HomeMy WebLinkAboutItem 11e - Ambulance Billing and Collection Services
DATE: June 5, 2018
TO: Honorable Mayor and City Council
FROM: Michael E. Lang, Fire Chief
By: Maria Lourdes A. Taylor, Senior Management Analyst
SUBJECT: PROFESSIONAL SERVICES AGREEMENT WITH WITTMAN
ENTERPRISES, LLC FOR AMBULANCE BILLING AND COLLECTION
SERVICES IN AN AMOUNT NOT TO EXCEED $83,400 FOR FISCAL
YEAR 2018-19
Recommendation: Approve
SUMMARY
The Fire Department recently solicited a Request for Proposal (“RFP”) to provide billing
and collection services for the City of Arcadia’s emergency medical transport services.
Upon review and evaluation of all proposals, it is recommended that the City Council
approve, authorize and direct the City Manager to execute a five-year Professional
Services Agreement with Wittman Enterprises, LLC in an amount not to exceed $83,400
for Fiscal Year 2018-19. The Professional Services Agreement includes the ability of
the City to renew the Agreement annually for a maximum of three (3) one-year renewals
after the initial 5-year term.
Attached is a copy of the proposed Professional Services Agreement (“Agreement”)
with Wittman Enterprises, LLC. Sufficient funds have been budgeted in the Fire
Department’s Fiscal Year 2018-19 Operating Budget.
DISCUSSION
Ambulance billing and revenue collection is a complicated process that involves
gathering patient insurance information, navigating through the Medicare and Medi -Cal
systems for reimbursement, maintaining compliance with governmental regulatory
requirements, and continuous training on the ever-changing health care laws.
Professional Services Agreement for Ambulance Billing
June 5, 2018
Page 2 of 4
Annually, the City of Arcadia Fire Department receives nearly 6,000 incident calls, of
which 70% of these calls comprise of rescue and emergency medical calls. Ambulance
charges, also called Emergency Medical Services (“EMS”) fees, are the single largest
revenue source for the Arcadia Fire Department. The revenues collected by the City
depend primarily on the quantity of transported patients by the Fire Department and the
type of emergency medical services rendered to each patient. Based on historical call
volume and billing over the years, the Fiscal Year 2018-19 projected revenue is at $1.5
million generated from at least 2,700 billable EMS transports. The Fire Department only
bills for EMS calls that involve medical transports.
In April 2018, the Arcadia Fire Department issued an RF P seeking a consultant to
perform these specialized ambulance billing services. Selection of the most qualified
firm would enable collection of the maximum allowable reimbursement from various
insurance providers and, therefore, obtain the most optimal cost recovery.
In soliciting proposals, a Notice Inviting Proposals was published twice in the City’s
adjudicated newspaper including posting on the City’s website, and distribution of RFP
packets to potentially qualifying firms. Three (3) proposals were received and
independently reviewed and evaluated by a panel from the Fire and Finance
departments. Based on this, the proposals resulted in the following:
Wittman Enterprises,
LLC
(Rancho Cordova, CA)
Intermedix
Corporation
(Fort Lauderdale,
FL)
Health Care
Partners, LLC
(Upland, CA)
Average Evaluation
Score (Out of 100) 95.00 83.00 14.33
Fee Proposal 4.25% of Net
Collections
2.35% of Net
Collections
Various billing
tiers up to 6%
Annual Rate
Increase N/A N/A .50% to 1%
after 1st year
Upon reviewing and evaluating the RFPs, it was determined that Wittman Enterprises,
LLC (“Wittman”) is the most qualified firm that can deliver the specific requirements
outlined in the RFP. In addition to the fee proposal, the evaluation panel rated the
proposers based on technical factors that included project understanding, experience
and qualifications, project approach, project timeline, and references.
Health Care Partners, LLC scored the lowest since it failed to meet the standards set
forth in the RFP’s evaluation criteria specifically in the areas of proposal presentation,
project requirements and timeline, and its lack of experience and references in working
with similar projects or with governmental entities, and a confusing fee
structure/schedule.
Professional Services Agreement for Ambulance Billing
June 5, 2018
Page 3 of 4
While Intermedix Corporation offered the lowest net collection charge, it was not
selected as the winning proposer due to its inadequate experience in its integration with
Medic ClipBoard System, the City’s current electronic patient care reporting (“ePCR”)
data collector. Substantial experience in effectively working with Medic ClipBoard
System via Digital EMS Solutions is vital since the City’s efficient revenue collection
process will depend in the firm’s ability to successfully interface and transition into such
system. A seamless system interface and transition will also prevent unnecessary
delays in maximizing the City’s reimbursement opportunity and cost recovery.
Furthermore, Intermedix lacked experience in working with Los Angeles County
agencies and municipalities and references that were available showed a pattern of
concerns raised by agencies that had used Intermedix; in fact more than one agency is
considering not renewing their contract and instead, will competitively seek out
proposals despite the cost savings due to customer service issues.
Based on the total RFP evaluation process, it is recommended that the City select
Wittman Enterprises, LLC as the most qualified firm to provide ambulance billing
services for the City. Wittman surpassed the other proposers in several major areas
such as the following: extensive Los Angeles County client base (23 clients) including
neighboring cities such as Burbank, Pasadena, Huntington Beach, and Culver City ;
largest Digital EMS Solutions partner in Los Angeles County; proven track record in its
diligence in seeking full reimbursements; industry knowledge and outstanding
performance history; excellent references; and a large well-trained and highly
responsive staff. Furthermore, Wittman has been providing exceptional customer
service to the City and its patients since 2010, and has optimized revenue recovery on
behalf of the City while also keeping City staff abreast of the latest changes in health
care laws, compliance, and Medicare regulations.
