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HomeMy WebLinkAboutReso 48-2018 (18-144)City of South San Francisco P.O. Box 711 (City Hall, 400 Grand Avenue) South San Francisco, CA City Council Resolution: RES 48 -2018 File Number: 18 -144 Enactment Number: RES 48 -2018 RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE A FIRST AMENDMENT TO A FEE FOR SERVICES AGREEMENT WITH RESOLVE INSURANCE SYSTEMS, LLC FOR SECONDARY BILLING SERVICES OF AGED ACCOUNTS AT A COMPENSATION RATE NOT TO EXCEED 30 PERCENT OF RECOVERED REVENUE. WHEREAS, on April 27, 2016, City Council authorized the City Manager to execute a two -year agreement between the City and Resolve for secondary ambulance billing services; and WHEREAS, during the term of the agreement, Resolve has collected $181,422 in revenue that would not have previously been recovered; and WHEREAS, the South San Francisco Fire Department ( SSFFD) believes that Resolve has performed to the City's expectations and has been a good partner in the Fire Department ambulance revenue -cycle management; and WHEREAS, the SSFFD staff recommends that the City Council adopt a resolution authorizing the City Manager to execute a first amendment fee to a for services agreement with Resolve Insurance Systems, LLC., ( "Resolve ") to review ambulance billing accounts that have been designated for write off by our primary billing contractor; and WHEREAS, this amendment retains the terms of the original agreement two additional years and, authorizes the City to pay Resolve above the City Manager's approval authority threshold of $75,000; and WHEREAS, this process continues to align with the South San Francisco Municipal Code subsection (a) of Section 4.04.080 which permits the City to dispense of open market procedures if a commodity can only be obtained from one vendor. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of South San Francisco authorizes the City Manager to execute a first amendment to a fee for services agreement with Resolve, LLC, attached hereto as Exhibit A, to review ambulance billing accounts that have been designated for write off by the secondary billing contractor, subject to approval as to form by the City Attorney. City of South San Francisco Page 1 File Number. 18 -144 Enactment Number., RES 48 -2018 BE IT FURTHER RESOLVED that the City Manager is hereby authorized to take any other action consistent with the intent of this resolution. At a meeting of the City Council on 3/28/2018, a motion was made by Mark Addiego, seconded by Richard Garbarino, that this Resolution be adopted. The motion passed. Yes: 5 Mayor Normandy, Mayor Pro Tem Matsumoto, Councilmember Garbarino, Councilmember Gupta, and Councilmember Addiego by City of South San Francisco Page 2 Exhibit A FIRST AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SOUTH SAN FRANCISCO AND RESOLVE INSURANCE SYSTEMS, LLC THIS FIRST AMENDMENT TO THE CONSULTING SERVICES AGREEMENT is made at South San Francisco, California, as of May 1, 2018 by and between THE CITY OF SOUTH SAN FRANCISCO ( "City "), a municipal corporation, and Resolve Insurance Systems ( "Contractor "), (sometimes referred together as the "Parties ") who agree as follows: RECITALS A. On April 27, 2016, City and Contractor entered that certain Services Agreement ( "Agreement ") whereby Contractor agreed to provide secondary billing services. A true and correct copy of the Agreement and its exhibits is attached as Exhibit A. B. City and Contractor now desire to amend the Agreement. NOW, THEREFORE, for and in consideration of the promises and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, City and Contractor hereby agree as follows: 1. All terms which are defined in the Agreement shall have the same meaning when used in this Amendment, unless specifically provided herein to the contrary. 2. Section 1. The April 30, 2018 end date for the term of services identified in Section 1 of the Agreement is hereby replaced with April 30, 2020. All other terms, conditions and provisions in the Agreement remain in full force and effect. If there is a conflict between the terms of this Amendment and the Agreement, the terms of the Agreement will control unless specifically modified by this Amendment. [SIGNATURES ON THE FOLLOWING PAGE] Dated: - � Ziu CITY OF SOUTH SAN FRANCISCO CONTRACTOR City Manager Approved as to Form: City Attorney By: �J 'PiAMfl ry ,vE,o-, SOUTH SAN FRANCISCO SERVICES AGREEMENT This Services Agreement (this "Agreement ") is made and entered into between the City of South San Francisco, a municipal corporation ( "City ") and Resolve Insurance Systems, W C- 3,- �- f.4P- (4-rir iced li.l�ilir conl3a��;,- located at 864 Grand Ave. #528 San Diego, CA 92109 ( "Consultant ") effective as of April 27, 2016 (the "Effective Date "). City and Consultant are hereinafter collectively referred to as (the "Parties "). In consideration of their mutual covenants, the Parties hereby agree as follows: 1. Scope of Work. Consultant shall provide the following services and /or materials ( "the Work "): RIS reviews and analyzes medical service providers' accounts receivables related to patient care and helps facilitates insurance payments for its clients that identify expedient recovery methods for those accounts receivables, as more specifically described in the Scope of Services, attached hereto as Exhibit A. The Work shall commence on May 1, 2016 and shall be completed to the satisfaction of the City by April 30, 2018 unless such date is extended or otherwise modified by the City in writing. In the event of a conflict or inconsistency between the text of the main body of this Agreement and Exhibit A, the text of the main body of this Agreement shall prevail. 