Title
Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or a designee to execute amendment No. 1 to the agreement (A-17040) with Healthcare Coding & Consulting Services, LLC for U.S. base medical record coding and consulting services, adding $780,000 for a revised total agreement amount not to exceed $1,380,000 with no change to the existing term of August 22, 2024 through August 21, 2026.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or a designee to execute amendment No. 1 to the agreement (A-17040) with Healthcare Coding & Consulting Services, LLC for U.S. base medical record coding and consulting services, adding $780,000 for a revised total agreement amount not to exceed $1,380,000 with no change to the existing term of August 22, 2024 through August 21, 2026.
SUMMARY:
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.
DISCUSSION:
HCCS provides coding support for Specialty, Medical Groups and Emergency Services to include both trauma and non-trauma services and the appending of charges for all coded accounts executed by them. This vendor was chosen due to the complexity and distinctiveness of both services (general and trauma) and the various coding requirement, complexities and guidelines of state and federal regulatory entities. HCCS coding support ensures quality requirements mandated by state and federal regulations are submitted timely in addition to accurate reimbursement from all payers.
HCCS has certified coders to review complicated encounters; conduct monthly audits of the coding staff assigned to the Natividad Accounts, 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 volume of Emergency/Labor, Emergency, Trauma, Specialty and All Medical Groups, it is imperative to insure the level of complexity with accurate coding of these services. In addition to the on-going difficulties with recruitment and retaining of qualified credentialed candidates we are not capable of meeting the facilities/ management level of expectations and demand.
OTHER AGENCY INVOLVEMENT:
The Office of County Counsel has reviewed and approved this amendment No. 1 as to form, and the Auditor-Controller has reviewed and approved as to payment provisions. The amendment No. 1 has also been reviewed and approved by NMC’s Finance Committee and by its Board of Trustees on November 7, 2025.
FINANCING:
The cost for this amendment No. 1 is $780,000, of which $780,000 is included in the FY 2025-26 Adopted Budget. Amounts for remaining years of the agreement will be included in those budgets as appropriate. There is no impact on the General Fund with this action.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS SECTION:
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
__ Well-Being and Quality of Life
__ Sustainable Infrastructure for Present and Future
X Safe and Resilient Communities
__Diverse and Thriving Economy
__ Administrative
Prepared by: Kim Williams-Neal, Director of Health Information Management, 783-2440
Approved by: Charles R. Harris, Chief Executive Officer, 783-2553
Attachment(s):
Board Report
Healthcare Coding & Consulting Services, LLC Amendment No. 1
Healthcare Coding & Consulting Services, LLC Original Agreement
Attachments on file with the Clerk of the Board