay the Vendor for work performed under this Agreement upon
timely submitted invoices detailing work performed and expenses for which
reimbursement is sought. The City shall approve all invoices before payment is
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issued. Payment shall occur within thirty (30) days of receipt and approval of an
invoice.
3.4 The City shall pay the Vendor for all work performed and expenses incurred under
this Agreement, as follows.
® Other: $22.00 per billable claim plus actual postage for statements and
invoices sent on behalf of the City.
4. Reports and inspections.
4.1 The Vendor at such times and in such forms as the City may require, shall furnish
to the City such statements, records, studies, surveys, reports, data, and information
as the City may request pertaining to matters covered by this Agreement.
4.2 The Vendor shall, at any time during normal business hours and as often as the
City, the Washington State Auditor or Centers for Medicare and Medicaid Services
(CMS) may reasonably deem necessary, make available for examination all of its
records and data with respect to all matters covered, directly or indirectly, by this
Agreement and shall permit the City, or its designated authorized representative to
audit and inspect other data relating to all matters covered by this Agreement. The
City shall receive a copy of all audit reports made by the agency or firm as to the
Vendor's activities. The City may, at its discretion, conduct an audit at its expense,
using its own or outside auditors, of the Vendor's activities, which relate, directly
or indirectly, to this Agreement. Vendor shall be provided a copy of such reports.
4.3 The Vendor, during the term of this Agreement, shall obtain all permits and
registration documents necessary for the performance of its work and for the
execution of services at its own expense, and shall maintain its validity. Upon
request, the Vendor shall deliver to the City copies of these licenses, registration
documents, and permits or proof of their issuance or renewal.
4.4 Vendor shall maintain books, records and documents, which sufficiently and
properly reflect all direct and indirect costs related to the performance of this
Agreement, and shall maintain such accounting procedures and practices as may be
necessary to assure proper accounting of all funds paid pursuant to this Agreement.
These records shall be subject, at all reasonable times, to inspection, review, or
audit as provided above.
4.5 The Vendor shall retain all books, records, documents or other material relevant to
this Agreement for as per applicable State and Federal record retention requirement.
Vendor agrees that the City, or its designee, shall have full access and right to
examine any of said materials at all reasonable times during this period.
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Ownership and Use of Documents.
5.1 All research, tests, surveys, preliminary data, information, drawings and documents
made, collected, or prepared by the Vendor for performing the services subject to
this Agreement, as well as any final product, collectively referred to as "work
product," shall be deemed as the exclusive property of the City, including copyright
as secured thereon. Vendor may not use them except in connection with the
performance of the services under this Agreement or with the prior written consent
of the City. Any prior copyrighted materials owned by the Vendor and utilized in
the performance of the services under this Agreement, or embedded in with the
materials, products and services provided thereunder, shall remain the property of
the Vendor subject to a license granted to the City for their continued use of the
products and services provided under this Agreement. Any work product used by
the Vendor in the performance of these services which it deems as "confidential,"
"proprietary," or a "trade secret" shall be conspicuously designated as such.
5.2 In the event of Vendor's default, or in the event that this Agreement is terminated
prior to its completion, the work product of the Vendor, along with a summary of
the services performed to date of default or termination, shall become the property
of the City, and tender of the work product and summary shall be a prerequisite to
final payment under this Agreement. The summary of services provided shall be
prepared at no additional cost, if the Agreement is terminated through default by
the Vendor. If the Agreement is terminated through convenience by the City, the
City agrees to pay Vendor for the preparation of the summary of services provided.
6. Public Records.
6.1 Vendor acknowledges that the City is an agency subject to Chapter 42.56 RCW
"Public Records Act." All preliminary drafts or notes prepared or gathered by the
Vendor, and recommendations of the Vendor are exempt prior to the acceptance by
the City or public citation by the City in connection with City action.
6.2 If the Vendor becomes a custodian of public records of the City and request for
such records is received by the City, the Vendor shall respond to the request by the
City for such records within five (5) business days by either providing the records,
or by identifying in writing the additional time necessary to provide the records
with a description of the reasons why additional time is needed. Such additional
time shall not exceed twenty (20) business days unless extraordinary good cause is
shown.
