Title
Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute renewal and amendment No. 4 to the agreement (A-13580) with PARA Healthcare Analytics, LLC for revenue integrity program services, extending the agreement an additional one (1) year period (retroactively from July 1, 2022 through June 30, 2023) for a revised full agreement term of July 1, 2016 through June 30, 2023, and adding $80,000 for a revised total agreement amount not to exceed $454,500.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute renewal and amendment No. 4 to the agreement (A-13580) with PARA Healthcare Analytics, LLC for revenue integrity program services, extending the agreement an additional one (1) year period (retroactively from July 1, 2022 through June 30, 2023) for a revised full agreement term of July 1, 2016 through June 30, 2023, and adding $80,000 for a revised total agreement amount not to exceed $454,500.
SUMMARY/DISCUSSION:
PARA Healthcare Analytics, LLC provides Natividad Medical Center with a web-based revenue integrity program, PARA Data Editor™ (PDE). The PDE provides NMC with the ability to analyze, repair, and improve revenue cycle processes. Following are key features of the system:
• Charge Quote‐Provide accurate and timely price quotes with EDI (Electronic Data interface) to allow real-time eligibility verification including No Surprise Act Good Faith Estimate Regulations
• Charge Process‐Streamline all requests made to the charge master
• Claim/RA Evaluator‐Evaluate all claims to ensure proper billing techniques and reimbursement. Analyze denials for follow up
• Contract Analysis‐Manage and model all contracts for better reimbursement
• Pricing Data‐Access current detailed market data for three separate, defined markets of Natividad competition’s prices
• Pricing Iterations‐Create pricing scenarios to determine the net and gross revenue impact on the bottom line
• Pharmacy/Supplies‐Manage all pharmacy and supply mark-ups for price appropriateness
• Filters/CDM‐Access to current charge master file for managing all coding and billing issues to ensure an up to date, compliant charge master
• Advisory‐Access all supporting documentation on industry changes for: OIG (Office of inspector General), RAC (Recovery Audit Contractors), and CMS (Center for Medicare and Medicaid Services) transmittals, articles and bulletins
Fiscal staff at NMC currently access the PDE to make decisions more efficiently while improving accuracy. The web-based system can be accessed from any computer with internet access.
NMC is requesting a one (1) year term extension to allow for continued use of the system.
Due to heavy workload and staffing shortages this amendment was not completed prior to expiration.
OTHER AGENCY INVOLVEMENT:
The Office of County Counsel has reviewed and approved this renewal and amendment No. 4 as to form, and the Auditor-Controller has reviewed and approved as to payment provisions. The renewal and amendment No. 4 has also been reviewed and approved by NMC’s Finance Committee and by its Board of Trustees on September 9, 2022.
FINANCING:
The cost for this renewal and amendment No. 4 is $80,000 which is included in the Fiscal Year 2022-23 Adopted Budget.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
This agreement is for revenue integrity and analysis programs that manage and improve revenue processes and compliance; contributing to efficient, revenue generating business operations at NMC.
__ Economic Development
X Administration
__ Health and Human Services
__ Infrastructure
__ Public Safety
Prepared by: Tracy Short, Director of Patient Financial Services, 783-2347
Approved by: Charles R. Harris, Chief Executive Officer, 783-2504
Attachments:
PARA Healthcare Analytics, LLC Renewal and Amendment 4
PARA Healthcare Analytics, LLC Amendment 3
PARA Healthcare Analytics, LLC Assignment and Assumption
Peter A Ripper & Associates Inc dba PARA Amendment 2
Peter A Ripper & Associates Inc dba PARA Amendment 1
Peter A Ripper & Associates Inc dba PARA Agreement
Attachments on file with the Clerk of the Board