The proposed Agreement is for a term of five years, with three additional annual
extensions possible, at the City’s sole discretion. Wittman originally bid a tiered billing
rate of 4.55%-4.75%; however, after negotiations with the City, they reduced the net
collection fee to a flat rate of 4.25% for the entire contract, including any extension
years. This demonstrated their commitment to the business relationship and continued
incentive to seek the highest levels of reimbursement for the City. This will be a
reduction of 0.75% from the current W ittman rate of 5.0%.
FISCAL IMPACT
The total charges paid to Wittman for ambulance billing services is predicated on the
total payments collected by Wittman on behalf of the City. In FY 2018-19, it is
estimated that up to $1,550,000 in billing receipts will be collected by Wittman.
Therefore, the projected 4.25% total net collection fee that will be due to Wittman is
approximately $66,000.
Professional Services Agreement for Ambulance Billing
June 5, 2018
Page 4 of 4
Additionally, the City will reimburse Wittman for their continued payment of the City’s
annual electronic Patient Care Report (“ePCR”) licensing and storage fee to Digital EMS
Solutions in the amount of $17,400. In total, for FY 2018-19, the contract amount for
the ambulance billing and collection services will be $83,400.
It is worth noting that in the current Agreement for ambulance billing services, the City is
charged with a 5.0% net collection fee. With a reduced fee of 4.25%, the estimated
savings for the next five (5) years would be $58,100.
Sufficient funds have been budgeted in the FY 2018-19 Fire Department Operating
Budget for ambulance services.
ENVIRONMENTAL IMPACT
The Professional Services Agreement with Wittman Enterprises, LLC, is not considered
a project as defined by California Environmental Quality Act (“CEQA”) Section 15378;
as a service contract of this nature is considered ministerial.
RECOMMENDATION
It is recommended that the City Council approve, direct and authorize the City Manager
to execute a five-year Professional Services Agreement with Wittman Enterprises, LLC
to provide billing and collection services for the City of Arcadia’s emergency medical
transport services in an amount not to exceed $83,400 for Fiscal Year 2018-19.
Attachment: Proposed Professional Services Agreement
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CITY OF ARCADIA
PROFESSIONAL SERVICES AGREEMENT REGARDING
BILLING AND COLLECTION SERVICES
FOR EMERGENCY MEDICAL TRANSPORT SERVICES
1. PARTIES AND DATE.
This Agreement is made and entered into this ____ day of ______________,
20__ by and between the City of Arcadia, a charter city organized under the
Constitution and laws of the State of California with its principal place of business at 240
West Huntington Drive, Arcadia, California 91066 -6021 ("City") and Wittman
Enterprises, LLC, a California Limited Liability Company, with its principal place of
business at 11093 Sun Center Drive, Rancho Cordova, CA 95670 ("Consultant"). City
and Consultant are sometimes individually referred to as “Party” and collectively as
“Parties.”
2. RECITALS.
2.1 Consultant.
Consultant desires to perform and assume responsibility for the provision of
certain professional services required by the City on the terms and conditions set forth
in this Agreement. Consultant represents that it is experienced in providing for the
billing and collection services for emergency medical transport services to public
clients, is licensed in the State of California, and is familiar with the plans of City.
2.2 Project.
City desires to engage Consultant to render such services for the billing and
collection services for emergency medical transport services as set forth in this
Agreement.
3. TERMS.
3.1 Scope of Services and Term.
3.1.1 General Scope of Services. Consultant promises and agrees to
furnish to the City all labor, materials, tools, equipment, services, and incidental and
customary work necessary to fully and adequately supply the professional ambulance
billing and collection services necessary for the Project ("Services"). The Services are
more particularly described in Exhibit "A" attached hereto and incorporated herein by
reference. All Services shall be subject to, and performed in accordance with, this
Agreement, the exhibits attached hereto and incorporated herein by reference, and all
applicable local, state and federal laws, rules and regulations.
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3.1.2 Term. The term of this Agreement shall be from July 1, 2018, to
June 30, 2023, with the City’s option to renew the Agreement thereafter for a
maximum of three (3) one-year renewals, unless earlier terminated as provided
herein. Consultant shall complete the Services within the term of this Agreement, and
shall meet any other established schedules and deadlines.
3.2 Responsibilities of Consultant.
3.2.1 Control and Payment of Subordinates; Independent Con tractor.
The Services shall be performed by Consultant or under its supervision. Consultant will
determine the means, methods and details of performing the Services subject to the
requirements of this Agreement. City retains Consultant on an independent contractor
basis and not as an employee. Consultant retains the right to perform similar or
different services for others during the term of this Agreement. Any additional personnel
performing the Services under this Agreement on behalf of Consultant sh all also not be
employees of City and shall at all times be under Consultant's exclusive direction and
control. Consultant shall pay all wages, salaries, and other amounts due such
personnel in connection with their performance of Services under this Agre ement and
as required by law. Consultant shall be responsible for all reports and obligations
respecting such additional personnel, including, but not limited to: social security taxes,
income tax withholding, unemployment insurance, disability insurance, and workers'
compensation insurance.
3.2.2 Schedule of Services. Consultant shall perform the Services
expeditiously, within the term of this Agreement, and in accordance with the Schedule of
Services set forth in Exhibit "B" attached hereto and incor porated herein by reference.
