HomeMy WebLinkAbout2013-11-20 PACKET 04.I.REQUEST OF CITY COUNCIL ACTION COUNCIL AGENDA
MEETING ITEM #�/
DATE 11-20-13 .
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PREPARED BY: Public Safety Craig Woolery
ORIGINATING DEPARTMENT STAFF AUTHOR
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COUNCIL ACTION REQUEST
Pass a motion to approve the ambulance billing contract between the city of Cottage Grove
and Expert T. Billing, Inc. for 2014-2015 and the required HIPAA Business Associate
Addendum.
STAFF RECOMMENDATIO
Pass a motion to approve the ambulance billing contract between the city of Cottage Grove
and Expert T. Billing, Inc. for 2014-2015 and the required HIPAA Business Associate
Addendum.
SUPPORTING DOCUMENTS
❑ MEMO/LETTER: Memo from EMS Coordinator Wes Halvorsen dated 11-13-13
OTHER: 2014 — 2015 Agreement between Expert T Billing and city of Cottage Grove
HIPAA Business Associate Addendum
ADMINISTRATORS COMMENTS
City Administrator
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Date
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COUNCIL ACTION TAKEN: ❑ APPROVED ❑ DENIED ❑ OTHER
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Department of Public Safety
Police • Fire • EMS
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To:
From:
Date:
Subject:
INTRODUCTION
Director Craig Woolery
Deputy Fire Chief Halvorsen
November 13, 2013
APPROVAL OF EXPERT-T BILLING CONTRACT 2014-2015
Currently Cottage Grove EMS is contracted with Expert-T Billing and our 2012-2013 contract agreement
will be expiring at the end of the year.
BACKGROUND
Expert-T Billing has fulfilled their obligations in our 2012-2013 contract of implementation and
submission of all electronic patient care reports (EPCR) via the HealthEMS system, along with receivable
electronic payments from the billed insurance carriers.
Cottage Grove EMS's contracted price per billable run for 2012-2013 is $26.00. The new contracted price
would be $26.50 per billable run for a two year contract from 2014-2015.
RECOMMENDATION
I recommend we continue with our contracted services with Expert-T Billing and sign the new 2014-2015
contract and HIPPPA Business Associate Addendum. Expert-T or the City of Cottage Grove may
terminate this agreement for any reason upon 60 days notice.
CC:
Fire Chief Rick Redenius
CITY OF COTTAGE GROVE • 12800 Ravine Parkway • Cottage Grove, Minnesota 55016
www.cotta�e-�rove.or� • 651-458-2850 • Fax 651-458-2820 • Equal OpportunitV Employer
AMBULANCE SERVICE BILLING AGREEMENT BETWEEN
EXPERT T BILLING
AND
THE CITY OF COTTAGE GROVE AMBULANCE
This agreement for service made as of January l, 2014 between the City of Cottage Grove, a
Minnesota municipal corporation ("CITY) and Expert T Billing, a Minnesota company
("CONTRACTOR") shall specify the billing services the CONTRACTOR will provide to the
CITY. .
1. CONTRACTOR SERVICES AND OBLIGATIONS
1.1 The CONTRACTOR agrees to provide and fuinish ambulance billing service for
the accounts receivable of the CITY as follows:
l.l.l Preparation of initial and monthly statements for all accounts and mailing
to responsible pai�ties.
1.1.2 Processing insurance on accounts that are subject to Medicare,
Minnesota Care and Medicaid coverage.
1.1.3 Processing and assisting individuals with accounts and with third party
, insurance payments (private insurance) in order to coordinate payment to
the CITY.
1.1.4 Issue up to three (3) billing statements on each account.
1.1.5 Issue delinquent account letters on all accounts that have not had any
payment activity for 120 days.
1.1.6 Perform telephone follow-up calls on accounts to patients, medical
providers, insurance cai7iers, or other facilitators to ensure reasonable
collection efforts have been attempted. This would include the use of
internet resources when applicable.
1.1.7 Per CITY authorization or directive, refer to a designated collection
agency all delinquent accounts which have failed to have payment
activity a$er the delinquent account letter was mailed and telephone calls
made.