6.3 In the event the City receives a public records request for protected work product
of the Vendor within its possession, the City shall, prior to the release of any
protected work product or as a result of a public records request or subpoena,
provide Vendor at least ten (10) business days prior written notice of the pending
release and to reasonably cooperate with any legal action which may be initiated
by the Vendor to enjoin or otherwise prevent such release.
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7. Independent Contractor Relationship.
7.1 The parties intend that an independent contractor relationship is created by this
Agreement. The City is interested primarily in the results to be achieved; subject
to the scope of services and the specific requirements of this Agreement, the
implementation of services will lie solely with the discretion of the Vendor. No
agent, employee, officer or representative of the Vendor shall be deemed to be an
employee, agent, officer, or representative of the City for any purpose, and the
employees of the Vendor are not entitled to any of the benefits or privileges the
City provides for its employees. The Vendor will be solely and entirely responsible
for its acts and for the acts of its agents, employees, officers, subcontractors or
representatives during the performance of this Agreement.
7.2 In the performance of the services provided in this Agreement, Vendor is an
independent contractor with full authority to control and direct the performance of
the details of the work, however, the results of the work contemplated herein must
meet the approval of the City and shall be subject to the City's general rights of
inspection and review to secure the satisfactory completion thereof.
7.3 The Vendor shall comply with all State and Federal laws including, but not limited
to:
7.3.1 The definition requirements of RCW 50.04.140 (Employment Security).
7.3.2 RCW 51.08.195 (Industrial Insurance).
7.3.3 Obtain a City of Pasco business license.
7.4 The City may, at its sole discretion, require the Vendor to remove any employee,
agent or servant from employment on this Project who, in the City's sole discretion,
may be detrimental to the City's interest.
8. Indemnification.
8.1 Each party shall defend, indemnify, and hold harmless the other party, its officers,
officials, agents, employees, and volunteers from any and all claims and causes of
action, including, but not limited to, actions of law or administrative proceedings
for all injuries to persons or damages to property, and all losses, damages, demands,
suits, judgments, including attorney fees, arising out of, or as a result of, or in
connection with the work performed under this Agreement, and caused or
occasioned in whole or in part by reason of errors, negligent acts or omissions of
each party or its subcontractors in the performance of this Agreement, except for
injuries and damages caused by the sole negligence of each party, its officers,
employees, agents, and volunteers.
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8.2 Should a Court of competent jurisdiction determine that this Agreement is subject
to RCW 4.24.115, then, in the event of liability for damages arising out of bodily
injuries or damages to property caused by or resulting from the concurrent
negligence of the Vendor, and the City, its officers, employees, agents and
volunteers, each party's liability and obligation to defend hereunder shall only be
the proportionate extent of their negligence.
8.3 It is further agreed that the indemnification provided herein constitutes the
Vendor's waiver of immunity under Industrial Insurance, Title 51 RCW, solely for
the purposes of this indemnification.
8.4 No liability shall attach to the City by reason of entering into this Agreement except
as expressly provided herein.
8.5 This indemnification shall include damages, penalties and attorney fees sustained
as a result of Vendor's delayed or failed performance of Section 6 above.
8.6 Notwithstanding Section 8.1 above, the Vendor shall be liable for all audit -related
damages occurring as a consequence of Vendor's inaccurate, incomplete, or
improper billing procedures or actions. Vendor shall not be liable for any audit -
related damages occurring as a consequence of improper documentation by the
City.
8.7 This waiver has been mutually negotiated by the parties, and the provisions of this
section shall survive the expiration or termination of this Agreement.
9. Insurance. The Vendor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which may arise
from or in connection with the performance of the work hereunder by the Vendor, its
agents, representatives, employees, or subcontractors.
9.1 Minimum Scope of Insurance. Vendor shall obtain insurance of the types described
below:
9.1.1 Automobile Liability insurance covering all owned, non -owned, hired and
leased vehicles. Coverage shall be written on Insurance Services Office
(ISO) form CA 00 01 or a substitute form providing equivalent liability
coverage. If necessary, the policy shall be endorsed to provide contractual
liability coverage.
9.1.2 Commercial General Liability insurance shall be written on ISO occurrence
form CG 00 01 and shall cover liability arising from premises, operations,
independent contractors and personal injury and advertising injury. The
City shall be named as an insured under the Vendor's Commercial General
Liability insurance policy with respect to the work performed for the City.
