HomeMy WebLinkAboutStaff Report 284-09TO:
FROM:
DATE:
SUBJECT:
City of Palo Alto 9
City Manager's Report
HONORABLE CITY COUNCIL
CITY MANAGER DEPARTMENT: FIRE
JUNE 15, 2009 CMR: 284:09
Adoption of Ordinance Amending the Budget for Fiscal Year 2008-09
to Provide an Additional Appropriation of $215,000 for the Extension
of Contract No. C06116197 with Advanced Data Processing West,
Incorporated (ADPI) for Ambulance Billing Services
RECOMMENDATION
Staff recommends that Council adopt the attached Budget Amendment Ordinance (BAO) to
appropriate an additional amount of $215,000 for the contract with ADPIfor ambulance billing
services. This BAO will meet the expense obligation generated by the contract extension that
was approved on April 27, 2009 (CMR 211 :09).
DISCUSSION
At the Council meeting of April 27, 2009 the Council approved an amendment to the ,~PI
Contract extending the term and adding $215,000 to the contract in order to give staff additional
time to incorporate the audit recommendations into the upcoming request for proposals for
ambulance hilling services. The Budget Amendment Ordinance was inadvertently omitted from
Council action on that date. Approval of the BAO will allow the $215,000 in funds to be released
and added to the contract to pay for ambulance billing contract services until a new contract is in
place. The Finance Committee is scheduled to review the ambulance billing Scope of Services
on July 7,2009. Staff anticipates having a new contract by December, 2009.
RESOURCE IMPACT
Contract fees are based on a percentage of funds collected for EMS transport services; thus,
revenue generated during the contract extension period will more than offset the contract
Increase.
POLICY IMPLICATIONS
This recommendation is consistent with existing City policies.
ENVIRONMENTAL REVIEW
This BAO and the related contract are not a project under the provisions of the California
Environmental Quality Act.
CMR284:09 Page 1 of 2
ATTACHMENTS
Attachment # 1, Budget Amendment Ordinance
Attachment #2, CMR 211 :09
APPROVED BY: NI~1L~
Fire Chief
CITY MANAGER APPROVAL: ~frft~
City Manager
CMR284:09 Page 2 of 2
ORDINANCE NO.
ORDINANCE OF THE COUNCIL OF THE CITY OF PALO ALTO
AMENDING THE BUDGET FOR FISCAL YEAR 2008-09 TO PROVIDE AN
ADDITIONAL APPROPRIATION OF $215,000 FOR THE EXTENSION OF
CONTRACT NO. C06116197 WITH ADVANCED DATA PROCESSING
WEST, INCORPORATED (ADPI) FOR AMBULANCE BILLING SERVICES
Attachment #1
WHEREAS, pursuant to the provisions of Section 12 of Article
III of the Charter of the City of Palo Alto, the Council on June 09,
2008 did adopt a budget for fiscal year 2008-09; and
WHEREAS, ADPI provides service for outsource billing and
collection for Emergency Medical Services (EMS) transports by the
City of Palo Alto Fire Department.
WHEREAS, the current contract with ADPI expired November 2008
and was extended for six months ending in May 2009 pending
recommendations from the City Auditor's report on ambulance billing
procedures.
WHEREAS, On April 27, 2009 the Council approved a contract
amendment extending the term for a second time to give staff
additional time to incorporate the City Auditor's recommendations on
current billing practices into a new expanded scope of services and
Request for Proposal (RFP).
WHEREAS, additional appropriations are requested to fund the
extension of the ADPI contract approved on April 27, 2009.
WHEREAS, City Council authorization is needed to amend the
2008-09 budget as hereinafter set forth.
NOW, THEREFORE, the Council of the City of Palo Alto does
ORDAIN as follows:
SECTION 1. The sum of Two Hundred and Fifteen Thousand Dollars
($215,000) is hereby appropriated to contract services in the
Advanced Emergency Medical -Paramedic Functional Area of the Fire
Department, and the Budget Stabilization Reserve is correspondingly
reduced.
SECTION 2. This transaction will reduce the Budget
Stabilization Reserve from $20,926,089 to $20,711,089.
SECTION 3. As specified in Section 2.28.080(a) of the Palo
Al to Municipal Code, a two-thirds vote of the City Council is
required to adopt this ordinance
SECTION 4. The Council of the City of Palo Alto hereby finds
that this is not a project under the California Environmental
Quality Act and, therefore, no environmental impact assessment is
necessary.
SECTION 5. As provided in Section 2.04.350 of the Palo Alto
Municipal Code, this ordinance shall become effective upon adoption.
INTRODUCED AND PASSED:
AYES:
NOES:
ABSTENTIONS:
ABSENT:
ATTEST:
City Clerk
APPROVED AS TO FORM:
Senior Asst. City Attorney
APPROVED:
Mayor
City Manager
Director
Services
of Administrative
TO:
FROM: CITY MANAGER
DATE: APRIL 27, 2009
REPORT TYPE: CONSENT
Attachment #2
City of Palo Alto
City Manager's·Report
DEPARTMENT: FIRE
CMR: 211:09
SUBJECT: Approval of Amendment No.2 to Contract No. C06116197, with
Advanced Data Processing West, Incorporated (AD PI) to Extend the
Term and Add $215,000 for a Total not to Exceed Amount of $600,000
RECOMMENDATION
Staff recommends that Council approve and authorize the City Manager to execute the attached
Amendment (Attachment #1) for the extension of the contract with Advanced Data Processing
West, Incorporated (ADPI) through September 30, 2009 with an option to extend for an
additional three month period as necessary to close out existing accounts in the event the City
decides to change contractors.
Staff also recommends Council approve and authorize the City Manager to increase the contract
by $215,000, not to exceed a total of $600,000 to meet the expense obligation generated by the
contract extension. The amount of increase requested is based upon the average monthly costs
for billing fees that would cover the anticipated costs for calendar year 2009 and any overlap.
DISCUSSION
ADPI had a 1 year contract starting December 1, 2005 with the potential of renewal for a total
term up to 3 years and a total amount not to exceed $385,000 in any contract year. ADPI
provides service for outsource billing and collection for Emergency Medical Services (EMS)
transports by the Palo Alto Fire Department. For their service, ADPI retains a 7 percent service
fee for net funds that are collected. The 3 year contract term ended in November 30, 2008 and
was extended by mutual agreement of both parties pending the outcome of the recommendations
from the City Auditor's report on ambulance billing procedures.
As a result of the Auditor's report of current billing practices, staff recommends that the contract
be amended to extend the term. This extension will allow time to incorporate many of the audit
recommendations into a new expanded scope of service and issue a Request for Proposal (RFP)
that will respond more fully to the issues and needs identified in the audit. The September 30,
2009 extension is anticipated to allow adequate time to release an RFP, review responses and
award a new contract.
CMR 211:09 Page 1 of3
Some of the major highlights from the audit called for improved consistency, more detailed
reporting and review procedures for billing reconciliation, stricter controls for billing follow-up,
regular and frequent meetings to discuss billing issues and outstanding items, establishing a
system for payment by credit card, and negotiating a lower rate of commission for service.
ASD and Fire staff members have worked with the vendor and have implemented improvements
in reporting and review procedures, consistent monthly and quarterly meetings to monitor status
and address current issues, and a system for credit card payments. Staff members are continuing
to work with the vendor to improve and refine software data reporting systems, improved
mechanisms for monitoring progress and follow-up, and for improved efficiency in pursuing
uncollected or outstanding accounts. A lower rate of commission will be pursued in the RFP
process for the new billing contract.
The audit recommendations with Staffs progress and work plan to implement them are noted in
Attachment 2 (Pages 31-36 of the Audit City Manager's response dated February 3, 2009).
At the February 3 Finance Committee, members of the committee requested to review the final
RFP document prior to distribution to potential bidders. In addition, in the event a different
vendor is awarded the contract, staff anticipates that it would be beneficial to give ADPI time to
close open accounts for the City. If such overlap is necessary, the additional time through
December 31, 2009 would provide continuity and sufficient time to complete accounts being
appealed or in process with insurance companies, etc.
RESOURCE IMPACT
Contract fees are based on a percentage of funds collected for EMS transport services; thus,
revenue generated during the contract extension period will more than offset the proposed
contract increase.
POLICY IMPLICATIONS
This recommendation is consistent with existing City policies and will allow staff to fully
address the audit recommendations.
ENVIRONMENTAL REVIEW
This contract is not a project under the provisions of the California Environmental Quality Act.
ATTACHMENTS
#1 Amendment No.2 to Agreement No. C06116197
Amendment No.1 to the Agreement No. C06116197
ADPI Agreement
#2 City Manager's Response -Pages 31-36 of the Audit Report
#3 Budget Amendment Ordinance
CMR211:09 Page 2 of3
PREPARED BY:
KIM RODERICK
Emergency Medica] Services Coordinator
APPROVED BY: 'lkl!ik 1YL~ NICOLAS MARINARO
Fire Chief
CITY MANAGER APPROVAL:
CMR211:09 Page 3 of3
I
I
·' I
. I
AMENDMENT NO. 2 TO AGREEMENT NO. C06116197
BE'l"WEEN THE CITY OF PALO ALTO AND
ADPI, WEST INC.
This Amendment No. 2 to Agreement No. C06116197
("Agreement") is enteJ:ed into May 15, 2009, by and between the
CITY OF PALO ALTO ("CITY") I and ADPI I WEST INC., a Delaware
Corporation, located at 7750 Pardee Lane, Suite 1200, Oakland,
CA 9462J. (PH)510-769-9648 ("CONTRACTOR").