1.1.8 All accounts authorized for collection agency handling and as permitted
under MN State Statute 270 A, shall be submitted to the Minnesota
Department of Revenue and certified for collection per the Minnesota
Revenue Recapture Act.
1.1.9 Furnish to the CITY a monthly accounting of all charges and revenue
statements handled during the month as well as other billing system
reports.
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1.1.10 Respond to inquiries from individuals who have xeceived ambulance
service which are related to their accounts and balances due.
1.1.11 Forward complaints and all written comments received regarding the
CITY to the CITY' S designee.
1.1.12 Retain possession of a back-up billing soflware program at a secure off-
site location.
1.1.13 Perform and lnaintain a computer back-up of accounts receivable records
on a daily basis.
1.1.14 Upon termination of this agreement, return to the CTTY all accounts
receivable records and billing information as provided by the CITY over
the course of the billing agreement(s).
1.1.15 Train and, where required, license CONTRACTOR personnel to provide
services hereunder and to provide such services in accordance with all
applicable laws, ordinances, regulations and rules of federal, state and
local authority. CONTRACTOR will obtain all necessary certificates,
permits and licenses at CONTRACTOR'S sole expense and, upon
request, provide the CITY with evidence thereof.
1.1.16 Maintain a general liability insurance policy with a contract liability rider
of $2,000,000 annual aggregate and $1,000,000 per occurrence. The
CITY shall be named as an additional insured on the policy.
2. CITY OBLIGATIONS
2.1 The CITY agrees to provide and fut�nish the CONTRACTOR the following:
2.1.1 Information required by the CONTRACTOR to properly bill the
accounts. Information shall be in the form of legible EMS Patient Care
Reports (PCRs) or typewritten information taken from the EMS - PCR.
Legible information shall be required from electronic as well as paper
information.
2.1.2 THE CITY shall provide the CONTRACTOR with hospital admission
face sheets and other infoi�nation, including patient signatures, which
may be available and legally obtainable for individuals receiving
ambulance service when necessary for billing purposes.
2.1.3 The CITY shall provide the CONTRACTOR with information that is
necessary regarding collection for accounts that remain delinquent after
the CONTRACTOR has provided billing services.
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3. PAYMENT FOR SERVICES
3.1 The CITY agrees to pay for services performed by the CONTRACTOR as
follows:
3.1.1 The charge of $ 26.50 per each billable transport run.
3.2 The CONTRACTOR shall invoice the CITY on a monthly basis for services
rendered and payment of each invoice shall be due within 30 days of the date of
the invoice.
4. TERM, DEFAULT, AND TERMINATION
4.1 This agreeinent shall be effective on the date first mentioned above and shall
extend through and including Deceinber 31, 2015, unless terminated prior to that
date pursuant to this Article Four.
4.2 If any one or more of the following occurs; (1) a payment due fi•om CITY to
CONTRACTOR shall be and remain unpaid in whole or in part for more than
sixty (60) days after same is due and payable; (2) CITY shall violate or default
on any of the other covenant agreements, stipulations or conditions herein and
such violation or default shall continue for a period of ten (10) days after written
notice from CONTRACTOR of such violation or default; then it shall be optional
for CONTRACTOR, without further demand or notice, to declare this agreement
forfeited and the said Term ended and CONTRACTOR shall not be liable for
damages by reason of such termination; but notwithstanding termination by
CONTRACTOR, the liability of CITY for the payments provided herein shall not
be relinquished or extinguished for the services provided prior to termination.
CITY shall be responsible for, in addition to the payments agreed to be paid
hereunder, reasonable attoi�eys' fees and costs incurred by CONTRACTOR to
enforce the provisions of this Agreement or to collect the payments due
CONTRACTOR hereunder. .
4.3 Each right or remedy of CONTRACTOR provided for in this agreement shall be
cumulative and shall be in addition to eveiy other right or remedy provided for in
this agreement now or hereafter existing at law or in equity or by statute or
otherwise.