Consultant represents that it has the professional and technical personnel required to
perform the Services in conformance with such conditions. In order to facilitate
Consultant's conformance with the Schedule, City shall re spond to Consultant's
submittals in a timely manner. Upon request of City, Consultant shall provide a more
detailed schedule of anticipated performance to meet the Schedule of Services.
3.2.3 Conformance to Applicable Requirements. All work prepared by
Consultant shall be subject to the prior written approval of City.
3.2.4 Substitution of Key Personnel. Consultant has represented to City
that certain key personnel will perform and coordinate the Services under this
Agreement. Should one or more of such personnel become unavailable, Consultant
may substitute other personnel of at least equal competence upon prior written approval
of City. In the event that City and Consultant cannot agree as to the substitution of key
personnel, City shall be entitled to terminate this Agreement for cause. As discussed
below, any personnel who fail or refuse to perform the Services in a manner acceptable
to the City, or who are determined by the City to be uncooperative, incompetent, a
threat to the adequate or timely completion of the Project or a threat to the safety of
persons or property, shall be promptly removed from the Project by the Consultant at
the request of the City. The key personnel for performance of this Agreement are as
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follows: Heather Montano, Division Manager; Nicole Powers, Division Manager;
Judy Vang, Client Liaison; and Russ Harms, Director of Business Development.
3.2.5 City’s Representative. The City hereby designates Michael E.
Lang, Fire Chief, or his or her designee, to act as its representative for the
performance of this Agreement (“City’s Representative”). City’s Representative shall
have the power to act on behalf of the City for all purposes under this Contract.
Consultant shall not accept direction or orders from any person other than the City’s
Representative or his or her designee.
3.2.6 Consultant’s Representative. Consultant hereby designates
Corinne Wittman-Wong, Chief Executive Officer, or his or her designee, to act as its
representative for the performance of this Agreement (“Consultant’s Representative”).
Consultant’s Representative shall have full authority to represent and act on behalf of
the Consultant for all purposes under this Agreement. The Consultant’s Representative
shall supervise and direct the Services, using his best skill and attention, and shall be
responsible for all means, methods, techniques, sequences and procedures and for the
satisfactory coordination of all portions of the Services under this Agreement.
3.2.7 Coordination of Services. Consultant agrees to work closely with
City staff in the performance of Services and shall be available to City's staff,
consultants and other staff at all reasonable times.
3.2.8 Standard of Care; Performance of Employees . Consultant shall
perform all Services under this Agreement in a skillful and competent manner,
consistent with the standards generally recognized as being employed by professionals
in the same discipline in the State of California. Consultant represents and maintains
that it is skilled in the professional calling necessary to perform the Services. Finally,
Consultant represents that it, its employees and subcontractors have all licenses,
permits, qualifications and approvals of whatever nature that are legally required to
perform the Services, including a City Business License, and that such licenses and
approvals shall be maintained throughout the term of this Agreement. As provided for in
the indemnification provisions of this Agreement, Consultant shall perform, at its own
cost and expense and without reimbursement from the City, any services necessary to
correct errors or omissions which are caused by the Consultant’s failure to comply with
the standard of care provided for herein. Any employee of the Consultant or its sub -
consultants who is determined by the City to be uncooperative, incompetent, a threat to
the adequate or timely completion of the Project, a threat to the safety of persons or
property, or any employee who fails or refuses to perform the Services in a manner
acceptable to the City, shall be promptly removed from the Project by the Consultant
and shall not be re-employed to perform any of the Services or to work on the Project.
3.2.9 Laws and Regulations. Consultant shall keep itself fully informed of
and in compliance with all local, state and federal laws, rules and regulations in any
manner affecting the performance of the Project or the Services, including all Cal/OSHA
requirements, and shall give all notices required by law. Consultant shall be liable for all
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violations of such laws and regulations in connection with Services. If the Consultant
performs any work knowing it to be contrary to such laws, rules and regulations and
without giving written notice to the City, Consultant shall be solely respon sible for all
costs arising therefrom. Consultant shall defend, indemnify and hold City, its officials,
directors, officers, and employees free and harmless, pursuant to the indemnification
provisions of this Agreement, from any claim or liability arising out of any failure or
alleged failure to comply with such laws, rules or regulations.
3.2.9.1 Immigration Reform and Control Act. Consultant
acknowledges that Consultant, and all subcontractors hired by Consultant to perform
services under this Agreement, are aware of and understand the Immigration Reform
and Control Act ("IRCA"). Consultant is and shall remain in compliance with the IRCA
and shall ensure that any subcontractors hired by Consultant to perform services under
this Agreement are in compliance with the IRCA. In addition, Consultant agrees to
indemnify, defend and hold harmless the City, its directors, officials, officers and
employees, from any liability, damages or causes of action arising out of or relating to
any claims that Consultant's employees, or the employees of any subcontractor hired by
Consultant, are not authorized to work in the United States for Consultant or its
subcontractor and/or any other claims based upon alleged IRCA violations committed
by Consultant or Consultant's subcontractor(s).
3.2.10 Insurance.
3.2.10.1 Time for Compliance. Consultant shall not
commence Work under this Agreement until it has provided evidence satisfactory to the
City that it has secured all insurance required under this section. In addi tion, Consultant
shall not allow any subcontractor to commence work on any subcontract until it has
provided evidence satisfactory to the City that the subcontractor has secured all
insurance required under this section; provided, however, that in lieu the reof, the
Consultant may provide evidence to the City that all subcontractors are additional
insureds under the Consultant’s policies of insurance.