R Eel TAL S:
WHEREAS, the Agreement was entered into between the
parties for the provision of Outsource Billj.ng Services; and
WHEREAS, the parties wish to amend the Agreement;
NOW, THEREFORE, in consideration of the covenants, terms,
conditions, and provisions of this Amendment, the parties agree:
ECTION 3. The following provisions shall be added to
Section 3 entitled "TIME OF PERFORMANCE":
(190<117 9(JOOOSO
"TIME OF PERFORMANCE. The Term of this Agreement shall
be extended through September 30, 2009, under the current
Terms and Conditions of this Agreement.u
(a) Option to Renew for Close-Out of the Existing
Claims
The CITY retains the option to renew the Agreement
for the period of October 1, 2009 through December
31, 2009. Such renewal shall be made by CITY in
writing and shall be fo~ the purpose of allowing
CONTRACTOR to complete col.lection proceedings
1
Amend.agl
Rev. July 31, 199R
already in process, including those claims through
Medicare. Upon receipt of "Notice" from CITY, and
every 30 days thereafter, CONTRACTOR shall provide
to cn'Y a list of current accounts and
corresponding age. On December 31, 2009, or within
10 da of request by CITY, CONTRACTOR will
turnover to CITY the aLL accounts receivable and
supporting documents for all outstanding claims.
SECTION 4. The section entitled "COMPENSATION AND
METHOD OF PAYMENT u is hereby amended, to read as follows:
0904 17 90000S()
4. COMPENSATION AND METHOD OF PAYMENT
4.01 The CITY reserves the right to request changes in the
services within the general scope of the Agreement to be
performed upon mutual agreement by the CITY and CONTRACTOR
that shall specify the change ordered and the adjustments of
time and compensation required therefore. The CITY reserves
the right to challenge all or any part of an invoice.
4.02 Any services added to the scope of this Agreement by a
change order shall be executed in compliance with all other
applicable conditions of this Agreement. No c im for
additional compensation or extension shall be recognized
unless contained in the duly executed change order.
4.03 The CONTRACTOR shall be paid by the CITY a monthly
amount representing fees for the services provided computed
2
Amcnd.ngl
Re\, . .lilly 31. 19<)R
a· c' • -' .
Seven percent ('7%) of all monies collected by
CONTRACTOR; not to exceed a total of $600,000.
The CONTRACTOR and the CITY shall agree to
increase fees if the Unj.ted States Postal Services increases
postage, but only to cover additibnal postal costs. The fee
increase shall be determined on the current postal rate and
the new rate increase by cents value.
4.04 The CITY shall issue a check for the amount invoiced,
within thirty (30) days of an accurate invoice. CONTRACTOR
will resolve any disputed amounts within 60 days from the
date CITY gives notification.
4.05 CITY, should they elect to participate in any credit
card acceptance program, agrees to assume and be responsible
for all costs associated with such program,
4.06 All other costs incurred by CONTRACTOR in the
performance of services as specified herein (including, but
not limited to postage, materials, communications and phone
costs and other operating costs) shall be assumed by the
CONTRACTOR.
Except as herein modified, all other provisions of the
Agreement, including any exhibits and subsequent amendments
thereto, shall remain in full force and effect.
3
090117 9000050 AIl1CIllI.~g'
Re\', July J 1.1998
IN WITNESS WHEREOF, the parties have by their duly
authorized J~epresentatives executed this Amendment on the date
first above written.
CITY OF PALO ALTO
APPROVED AS TO FORM:
Sen or Asst. y Attorney
APPROVED:
Pu Manager
O<)()4 17 <)00005()
4
ADPI
Title:
By: _. ______ . __ . ______ . __
Name:
Title:
Amend.flg1
Rev. Jllly ) I, 1998
s Amend~enc ~o. 1 to ~gree~en~ C0611619-:;'
("Agreement") is entered into Ja. 16, 2009, by and between
the CITY OF PALO ALTO ("CITY"), and ADPI, WEST INC. a Delaware
CorDoration located at 7750 Pardee La~e, Suite #200, Oakland, ..L.: _._,
CA 94621 (PH) 510-769 9648 ("CONTRACTOR")
R Eel TAL s:
~lHEREAS, the Agreement was ent into between the
parties the provision of Outsource Billing Services; and
WHEREAS, the parties wish to amend the Agreement;
NOW, THEREFORE, in consideration of the covenants, terms,
conditions, and provisions of this Amendment, the parties
SECTION :3. The following sentence shall beac1ded to
Section 3 entitl "TIfvIE OF PERFORMANCE":
0901189000050
"TINE OF PERFORMANCE. The Term of this Agreement shall
be extended t.hrough May 14, 2009, under the current Terms
and Conditions of this Agreement.
1
Amend,agl
Rev, July 31. t 998
E:{cept as :,. modifi all or:
p_greement, including any exhibits and subsequent amendments
thereto, shall remain in full fc=ce a~d effect.
IN WITNESS vlHEREOF, the parties have by their duly
authori zed representatives executed this Amendment on the date
first above written.
CITY OF PALO ALTO ADPI WEST,
Senior Asst. City ~()torney
By: ___ , .... ~~ _____ ,, ________ ._. __ _
Contra Name: .' ------------------------------
Title: -----------------------------
2
0901289000050 Amend,agt
Rev. July 31, 1998
, ,;
SERVICES AGREEMENT BETWEEN
eTY OF PALO ALTO
AND
ADVANCED DATA PROCESSING, INC.
FOR AMBULANCE BILLING, COLLECTION A~D RELATED PROFESSIONAL
SERVICES.
THIS AGREEMENT, hereinafter "AGREEMENT', made and entered into this __ day of
October, 2005 by and between CITY OF PALO ALTO, a California Charter City, with
principa I offices located at 250 Hamilton Avenue, Palo Alto, California 94301, hereinafter
referred to as the "CITY''. and ADPI West, Inc., a Delaware corporation with offices
located at 7750 Pardee Lane, Oakland, California 94621, hereinafter referred to as the
"CONTRACTOR".
WITNESSETH:
WHEREAS, CITY has need for billing services for EMS fees;
WHEREAS, CONTRACTOR is competent, experienced and able to perform said
services; and,
WHEREAS, CONTRACTOR has provided the most advantageous and best
responsible proposal for such services to another public agency (the City of San
Bernardino); and,
WHEREAS, the parties hereto now wish to enter into an agreement, pursuant to
which the CONTRACTOR will render those professional services in connection with said
project as hereinafter provided;
NOW THEREFORE, the parties hereto agree as follows:
1. DEFINITION OF THE PROJECT. The objective of the project is to utilize the services
of the CONTRACTOR to provide the CITY with billing services for EMS services as
stated on the City's Fee Schedule.
2. SCOPE OF SERVICES. The CONTRACTOR shall perform and carry out the work as
defined in "EXHIBIT B -Scope of Work".
Contractor shall not harass or annoy patients or payers in any correspondence or
telephone contacts seeking payment. Contractor shall exercise extreme sensitivity and
be courteous and professional in any communications with patients and payers .
. '
3. TIME OF PERFORMANCE. This Agreement shall be effective for a one-year period.
This Agreement will automatically renew for two (2) additional one year periods under
the then in force terms and conditions unless notified otherwise by the CITY within thirty
(30) days of the renewal date.
4. COMPENSATION AND METHOD OF PAYMENT.
4.01 The CITY reserves the right to request changes in the services within the general
scope of the Agreement to be performed upon mutual agreement by the CITY and
CONTRACTOR that shall specify the change ordered and the adjustment of time and
Agreement Page 1 of 9
compensation required therefore. The CITY reserves the right to challenge all or any
part of an invoice.
4.02 Any services added to the scope of this Agreement by a change order shall be
executed in compliance with all other applicable conditions of this Agreement. No claim
for additional compensation or extension of time shall be recognized unless contained in
the duly executed change order.
4.03 The CONTRACTOR shall be paid by the CITY a monthly amount representing fees
for the services provided computed as:
Seven percent (7%) of all monies collected by CONTRACTOR.
The Contractor and the CITY shall agree to increase fees if the United States Postal
Service increases postage, but only to cover additional postage costs. The fee increase
shall be determined on the current postage rate and the new rate increase by cents
value.
4.04 The CITY shall issue a check for the amount invoiced, within thirty (30) days of
receipt and acceptance of an accurate invoice. Contractor will resolve any
disputed amounts within 60 days from the date CITY gives notification.
4.05 CITY. should they elect to participate in any credit card acceptance program,
agrees to assume and be responsible for all costs associated with such program.
4.06 All other costs incurred by CONTRACTOR in the performance of services as
specified herein (including, but not limited to postage, materials, communications
and phone costs and other operating costs) shall be assumed by the
CONTRACTOR.
5. COLLECTIONS AND DEPOSITS. The CONTRACTOR will collect and deposit
payments to bank institute pre-designated by the CITY. If the City would like ADPI to
receive all payments and mailings, ADPI will establish a PO Box in Alameda, CA as the
"mail to" address. Daily ADPI will have a courier pickup all correspondence and
payments from the PO Box and deliver them to the Oakland office where a staff member
will sort the mail to payments and non-payments. All non-payments, such as return mail
or insurance information, will be given to the appropriate department for immediate
handling. All payments will be photo copied and then deposited directly into the City's
bank account. ADPI will only have deposit only access to the City's bank account. All
statements and control of this account will be managed and maintained by the City of
Palo Alto. On the same ,day of each deposit, ADPI will fax a copy of the deposit slip
notifying the City of the deposit and amount to reconcile with ADPI month end reports
and bank statements. Along with the monthly reports, ADPI will include an invoice for
our fees based upon the net revenue of the previous month.
