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2009-085 EMS - EMS Management and Consultants, Inc Billing Services Agreement
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2009-085 EMS - EMS Management and Consultants, Inc Billing Services Agreement
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Last modified
11/18/2009 10:54:31 AM
Creation date
11/16/2009 10:35:42 AM
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BOCC
Date
10/20/2009
Meeting Type
Regular Meeting
Document Type
Agreement
Agenda Item
6f
Document Relationships
Agenda - 10-20-2009 - 6f
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\Board of County Commissioners\BOCC Agendas\2000's\2009\Agenda - 10-20-2009
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for all dates of service during the term hereof. The Client may not directly file, <br />submit or invoice for any Services rendered while this Agreement is in effect <br />b. CLIENT COLLECTION ACTIVITY - In addition, Client agrees not to collect <br />or accept payment for services from any patient unless the service requested <br />does not meet coverage requirements under any insurance program in which the <br />patient is enrolled, or the patient is uninsured; or the patient's record is returned to <br />Client in accordance with section 1.a(4) and 1.d(1) of this Agreement. All other <br />payments received directly by Client, other than those mentioned above, for these <br />services must be reported to EMS~MC as provided in paragraph 3(b) and shall be <br />treated as Net Collections for purposes of paragraph 2(a). <br />c. CLIENT SERVICE RATES - In compliance with CMS regulations, <br />Medicare patients will not be charged by Client a higher rate or amount for <br />identical covered services charged to other insurers or patients. Accordingly, only <br />one fee schedule shall exist and be used in determining charges for all patients <br />regardless of insurance coverage. <br />d. INCOMPLETE OR INACCURATE RECORDS - EMS~MC reserves the right <br />not to submit a claim for reimbursement on any patient in which the PCR and/or <br />associated medical records are incomplete or appear to be inaccurate or do not <br />contain enough information to substantiate or justify reimbursement. This includes <br />missing patient demographic information, insurance information, physician <br />certification statements (PCS) or any required crew and/or patient signatures, or <br />otherwise contradictory medical information. EMS~MC shall notify Client in writing <br />within ten (10) days of determining that the PCR and/or associated medical <br />records are incomplete or appear to be inaccurate or do not contain enough <br />information to substantiate or justify reimbursement. The notice shall specify the <br />records required for submission of a claim for reimbursement. In the event the <br />records are unavailable, Client shall instruct EMS~MC how to proceed. <br />e. CLIENT COMPLIANCE PLAN <br />(1) The Client shall implement and maintain a working compliance plan <br />("Compliance Plan") in accordance with the most current guidelines of the <br />U.S. Department of Health and Human Services ("HHS"). The Compliance <br />Plan must include, but not limited to, formal written policies and procedures <br />9 <br />
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