3.2.10.2 Minimum Requirements. Consultant shall, at its
expense, procure and maintain for the duration of the Agreement insurance against
claims for injuries to persons or damages to property which may arise from or in
connection with the performance of the Agreement by the Consultant, its agents,
representatives, employees, subcontractors and volunteers. Consultant shall also
name and obtain insurer’s consent to naming City, its directors, officials, officers, and
employees as an additional insured with proof of certificate of insurance that they are an
additional insured. Such insurance shall meet at least the following minimum levels of
coverage:
(A) Minimum Scope of Insurance. Coverage shall be
when commercially available (occurrence based) at least as broad as the latest version
of the following: (1) General Liability: Insurance Services Office Commercial General
Liability coverage for premises and operations, contractual liability, personal injury,
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bodily injury, independent contractors, broadform property damage, explosion, collapse,
and underground, products and completed operations; (2) Automobile Liability:
Insurance Services Office Business Auto coverage for any auto owned, leased, hired,
and borrowed by Consultant or for which Consultant is responsible; and (3) Workers’
Compensation and Employer’s Liability: Workers’ Compensation insurance as required
by the State of California and Employer’s Liability Insurance.
The City, its directors, officials, officers, and employees shall be listed as additional
insured. Any deductibles or self -insured retentions must be declared to and approved
by City and conform to the requirements provided in Section 3.2.10.6 herein.
(B) Minimum Limits of Insurance. Consultant shall
maintain limits no less than: (1) General Liability: $1,000,000 combined single limit per
occurrence for bodily injury, personal injury and property damage, with an aggregate
limit of $1,000,000. If Commercial General Liability Insurance or other form with general
aggregate limit is used, either the general aggregate limit shall apply separately to this
Agreement/location or the general aggregate limit shall be twice the required
occurrence limit; (2) Automobile Liability: $1,000,000 combined single limit per accident
for bodily injury and property damage; and (3) Workers’ Compensation and Employer’s
Liability: Workers’ Compensation limits as required by the Labor Code of the State of
California. Employer’s Liability limits of $1,000,000 per accident for bodily injury or
disease.
3.2.10.3 Professional Liability. Consultant shall procure and
maintain, and require its sub-consultants to procure and maintain, for a period of three
(3) years following completion of the Project, errors and omissions liability insurance
appropriate to their profession. Such insurance shall be in an amount not less than
$1,000,000 per claim, and shall be endorsed to include contractual liability.
3.2.10.4 Insurance Endorsements. The insurance policies
shall contain the following provisions, or Consultant shall provide endorsements on
forms supplied or approved by the City to add the following provisions to the insurance
policies:
(A) General Liability. The general liability policy shall be
endorsed to state that: (1) the City, its directors, officials, officers, and employees shall
be covered as additional insured with respect to liability arising out of Services
operations and for completed operations performed by or on behalf of the Consultant,
including materials, parts or equipment furnished in connection with such work; and (2)
the insurance coverage shall be primary insurance as r espects the City, its directors,
officials, officers, and employees, or if excess, shall stand in an unbroken chain of
coverage excess of the Consultant’s scheduled underlying coverage. Any insurance or
self-insurance maintained by the City, its directors, officials, officers, employees and
volunteers shall be excess of the Consultant’s insurance and shall not be called upon to
contribute with it in any way.
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(B) Automobile Liability. The automobile liability policy
shall be endorsed to state that: (1) the City, its directors, officials, officers, and
employees shall be covered as additional insureds with respect to the ownership,
operation, maintenance, use, loading or unloading of any auto owned, leased, hired or
borrowed by the Consultant or for which the Consultant is responsible; and (2) the
insurance coverage shall be primary insurance as respects the City, its directors,
officials, officers, and employees, or if excess, shall stand in an unbroken chain of
coverage excess of the Consultant’s scheduled underlying coverage. Any insurance or
self-insurance maintained by the City, its directors, officials, officers, and employees
shall be excess of the Consultant’s insurance and shall not be called upon to contribute
with it in any way.
(C) Workers’ Compensation and Employers Liability
Coverage. The insurer shall agree to waive all rights of subrogation against the City, its
directors, officials, officers, and employees for losses paid under the terms of the
insurance policy which arise from work performed by the Consultant.
(D) All Coverages. Each insurance policy required by this
Agreement shall be endorsed to state that: (A) coverage shall not be, reduced or
canceled except after thirty (30) days prior written notice by certified mail, r eturn receipt
requested of cancellation, of intended non-renewal or endorsement reduction in limit or
scope of coverage; provided, however, that in the event of cancellation due solely to
non-payment of premium, ten (10) days notice of cancellation for non -payment of
premium may instead be given to the City.; and (B) any failure to comply with reporting
or other provisions of the policies, including breaches of warranties, shall not affect
coverage provided to the City, its directors, officials, officers, and employees.
3.2.10.5 Separation of Insureds; No Special Limitations. All
insurance required by this Section shall contain standard separation of insureds
provisions. In addition, such insurance shall not contain any special limitations on the
scope of protection afforded to the City, its directors, officials, officers, and employees.
3.2.10.6 Deductibles and Self-Insurance Retentions. Any
deductibles or self-insured retentions must be declared to and approved by the City.
Consultant shall guarantee that, at the option of the City, either: (1) the insurer shall
reduce or eliminate such deductibles or self -insured retentions as respects the City, its
directors, officials, officers, and employees; or (2) the Consultant shall procure a bond
guaranteeing payment of losses and related investigation costs, claims and
administrative and defense expenses.