6. REPORTS. The CONTRACTOR shall provide the CITY with status reports as set
forth in Exhibit B and included in the Proposal. The CONTRACTOR shall also provide
changes to· such reports and ad hoc report requests on a reasonable basis and as
mutually agreed, CONTRACTOR reserves the right to charge an additional fee for any
Agreement Page 2 ot9
.' ,
programming cost associated with ad hoc reports that would require more than a
reasonable amountJf time to accomplish.
7. DATA TO BE FURNISHED 8'( CITY. The CITY will make availab;e to the
CONTRACTOR, for use in performailc·e of services L:nder this Agreement, all available
reports, studies or any other materials in its possession that may be useful to the
CONTRACTOR All material furnished by the CITY will not be disclosed to any party,
other than as required under the scope of the Agreement, without the CITY's prior
written approval.
8. INDEPENDENT CONTRACTOR. The CONTRACTOR is an independent contractor
and not an employee or agent of the CITY with the following exception:
To the extent necessary to fulfill its billing and collection efforts
under the Agreement, the CONTRACTOR is authorized to sign in an
administrative capacity for the CITY the foJ/owing types of standard
forms and correspondences only: probate filings; letters to patients or
their representatives verifying that an account is paid in full; forms
verifying the tax-exempt status of the CITY; and insurance filings and
related forms. The CONTRACTOR has no authority to sign any
document that imposes any additional liability on the CITY. A copy of all
such documents signed by the CONTRACTOR in an administrative
capacity for the CITY shall be immediately sent to the CITY's
representative designated in Paragraph 17, Notices, herein.
The CONTRACTOR shall perform work tasks as directed by the Fire Chief or designee,
but for all intents and purposes, CONTRACTOR shall be an independent contractor and
not an agent or employee of the CITY.
In the performance of this Agreement and in hiring and recruitment of employees,
CONTRACTOR shall not discriminate on the basis of race, creed, color, religion, sex,
physical handicap, ethnic background or country of origin.
The CONTRACTOR shall retain full control over the employment, direction,
compensation and discharge of all persons assisting in the performance of service by
CONTRACTOR. The CONTRACTOR shall be fully responsible for all matters relating to
payment of employees, including compliance with Social Security, withholding tax and all
other laws and regulations governing such matters. The CONTRACTOR shall be
responsible for its own acts and those of its agents and employees during the term of
this Agreement.
CONTRACTOR shall not utilize subcontractors in the performance of this Agreement.
The use of subcontractors requires the prior approval of the CITY. Subcontractor shall
be defined as persons who perform billing and accounts receivable management
services substantially similar to those services performed by CONTRACTOR.
9. INDEMNIFICATION. Both Parties shall indemnify and hold the other party harmless
from any and all claims, losses and causes of actions which may arise out of each
party's performance of this Agreement as a result of an act of negligence or intentional
acts, omissions, or wrongdoings of the parties including their employees, agents,
representatives, consultants, or subcontractors. The Wrongful Party shall pay all
Agreement Page 30f9
reasonable claims and losses of any nature whatsoever in connection therewith and
shall pay all reasonable costs and judgments (including, but not limited to, attorneys'
fees and expenses incurred at the trial, administrative levels, or on appeal) that may
issue thereon. The above provisions shall survive the termination of this Agreement and
shall pertain to any occurrence during the term of this Agreement, even though the claim
may be made after the termination hereof.
Nothing contained herein is intended nor shall be construed to waive Either Parties
rights and immunities under the common law or applicable State Statutes, as amended
from time to time.
This contract shall not confer rights to third parties in any matters arising out of this
Agreement or any other contract and shall not be construed as consent by the parties to
be sued by third parties in any matter arising out of this Agreement or any other contract.
This contract shall not serve as a waiver of sovereign immunity to which sovereign
immunity may be applicable.
10. INSURANCE. Contractor shall 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 work hereunder by
the Contractor, his agents, representatives, employees, or subcontractors. The cost of
such insurance is the responsibility of the Contractor.
10.01 Minimum Limits of Insurance
Contractor shall maintain limits no less than:
a. General Liability: $1,000,000 Combined Single Limit for bodily injury and
property damage per occurrence with a $2,000,000 annual aggregate.
b. Automobile Liability: One Million ($1,000,000.00) Dollars combined single
limit per accident for bodily injury and property damage. (Non-owned, Hired Car).
c. Workers' Compensation Employers Liability: Insurance covering all
employees meeting Statutory Limits in compliance with the applicable state and
federal laws and Employee's Liability with a limit of $500,000 per accident,
$500,000 disease policy limit, $500,000 disease each employee. Waiver of
Subrogation in lieu of Additional Inslired will suffice.
d; Professional Liability Insurance, including errors and omissions: for all services
provided under the terms of this agreement with minimum limits of One Million
($1,000,000.00) Dollars per occurrence; or claims made form with "tail coverage"
extending three (3) years beyond the term of the agreement. Proof of "tail
coverage" must be submitted with the invoice for final payment. In lieu of "tail
coverage", Contractor may submit annually to the CITY a current Certificate of
Insurance proving claims made insurance remains in force throughout the same
three (3) -year periods.
e. Umbrella: $2,000,000 combined single limit for bodily injury and property
damage combined per occurrence and annual aggregate. The coverage shall
provide excess coverage for employer's liability, general liability, including
completed operations and auto liability.
Agreement Page4of9
• t
f. Crime Policy: Contractor shall provide a Crime Policy in the amount of
$500,000. Coverage to be prov;ded shall include: Theft -Per Loss Coverage;
Forgery or Alteration; Inside the Premises -ThE:t of MOr.ESY and S\=:curities;
Inside the Premises -Robbery or ~afe Bur:::lary of :Jther Property; Outside the
Premises; Computer Fraud; Funds Transfer Fral:d; and I\;loney Orders and
Counterfeit Paper Currency.
10.02. OeductibJes and Self-Insured Retentions
Deductibles or self-insurance shall be maintained in amounts or at levels which are
customary for the size, profile and industry in which CONTRACTOR is employed. No
decreases in coverage can occur without the approval of the CITY.
10.03. Other Insurance Provisions
The policies are to contain, or be endorsed to contain, the following provisions:
a. General Liability and Automobile Liability Coverage (CITY is to be named as
Additional Insured).
1. The CITY, its officers, officials, employees and volunteers are to be
covered as additional insured as respects; liability arising out of activities
performed by or on behalf of the Contractor, including the insured general
supervision of the Contractor; products and completed operations of the
Contractor; premises owned, occupied or used by the Contractor; or
automobiles owned, leased, hired or borrowed by the Contractor. The
coverage shall contain no special limitations on the scope of protections
afforded the CITY, its officers, officials, employees or volunteers.
2. The Contractor's insurance coverage shall be primary insurance as
respects the CITY, it officers, officials, employees and volunteers. Any
insurance of self-insurance maintained by the CITY, its officers, officials,
employees or volunteers shall be excess of the Contractor's insurance
and shall not contribute with it. Contractor hereby waives subrogation
rights for loss or damage against the CITY.
3. Any failure to comply with reporting provisions of the policies shall not
affect coverage provided to the CITY, its officers, officials, employees or
volunteers.
4. The Contractor's insurance shall apply separately to each insured
against whom a claim is made or suit is brought, except with respect to
the limits of the insurer's liability.
5. Companies issuing the insurance policy, or policies, shall have no
recourse against the CITY for payment of premiums or assessments for
any deductibles with are all at the sole responsibility and risk of
Contractor.
b. All Coverage
Each insurance policy required by this clause shall be endorsed to state
that coverage shall not be suspended, voided, canceled by either party,
reduced in coverage or in limits except after thirty (30) days prior written
notice by certified mail, return receipt requested, has been given to the
CITY.
10.04. Acceptability of Insurers
Insurance is to be placed with insurers with a Best rating of no less than A: VII.
Agreement Page 5 of 9
10.05. Verification of Coverage
Contractor shall furnish the CITY with certificates of insurance and with original
endorsements effecting coverage required by this clause. The certificates and
endorsements for each insurance policy are to be signed by a person authorized by that
insurer to bind coverage on its behalf. All certificates and endorsements are to 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.
11. OWNERSHIP OF DOCUMENTS. CONTRACTOR shall be required to work in
harmony with other consultants relative to providing information requested in a timely
manner and in the specified form. The CONTRACTOR agrees that any and all
documents, records, disks, and electronic data produced in the performance of this
Agreement shall be the sole property of the CITY, including all rights therein of whatever
kind except as may otherwise be provided hereinafter. Failure to turn over such
documents within thirty (30) days of a written request by CITY may be cause for the
CITY to withhold payments due CONTRACTOR or to enforce this clause by legal
remedies.
12. ATTACHMENTS. The following named attachments are made an integral part of this
Agreement:
A. Business Associate Addendum (Exhibit A attached hereto and made a part hereof)
B. Scope of Work (Exhibit 8 attached hereto and made a part hereof)
C. Certificate Of Liability Insurance
D. Provider's Affirmative Action Statement
)
13. TERMINATION. During the time of this agreement either party may terminate this
Agreement either for convenience or for default after first giving to other party thiriy (30)
days written notice.
For cases of default, the CONTRACTOR shall be given opportunity to cure the default
within the thirty (30) day period following such written notice. In the event the acts
constituting default are a violation of law, CONTRACTOR shall be subject to immediate
termination of Agreement.
Upon termination for any cause, the CONTRACTOR shall submit an invoice(s) to the
. CITY in an amount(s) representing fees for services actually performed or obligations
incurred to the date of effective termination for which the CONTRACTOR has not been
previously compensated. Upon payment of all sums found due, the CITY shall be under
no further obligation to the CONTRACTOR, financial or otherwise.