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9.1.3 Workers' Compensation coverage as required by the Industrial Insurance
laws of the State of Washington.
9.1.4 Professional Liability insurance appropriate to the Vendor's profession.
9.2 Minimum Amounts of Insurance. Vendor shall maintain the following insurance
limits:
9.2.1 Automobile Liability insurance with a minimum combined single limit for
bodily injury and property damage of $1,000,000 per accident.
9.2.2 Commercial General Liability insurance shall be written with limits no less
than:
❑ $1,000,000 each occurrence;
❑ $2,000,000 general aggregate; or
® $,1,000,000 each occurrence; and $2,000,000 general aggregate
9.2.3 Professional Liability insurance shall be written with limits no less than:
❑ $1,000,000 per claim;
❑ $1,000,000 policy aggregate limit; or
® $1,000,000 per claim; and $1,000,000 per policy aggregate limit
9.3 Other Insurance Provisions. The insurance policies are to contain, or be endorsed
to contain, the following provisions for Automobile Liability, Professional
Liability, and Commercial General Liability insurance:
9.3.1 The Vendor's insurance coverage shall be primary insurance as respects the
City. Any insurance, self-insurance, or insurance pool coverage maintained
by the City shall be excess of the Vendor's insurance and shall not
contribute with it.
9.3.2 The Vendor's insurance shall be endorsed to state that coverage shall not be
cancelled by either party, except after thirty (30) days prior written notice
by certified mail, return receipt requested, has been given to the City.
9.4 Acceptability of Insurers. Insurance is to be placed with insurers with a current
A.M. Best rating of not less than A:VII.
9.5 Verification of Coverage. Vendor shall furnish the City with original certificates
and a copy of the amendatory endorsements, including, but not necessarily limited
to, the additional insured endorsement evidencing the insurance requirements of the
Vendor before commencement of the work.
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10. Nondiscrimination. In the performance of this Agreement, the Vendor will not
discriminate against any employee or applicant for employment on the grounds of race,
creed, color, national origin, sex, marital status, age or the presence of any sensory, mental
or physical handicap; provided that the prohibition against discrimination in employment
because of handicap shall not apply if the particular disability prevents the proper
performance of the particular worker involved. The Vendor shall ensure that applicants
are employed, and that employees are treated during employment in the performance of
this Agreement without discrimination because of their race, creed, color, national origin,
sex, marital status, age or the presence of any sensory, mental or physical handicap.
Vendor shall take such action with respect to this Agreement as may be required to ensure
full compliance with local, State and Federal laws prohibiting discrimination in
employment.
11. Covenant Against Contingent Fees. The Vendor warrants that it has not employed nor
retained any company, firm, or person, other than a bona fide employee working
exclusively for the Vendor, to solicit or secure this Agreement; and that it has not paid or
agreed to pay any company, person or firm, other than a bona fide employee working
exclusively for the Vendor, any fee, commission, percentage, brokerage fee, gift, or other
consideration contingent upon or resulting from the award or making of this Agreement.
For breach or violation of this warranty, the City shall have the right to terminate this
Agreement.
12. Assignment and Subcontracting.
12.1 The City has awarded this Agreement to the Vendor due to its unique qualifications
to perform these services. The Vendor shall not assign (or subcontract other than
as specifically identified in Exhibit A) its performance under this Agreement or any
portions of this Agreement without the prior written consent of the City, which
consent must be sought at least thirty (30) days prior to the date of any proposed
assignment.
12.2 Any work or services assigned or subcontracted hereunder shall be subject to each
provision of this Agreement including Section 6, Public Records; Section 10,
Nondiscrimination; proper bidding procedures where applicable; and all local, State
and Federal statutes, ordinances and guidelines.
12.3 Any technical or professional service subcontract not listed in this Agreement, must
have prior written approval by the City.
13. Termination.
13.1 Termination for Convenience. Either party may terminate this Agreement for any
reason upon giving the other party no less than sixty (60) business day's written
notice in advance of the effective date of such termination. In the event of
termination, the vendor shall perform sixty (60) days of follow-up services on
claims already billed.
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14.
15.