3.2.10.7 Acceptability of Insurers. Insurance is to be placed
with insurers with a current A.M. Best’s rating no less than A:VII, admitted or app roved
to do business in California, and satisfactory to the City.
3.2.10.8 Verification of Coverage. Consultant shall furnish City
with complete and accurate copies of current certificates of insurance and
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endorsements effecting coverage required by this Agreement on forms satisfactory to
the City. The certificates and endorsements for each insurance policy shall be signed
by a person authorized by that insurer to bind coverage on its behalf, and shall be on
forms provided by the City if requested. Copies of all certificates and endorsements
must be received and approved by the City before work commences. The City reserves
the right to require complete, certified copies of all required insurance policies, at any
time.
3.2.10.9 Safety. Consultant shall execute and maintain its
work so as to avoid injury or damage to any person or property. In carrying out its
Services, the Consultant shall at all times be in compliance with all applicable local,
state and federal laws, rules and regulations, and shall exercise all necessary
precautions for the safety of employees appropriate to the nature of the work and the
conditions under which the work is to be performed. Safety precautions as applicable
shall include, but shall not be limited to: (A) adequate life protection and life saving
equipment and procedures; (B) instructions in accident prevention for all employees and
subcontractors, such as safe walkways, scaffolds, fall protection ladders, bridges, gang
planks, confined space procedures, trenching and shoring, equipment and other safety
devices, equipment and wearing apparel as are necessary or lawfully required to
prevent accidents or injuries; and (C) adequate facilities for the proper inspection and
maintenance of all safety measures.
3.2.10.10 Material Breach. Lack of insurance does not negate
Consultant’s obligations under this Agreement. Maintenance of proper insurance
coverage is a material element of this Agreement and failure to maintain or renew
coverage or to provide evidence of renewal may be treated by the City as a material
breach of the Agreement.
3.3 Fees and Payments.
3.3.1 Compensation. Consultant shall receive compensation, including
reimbursements which receive the City’s prior written authorization, for all Services
rendered under this Agreement at the rates set forth in Exhibit "C" attached hereto and
incorporated herein by reference. The total compensation shall not exceed 4.25% of
the total net collected dollars from ambulance billing without written approval of the
City Manager. Extra Work may be authorized, as described below, and if authorized,
will be compensated at the rates and manner set forth in this Agreement.
3.3.2 Payment of Compensation. Consultant shall submit to City a
monthly itemized statement which indicates work completed and hours of Services
rendered by Consultant. The statement shall describe the amount of Services and
supplies provided since the initial commencement date, or since the start of the
subsequent billing periods, as appropriate, through the date of the statement. City
shall, within forty-five (45) days of receiving such statement, review the statement and
pay all approved charges thereon.
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3.3.3 Reimbursement for Expenses. Consultant shall not be reimbursed
for any expenses unless prior written authorization is obtained from the City.
3.3.4 Extra Work. At any time during the term of this Agreement, City
may request that Consultant perform Extra Work. As used herein, "Extra Work" means
any work which is determined by City to be necessary for the proper completion of the
Project, but which the parties did not reasonably anticipate would be necessary at the
execution of this Agreement. Consultant shall not perform, nor be compensated for,
Extra Work without prior written authorization from City's Representative.
3.4 Accounting Records.
3.4.1 Maintenance and Inspection. Consultant shall maintain complete
and accurate records with respect to all costs and expenses incurred under this
Agreement. All such records shall be clearly identifiable. Consultant shall allow a
representative of City during normal business hours to examine, audit, and make
transcripts or copies of such records and any other documents created pursuant to this
Agreement. Consultant shall allow inspection of all work, data, documents, proceedings,
and activities related to the Agreement for a period of three (3) years from the date of
final payment under this Agreement.
3.5 General Provisions.
3.5.1 Termination of Agreement.
3.5.1.1 Grounds for Termination. City may, by written notice
to Consultant, terminate the whole or any part of this Agreement at any time and without
cause by giving written notice to Consultant of such termination, and specifying the
effective date thereof, at least seven (7) days before the effective date of such
termination. Upon termination, Consultant shall be compensated only for those services
which have been adequately rendered to City, and Consultant shall be entitled to no
further compensation. Consultant may not terminate this Agreement except for cause.
A termination without cause by City shall not act as or be deemed a waiver of any
potential known or unknown City claims associated with Consultant’s performance prior
to the date of termination.
3.5.1.2 Effect of Termination. If this Agreement is terminated
as provided herein, City may require Consultant to provide all finished or unfinished
Documents and Data and other information of any kind prepared by Consultant in
connection with the performance of Services under this Agreement. Consultant shall be
required to provide such document and other information within fifteen (15) days of the
request.
3.5.1.3 Additional Services. In the event this Agreement is
terminated in whole or in part as provided herein, City may procure, upon such terms
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and in such manner as it may determine appropriate, services similar to those
terminated.
3.5.2 Delivery of Notices. All notices permitted or required under this
Agreement shall be given to the respective parties at the following address, or at such
other address as the respective parties may provide in writing for this purpose:
Consultant:
Wittman Enterprises, LLC
11093 Sun Center Drive
Rancho Cordova, CA 95670
Contact Person: Corinne Wittman-Wong, CEO
City:
City of Arcadia
240 West Huntington drive
Arcadia, CA 91007
Attn: Michael E. Lang, Fire Chief
Such notice shall be deemed made when personally delivered or when mailed, forty -
eight (48) hours after deposit in the U.S. Mail, first class postage prepaid and
addressed to the party at its applicable address. Actual notice shall be deemed
adequate notice on the date actual notice occurred, regardless of the method of service.
