Title
a. Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute an agreement with Healthcare Coding & Consulting Services, LLC for U.S. based remote medical record coding and consulting services at NMC for an amount not to exceed $600,000 with an agreement term August 22, 2024 through August 21, 2026.
b. Authorize the Chief Executive Officer for Natividad Medical Center or his designee to execute up to three (3) future amendments to the agreement which do not significantly alter the scope of work and do not cause an increase of more than 10% ($60,000) of the original cost of the agreement, for total contract liability of ($660,000).
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
a. Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute an agreement with Healthcare Coding & Consulting Services, LLC for U.S. based remote medical record coding and consulting services at NMC for an amount not to exceed $600,000 with an agreement term August 22, 2024 through August 21, 2026.
b. Authorize the Chief Executive Officer for Natividad Medical Center or his designee to execute up to three (3) future amendments to the agreement which do not significantly alter the scope of work and do not cause an increase of more than 10% ($60,000) of the original cost of the agreement, for total contract liability of ($660,000).
SUMMARY/DISCUSSION:
Healthcare Coding and Consulting Services (HCCS) provides coding of accounts support, utilizing International Classification of Diseases Tenth Revision (ICD10-CM/PCS), Current Procedural Terminology (CPT), Evaluation /Management Levels (E/M), APC-DRG Review and Auditing, HCPCs Medical Supply conventions to Natividad designated medical encounters and Education and Training to Natividad as changes occur within the coding spectrum.
HCCS provides coding support for hospital inpatient and emergency services to both trauma and non-trauma services, the appending of charges for emergency services and coding support for outpatient clinical services. This vendor was chosen due to the complexity and distinctiveness of both services (general and trauma) and the various coding requirement from state and federal coding requirements from state and federal coding guidelines for inpatient and outpatient services are comprise of multiple layers of treatment management, equipment, procedures and extensive documentation. HCCS provides coding support purposes for quality requirements mandated by state and federal regulations and ultimately for timely and accurate reimbursement from all payers.
HCCS has certified coders to review complicated encounters; conduct monthly audits of the coding staff assigned to Natividad account, which meets the compliance requirement. The results are distributed, reviewed, discussed, and recommendations to enhance beneficial outcomes for the organization are considered and often executed. HCCS also provides auditing and validation summary documentation of specific third-party payor accounts required service justification.
Natividad Medical Center recognizes with the increased volume of emergency/labor delivery emergency, trauma encounters, outpatient and inpatient, the level of complexity with accurate coding of these services; as well as the on-going difficulties with recruitment and retaining of qualified credentialed candidates we are not capable of meeting the management’s level of expectations and demand.
OTHER AGENCY INVOLVEMENT:
The Office of County Counsel has reviewed and approved this agreement as to form, and the Auditor-Controller has reviewed and approved as to payment provisions. The agreement has also been reviewed and approved by NMC’s Finance Committee and by its Board of Trustees on July 19, 2024.
FINANCING:
The cost for this agreement is $600,000 of which $300,000 is included in the FY 2024-25 Adopted Budget. Amounts for remaining years of the agreement will be included in those budgets as appropriate. Funding will be provided from NMC’s Enterprise Fund 451-9600- 6613.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
The services rendered in this agreement provides Natividad Medical Center with the additional support which is needed due to the credential requirements to ensure accurate appending coding for reimbursement, regulatory, patient care initiatives and data reporting.
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Prepared by: Kim Williams-Neal, Director of HIM, 831-783-2440
Approved by: Charles R. Harris, Chief Executive Officer, 783-2553
Attachments:
Healthcare Coding and Consulting Services, LLC Agreement
Attachments on file with the Clerk of the Board