2. Payment. City shall pay Consultant an amount not to exceed 30% for the full and satisfactory completion of the Work in accordance with the terms and conditions of this Agreement. The calculation of payment for the Work shall be set forth as follows: 30% of the total amount recovered per month. The amount stated above is the entire compensation payable to Consultant for the Work performed hereunder, including all labor, materials, tools and equipment furnished by Consultant. City shall make payments, based on invoices received, for Work satisfactorily performed. City shall have fifteen (15) days from the receipt of an invoice to pay Consultant. 3. Independent Consultant. It is understood and agreed that this Agreement is not a contract of employment and does not create an employer- employee relationship between the City and Consultant. At all times Consultant shall be an independent Consultant and City shall not control the manner of Consultant accomplishing the Work., Consultant is not authorized to bind the City to any contracts or other obligations without the express written consent of the City. 4. Indemnification. To the fullest extent permitted by law, Consultant shall indemnify, defend (with counsel acceptable to the City), and hold harmless the City and its elected and appointed officers, officials, employees, agents, Consultants and consultants (collectively, the "City lndemnitees ") from and against any and all liability, loss, damage, claims, expenses and costs (including, without limitation, attorneys' fees and costs of litigation) (collectively, "Liability ") of every nature arising out of or in connection with Consultant's performance of the Work or Consultant's failure to comply with this Agreement, except such Liability caused by the gross negligence or willful misconduct of the City Indemnitees. 5. Insurance. Prior to beginning the Work and continuing throughout the term of this Agreement, Consultant (and any sub - consultants) shall, at Consultant's (or sub - consultant's) sole cost and expense, furnish the City with certificates of insurance evidencing that Consultant has obtained and maintains insurance in the following amounts: A. Workers' Compensation that satisfies the minimum statutory limits. B. Commercial General Liability and Property Damage Insurance in an amount not less than ONE MILLION DOLLARS ($1,000,000) combined single limit per occurrence, TWO MILLION DOLLARS ($2,000,000) annual aggregate, for bodily injury, property damage, products, completed operations and contractual liability coverage. C. Contractor will not be using an automobile as part of the scope of services; therefore comprehensive automobile insurance is not required. D. Professional Liability Insurance in an amount not less than ONE MILLION DOLLARS ($1,000,000) covering the licensed professionals' errors and omissions. All insurance policies shall be written on an occurrence basis and shall name the City Indemnitees as additional insureds with any City insurance shall be secondary and in excess to Consultant's insurance. If the Consultant's insurance policy includes a self - insured retention that must be paid by a named insured as a precondition of the insurer's liability, or which has the effect of providing that payments of the self - insured retention by others, including additional insureds or insurers do not serve to satisfy the self - insured retention, such provisions must be modified by special endorsement so as to not apply to the additional insured coverage required by this agreement so as to not prevent any of the parties to this agreement from satisfying or paying the self - insured retention required to be paid as a precondition to the insurer's liability. Additionally, the certificates of insurance must note whether the policy does or does not include any self - insured retention and also must disclose the deductible. The certificates shall contain a statement of obligation on the part of the carrier to notify City of any material change, cancellation, termination or non - renewal of the coverage at least thirty (30) days in advance of the effective date of any such material change, cancellation, termination or non - renewal. The City's Risk Manager may waive or modify any of the insurance requirements of this section. 6. Compliance with all Applicable Laws, Nondiscrimination. Consultant shall comply with all applicable local, state and federal laws, regulations and ordinances in the performance of this Agreement. Consultant shall not discriminate in the provision of service or in the employment of persons engaged in the performance of this Agreement on account of race, color, national origin, ancestry, religion, gender, marital status, sexual orientation, age, physical or mental disability in violation of any applicable local, state or federal laws or regulations. 