3.5.3 Ownership of Materials and Confidentiality.
3.5.3.1 Documents & Data; Licensing of Intellectual Property.
This Agreement creates a non-exclusive and perpetual license for City to copy, use,
modify, reuse, or sublicense any and all copyrights, designs, and other intellectual
property embodied in plans, specifications, studies, drawings, estimates, and other
documents or works of authorship fixed in any tangible medium of expression, including
but not limited to, physical drawings or data magnetically or otherwise recorded on
computer diskettes, which are prepared or caused to be prepared by Consultant under
this Agreement (“Documents & Data”). Consultant shall require all subcontractors to
agree in writing that City is granted a non-exclusive and perpetual license for any
Documents & Data the subcontractor prepares under this Agreement. Consultant
represents and warrants that Consultant has the legal right to license any and all
Documents & Data. Consultant makes no such representation and warranty in regard
to Documents & Data which were prepared by design professionals other than
Consultant or provided to Consultant by the City. City shall not be limited in any way in
its use of the Documents and Data at any time, provided that any such use not within
the purposes intended by this Agreement shall be at City’s sole risk.
3.5.3.2 Confidentiality. Except as otherwise required by
California law, all ideas, memoranda, specifications, plans, procedures, drawings,
descriptions, computer program data, input record data, written information, and other
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Documents and Data either created by or provided to Consultant in connection with the
performance of this Agreement shall be held confidential by Consultant. Such materials
shall not, without the prior written consent of City, be used by Consultant for any
purposes other than the performance of the Services. Nor shall such materials be
disclosed to any person or entity not connected with the performance of the Services or
the Project. Nothing furnished to Consultant which is otherw ise known to Consultant or
is generally known, or has become known, to the related industry shall be deemed
confidential. Consultant shall not use City's name or insignia, photographs of the
Project, or any publicity pertaining to the Services or the Project in any magazine, trade
paper, newspaper, television or radio production or other similar medium without the
prior written consent of City.
3.5.4 Cooperation; Further Acts. The Parties shall fully cooperate with
one another, and shall take any addit ional acts or sign any additional documents as
may be necessary, appropriate or convenient to attain the purposes of this Agreement.
3.5.5 Indemnification.
3.5.5.1 To the fullest extent permitted by law, Consultant shall
defend, indemnify and hold the City, its officials, officers, and employees free and
harmless from any and all claims, demands, causes of action, costs, expenses, liability,
loss, damage or injury, in law or equity, to property or persons, including wrongful death,
in any manner arising out of or incident to any alleged acts, omissions or willful
misconduct of Consultant, its officials, officers, employees, agents, consultants and
contractors arising out of or in connection with the performance of the Services, the
Project or this Agreement, including without limitation the payment of all consequential
damages and attorney’s fees and other related costs and expenses. Notwithstanding
the foregoing, to the extent Consultant’s Services are subject to Civil Code Section
2782.8, the above indemnity shall be limited, to the extent required by Civil Code
Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence,
recklessness, or willful misconduct of the Consultant. Consultant shall defend with
Legal Counsel of City’s choosing, at Consultant’s own cost, expense and risk, any and
all such aforesaid suits, actions or other legal proceedings of every kind that may be
brought or instituted against City, its directors, officials, officers, and employees.
Consultant shall pay and satisfy any judgment, award or decree that may be rendered
against City or its directors, officials, officers, and employees, in any such suit, action or
other legal proceeding arising from Consultant’s performance of the Services, the
Project or this Agreement; except to the extent that liability is caused by the active
negligence or willful misconduct by the City or its directors, officials, officers, and
employees. Consultant shall reimburse City and its directors, officials, officers, and
employees, for any and all legal expenses and costs incurred by each of them in
connection therewith or in enforcing the indemnity herein provided. Consultant’s
obligation to indemnify shall not be restricted to insurance proceeds, if any, received by
the City, its directors, officials, officers, and employees, and shall take effect
immediately upon execution of this Agreement.
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3.5.5.2 The duty to defend and to hold harmless, as set forth
above, shall include the duty to defend as established by Sec tion 2778 of the California
Civil Code, and the duty to defend shall arise upon the making of any claim or demand
against the City, its respective officials, officers, agents, employees and representatives,
notwithstanding that no adjudication of the underlying facts has occurred, and whether
or not Consultant has been named in the claim or lawsuit.
3.5.6 Entire Agreement. This Agreement contains the entire Agreement
of the Parties with respect to the subject matter hereof, and supersedes all prior
negotiations, understandings or agreements. This Agreement may only be modified by
a writing signed by both Parties.
3.5.7 Attorney’s Fees. If either party commences an action against the
other party, either legal, administrative or otherwise, arising out of or in connection with
this Agreement, the prevailing party in such litigation shall be entitled to have and
recover from the losing party reasonable attorneys’ fees and all other costs of such
action.
3.5.8 Governing Law. This Agreement shall be governed by the laws of
the State of California. Venue shall be in Los Angeles County.
3.5.9 Time of Essence. Time is of the essence for each and every
provision of this Agreement.
3.5.10 City's Right to Employ Other Consultants. City reserves right to
employ other consultants in connection with this Project.
3.5.11 Successors and Assigns. This Agreement shall be binding on the
successors and assigns of the Parties.
3.5.12 Assignment or Transfer. Consultant shall not assign, hypothecate,
or transfer, either directly or by operation of law, this Agreement or any interest herein
without the prior written consent of the City. Any attempt to do so shall be null and void,
and any assignees, hypothecates or transferees shall acquire no right or intere st by
reason of such attempted assignment, hypothecation or transfer.