13.2 Termination for Cause. If the Vendor fails to perform in the manner called for in
this Agreement, or if the Vendor fails to comply with any other provisions of this
Agreement and fails to correct such noncompliance within five (5) business days
of written notice thereof, the City may terminate this Agreement for cause.
Termination shall be effected by serving a notice of termination on the Vendor
setting forth the manner in which the Vendor is in default. The Vendor will only
be paid for services and expenses complying with the terms of this Agreement,
incurred prior to termination.
General Provisions.
14.1 For the purpose of this Agreement, time is of the essence.
14.2 Notice. Notice provided for in this Agreement shall be sent by one of the following:
14.2.1 Personal service upon the Project Administrators; or
14.2.2 Certified mail return receipt requested, to the attention of the individual or
person identified below and to the physical address of the parties, to be
deemed served when mailed; or
14.2.3 By electronic transmission to the e-mail addresses designated for the parties
below.
14.3 The Project Administrator for the purpose of this Agreement shall be:
14.3.1 For the City:
14.3.2 For the Vendor:
Disi)ute Resolution.
Robert Gear or his/her designee
Fire Chief, City of Pasco
525 North 3`d Avenue
PO Box 293
Pasco, WA 99301
eg arbgpasco-wa. og_v
Jennifer Braus, or his/her designee
CEO, Systems Design West LLC
PO Box 3510
Silverdale, WA 98383
iennb @,sdwems.cc,
15.1 This Agreement has been and shall be construed as having been made and entered
into and delivered within the State of Washington and it is agreed by each party
hereto that this Agreement shall be governed by the laws of the State of
Washington.
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15.2 In the event of a dispute regarding the enforcement, breach, default, or
interpretation of this Agreement, the Project Administrators, or their designees,
shall first meet in a good faith effort to resolve such dispute. In the event the dispute
cannot be resolved by agreement of the parties, said dispute shall be resolved by
arbitration pursuant to RC W 7.04A, as amended, with both parties waiving the right
of a jury trial upon trial de novo, with venue placed in Pasco, Franklin County,
Washington. The substantially prevailing party shall be entitled to its reasonable
attorney fees and costs as additional award and judgment against the other.
16. Nonwaiver. Waiver by the City of any provision of this Agreement or any time limitation
provided for in this Agreement shall not constitute a waiver of any other similar event or
other provision of this Agreement.
17. Integration. This Agreement between the parties consists in its entirety of this document
and any exhibits, schedules or attachments. Any modification of this Agreement or change
order affecting this Agreement shall be in writing and signed by both parties.
18. Authorization. By signature below, each party warrants that they are authorized and
empowered to execute this Agreement binding the City and the Vendor respectively.
IN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the
date first written above.
CITY OF PASCO, WASHINGTON
ATTEST:
: �)� r" y�1
Debra
Barham, City Clerk
APPROVED AS TO FORM:
Kerr Fe n Law, PLLC, City Attorney
VENDOR
Jenni4rdus, CEO, Systems Design West
LLC
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EXHIBIT A
SCOPE OF SERVICES
1. The Vendor may release information on billing only to the patient, spouses or legal guardian,
the patient's insurer or other interested insurers as may be required for claim processing or
payment, to the City of Pasco as requested, or to another party only as may be allowed in
compliance with State and Federal law.
2. The City agrees to provide a complete and legible "PCR" (Patient Care Report) to the Vendor,
including patient name, address and pertinent billing and insurance information as available from
the field, including a copy of the patient signature when available for authorization of benefits and
responsibility for payment, authorizing billing of Medicare, Medicaid and any insurance the
patient is a subscriber to. The original patient signature must be maintained by the City and made
available to the Vendor and/or insurance payers upon request. The amounts to be billed will be
determined by the City's current municipal code (PMC). The City will notify the Vendor when the
PMC is changed or updated.
3. The Vendor shall provide pre-printed Health Care Financing Administration (HCFA) billing
forms, mailing envelopes, and invoices for use by the City and shall work with the City to develop
or modify forms as needed. The Vendor shall be responsible for maintaining an adequate supply
of forms.