For purposes of this section, the notice period begins when the CONTRACTOR receives
written notice from the CITY.
14. UNCONTROLLABLE FORCES. Neither the CITY nor CONTRACTOR shall be
considered to be in default of this Agreement if delays in or failure of performance shall
be due to Uncontrollable Forces, the effect of which, by the exercise of reasonable
diligence, the non-performing party could not avoid. The term "Uncontrollable Forces"
shall mean any event which results in the prevention or delay of performance by a party
of its obligations under this Agreement and which is beyond the reasonable control of
the non-performing party. It includes, but is not limited to fire, flood, earthquakes, storms,
Agreement Page 6 of 9
lightning, epidemic, war, riot, civil disturbance, sacctage, terrorism and governmental
actions.
Neither party shall, however, be excLsed from performance if non-performance is due to
forces t;,at are preventable, rem0v8ble, or rer':;:;;ble nor which the non-pe:iorming
party cC'.Jld have, with the exercise of reasor.,,·,,: 'e. ::liligence, prevented. remo';ed, or
remedied with reasonable dispatch. The non-perfof;-;ing par:y shall, within a reasonable
time of being prevented or delayed from performance by an uncontrollable force, give
written notice to the other party describing the circumstances and uncontrollable forces
preventing continued performance of the obligations of this Agreement.
15. JURISDICTION, VENUE and CHOICE OF LAW. All questions pertaining to the
validity and interpretations of this Agreement shall be determined in accordance with the
laws of the State of California. Any legal action by either party against the other
concerning this agreement shall be filed in County of Santa Clara, California, which shall
be deemed proper jurisdiction and venue for the action.
16. ASSIGNMENT OF AGREEMENT. Except to a parent, subsidiary, or affiliate, the
CONTRACTOR shall not sell, transfer, assign or otherwise dispose of this Agreement or
any part thereof or work provided therein, or of its right, title or interest therein, unless
otherwise provided in the Agreement, without express prior consent by the CITY.
17. NOTICES. All notices pertaining to this Agreement shall be delivered or mailed, with
the United States Postal Service, Postage Pre-paid. to such party at their respective
address as follows:
To the CITY:
Dan Lindsey, Acting Deputy Chief
711 Serra Street
Stanford, CA 94305
To the CONTRACTOR:
Brad Williams, Vice President-Controller
ADPI West. Inc.
520 NW 165th Street Suite 201
Miami. FL 33169
18. REPESENTATION AND WARRANTY. CONTRACTOR represents that they have
experience and agrees to follow all Federal, State and Local Laws including, but not
limited to, Public Records Laws and those laws and statutes applicable to discrimination.
19. INTEREST OF CONTRACTOR. It is agreed that the CONTRACTOR presently has
no interest and shall not acquire any interest, direct or indirect, which would conflict in
any manner or degree with the performance of the CONTRACTOR'S services under this
Agreement. It is further agreed that in the performance of this Agreement the
CONTRACTOR shall employ no person having any such interest.
Agreement Page 7 of9
20. SERVERABILITY. Should any part, term or provision of this Agreement be by the
courts decided to be illegal or in conflict with any law of the State of California. the
validity of the remaining portions or provisions shall not be affected tllereby.
21. ENTIRE AGREEMENT. This Agreement contains the entire agreement between the
parties. The CONTRACTOR represents that in entering into this Agreement it has not
relied on any previous oral and/or implied representations, inducements or
understandings of any kind or nature.
22. NON*APPROPRIATION. This Contract is subject to the fiscal provisions of the
Charter of the City of Palo Alto and the Palo Alto Municipal Code. This Contract will
terminate without any penalty (a) at the end of any fiscal year in the event that funds are
not appropriated for the following fiscal year. or (b) at any time within a fiscal year in the
event that funds are only appropriated for a portion of the fiscal year and funds for this
Contract are no longer available. This Section shall take precedence in the event of a
conflict with any other covenant, term, condition, or provision of this Contract.
Agreement Page 80f9
· ,
IN WITNESS OF THE FOREGOING, the CITY has caused :his Agreement to be
signed by the Mayor, attested by the CITY Clerk, and the Contractor has executed this
Agreement effect!ve as of the date set forth above.
CITY OF PALO ALTO. CA:"lFORNIA
ATTEST:
"
(SEAL)
Approved as to form:
And legal content:
City Attorney
by:
Mayor
City of Palo Alto
CONTRACTOR:
Adv~~ata .proceSSing, Inc. r~ (/ -',:oo:G ~i'~O;---.
PRESIDENT
BEFORE ME, an officer duly authorized by law to administer oaths and take
acknowledgments, personally appeared Doug Shamon, as President of Advanced
Data Processing, Inc., a Delaware corporation, and acknowledged execution of the
foregoing Agreement for the use and purposes mentioned in it and that the instrument
is the act and deed of the Contractor.
IN WITNESS OF THE FOREGOING, I have set my hand and official seal at in
the State and County aforesaid on -J." ~>h'n~\vr Yj ,2005. (\1 \
\ .\" \ " J \ .~ I\~Y \..1,/"--..... i1 v Notary Public
1 ) <._1'
Agreement Page 90f9
Exhibit A
Business Associate Addendum
Advanced Data Processing, Inc. the "Business Associate" (hereinafter referred to
as "ADPI") and City of Palo Alto (hereinafter referred to as City of Paio Alto) hereby
amend the Agreement entered into on October __ , 2005, ("the Agreement") by
adding the following additional language to the Agreement.
1. ADPI shall carry out its obligations under this Addendum in compliance with the
privacy regulations pursuant to Public Law 104-191 of August 21, 1996, known
as the Health Insurance Portability and Accountability Act of 1996, Subtitle F -
Administrative Simplification, Sections 261, et seq., as amended ("HIPAA"), to
protect the privacy of any personally identifiable protected health information
("PHI") that is collected, processed or learned as a result of the Billing Services
provided hereunder. In conformity therewith, ADPI agrees that it will:
a. Not use or further disclose PHI except as permitted under this Addendum or
required by law;
b. Use appropriate safeguards to prevent use or disclosure of PHI except as
permitted by this Addendum;
c. To mitigate, to the extent practicable, any harmful effect that is known to ADPI of
a use or disclosure of PHI by ADPI in violation of this Addendum.
d. Report to City of Palo Alto any use or disclosure of PH I not provided for by this
Addendum of which ADPI becomes aware;
e. Ensure that any agents or subcontractors to whom ADPI provides PHI, or who
have access to PHI, agree to the same restrictions and conditions that apply to
ADPI with respect to such PHI;
f. Make PHI available to City of Palo Alto and to the individual who has a right of
access as required under HIPAA within 30 days of the request by City of Palo
Alto regarding the individual;
g. Incorporate any amendments to PHI when notified to do so by City of Palo Alto;
h. Provide an accounting of all uses or disclosures of PHI made by ADPI as
required under the HIPAA privacy rule within sixty (60) days;
i. Make their internal practices, books and records relating to the use and
disclosure of PHI available to the Secretary of the Department of Health and
Human Services for purposes of determining ADPI's and City of Palo Alto's
compliance with HIPAA; and
j. At the termination of the Agreement, return or destroy all PHI received from, or
created or received by ADPI on behalf of City of Palo Alto, and if return is
infeasible, the protections of this Addendum will extend to such PHI.
Exhibit A Page 1 of4
.' .
2. The specific uses and disclosures of PHI that may be made by AD?I on behalf of
City of Palo Alto include:
a. The preparation of invoices to patients, carriers. insurers and others responsible
for '::ayment or reimbursement of the services provided by City of Paio Alto to its
patients;
b. Preparation of reminder notices and documents pertaining to collections of
overdue accounts;
c. The submission of supporting documentation to carriers, insurers and other
payers to substantiate the health care services provided by City of Palo Alto to its
patients or to appeal denials of payment for same.
~ d. Uses required for the proper management of ADPI as business associate.
e. Other uses or disclosures of PHI as permitted by the HIPAA privacy rule.
3. Notwithstanding any other provisions of this Addendum, the Agreement may be
terminated by City of Palo Alto if ADPI has violated a term or provision of this
Addendum pertaining to ADPI's material obligations under the HIPAA privacy
rule, or if ADPI engages in conduct which would, if committed by City of Palo
Alto, result in a violation of the HIPAA privacy rule by City of Palo Alto.
Exhibit A
Page 2 of 4
Exhibit s: Scope of Services
Contractor shall provide complete medical billing and accounts receivable management
services for CITY's first responder, paramedic, and membership program fees in
accordance with the responsibilities outlined below.
Contractor's Responsibilities:
Contractor will provide timely and accurate billing services for emergency medical
treatment utilizing information provided by CITY and information obtained from other
reliable sources including:
All services will be provided as stated in the Proposal. The following is a summary of these
responsibilities: c.
I. Provide billing and accounts receivable management services to CITY for Emergency
and Non-Emergency care per City Fee Schedule.
2. Ensure that all required documentation and agreements with payors (e.g. Medicare,
Medicaid, Champus, etc.) are filed and maintained and that the CITY is kept apprised
of important changes to industry regulations.
3. Ensure knowledge of different industry insurance plans and will ensure that every
billable claim is pursued.
4. Provide reasonably necessary training periodically. as requested by CITY. to CITY's
EMS and/or CITY FIRE RESCUE PARAMEDICS personnel regarding the gathering
of the necessary information and proper completion of run tickets. .
5. Provide prompt submission of Medicare, Medicaid and insurance claims after
receiving completed run ticket and corresponding insurance claim information.
Secondary insurance provider claims shall be submitted after the primary insurance
provider has paid.