3.5.13 Construction; References; Captions. Since the Parties or their
agents have participated fully in the preparation of this Agreement, the language of this
Agreement shall be construed simply, according to its fair meaning, and not strictly for
or against any Party. Any term referencing time, days or period for performance shall
be deemed calendar days and not work days. All references to Consultant include all
personnel, employees, agents, and subcontractors of Consultant, except as otherwise
specified in this Agreement. All references to City include its elected officials, officers,
and employees except as otherwise specified in this Agreement. The captions of the
various articles and paragraphs are for convenience and ease of reference only, and do
not define, limit, augment, or describe the scope, content, or intent of this Agreement.
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3.5.14 Amendment; Modification. No supplement, modification, or
amendment of this Agreement shall be binding unless executed in writing and signed by
both Parties.
3.5.15 Waiver. No waiver of any default shall constitute a waiver of any
other default or breach, whether of the same or other covenant or condition. No waiver,
benefit, privilege, or service voluntarily given or performed by a Party shall give the
other Party any contractual rights by custom, estoppel, or otherwise.
3.5.16 No Third Party Beneficiaries. There are no intended third party
beneficiaries of any right or obligation assumed by the Parties.
3.5.17 Invalidity; Severability. If any portion of this Agreement is declared
invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the
remaining provisions shall continue in full force and effect.
3.5.18 Prohibited Interests. Consultant maintains and warrants that it has
not employed nor retained any company or person, other than a bona fide employee
working solely for Consultant, to solicit or secure this Agreement. Further, Consultant
warrants that it has not paid nor has it agreed to pay any company or person, other than
a bona fide employee working solely for Consultant, any fee, commission, percentage,
brokerage fee, gift or other consideration contingent upon or resulting from the awar d or
making of this Agreement. For breach or violation of this warranty, City shall have the
right to rescind this Agreement without liability. For the term of this Agreement, no
member, officer or employee of City, during the term of his or her service with City, shall
have any direct interest in this Agreement, or obtain any present or anticipated material
benefit arising therefrom.
3.5.19 Equal Opportunity Employment. Consultant represents that it is an
equal opportunity employer and it shall not discriminate against any subcontractor,
employee or applicant for employment because of race, religion, color, national origin,
handicap, ancestry, sex, sexual orientation or age. Such non -discrimination shall
include, but not be limited to, all activities related to initial employment, upgrading,
demotion, transfer, recruitment or recruitment advertising, layoff or termination.
Consultant shall also comply with all relevant provisions of City's Minority Business
Enterprise program, Affirmative Action Plan or other related programs or guidelines
currently in effect or hereinafter enacted.
3.5.20 Labor Certification. By its signature hereunder, Consultant certifies
that it is aware of the provisions of Section 3700 of the California Labor Code which
require every employer to be insured against liability for Worker's Compensation or to
undertake self-insurance in accordance with the provisions of that Code, and agrees to
comply with such provisions before commencing the performance of the Services.
3.5.21 Authority to Enter Agreement. Consultant has all requisite power
and authority to conduct its business and to execute, deliver, and perform the
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Agreement. Each Party warrants that the individuals who have signed this Agreement
have the legal power, right, and authority to make this Agreement and bind each
respective Party.
3.5.22 Counterparts. This Agreement may be signed in counterparts,
each of which shall constitute an original.
3.5.23 Exhibits and Recitals. All Exhibits and Recitals contained herein
are hereby incorporated into this Agreement by this reference.
3.6 Subcontracting.
3.6.1 Prior Approval Required. Consultant shall not subcontract any
portion of the work required by this Agreement, except as expressly stated herein,
without prior written approval of City. Subcontracts, if any, shall contain a provision
making them subject to all provisions stipulated in this Agreement.
In witness whereof the Parties have executed this Professional Services
Agreement on the date set forth below.
CITY OF ARCADIA WITTMAN ENTERPRISES, LLC
By By ____________________________
Dominic Lazzaretto Signature
City Manager
Date: ______________________ ______________________________
Print Name and Title
ATTEST: Date: _________________________
___________________________ By____________________________
City Clerk Signature
APPROVED AS TO FORM: ______________________________
Print Name and Title
___________________________ Date: _________________________
Stephen P. Deitsch
City Attorney CONCUR:
______________________________
Michael E. Lang, Fire Chief
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EXHIBIT "A"
SCOPE OF SERVICES
CONSULTANT SHALL PROVIDE THE FOLLOWING SCOPE OF SERVICES.
Overview
Provide all supplies, equipment, personnel, computer hardware and software,
billing forms, insurance forms, lien forms, envelopes, postage and supplies
necessary to administer, on a day to day basis, the City’s EMS billing and
accounts receivable functions.
Interface with Medic ClipBoard system by Digital EMS Solutions, Inc. in
processing ePCRs for billing. The City will continue to utilize this technology
and system process to the City’s best advantage.
Professional Conduct
Perform all work required to effectively, efficiently, and ethically maximize the
collection of emergency medical payments.
Provide excellent and responsive customer service to Arcadia residents, City
staff, and other customers who communicate with all parties in a polite, patient,
and helpful manner.
Treat all patients, including debtors, with professionalism, honesty, and integrit y
while obtaining the maximum results. The City shall make the final decision on
any accounts involving a dispute.
Compliance & Regulatory Requirements
Comply with all provisions and specifications of the Health Insurance Portability
and Accountability Act (HIPAA) including other statutory, regulatory, and legal
requirements addressing patient privacy issues.