4. The Vendor is responsible for all other labor, materials, except as stated in Section 3.4 of the
Services Agreement for invoices and statements billed on the City's behalf, delivery charges,
software, computer equipment, and telephone costs, supervision, and other incidentals necessary
for the performance under this agreement. The Vendor shall be responsible for keeping accurate
and up-to-date records of all bills, payments, and correspondence related to the billing system. The
City reserves the right, with five (5) working days' notice, to perform an audit of said records at
the Vendor's place of business during normal business hours and may require Vendor's attendance
at certain council meetings.
5. The Vendor shall make reasonable attempt to procure accurate information from the City or
other agencies to ensure timely billing, including, but not limited to, procuring complete face
sheets, performing insurance verifications, etc.
6. The City agrees to generate any refund check due to overpayments identified by the Vendor
directly to the payer to which the refund is due, based on detailed information provided by the
Vendor, which shall include the patient's payment history.
7. The City shall provide additional information as may be required by insurance companies or
other agencies in order to facilitate the Vendor's obligations to the City.
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8. The Vendor shall prepare and mail an original itemized bill for each patient within five (5)
working days of receipt of the complete patient record. Thereafter, an invoice showing at least the
date of service and billing, amount owed, any payment received, and any request for additional
information shall be mailed as required by law.
9. If the patient or other person responsible for the payment of the bill has been deemed delinquent
as per City's codes and State law, the Vendor shall "pull" these accounts and send a list of them
to the City. The list must include the account number, patient name, date/s of service and billing,
any payment received, address, amount owed, specific reason the account is delinquent (i.e.
returned mail, bankruptcy, etc.), as well as, copies of invoices. The City will approve which
accounts will be sent to collections on a monthly basis. Once such approval is received, the Vendor
shall provide this report to the collection agency assigned by the City for collection purposes.
Explanation of delinquency on each account submitted for collection is required.
10. If the initial bill or subsequent invoice is returned as undeliverable by the post office and the
Vendor, after making reasonable attempts to locate the person, is unable to do so, the Vendor shall
pull that account and include it in the collection approval process as mentioned in Section 9.
11. The Vendor will be responsible for dealing with, negotiating with, and handling dispute
resolution, and all appeals with Medicare, Medicaid, and all other insurance payers.
12. The Vendor shall be available at least six hours per day Pacific Time between 8am and 5pm,
Monday through Friday, excluding holidays, on a fixed schedule approved by the City to answer
inquiries from patients or other persons responsible for payment concerning accounts due. During
remaining hours when the Vendor is not available, the Vendor must provide a dedicated phone
line with voicemail service. The Vendor shall, at their expense, maintain a toll-free phone number,
available from Washington, to facilitate patient inquiries.
13. The City will have the sole authority to determine which accounts will be sent to collection, be
waived, or stay in the billing process per RCW 19.16.500. The City may allow for a time -payment
schedule for their accounts. The City shall have the sole authority to set any interest charges on
overdue accounts as allowed by law.
14. The Vendor shall adhere to all Federal and State of Washington laws regarding billing payers,
collectible balances, and required write-offs. All legally collectible balances are to be billed to
applicable payers, in the necessary order, until all applicable payer options have been exhausted.
The Vendor is prohibited from discounting or adjusting any fee outside of the required contractual
write-off unless approved by an authorized representative at the City. The amounts of all write-
offs shall be reported monthly to the City.
15. The Vendor will be expected to acquire an assignment of benefits from the patient and bill the
insurance provider directly where insurance is available and identified.
16. Vendor shall mail ambulance billings separately from any other accounts handled by the
Vendor.
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17. The Vendor shall, on a weekly or on an as -needed basis, deposit all payments received for
ambulance service collections in a designated City account.
18. The City shall receive the following information in report format on a monthly basis. Reports
will be submitted to the City Finance Department. The Vendor shall document how they intend to
provide this information:
a. Names of patients billed.
b. Type of insurance (i.e., HCA, Medicare/Medicaid).
c. Dates of service.
d. Dates of billing.
e. Dates payments were received.
f. Amount of charges by patient.
g. Amount of payments by insurance.
h. Amount of GEMT fee.
i. Outstanding balances by patient.
j. Outstanding balances by age of account by patient (i.e., 30 days, 60 days, 90 days, etc.).
k. Outstanding balances by age of account by payer (i.e., 30 days, 60 days, 90 days, etc.).