6. Provide follow-up on rejected and inactive claims.
7. Utilize most up-to-date knowledge and information with regard to coding
requirements and standards. to ensure compliance with applicable Federal. State
and local regulations.
8. Reconcile the number of transports processed with those received.
9. Provide a designated liaison for patienUpayor concerns.
10. Provide all customer-related inquiry services and prepare additional third-party claims
or patient payment arrangements based on this information exchange.
11. Provide a toll free telephone number for patients to be answered as designated by
the CITY.
12. Facilitate proper security of confidential information and proper shredding of all
disposed materials containing such information.
13. Establish arrangements with hospitals to obtain/verify patient insurance and contact
information.
Exhibit B
• J
14. Respond to any CITY or patient ir.l~uiry or questions promptly
15. Maintain appropriate accounting procedures for reconciling all deposits, receivables,
billings, patient accounts, acjL::tmer.~:: :::nd refuncs.
16. Provide access to CITY fer all requested information in order for CITY to perform
appropriate and periodic audits. Re2::'onable notice will be given to CONTRACTOR
for any planned audit and will be conducted during normal business t10urs of
CONTRACTOR
17. Provide timely comprehensive reports facilitating all required aspects of monitoring,
evaluating, auditing and managing the services provided. Process refund requests
and provide the CITY with documentation substantiating each refund requested.
J 8. Provide CITY all unpaid invoices along with the complete processing history once
collection efforts are exhausted.
Specific Scope Compliance
The CONTRACTOR will provide the specific services:
1. Assign billing patient numbers providing cross-reference to the CITY'S assigned transport
numbers.
2. Maintain responsibility for obtaining miSSing or incomplete insurance information.
3. Provide accurate coding of medical claims.
4. Make recommendations for fee schedule changes; regularly advise on changes in
statutes and industry regulations.
5. Respond to all patients' requests and inquiries, either written or verbal.
6. Initial invoices will be mailed out within 2 days of receipt of paramedic run tickets. The
following billing cycle will be followed:
Self Pay Cycle:
Initial Invoice 2 days
Second Notice 30 days
Telephone Contact 45 days
First Letter Contact 60 days
Second Letter ContracU 90 days
Second Telephone Contact
Third Letter Contact 120 days
Delinquent AudiUPhone Audit 135 days
Final Demand Notice 150 days
Refer to City Policy 180 days
Insurance Accounts Cycle:
Initial Invoice 2 days
First Follow Up 30 days
Exhibit B
Page 2 of 4
Continued Follow Ups
Special Accounts Cycle:
Installment Follow Up
Lien/Bankruptcy Follow Up
Special Program Follow UP
Returned Mail Cycle:
30 days (every)
30 days
60 days (every)
60 days (every
Skip Search Request Hospital Assistance
Billing cycles will be reset upon billing a different payor.
All follow-up work required in order to collect insurance payments, including additional
correspondence and telephone calls, will be performed by the CONTRACTOR and
logged automatically in the patient's ledger.
CONTRACTOR will submit to the CITY documentation of each time they work an
account, whether it is a phone call or correspondence with the patient or insurance
company. A notation will be made on the patient's record of the date and information
learned from the contact person. Information such as mail returned or phone
disconnected, etc., will also be recorded. The CONTRACTOR has a message box on
their statements where the patient will be informed he/she is delinquent, and if no
response, a deadline before collection and then a final demand all in the time frame or
cycles previously defined.
Cash accounts (Self-pay) over 180 days delinquent will be referred to the CITY along
with above documentation of contact and' recommendation made for turnover to
collection agency or recommendation for write-off.
A. CONTRACTOR will provide two separate reports to the CITY, one for those
recommended for collection and the other for recommended write-offs. These
reports to be generated twice a month.
B. Both reports will include all information regarding the patient: name, date of service,
employer. reason why account is uncollectible, proof and dates of the
CONTRACTOR's attempts to collect on the account. Upon approval and direction by
the CITY, the CONTRACTOR will reference in billing history the date account is
written-off and reference collection agency aSSigned to account. The
CONTRACTOR will then return to the CITY accounts to be assigned to outside
collection agency.
7. Negotiate and arrange modified payment schedules for individuals unable to pay full
amount when billed.
8. Retain all accounts for a minimum of six (6) months (unless otherwise specified by
mutual agreement) turning over accounts for which no collection has been made (unless
insurance payment is pending or modified schedules are arranged and show payment
progress).
9. Main~ain records in an electronic format that is readily accessible by the CITY personnel
and meets all federal and state requirements for maintaining patient medical records.
10. Maintain daily deposit control sheets and original documentation.
Page 30f4
11. CONTRACTOR shall be capable to receive and send tata compatible with the CITY's
field data system billing extract software. CONTRACTOR shall be able to interface or
tlave a link that is capable of d0'Nnloading or uploading information from the City's data
collection server.
12. Imple;;ent and comply with a Compliance F'c;~1 consiste;~ with the intent and activities
incluC'3d in the U.S. Office of Inspector Generc: (OIG) Ccmpiiance Program Guidance fc~
Third Party Medical Billing Companies 63 FR 7C 138; (December 18, 1998).
CITY's Responsibilities:
Exhibit B
1. CITY will provide Contractor with patient encounter information on a timely
basis and in sufficient detail to support diagnosis and procedure coding.
CITY will also provide patient demographic information necessary for
accurate patient identification including name, address, social security
number, date of birth, and telephone number. Where possible, CITY will
obtain and provide contractor with patient health insurance, auto insurance,
or other insurance information.
2. CITY will provide Contractor with necessary documents required by third
parties to allow for the electronic filing of claims by Contractor on CITY's
behalf.
3. CITY will provide Contractor with its approved billing policies and procedures
including fee schedules and collection protocols. CITY will be responsible for
engaging any third party collection service for uncollectible accounts after
Contractor has exhausted its collection efforts.
4. CITY will timely process refunds identified by Contractor for account
overpayments.
5. CITY will cooperate with Contractor in all matters to ensure proper
compliance with laws and regulations.
Page 4 of4
Palo ~t\lto l':1unicipal Code
2.30.360 Exemptions from competitive sollcitation requirements.
The follovving arc exemptions from the informal and formal competitive solicitation
requirements of this chapter. It is expected that the exemptions will be nan-owly applied.
The department requesting an exemption shall provide all relevant information
supporting the application of the exemption to the purchasing manager. Based on this
infonnation, the purchasing manager shall make a recommendation to the city manager
and the city manager shall determine whether an exemption fro111 competitive solicitation
requirements applies. Nothing herein is intended to preclude use of competitive
solicitations where possible.
U) Contracts with any public agency or governmental body to obtain goods and/or
services that meet either of the following criteria:
(1) Cooperative purchases where the city participates with one or more other
governmental or public agencies in a cooperative agreement, provided at least one of the
agencies has used solicitation process methods substantially similar to those required by
this chapter; or
(2) The use of another governmental or public agency's contract provided
the original parties to the contract agree, the contract was awarded within twelve
months of the date the city contracts for the goods and/or services, and the contract
resulted from solicitation methods similar to those required by this chapter.
To:
PURCHASE REQUISITION (PR)
INFORMATlON TRANSMITTAL
Purchase Requisition Number:_i_! i_' J {j 7
Administrative Services Department
Purchasing/Contract Administration
-a~(t~,'l~t;> IWa,t/f tf7td
(Buyer or Contract Manager Name)
Phone extension
r, _ ,_ .'1 --'cj j" Date: '/-d )) </1 j(r V
''l?2./~,? ...... ___ _
LocationTPhone Extension
fl~G !&/l}!:J /S-t-t'-L qf-~"'
Dept.lOivision/Locat'ion
The following information is attached for your review and reference (check all that
apply and indicate on PR Header text in SAP that the attached will follow via.,
inter-office mail): ~,;
~Amendment/Change Order -'~--. Speclications/Scope of Services/Description of item(s)*
Vendor information (for example, W-9)
Sole Source
Proposal(s)/Quote(s)
Certificate(s) of Insurance
Other (explain): C ~\ 1<-4o"'t ~O~-; COLINe I L-
I A F F 11<-f--\ /::>.",1'\/ t:;.. I:;X: -I I {I N r'C:\2. f-..: \
'If purchase requisition is for a formal bid or proposal request, use project checklist as PR transmittal
sheet.