Maintain proficiency and comply with all statutory, regulatory, and other legal
requirements which may impact billing, reimbursement, and/or collections for
emergency medical services, and release of private medical information.
Provide on-going consultation to assist the City on matters related to the
collection of the EMS charges, to include advice on current developments in
Medi-Cal and Medicare reimbursements, private healthcare insurance
reimbursements, and claims management techniques.
Assistance and on-going consultation regarding Medicare Revalidation process,
California Ground Emergency Ambulance Transportation (GEMT), including
California SB 523 (GEMT), and other issues and regulations relating to
ambulance billing.
Execute a Business Associate Agreement for HIPAA compliance.
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Quality Control & Training
Implement an active Quality Assurance Program and Internal Auditing Controls
for detecting, correcting, and minimizing avoidable human or technical errors.
Provide mandatory and relevant staff training on a continuous basis.
The City reserves the right to audit the records of the proposer’s Billing
Agent(s) and its designees. The Billing Agent(s) and its designees shall
make and keep full and complete records and books of accounts of revenue
and income, costs and expenses that specifically relate to performance
under this contract. Records and books of account, together with any or all
other memoranda pertaining thereto that may be kept, maintained or
possessed by the Billing Agent(s) and its designees, shall be open to
examination during regular business hours by the City or its representatives
for the purpose of inspection, auditing, verifying, or copying the same or
making extracts therefrom. The Billing Agent(s) and its designees shall make
and keep said records and books of account in accordance with generally
accepted accounting practices and legal records retention requirements.
Proposer shall follow industry best practices regarding data security.
Receipt & Verification of Billing Information
Receive EMS patient reports from the City and confirm with City staff of receipt
of such reports.
Perform the following tasks within three (3) business days of the receipt of
patient care reports: Review patient reports for completeness of billing
information; make contact with patients, either via telephone or mailing, to
obtain accurate billing information; gather billing information from other
applicable resources, if necessary; and identify correct payers for patient
accounts prior to billing.
Provide a mechanism for not sending bill to Arcadia patients if they are a
member of the City’s Paramedic Membership Program (PMP). Every month,
the City forwards its PMP list (in Excel format) to its current ambulance billing
contractor. Membership to this program waives any out-of-pocket expenses
from emergency medical transport services provided by the AFD or its
authorized EMT providers.
Billing – Private Party
Provide sufficient qualified personnel to generate over 2,700 billable transports
annually and perform all related preparatory and follow-up tasks in a timely
manner to secure payments.
Produce billing invoice within two (2) business days of the receipt of all
necessary information and identification of correct account payers.
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All mailings shall have the capability to be customized to meet the needs of the
City. Customized mailings, including but not limited to information request form,
invoice, past due notice, and final request notice, shall be reviewed and
approved by the City to ensure that the City is properly represented to the
public.
Provide a toll free 800- customer service telephone number with 24-hour
voicemail system capability and make a good faith effort to respond to
customers’ inquiries within one (1) business day. Provide reasonable
accommodation for customers who require language translation assistance.
Billing – Others
Bill Medicare, Medi-Cal, primary and secondary insurance sources, Worker’s
Compensation insurers, Health Maintenance Organizations (HMO), Preferred
Provider Organization (PPO) plans, third party liability insurers, benefit
programs, and self-insurance programs within two (2) business days of the
receipt of all necessary billing information.
Utilize electronic billing and data transmittal when deemed appropriate to
expedite payments to the City.
Delinquent Accounts
Accounts that are 45 days delinquent shall be followed up by telephone and/or
mailings for payment arrangements.
Coordinate with the Collection Agency on delinquent account collection efforts
after all internal collection procedures have been exhausted.
Payment Collection
Accept direct payments, collect payments made by billed parties, and deposit
payments into the designated City bank accounts within one (1) business day of
receipt. All receipts and funds are under exclusive control of the City.
Post payments to patient accounts within one (1) business day of receipt.
Reports & Inquiries
Provide monthly financial reports detailing deposits, adjustments, refunds, and
balances promptly and whenever requested by the City.
To manage the account receivable generated by the AFD’s EMS, the monthly
financial reports shall also include, but not limited to, the following:
o Gross and net charges & collection
o Detailed accounts receivable of aging reports
o Analysis of charges and receipts by pay classification (i.e., self -pay,
commercial insurance, Medicare, Medi-Cal, etc.)
o Analysis of bad debts written off
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o Reconciliation of beginning and ending accounts receivable balances for
the month.
Provide other statistical reports, as requested.
Make a good faith effort to acknowledge and/or respond to inquiries and
requests made by City staff within one (1) business day.
Services Location
The billing and collection services for the City’s emergency medical transport
services are expected to be performed at the proposer’s business location.
As a point of reference, the following are the City’s facility locations:
The Arcadia Fire Department Headquarters, Station 105, is located at
710 S. Santa Anita Ave., Arcadia, CA 91006.
The Arcadia City Hall is located at 240 W. Huntington Dr., Arcadia, CA 91007.
Records Retention
Provide with all Federal, State, and City requirements for records retention.
Upon the termination of the contract, all records requiring retention shall be
returned to the City in a complete and organized manner complying with
the City’s then current storage and retention requirements.
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Exhibit "B"
SCHEDULE OF SERVICES
Consultant shall perform services within the term of the Professional Services
Agreement.
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Exhibit "C"
COMPENSATION
Services Fee
Ambulance Billing and Collections 4.25% of Total Net Collections
(Years 1 – 8)
Digital EMS ePCR Software Fees Monthly invoiced
pass-through cost