Title
Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute amendment No. 7 to the agreement (A-13517) with Healthcare Coding and Consulting Services, LLC for U.S.-based remote medical record coding and consulting services with no change to the term of Agreement (August 22, 2016 through August 21, 2024) and adding $700,000 for a revised total agreement amount not to exceed $5,005,000.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute amendment No. 7 to the agreement (A-13517) with Healthcare Coding and Consulting Services, LLC for U.S.-based remote medical record coding and consulting services with no change to the term of Agreement (August 22, 2016 through August 21, 2024) and adding $700,000 for a revised total agreement amount not to exceed $5,005,000.
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 amendment No. 7 as to form, and the Auditor-Controller has reviewed and approved as to payment provisions. The amendment No. 7 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 amendment No. 7 is $700,000 of which $550,000 is included in the FY 2023-24 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 Amendment 7
Healthcare Coding and Consulting Services, LLC Amendment 6
Healthcare Coding and Consulting Services, LLC Amendment 5
Healthcare Coding and Consulting Services, LLC Amendment 4
Healthcare Coding and Consulting Services, LLC Renewal & Amendment 3
Healthcare Coding and Consulting Services, LLC Amendment 2
Healthcare Coding and Consulting Services, LLC Amendment 1
Healthcare Coding and Consulting Services, LLC Agreement
Attachments on file with the Clerk of the Board