4.4 CONTRACTOR shall not be deemed to be in default under�this agreement until
CITY has given CONTRACTOR wr•itten notice specifying the nature of the
default and CONTRACTOR does not cure such default within (30) days after
receipt of such notice or within such reasonable time thereafter as may be
necessary to cure such default where such default is of such a,character as to
xeasonably require more than thirty (30) days to cure.
4.5 No waiver of any default of CITY hereunder shall be implied from any omission
to take any action on account of such default if such default persists or is
repeated, and no express waiver shall affect any default other than the default
specified in the express waiver and that only for the time and to the extent therein
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stated. One or more waivers by CONTRACTOR shall not be const�ued as a
waiver of a subsequent breach of the same covenant, term or condition.
4.6 CONTRACTOR or CITY may teiminate this agreement for any reason upon 60
days written notice.
5. INDEMNIFICATION
5.1 Each party agrees that it shall protect, indemnify and hold harinless fi•om and
against all liabilities, actions, damages, claims, demands, judgment, losses, costs,
expenses, suits or actions and attorneys' fees, and shall defend the other in any
suit, including appeals, for loss or damage to property caused by the negligent
acts or omissions of the indemnifying party, its agents or employees, in
connection with or as a result of this agreement, the performance of either par�ty's
obligations hereunder or the performance of services governed by this agreement.
Neither party shall be requued to reimburse, defend or indemnify the other party
for loss or claim due to the negligence of such other party. In case of joint or
concurrent negligence of the parties giving rise to a loss or claim against either
one or both, each shall have full rights of contribution against the other.
5.2 Each party shall promptly notify the other party of the assertion of any claim
against which the party is indemnified by the other party.
6. GENERAL PROVISIONS
6.1 Nothing in this agreement is intended or shall be construed to create an employer
- employee relationship, a partnership, a joint venture, or a lessor-lessee
relationship between the pai�ties.
6.2 Each party understands and agrees that it is responsible for payment of the
wages, salaries and benefits of its own employees and that the other party shall
not pay or withhold any sums for income tax, unemployment insurance, worlcers
compensation premiums, social security or any other withholding required by
law or any other agreement.
6.3 This agreement shall be interpreted, construed and goveined by the laws of the
State of Minnesota.
6.4 This agreement may be amended or modified only in writing and signed by both
parties.
6.5 This agreement constitutes the entire agreement between the parties and shall
bind and inure to the benefit of the CITY and the CONTRACTOR and their
respective successors and assigns.
6.6 This agreement may be executed in multiple counterparts, each of which shall be
deemed an original, but all of which, talcen together, shall constitute only one
agreement. �
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6.7 Any notice required or pei�nitted under this agreement shall be deemed
sufficiently given or served if sent by United States certified mail, return receipt
requested, addressed as follows:
If to CONTRACTOR to:
Exnert T. Billin� Attn: Bill Schommer
400 Third Street, Farmington Minnesota 55024
If to CITY to:
City of Cotta�e Grove
12800 Ravine Pkwv
Cotta�e Grove, MN 55016
CONTRACTOR and CITY shall each have the right from time to time to change
the place notice is to be given under this paragraph by written notice thereof to
the other party.
6.8 If any term or provision of this agreement shall to any extent be held invalid or
unenforceable, the remainder shall not be affected thereby, and each other term
and provision of this agreement shall be valid and be enforced to the fullest
extent peimitted by law. No receipts or acceptance by CONTRACTOR from
CITY of less than the monthly payments herein stipulated shall be deemed to be
other than a partial payment on account for any due and unpaid amounts; no
endorsement or statement of any check ox any letter or other writing
accompanying any checic or payment of rent to CONTRACTOR shall be deeined
an accord and satisfaction, and CONTRACTOR may accept and negotiate such
check or payment without prejudice to CONTRACTOR's riglits to (i) recover the
remaining balance of such unpaid amounts or (ii) pursue any other remedy
provided in this agreement. Time is of the essence with respect to the due
performance of the terms, covenants and conditions herein contained.