For Purchasing Use Only
Name /tlv/,l>C"'-!!!" Pr(}~;,,1 A ~o #/Contract #: C 0 C. /I ~j 9 7
1f. IOu '11,-> Amount IttC/,oo,j'
[-qYJ,j}-
\~ ,...----
" '( 0 ' )(,.(,1 :T,,~ Release Strategy ;:;r . ,J
for Release: _I,\,.:b....,~"": ~ .... "'-L~"::'>O<_~. ___ (Contract Manager/Buyer)
___________ {Purchasing Manager) ~
(signature required) ___________ (Assist~nt City Manager)
,-."1
Revised 8115/03
Client#: 16916 ADP!HOl
CERTIFICATE OF LIABILITY INSURANCE DATE IMMJDDIYYYY)
11/08/2005
r:-~DUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
I Wachovla Insurance Serv-AT, GA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 14401 Northside Pkwy, Suite 400 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Atlanta, GA 30327·3071'5
i 770 850-0050 INSURERS AFFORDING COVERAGE NAIC# ! INSURED :NSURERA; St Paul Fire & Marine Insurance Co 24767 I AD PI Holding, Inc. ~:~ Illinois Union Insurance Company , 27960
I
520 NW 165th Street Road; Suite 201
Miami, FL 33169·6303 INSURER 0:
INSURERE:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
II~iRI{ ~~c TYPE OF INSURANCE POLICY NUMBER PJlALf~~J~)68tWf p~~fJ 1'f,.x,ft~~N LIMITS
A ~ERAL LIABILITY TT06800205 06/30/05 06/30/06 EACH OCCURRENCE $1000000
,x.. COMMERCIAL GENERAL LIABILITY ~~~~~J?E~~~~ncel $250000
i---:=J CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $10000
f---PERSONAL & ADV INJURY $1 000000
f---GENERAL AGGREGATE $2000000
n'L AGGREAE LIMIT APPlS PER: PRODUCTS COMPJOP AGG $2,000000
POLICY ~~8T LOC
A ~TOMOBILE LIABILITY TT06800205 06/30/05 06/30/06 COMBINED SINGLE LIMIT
X ANY AUTO (Ea accidenl) $1,000,000
~ ALL OWNED AUTOS BODIL Y INJURY i---$
SCHEDULED AUTOS (Per ""rson)
-, .!.. HIRED AUTOS BOOIL Y INJURY $ i ~~:;~::~~S (Per accident)
$1,000 Comp PROPERTY DAMAGE
Deductibles $1,000 Coli (Per acadenl) S
I ~AGE LIABILITY AUTO ONLY -EA ACCIDENT $ -----~
i ANY AUTO I ~J~fRTHAN EAACC Is
o ONLY: AGG Is
A ~ESS/uMBRELLA LIABILITY TT06800205 06/30/05 06/30/06 ~RENCE 53,000000
OCCUR D CLAIMS MADE 53000,000
s i DEDUCTIBLE $
RETENTION $10000 $
A WORKERS COMPENSATION AND WVA6811458 06/30/05 06/30/06 X I T"d~l'l~¥s I IOJ~-
EMPLOYERS' LIABILITY 5500,000 ANY PROPRIETOR/PARTNERlEXECUTIVE E.L. EACH ACCIDENT
OFFICERlMEM!3ER EXCLUDED? 1i..!::..Q1~~AS§.':y~_f:!.<1P-':.~)Y~ ~.~~2 > <!!>2 ________ II yes, describe
SPECIAL PRO'IISIONS below E.L. DISEASE· POLICY LIMIT $500,000
B OTHER Errors And BMI20023494 06/30/05 06/30/06 Limit:$2,OOO,OOO
Omissions Retention: $25,000
DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES I EXClUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Evidence of Insurance
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELI.ED BEFORE THE EXPIRATION
City of Palo Alto DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL .......30.... DAYS WRllTEN
250 Hamilton Ave NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Palo Alto, CA 94301 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE • .;;;:t.
ForWISby: -;;fhV e::> ~~ •
ACORD 25 (2001/08) 1 of 2 #S714660/M660126 DLS01 @ ACORD CORPORATION 1988
· ,
IMPORTj\NT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-5 (2001/08) 2 of 2 #S714660/M660126
TO: HONORABLE CITY COUNCIL
FROM: CITY MANAGER
DATE: NOVEMBER 14,2005
,\ !I
DEPARTMENT: FIRE
CMR: 404:05
SUBJECT: APPROVAL OF CONTRACT WITH ADVANCED DATA PROCESSING
WEST, INCORPORATED FOR 7 PERCENT OF NET COLLECTED
REVENUE FOR ALL ADVANCED LIFE SUPPORT (ALS) AND BASIC
LIFE SUPPORT (BLS) AMBULANCE TR4NSPORT SERVICES FOR A
ONE YEAR TERM THAT CAN AUTOMATICALLY RENEW FOR TWO
ADDITIONAL ONE YEAR PERIODS
RECOMMENDATION
Staff recommends that Council approve and authorize the Mayor to execute the attached contract
for a one year period with Advanced Data Processing West, Incorporated (ADPI) in the amount
of 7 percent of net collected revenue for patient billing services when Advanced Life SUPpOlt
(ALS) and Basic Life SUppOlt (BLS) is provided by the Palo Alto Fire Department. This
contract will automatically renew for two additional one year periods.
DISCUSSION
Service Description
The work to be performed under the contract is for patient billing services when ALSIBLS
transport is provided by the Palo Alto Fire Department. The need for a billing services contractor
was necessitated by several factors:
• Insurance industry reporting changes require unique expertise in the field of patient billing.
At current staffing levels, it is impossible 10 cope with increasingly complex billing Clud
coding changes each year.
., Medicare's flat rate hilling process requires significant additionClI documentation and
accounts receivable processing. Current billing software utilized by the City does not
incorporate ever-changing mandated data requirements, such as insurance codes and
Medicare rate calculations.
• Inter-facility scheduled transport billing requires significantly unique documentation and
highly detail oriented accounts receivable processing.
• Average revenues for the program over the last three fiscal years (02-03, 03-04, and 04-05)
were $1.6 million. The City'S experience with outsourcing medical billing to a third party
administrator has demonstrated a significant increase in revenue generation.
CMR:404:05 Page lof3
Selection Process
Staff seeks to aware this contract to ADPI as the firm offers a \\'ide-range of servic~s that will
best meet [he Ciry's ,.~.erall ne~d.c. ADPI will pm'jdr the City "\:~:: a cc:;:rrehensive package of
billi,lg, collection, fe,How-up, a :cOl1nt posting, accounts rec?,vable rcc,:cHciliation, financial
accOl;ming, receipts management and reporting services, including the capability :0 extrapc!ate
data from a lap-top based computer system. In addi[ion, ADPI will provide Palo Alto Fire
Emergency Medical Services with customized financial, demographic, volume, acuity,
perfornlance, response, and productivity reports on demand. All services are to be provided on a
contingent fee basis \vith fees paid on a percentage of collections.
The City of San Bernardino conducted an extensive Request For Proposals (RFP) process for
patient billing services in April 2003. ADPI was selected by them due to the vendor's
experience and qualifications in municipal ambulance billing with specific regard to the
insurance industry's changing policies and procedures and due to its favorable level of fees. The
City ofPalo Alto proposes to share in this contract given the following:
• San Bernardino chose ADPI out of a broad range of vendors.
• The vendor agreed to provide to the City of Palo Alto the same basic scope of work for the
same rate as was offered to the City of San Bernardino. The percent offered is a half
percent Jess than the previously negotiated contract.
• The vendor offered an impressive fifteen-year track record of providing EMS billing and
collection services to cities around the Bay Area including Berkeley, San Rafael,
Sacramento, and others.
• ADPI's Oakland-based operation currently bills over 200,000 responses per year, with a staff
of It has the resources to maintain both the expertise and appropriate implementation of
medical billing.
• ADPI has proprietary software and technology for paperless, automated billing.
• AD PI offers extensive and customized reporting capabilities, ensuring the City will have
access to accurate information with which to monitor the program.
RESOURCE IMPACT
Contract language stipulates that 7 percent of net collected revenue for patient billing services
will be the established fee base. In fiscal year 2000-01, the City's gross billings were
approximately $1.33 million, \vith collection rates ranging from 55-60 ;.)crcent. Staff can report
that ADPI has been able to increase the City'S collection rate to 65-70 percent for fiscal year
2003-04 due to the following:
• ADPI has increased the net revenue for all of its clients over fifteen years in the emergency
medical services billing business.
• The average collection rate for ADPI's twenty current comparable customers is 68 percent.
(This includes only customers performing emergency medical transport services.)
POLICY IMPLICATIONS
This recommendation is consistent with existing City policies.
CMR:404:05 Page 20f3
ENVIRONlVIENTAL REVIE\V
This contract is not a project under the provisions of the California Environmental Quality Act.
ATTACHMENTS
Attachment A:
Attachment B:
PREPARED BY:
Contract Between the City of Palo Alto and Advanced Data Processing
West, Incorporated for Ambulance Billing and Collection Services.
Request for Proposal for Paramedic Services Billing and Collection, City
of San Bernardino, San Bernardino Fire Department.
Acting Deputy Chief Dan Lindsey
DEPARTMENT HEAD:
NICHOLAS MARINARO
Fire Chief
CITY MANAGER APPROVAL: ______________ _
CMR:404:05
EMIL Y HARRISON
Assistant City Manager
Page 3 of3
.'
~/lar,ufacturing Combinins District (8) Regulations], 18.60
[Umited Industrial/Research Park District Regulations] and
18.63 [Limited Industria! Site Combining District (3, 5)
P 2guiations]in its Entirety and E(actlng Portions ·of c' New
Chapter 18.20 [Office Research, and fv1anufactl~ring Districts]" (ist
Reading 1 0/1 lies, Passecf 6-1, t<ishimow voting no, Cordell, i"lossa,-, not participating)
2. Ordinance 4(384 entitled "Ordinance of the Council of the City of
Palo ,A,lto Updating the Office, Research, and I"lanufacturing
Districts of Title 18 [Zoning] of the Palo Alto Municipal Code by
Enacting Portions of a New Chapter 18.20 [Office Research, and
Manufacturing Districts]" (1stReading 10/11/05, Passed 7-2, Kleinberg, Mossarno)
3. Ordinance 4885 entitled "Ordinance of the Council of the City of
Palo Alto Amending the Budget for the Fiscal Year 2005-06 to
Provide Additional Appropriation from the Water Fund Rate
Stabilization Reserve of $244,980 into Capital Improvement
Program (CIP) Project Number WS-01010, Reservoir Booster
Station Improvements; $71,916 into Capital Improvement
Program (CIP) Project Number WS01011, Distribution System
Water Quality Enhancements; and $37,825 into Cpaital Program
(CIP) Project Number WS-OI012, Booster Station
Improvementsll
4. Resolution 8565 entitled "Resolution Authorizing the City's
Representative to the San Francisquito Creek Joint Powers
Authority to Vote for the Approval of a Cost Share Agreement
with the United States Army Corps of Engineers for the
Feasibility Phase of a San Francisquito Creek Flood Damage
Reduction and Ecosystem Restoration Project"
5. . Approval of Contract with Advanced Data Processing West,
Incorporated for 7 Percent of Net Collected Revenue for all
Advanced Life Support (ALS) and Basic Life Support (BLS)
Ambulance Transport Services for a One Year Term That Can
. Automatically Renew for Two Additional One Year Periods
MOTION PASSED 6-1 for Item No. I, Kishimoto no, Cordell, Mossar
not participating.