7. Termination. City may terminate or suspend this Agreement at any time and without cause upon written notification to Consultant. Upon receipt of notice of termination or suspension, Consultant shall immediately stop all work in progress under this Agreement. The City's right of termination shall be in addition to all other remedies available under law to the City. 8. Prevailing Wage. Where applicable, the wages to be paid for a day's work to all classes of laborers, workmen, or mechanics on the work contemplated by this Purchase Agreement, shall be not less than the prevailing rate for a day's work in the same trade or occupation in the locality within the state where the work hereby contemplates to be performed as determined by the Director of Industrial Relations pursuant to the Director's authority under Labor Code Section 1770, et seq. Each laborer, worker or mechanic employed by Consultant or by any subcontractor shall receive the wages herein provided for. The Consultant shall pay two hundred dollars ($200), or whatever amount may be set by Labor Code Section 1775, as may be amended, per day penalty for each worker paid less than prevailing rate of per diem wages. The difference between the prevailing rate of per diem wages and the wage paid to each worker shall be paid by the Consultant to each worker. An error on the part of an awarding body does not relieve the Consultant from responsibility for payment of the prevailing rate of per diem wages and penalties pursuant to Labor Code Sections 1770 -1775. The City will not recognize any claim for additional compensation because of the payment by the Consultant for any wage rate in excess of prevailing wage rate set forth. The possibility of wage increases is one of the elements to be considered by the Consultant. (A) Posting of Schedule of Prevailing Wage Rates and Deductions. If the schedule of 4 prevailing wage rates is not attached hereto pursuant to Labor Code Section 1773.2, the Consultant shall post at appropriate conspicuous points at the site of the project a schedule showing all determined prevailing wage rates for the various classes of laborers and mechanics to be engaged in work on the project under this contract and all deductions, if any, required by law to be made from unpaid wages actually earned by the laborers and mechanics so engaged. 9. Tax Withholding. Consultant represents and warrants that Consultant is a resident of the State of California in accordance with California Revenue & Taxation Code Section 18662, as may be amended, and is exempt from withholding. Consultant accepts sole responsible for verifying the residency status of any Consultants and withhold taxes from non - California Consultants as required by law. 10. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect. IL Entire Agreement. This Agreement represents the entire and integrated agreement between the Parties. This Agreement may be modified or amended only by a subsequent written agreement signed by both Parties. 12. Non - Liability of Officials, Employees and Agents. No officer, official, employee or agent of City shall be personally liable to Consultant in the event of any default or breach by City or for any amount which may become due to Consultant pursuant to this Agreement. IN WITNESS WHEREOF, the Parties have executed this Agreement as of the date written above. CITY: By: r i Mana r APPROVED AS TO FORM: Attorney 2051689.3 ATI ST: CITY CLERK CONSULTANT: By:Z�' / Print Name: /''JO/✓ 0/ ;8 )V 'V'4J Title: OwNs�z EXHIBIT A SCOPE OF SERVICES 1.1 Services. Subject to the terms and conditions provided for herein, (a) RIS, inconsideration of the Contract Price (as defined in Section 2.1) agrees to review and analyze accounts receivable related to patient care rendered by Client to others and provide Client with a report identifying/ facilitating expedient recovery methods for those accounts receivable (collectively, "Services "), and (b) Client agrees to pay for Services asset forth in Section 2.1. 1.2 Personnel. All personnel assigned by RIS to perform Services will be RIS employees or agents and RIS will pay all salaries and expenses of, and all federal, social security, federal and state unemployment taxes, and any other payroll or witholding taxes relating to, or any other compensation for, such employees or agents. RIS will be considered, for all purposes, an independent Consultant, and it will not, directly or indirectly, act as an agent, servant or employee of Client, or make any commitments or incur any liabilities on behalf of Client without its prior written consent. 