6.9 HIPAA BUSINESS ASSOCIATE ADDENDUM
The attached HIPAA Business Associate Addendum is incoi�porated herein in
order to satisfy the requirements of the final and/or amended regulations in
compliance with the privacy regulations pursuant to Public Law 104-191 of
August 21, 1996, lcnown as the Health Insurance Portability and Accountability
Act of 1996.
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IN WITNESS WHEREOF, each of the pai�ties hereto has caused this agreement to be executed
on its behalf by its duly authorized. officer or other representatives on this day of
. 2013.
CITY OF COTTAGE GROVE EXPERT T BILLING
:
:
Bill Schommer
Its: Its: President
:
Its:
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HIPAA BUSINESS ASSOCIATE ADDENDUM BETWEEN
THE CITY OF COTTAGE GROVE AMBULANCE
AND
EXPERT T BILLING
This Business Associate Addendum ("ADDENDUM") is made part ofthe billing ser•vice
agreement ("AGREEMENT") to which it is attached between the City of Cottage Grove, a
Minnesota ("CITY") and Expert TBilling, a Minnesota company ('BUSINESS ASSOCIATE"),
to ensure that the parties hereto satisfy the requireinents of all final regulations and that the
BUSINESS ASSOCIATE shall can•y out its obligations under this AGREEMENT in coinpliance
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 infonnation ("PHI") that is collected, processed or learned
as a result of the Billing Services provided hereunder.
ARTICLE I
Permitted Uses
I.I The BUSINESS ASSOCIATE may use individually identifiable health information PHI
received froin, or created or received by the BUSINESS ASSOCIATE on behalf of the
CITY in accordance with and for purposes of carrying out its obligations under the
AGREEMENT or as required by law.
1.2 Except as otherwise provided in the AGREEMENT or this ADDENDUM, the BUSINESS
ASSOCIATE inay also:
A. Use PHI far the preparation of invoices to patients, caniers, insurers and others
responsible for payinent or reimburseinent of the services provided by the CITY to
its patients;
B. Use PHI for the preparation of reininder notices and docuinents pertaining to
collections of overdue accounts;
C. Submit supporting documentation to carriers, insurers and other payers to
substantiate the health care services provided by the CITY to its patients or to
appeal denials of payinent for same;
D. Use PHI received by the BUSINESS ASSOCIATE for the proper
management and administration of the BUSINESS ASSOCIATE, or to carry out
the legal responsibilities of the BUSINESS ASSOCIATE, provided that such use
is permitted by law; and
E. Use or disclose PHI as permitted by the HIPAA privacy iule.
ARTICLE II
Business Associate Covenants
2.1 TheBUSINESS ASSOCIATE covenants to:
A. Not use or further disclose PHI except as permitted under the AGREEMENT, the
Privacy Standards and Minnesota law, as may be amended from time to time;
B. Use appropriate safeguards to prevent the use or disclosure of PHI other than as
provided for in this ADDENDUM;
C. To mitigate, to the extent practicable, any harmful effect that is known to the
BUSINESS ASSOCIATE of a use or disclosure of PHI by the BUSINESS
ASSOCIATE in violation of this agreement;
D. Report to the CITY any use or disclosure of PHI not provided for by this
AGREEMENT of which the BUSINESS ASSOCIATE becomes aware;
E. Ensure that any agents or subcontractors to whom the BUSINESS ASSOCIATE
provides PHI, or who have access to PHI, agree to the same restrictions and
conditions that apply to the BUSINESS ASSOCIATE with respect to such PHI;
F. Make PHI available to the CITY and to the individual who has a right of access as
required under HIPAA within 7 days of the request by the CITY on the individual;
G. Incorporate any amendments to PHI when notified to do so by the CITY;
H. Provide an accounting of all uses or disclosures of PHI made by the BUSINESS
ASSOCIATE as required under the HIPAA privacy rule within 60 days;
Make its internal practices, books and records relating to the use and disclosure of
PHI available to the Secretary of the Deparrinent of Health and Human Services
for purposes of detennining the BUSINESS ASSOCIATE and CITY compliance
with HIPAA;
J. At the termination or expiration of the AGREEMENT, if feasible, return or
destroy all PHI received fi�om, or created or received by the BUSINESS
ASSOCIATE on behalf of, CITY which the BUSINESS ASSOCIATE and/or its
subcontractars or agents still maintain in any form, and not retain any copies of
such information, ar if such return or destruction is not feasible, notify the CITY
of such event in writing, and extend the protections of the AGREEMENT and this
ADDENDUM to the PHI and limit further uses and disclosures to those purposes
that inake the return or destruction of the PHI infeasible; and
K. If the parties electronically exchange individually identifiable health infoi7nation,
maintain the integrity and confidentiality of the transmitted information and
protect the information from iinproper access and otherwise comply with the
security standards issued pursuant to HIPAA.