1. Amounts received from third party payers.
in. Total amount collected for the month.
n. Accounts for collection including history of billing activities.
o. Amount of write-off per patient and per payer.
p. Specific reason account flagged as delinquent.
19. The Vendor shall submit a monthly itemized statement of their charges. Payment by the City
will be made within 30 days of receipt of such invoice.
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EXHIBIT B
EMS Billing and Collections Procedures
PURPOSE
To establish procedures regarding ambulance services billing and collections. To include patient
services fee schedule, collections and payment policy.
DEFINITIONS
The City of Pasco, a Washington Municipal Corporation, is hereinafter referred to as "City".
System Design West, LLC. is designated as the "Billing Agency" with whom the City has entered
into a contract on the ;;�'j day of,�.0 20N to provide billing for emergency medical and
ambulance services.
POLICY
It is the policy of the City that no person will be denied treatment or transport to a definitive care
facility, regardless of the patient's ability to pay for service.
It is the policy of the City to pursue payment for ambulance treatment and/or transport services
provided according to the fee schedule approved by the City Council. While claims for service
will be processed based on the patient's individual situation (i.e.: insurance, self -pay, etc.), the
patient (except Medicare or Medicaid patients) is ultimately responsible for the total balance due.
Billing and collection practices will be in compliance with State and Federal laws; specifically
Medicare, Medicaid, and HIPAA guidelines.
PROCEDURE
All billing for ambulance services will be in accordance with the treatment and transport fee
schedule below that has been established by Resolution of the City of Pasco City Council.
Fees collected for Ambulance Standbys will be handled by PFD. All standby calls that result in a
patient transport to a medical facility will be deemed billable as a normal EMS call and will be
handled by the Billing Agency.
Patients attended to by PFD and then refuse treatment will be billed an "on -scene treatment" charge
per the current Council Resolution. "Attended to" is defined as providing any care or treatment
beyond an initial BLS level exam.
Patients that have resuscitation efforts terminated upon arrival at the hospital, or who are
pronounced deceased on scene, the Resolution rate will be billed to the patient's account. The
remaining balance owing shall be pursued against the deceased's estate until proven that there are
no further provisions for payment.
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PAYMENT POLICY
Those individuals with balances owed may request a payment schedule to pay the remaining
balance owed, which will be handled on a case-by-case basis. A request for a payment plan by an
individual or via a partial payment shall be referred to the City for approval.
Consideration of these requests will be given with regard to insurance available to the
patient, circumstances of the call, financial resources available, and ability to arrange
payment.
If approved by the Pasco Finance department, the Billing Agency shall resubmit an
adjusted bill to the patient.
If a payment schedule is agreed upon, it shall only be for a maximum of 12 months for
completion of payment.
COLLECTIONS
In the event that full or partial payment for ambulance treatment/transport services to Billing
Agency is not received within 120 days of the initial billing or accounts with an approved payment
plan that have not been paid in full after 12 months (see Billing Schedule below), the patient's
account will be considered delinquent and uncollectible and referred to the collection agency
currently under contract to the City of Pasco, based on procedures set out in Exhibit A Sections 9
and 13, who will attempt to collect the balance due. The Vendor will adhere to the Fair Debt
Collection Practices Act (FDCPA) with respect to any and all applicable actions taken under this
Agreement.
With accounts that are at -risk of being turned over to collections, the Billing Agency is
authorized to negotiate up to a 20% reduction in the balance due, with final approval by
the Pasco Finance department.
The negotiated amount must be paid in full. Otherwise, the account will be re -adjusted to
the previous balance with credit for any payments received and then sent to the designated
collections firm.
If a patient is paid directly by a third party for services, the City of Pasco is owed this
amount immediately.
BILLING SCHEDULE
Initial bill.
Second billing, 30 days after initial bill.
Third billing, 60 days after initial bill.
Final bill, 90 days after initial bill in the form of a pre -collect notice.
TREATMENT AND TRANSPORTATION FEE SCHEDULE
Resident Transport fee: $ 650.00
Non -Resident Transport Fee: $ 1100.00
Mileage Fee: $11.00 per mile
On -Scene Care Fee: $250.00
Balance Bill After Insurance Processes: Yes
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