101 ACORD CERTIFICATE QF LIABILITY INSURANCE 10512712016 MlDD/1YYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SCRIPPS INSURANCE SERVICES (858) 549.9005 - OFFICE 10650 SCRIPPS RANCH BLVD. (858) 549 -9235 - FAX ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. SUITE 128 POLICY EXPIRATION MOM LIMITS SAN DIEGO CA 92139 INSURERS AFFORDING COVERAGE ' NAIC # INSURED RESOLVE INSURANCE SYSTEMS 564 GRAND AVENUE INSURE A, SCOTTSDALE INDEMNITY COMAPNY 115580 INSURER B: #528 SAN DIEGO, CA 92109 INSURER C: GENERAL LIABILITY INSURER D INSURER E: EACH OCCURRENCE $1,000,000 %.VY THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH .RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD POLICY NUMBER POUCY EFFECTIVE DfYYl POLICY EXPIRATION MOM LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X X COMMERCIAL GENERAL LIABILITY EKI3190036 0512412016 05124 DAMAGE 70 RENTED $50,000 MED EXP. one person) E 5,000 CLAIMS MADE OCCUR PERSONAL & ADV INJURY GENERAL AGGREGATE -11,000,000 s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY FX7 PRO- LO PRODUCTS- COMWOP AGG E 2 000 000 AUTOMOBILE LIABILITY ANY AUTO Ea COMBINED SINGLE LIMIT E BODILY INJURY (Per person) E ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) E PROPERTY DAMAGE (Per accident) E GARAGE LIABILITY AUTO ONLY- EA ACCIDENT E OTHER THAN EA ACC E I E ANY AUTO E AUTO ONLY: AGG EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE S AGGREGATE E OCCUR EI CLAIMSMADE E E DEDUCTIBLE E RETENTION E WORKERS COMPENSATION AND %; STATLl OTH- rp EMPLOYERS' LIABILITY E. L. EACH ACCIDENT E ANY PROPRIETORIPARTNER/EXECUTIVE EL. DISEASE - EA EMPLOYEE E OFFICERIMEMBER EXCLUDED? II es, descrlbe under E.L. DISEASE - POLICY LIMIT E CA P I S below OTHER EACH CLAIM: $1,000,000 A PROFESSIONAL LIABILITY EK13190036 05/2412016 0512412017 AGGREGATE: $1,000,000 RETENTION EA CLM: $;500 DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS %.cr%IIrn.hIC nuLur-m GANGt:LLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN PROOF OF INSURANCE NOTICE T THE RTIFICATE HOLD NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NOR LIAR TY ANY KI POt�THE INSURER, ITS AGENTS OR REPR AT ALIT ACORD 25 (2001/08) © ACORD CORPORATION 1988 Additional Insured - Designated Person or Organization Scottsdale ndemni.ty ompany END . ATTACHED TO ENDORSEMENT AND FORMING A PART EFFECTIVE DATE NAMED INSURED AGENT NO. A.M. STANDARD OF TIME) TIME) POLICY NUMBER EK13190036 1 5/24/2016 Resolve Insurance Systems 29406 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SECTION SCHEDULE Name of Person or Organization: City of South San Francisco South San Francisco Fire Department 480 N Canal Street South San Francisco, CA 94080 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II., WHO IS AN INSURED, is amended to include as an Insured the person or organization shown in the Schedule as an Insured, but only with respect to liability arising out of your operations or premises owned by or rented to you. https:// www. bamapplication. com /EndorsementGenerateAndDisplay2 .asp ?Details = A2VNO... 6/7/2016 File Number: 16 -301 City of South San Francisco Resolution: RES 4 8-2016 P.O. Box 711 (City Hall, 400 Grand Avenue) South San Francisco, CA Enactment Number: RES 48 -2016 A RESOLUTION AUTHORIZING THE CITY MANAGER TO ENTER INTO A TWO YEAR FEE FOR SERVICES CONTRACT WITH RESOLVE INSURANCE SYSTEMS, LLC., FOR SECONDARY BILLING SERVICES OF AGED ACCOUNTS AT A COMPENSATION RATE NOT TO EXCEED 30 PERCENT OF RECOVERED REVENUE. WHEREAS, the South San Francisco Fire Department (SSFFD) staff recommends that the City Council adopt a resolution authorizing the City Manager to enter into a two year fee for services contract with Resolve insurance Systems, LLC., (RIS) for secondary billing services; and WHEREAS, since the December 16, 2015 ambulance financial report presented to City Council, staff has been working on a plan that will narrow the revenue and expense gap, derive revenue from accounts in aged status, collect a higher percentage of ambulance transport invoices and reduce the cost of ambulance operations in South San Francisco; and WHEREAS, a patient care report (PCR) may be rejected or not eligible for billing for a variety of reasons, including incomplete or incorrect patient information, or denial of the claim by the insurance company; and SSFFD does not have staffing or technology available to locate the patients or appeal a rejected claim; and WHEREAS, RIS's proprietary techniques will allow for a percentage of the aged accounts to be evaluated and submitted for reimbursement without any knowledge or contact with the patient or their family members; and, WHEREAS, RIS, similar to other collection agencies, charges a percentage of collected dollars for their services; WHEREAS; rather than recommending write off of all aged accounts in SSFFD's ambulance financial report, staff is recommending that these accounts be forwarded to RIS for evaluation and recovery efforts, and recommends that all aged accounts go through the secondary billing process prior to being forwarded to Council for write off consideration. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of South San Francisco hereby authorizes the City Manager to execute a two year fee for services agreement with RIS on behalf of the City of South San Francisco, subject to review and approval as to form by the City Attorney. BE IT FURTHER RESOLVED that the City Manager is hereby authorized to take any other action consistent with the intent of this Resolution. E3 f'ity nf.4auth .Can Franrkrn pave 1 Arintrd on 5/2 /1b File Number. 16-301 Enactment Number: RES 48 -2016 At a meeting of the City Council on 4/27/2016, a motion was made by Pradeep Gupta, seconded by Liza Normandy, that this Resolution be approved. The motion passed. yes: 4 Councilmember Normandy, Councilmember Matsumoto, Vice Mayor Gupta, and Mayor Addiego Absent: I Councilmember Garbarino Attest by _ l st in i C.'ity niSnvth .Can Frnioriccn Pa¢p 2 Printed nn V2176