MOTION PASSED 7-2 for Item No.2, Kleinberg, Mossar no.
MOTION PASSED 7-0 for Item No.3, Cordell, Mossar not
participating.
MOTION PASSED 9-0 for Item No.4.
11/14/05 5
MOTION PASSED 8-1 for Item No.5, Freeman no.
Director of Community Services Richard James spoke regarding the
community garden. He said all garden fees would be frozen with
everyone paying the same amount as in the previous year. Staff had
begun discussions with the gardeners. The item would come before the
Parks and Recreation Commission (PARC) in December for review and
recommendations. Staff's goal was to keep the community garden a
quality and sustainable program while reducing fees for the gardeners.
Council Member Morton said he understood the PARC meeting for
December had been cancelled.
Mr. James said the PARe's regular meeting had been cancelled and
rescheduled for December 27, 2005.
Council Member Freeman spoke regarding her "no" vote on Item No.
5. She said staff did not initiate a Request for Proposal (RFP), but used
information from the City of San Bernardino. She recommended future
assurance of open-bidding after the current contract was let.
PUBLIC HEARINGS
6. Public Hearing: Consideration of Recommendations of Staff and
the Planning and Transportation Commission to Approve the
Permanent Implementation of the Second Downtown North Trial
Traffic-Calming Plan. The Recommended Plan Includes Traffic
Circles on Everett at Emerson, Everett at Webster, and
Hawthorne at Cowper; Speed Tables on Hawthorne Near High
and on Palo Alto Avenue Between Alma and Emerson; Right Turn
Restrictions Between 7 a.m. and 10 a.m. from Middlefield onto
Hawthorne and Everett; and Left Turn Restrictions Between 7
a.m. and 10 a.m. and 3 p.m. and 6 p.m. from Alma onto
Hawthorne and Everett
Council Member Beecham stated he would not partiCipate in the item
due to a conflict of interest because his residence was within 500 feet
of the property.
Acting Chief Transportation Official Gayle Likens said in May 2004, the
Council directed staff to remove most of the elements of the first
Downtown North Trial Plan, which included a number of street
closures. The second Trial Plan began in September 2004, and
incorporated less restrictive measures in an "open streets" plan
composed of traffic circles, speed tables and turn restrictions from the
major arterial streets. Staff completed the evaluation of the second
trial, conducted a postcard survey of the residences in the Downtown
11/14/05 6
Exhibit D: Provider1s Affirmative Action Statement
PROVIDER'S AFFIRMATlVE ACTION STATEMENT
Affirmative Action Plan
Declaration of Policy
Date: Oct 17th, 2005
In accordance with requirements of the City of Palo Alto, Advanced Data Processing, Inc. affirms its
commitment to equal employment opportunity and that it has an Affirmative Action Plan for the purpose of
maintaining that promise with particular emphasis on the minority workforce popUlation and the utilization
of Minority professional firms, consultants and/or suppliers.
Date
! I J (:IL-!. ;i D,-:" •
Mari I.Catania Date
Affir ative Action Officer
Exhibit D
City Manager's Response
Date: February 3, 2009
From: James Keene, City Manager
Prepared By: Nicholas Malinaro, Fire Chief
Subject:
Lalo Perez, Director of Administrative Services
City Manager Overview of Emergency Medical Services (EMS) Billing Process
and the 2009 Audit of Ambulance Billing and Revenue Collections
In FY 2002, the City of Palo Alto outsourced ambulance billing in conjunction with a contract
executed by the San Francisco Fire Department. The original vendor was Allied Information
and Service CAIS). The City's current vendor, ADPI, purchased AIS approximately 4 years ago
and completed the initial contract ternl. TIle City entered into a new three-year contract with
ADPI in late 2005. The City has collected more revenue as a result of this contract. EMS
revenues totaled $2,000,000 in FY 2008. In the last year prior to billing being outsourced (FY
2002), the collection rate was approximately $1,300,000. As the program has developed, it was
clear that additional management controls needed to be put in place to ensure the highest rate of
return. Staff has learned much during this initial contract and is working to modify the new
bi1lirig contract in response to these concerns. The audit recommendations presented are part of
the continuing evolution of the City's performance with respect to the ambulance biUing
contract.
Various aspects of non-performance were initially identified in FY 2006 and staff began work at
that time to identify problem areas and improve accountability practices. The issues inc1uded:
lack of prompt invoice processing; minimal follow-up work on outstanding accounts; delays in
referring delinquent accounts to the City; deletion of accounts from the ADPI database; and lack
of timely and accurate reports for City review. Many of these deficiencies were a result of
c1erical errors, outdated data and software systems to meet the needs of Palo Alto and
inadequate management oversight. These deficiencies did result in lower system efficiencies
and revenue collections for the City. The biggest issue resulted from a lack of understanding
about the MedicarelMedi-Cal reimbursement process, which cost the City approximately
$70,000 in revenue during FY2005/06. In spite of these issues, contracting out for ambulance
billing remains a good business decision for the City. The City collects approximately 55% of
its ambulance transport bills, which exceeds industry standards in the area.
Beginning approximately two years ago, the billing vendor acknowledged these as legitimate
issues and City staff proceeded to schedule weekly conference calls and regular monthly
meetings to resolve them. A major problem was inaccurate, untimely, and insufficiently
-31 -
Attachment #2
City Manager's Response
detailed reports that were a result of outdated software programs and inefficient office practices
on the part of the vendor. These reports are critical to staff monitoring of ADPI activity and
achieving maximum reimbursement. ADPI implemented several improvements begilming in
May 2007 with their reporting system. Subsequent changes and improvements included:
increased training and oversight of clerical persOlmel, software updates, top management
reorganization, and improved data entry accountability. TIle final reporting capabilities were
implemented in June 2008. The new reporting system now provides the City with detailed and
transparent reports that are meeting all requirements set forth by ASD and Fire staff. The new
system also provides complete access to the vendor's database and allows staff to monitor
cllstomer accounts and provide improved service.
In addition to inlproving ADPI's internal procedures and reports, new in-house procedures were
implemented to ensure proper billing. In FY 2006, the Fire Department developed a new billing
foml that captured more detailed information. This brought the City into full compliance with
MedicarefMedi-Cal billing requirements and resulted in an immediate increase in revenues
collected. In addition, the Fire Department initiated daily and monthly audits of each account to
ensure all information was collected and processed by the vendor. To ensure these changes
continue, the department has instituted continuous training on up-to-date patient documentation
requirements for staff members.
The ASD and Fire Departments requested the Auditor's Office assistance in verifying the areas
for needed improvement in the current contract and to make recommendations for improved
practices and procedures. In the spring of2008, the Auditor's Office embarked on this audit of
the ambulance billing and revenue collections.
The City Auditor's recommendations identify and reflect issues that will continue to improve
system and operational efficiencies. Staff has begun the work on' a number of these processes
and is in overall agreement with the recommendations in the Auditor's report. At this time,
staff is confident that the numerous improvements in the paramedic billing process will result in
maximizing reimbursement and streamlining efficiencies. Staff is committed to the continuation
of enhanced reports that meet the City specifications and the monitoring of improved and
timelier assessments of ADPI's performance.
Recommendations:
RECOMMENDATION #1: T71e Fire Departmellt, with the assistance of ASD, should:
(1) Work with the ambulance billing contractor to provide the City with monthly lists of
accounts that are 180 days old alld turn those accounts over to the City each month;
(2) Develop a mechanism to ensure ambulance billing contractor returns ullcollected accounts
in a timely manner; and
(3) Work with the ambulance billing contractor to provide the City with a written planfor how it
will ensure that it does not continue to bill accounts that have already been returned to the City.
Staff agrees with this recommendation.
-32-
City Manager's Response
[tern (I) --This improvement was initiated in August 2008 and completed in December 2008.
The billing backlog has been processed and all delinquent aecollnts are being re-assigned to the
City after 180 days if appropriate. The ambulance billing contractor ADP1-lntcnnedix (AD PI) is
providing the City with detailed reports on a monthly basis.
Item (2) -Improved reports cited above address this isslic since thc status of all open accounts
by "age" are provided. ADPl has implemented a system control which prevents invoice
generation once an account is placed in "collection" status. Staff has requested a demonstration
from ADPI for January 26 and will continue to monitor the efficacy ofthis ftll1ction.
It is important to note that the 180 day rule will not apply (0 all invoices since certain siruations
require ADPI to retain the invoice, e.g., invoices undergoing appeal to Medicare or Medi-Cal.
Item (3) -Stan-has requested a written plan fi'om ADP! and has received cOl1lirmation that a
plan is being developed tor our review and comment. It is anticipated the plan and a revie\:-.' will
be completed by the end of February, 2009.
RECOMMENDATION #2:
Once the ambulance billing contractor returns the older accounts to the City, ASD's Revenue
Collections should review the accounts receivable balance to appropriately process and
reconcile'the outstanding balances.
