Title
Approval of a Resolution Authorizing an Agreement with Systems Design West for Fire Basic Life Support Transport and CARES Program Third Party Billing Services
Recommended Action
Committee Recommendation:
Not referred to a committee.
City Manager Recommendation:
Move to approve the Resolution Authorizing the Professional Services Agreement with Systems Design West.for Fire Basic Life Support Transport and CARES Program third party billing services.
Report
Issue:
Whether to approve the Resolution Authorizing the Professional Services Agreement with Systems Design West.for Fire Basic Life Support Transport and CARES Program third party billing services.
Staff Contact:
Matt Morris, Fire Chief, Olympia Fire Department, 360.753.8466
Presenter(s):
Matt Morris, Fire Chief, Olympia Fire Department
Background and Analysis:
The agreement with Systems Design West would allow them to provide the City of Olympia fire department with specific services related to the billing and payment processing of Basic Life Support (BLS) patient transport services provided to the public. Systems Design West will perform claim submissions, including follow up statements and any necessary rebilling of BLS patient transport services provided by the City of Olympia Fire Department to the subscriber’s medical insurances, Medicare, Medicaid and any and all known secondary insurance providers; produce and forward CMS 1500 forms and/or electronic medical claims; produce and mail an initial invoice and subsequent statements to all private patient accounts on behalf of the Fire Department; file any applicable appeals to insurance payers and/or Medicare and Medicaid on behalf of the patient if necessary to pursue the claim.
Systems Design West will procure payment for reimbursable services available to the OFD CARES program allowable under the Medicaid treat and refer program. The City of Olympia Fire Department shall pay Systems Design West an amount not to exceed $24.00 per billable patient care report (PCR). The City of Olympia Fire Department shall pay an amount not to exceed $7.00 per PCR for eligibility checks related to participation in the Treat and Refer Program. Systems Design West will receive all payments (except those directly deposited into the Provider’s account by insurances and Medicare/Medicaid via EFT).
Under this professional services agreement, patients will receive live customer service to via toll free phone numbers to answer patient billing questions Monday through Friday from 8:00am through 6:00 pm, Pacific Standard Time (except Federal holidays).
The BLS transportation and OFD CARES treat and refer services are anticipated to garner new revenue streams beginning July 1, 2024. Based on historical data, with time, we are hopeful that both programs will prove to be financially viable for the City of Olympia.
Climate Analysis:
While this agreement does not specifically address one of the sectors in the Climate Framework, it supports the City’s initiatives and efforts.
Equity Analysis:
A professional services agreement with Systems Design West broadens the City of Olympia’s ability to generate revenue and increase sustainability of much needed programs within the community. Community engagement, innovative crisis response, and caring for all people is conduit to a healthier and thriving city. Everyone deserves the opportunity to receive tools that will connect them to equitable medical care, culturally competent social services, and effective mental health services. The BLS transport program and OFD CARES programs through the Olympia Fire Department, offer additional resources for all members of the community we live, work, and play in.
Neighborhood/Community Interests (if known):
BLS transportation provided by the Olympia Fire Department will not only offer increased access to ambulance services beyond private ambulance, but it will also increase the response capacity for the Fire Department emergency services generated through the 911 system. Accessing the Medicaid Treat and Refer Program will assist in program sustainability, in turn increasing the program reach and resources. The community will benefit from improved health outcomes, a more holistic approach to service delivery, and an overall increased satisfaction with health care services provided by the City of Olympia Fire Department.
Financial Impact:
The initial financial impact is an investment in a service agreement that with time will procure funds that would otherwise be left behind. The knowledge and experience gained through the expertise of Systems Design West will in turn generate revenue beneficial to sustainability of these programs.
Options:
1. Approve the Resolution authorizing the Professional Services Agreement for the Basic Life Support Transport and CARES Programs with third party billing services provided by Systems Design West,
2. Do not approve the Resolution authorizing the Professional Services Agreement for the Basic Life Support Transport and CARES Programs with third party billing services provided by Systems Design West.
3. Take other action.
Attachments:
Resolution
Agreement