ARTICLE III
Termination
3.1, This ADDENDUM will continue while any AGREEMENT remains in effect with the
BUSINESS ASSOCIATE.
3.2 Notwithstanding anything to the contrary in this ADDENDUM or an AGREEMENT, the
CITY inay tei7ninate an AGREEMENT immediately upon notice to the BUSINESS
ASSOCIATE if the CITY detennines that the BUSINESS ASSOCIATE has violated a
material tei�rn of this ADDENDUM ar a provision of the AGREEMENT relating to PHI.
The CITY, in its sole discretion, may, but is not required to, provide the BUSINESS
ASSOCIATE with an opportunity to cure the breach within a time acceptable to the CITY.
3.3 Notwithstanding anything to the contrary in this ADDENDUM or an agreement, the terms
of this addendum shall survive tennination of an AGREEMENT with respect to the PHI
for which return or destruction is not feasible, as provided in Section 2.1, J, of this
ADDENDUM.
ARTICLE IV
General
4.1 Nothing in this ADDENDUM, including section 2.1, E, shall pe�7nit the BUSINESS
ASSOCIATE to assign or subcontract any of its rights or responsibilities under this
ADDENDUM or the AGREEMENT without the prior written consent of the CITY.
4.2 Nothing in this ADDENDUM shall be construed to create any third party beneficiary
rights in any person.
43 This ADDENDUM may not be modified, nor shall any provision hereof be waived or
amended, except by a writing signed by both parties.
4.4 The CITY is and shall continue to be the owner of all PHI received by the BUSINESS
ASSOCIATE from, or created or received by the BUSINESS ASSOCIATE on behalf of,
the CITY, including any de-identified information received or created by the BUSINESS
ASSOCIATE.
4.5 The BUSINESS ASSOCIATE agrees to indemnify and hold the CITY and each of its
affiliates, and their officers, directors and employees (the °Indernnified Parties") harmless
frorn and against all claims, causes of action, dainages, loss, costs and expenses suffered
or incurred by any of the Indemnified Parties and arising out of or related to a br•each of
this ADDENDUM or the AGREEMENT as it relates to PHI, by the BUSINESS
ASSOCIATE.
4.6 This ADDENDUM is intended to satisfy the CITY's obligations under the Privacy
Standards. (f there is a conflict between the teims of this ADDENDUM and any provision
of the Privacy Standards, the Privacy Standard provision shall supersede this
ADDENDUM, and the BUSINESS ASSOCIATE agrees to comply with such Privacy
Standard provision.
4.7 This ADDENDUM applies to the AGREEMENT and to any agreeinent which is entered
into hereafter which renews, extends, replaces ar succeeds the AGREEMENT, and to any
other agreeinent between the parties for which the Privacy Standards require such
language, unless another agreement meeting the requirements of the Privacy Standards is
entered into between the parties for such agreement.
4.8 The parties agree to talce such action as is necessary to amend this ADDENDUM fiorn
time to time as is necessary for the CITY to comply with the Privacy Standards and
HIPAA.
IN WITNESS WHEREOF, this ADDENDUM shall be incorporated as a part of the duly
authorized AGREEMENT by and between the CITY and the BUSINESS ASSOCIATE as
recognized by the signatures affixed below on this day of , 2013.
CITY OF COTTAGE GROVE EXPERT T BILLING
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