StatTagrees with the recommendation and Revenue Collections has initiated the
process. Monthly meetings with ADPJ to review the oldest, open [lccounts
November and will eonclude by the end of February.
review
began last
RECOMMENDA TJON #3: The Fire Department and ASD should work with the ambulance
billing contractor to: 1) provide the City with timely exception reports it regularly reviews to
provide assurance that accounts do not remain un billed if the system initially rejects the billing
address, and 2) implement a process to follow-up on the unbilled accounts.
Item (I). Staff agrees and will incorporate regular reviews of reports tu monitor billing address
and other issues. As indicated, ADPI \>.till provide standard repOlts to review and will provide
authorized City staffa higher level of access to its billing system. City staffwill receive training
that allows additional, ad-hoc reporting capability from the billing system. Such access will
result in more proactive steps to eon-eet address and other billing issues and to enhance
collection. Currently, the Fire Department is auditing all reports monthly to reconcile the
accounts that are sent and to ensure that there is no duplication and that completed intorrnatioll
is given to ADP) in a timely manncr.
Itcm (2) Staff agrees with the recommendation. With staffs input ADPI has developed a more
rigorous process to review accounts to ensure fi)llow-up. ADPI will contact the Fire Department
if essential patient care report information is missing and will review hospital face sheets for
33 -
City Manager's Response
JllISSJJ1g information required J()f billing. ADPI will access eXlstlllg databases tor this
int()I"l1lation and has initiated a "call the customer process" to obtain required data. Staff will
monitor this process to ensure the required intolll1ation is gathered and will review all monthly
repolts and discuss with the contractor. This toll ow-up wi 11 occur at the staff monthly meetings.
RECOMMENDATION #4: In order to improve and ensure continued improved contractor
pelfonnance, ASD and the Fire Department should continue to award the contract on a short-
term basis (one year for example) and develop and incorporate measurable criteria to renew
the contract based on satisfact01Y contractor peiformance.
Staff agrees with this recommendation. As ptllt of the current RI':P process and in the futtlrc,
stalTwill 'Nark to develop acceptable criteria.
ADI'I has been tasked by City 5tal'l'1o provide more accurate reporting with a higher level of
accounting detail. Clem' speciJications for inlbrmHtion requirements have been communicated
and the Fire Department, which manages this contTact, will implement perfbrmance standards.
These standards wiIl be negotiated as part ofthe contract specifications.
RECOMMENDATION #5: The Fire Department and ASD should request the ambulance billing
contractor to provide more consistent reporting to the City and prOVide supporting evidence
that gives the City a reasonable level of assurance regarding the accuracy of accounts
receivable balance and the predictability of write-offs·
StatT agrees with the rceollll1lcndation and ha') worked with ADPT to resolve this issue. Old
account inventory has been processed and all statutory adjustments are being recorded and
accounted fix in accordance with the City's requirements. Monthly rep0l1s now include the
level of detail nece...,sary to address Ihis recommendation.
RECOMMENDATION #6: ASD should establish a bank account to receive patient credit card
payments so that they are verifiable and no longer deducted from the ambulance billing
contractor's invoice.
Staff agrees and has initiated the process to establish direct deposit of all credit card payments
into the City's bank aCCOl1nt. Our bank (Wells Fargo) has been contacted to establish a new
merchant account number and the application has been submitted to Moneris (ADPl's credit
card provider). Direct deposit to the City's account is anticipated by the end of February 2009.
RECOMMENDATION #7: 171e Fire Department should develop a written process for
conducting spot checks of billed ambulance services to help ensure consistent
billings.
-34-
City Manager's Response
Staff agrees that a written policy will be developed and the Fire Department wiJl confer with the
Auditor's Office to recommend the parameters t()r conducting the "spot" checks.
RECOMMENDATION #8: The Fire Department should request that the ambulallce billing
contractor provide assurances to the City that it has sufficient internal controls ill place to
prevent duplicate billings. The Fire Departme1lt also should assess its own practices alld
identify internal controls that will prevent two PCRs from being completed for the same patient.
StatT agrees and \vill work with the vendor to put the necessary internal controls in place. The
Fire Department will evaluate its' internal controls and develop policies to minimize or
eliminate slIch occurrences. The current implementation of the electronic patient care report
should minimize any possibility ofdupJicalion.
RECOMMENDA TION #9: Revenue Collections should work with the City Attorney's Office to
clarify the applicable statute of limitations for billing patients for ambulance service.
Staff agrees and has already initiated the process. Revenue Collections has had conversations
with the Attorney's Office and a meeting has been scheduled for H)lIow-up. Revenue
Collections will request annual reviews of the procedures to determine if changes are necessary.
RECOMMENDATION #10: After completing recommendation #8, Revenue
Collections should revise write-off procedures for ambulance billing revenue. The revised
procedures should reflect actual practices and should cite the criteria used in deciding whether
to write off accounts.
Stall' agrees and will work to revise CUtTent procedures to re'l1e.c.t the
rec{)ll1mendations/guidelines provided by the City Attorney's Office.
RECOMMENDATION #11: The City Manager's Office should work with the Fire Department
and the Administrative Services Department to identify key roles related to ambulance billing
and to clarify in writing (with a table or matrix) specifically who is responsible for which roles.
Staff agrees regarding the importance of this issue. ASD and Fire will work with the City
Manager's Office to clearly define the necessary roles and responsibilities to achieve this goal.
RECOMMENDATION #12: The Fire Department, the Administrative Services Department,
and the ambulance billing contractor should establish a schedule to meet at least quarterly to
stay infonned about problems and opportunities related to ambulance billing.
Staff agrees and has been eonducting monthly meetings since August 2008. These meetings
have proved vcry bCl1clicial in identifying any arcas of concern and developing solutions for
-35-
City Manager's Response
them by all parties. ADPI has agreed to additional meetings and to more j]'equent meetings as
necessary .
RECOMMENDATION #13: The Fire Department should take a lead role in monitoring the
accuracy of invoices from the ambulance billing contractor. 17zis should include verifYing the
accuracy of the invoice by reviewing supporting documentation if necessGlY, to understand how
the amount was calculated.
Staff agrees and the Fire Depal1mcnt will work to provide the Ilecessary resources to satisfY this
recommendation through reallocation of existing duties or other means.
RECOMMENDATION #14: The Fire Department should work with the Accounting Division in
ASD to ensure the ambulance billing contractor's commission acijustment related to refunds, is
correct.
StaO'agrees and will work with ASD to provide a mechanism for adjustments that is accurate.
RECOMMENDATION #15: For the new ambulance billing contract, the City should clarifY key
provisions such as the 180-day timeframe to return uncollected accounts to the City and the
provisions specifYing the billing timelines the contractor will follow. Both should clearly state
the start date from which the number of days are counted.
Statf agrees and these language provisions can be incorporated into and clearly stated in the
contract language.
RECOMMENDATION #16: The City should attempt to negotiate a lower commission (than the
current 7%) in the new ambulance billing contract.
Stafl' agrees and will attempt to negotiate into the contract language 11 lower commission mte.
RECOMMENDATION #17: The Fire Department should ensure that all employees who access
patient health data related to ambulance billing (ill the Fire Department, ASD, and any other
departments) complete HIP AA training.
StatT agrees and the Fire Department will work with employees in other depaJ1ments and
Human Resources statfto assist in providing the nece...:;sary training. There arc currently training
program mechanisms in plac.e to easily accomplish this task.
-36-
ORDINANCE NO.
ORDINANCE OF THE COUNCIL OF THE CITY OF PALO ALTO
AMENDING THE BUDGET FOR THE FISCAL YEAR 2008-09 TO
PROVIDE AN APPROPRIATION OF $215,000 FOR THE EXTENTION OF
CONTRACT (C06116197) WITH ADVANCED DATA PROCESSING WEST,
INCORPORATED (ADPI)
Attachment #3
WHEREAS, pursuant to the provisions of Section 12 of Article
III of the Charter of the ty of Palo Alto, the Council on June 09,
2008 did adopt a budget fiscal year 2008-09; and
WHEREAS, ADPI provides service for outsource billing and
collection for Emergency Medical Services (EMS) transports by the
City of Palo Alto re Department.
WHEREAS, the current contract with ADPI expired November 2008
and was extended for six months ending in May 2009 pending
recommendations from the City Auditor's report on ambulance bil
procedures.
WHEREAS, additional appropriations are requested to fund the
extension of the current ADPI contract to give staff additional time
to incorporate the ty Auditors recommendations on current billing
practices into a new expanded scope of services and Request
Proposal (RFP).
WHEREAS, City Council authorization is needed to amend
2008-09 budget as hereinafter set forth.
NOW, THEREFORE, the Council of the City of Palo Alto
ORDAIN as follows:
The sum of Two Hundred and Fifteen Thousand Dol
($215,000) s hereby appropriated to contract services in the
Advanced Emergency Medical Paramedic Functional Area of the
Department, and Budget Stabilization Reserve is correspondingly
reduoed.
This transaction will reduce the Budget
Reserve from $20,926,089 to $20,711,089.
As specified in Section 2.28.080(a} of the
Al to Code, a two thirds vote of the Ci ty Council
required to adopt this ordinance
SECTION 4. The Council of the City of Palo Alto hereby
that this is not a project under the California Environmental
Quality Act and, therefore, no environmental impact assessment is
necessary.
SECTION 5. As provided in Section 2.04.350 of the Palo to
Municipal Code, this ordinance shall become ef tive upon adoptioN.
INTRODUCED AND PASSED:
AYES:
NOES:
ABSTENTIONS:
ABSENT:
ATTEST:
City Clerk
APPROVED AS TO FORM:
or Asst. City Attorney
APPROVED:
Mayor
City Manager
Director
Services
Administrative