Title
Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute amendment No. 5 to the agreement (A-13517) with Healthcare Coding and Consulting Services, LLC for US-based remote medical record coding and consulting services, to extend the agreement term for an additional two (2) year period (August 22, 2022 through August 21, 2024) for a revised full agreement term of August 22, 2016 through August 21, 2024, and to add $850,000 for a revised total agreement amount not to exceed $3,427,000.
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. 5 to the agreement (A-13517) with Healthcare Coding and Consulting Services, LLC for US-based remote medical record coding and consulting services, to extend the agreement term for an additional two (2) year period (August 22, 2022 through August 21, 2024) for a revised full agreement term of August 22, 2016 through August 21, 2024, and to add $850,000 for a revised total agreement amount not to exceed $3,427,000.
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), HCPCs Medical Supply conventions to Natividad designated medical encounters and Education and Training to Natividad as changes occur within the coding spectrum.
HCCS require their coding staff to possess coding credentials. The coders must also maintain their credentials annually, by attending education and training for their specific coding discipline.
HCCS provides coding support for hospital inpatient and emergency services to both trauma and non-trauma 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, 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 recognized with the increased volume of emergency/labor delivery emergency, trauma encounters and inpatient, the level of complexity with accurate coding of these services; our existing coding staff are not capable of meeting the managements level of expectations and demand.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this amendment No. 5 as to legal form, and the Auditor-Controller has reviewed and approved as to payment provisions. The amendment No. 5 has also been reviewed and approved by Natividad’s Finance Committee and by its Board of Trustees on March 11, 2022.
FINANCING:
The cost for this amendment No. 5 is $850,000. $300,000 is included in the Fiscal Year 2021-22 Adopted Budget for this agreement. Amounts for remaining years of the agreement will be included in those budgets as appropriate.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
The services rendered in this agreement provides Natividad 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, 783-2504
Attachments:
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