Agenda Item Name:
Title
Title
Agreement between Alachua County and Zoll Data Systems, Inc. for Payor Logic Software Services
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Presenter:
Harold Theus, Chief 352-384-3101
Description:
Zoll Data Systems, Inc. Order Form/Agreement for Payor Logic Software Services will provide insurance clearinghouse, insurance discovery, and demographic verifier services for Fire Rescue’s ambulance patients.
Recommended Action:
Recommended Action
Approve the Agreement for Zoll Data Systems, Inc. and the BAA with Zoll Data Systems, Inc.
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Prior Board Motions:
N/A
Fiscal Consideration:
Fiscal Consideration
On December 10, 2019 the County approved the receipt of additional revenue from the transportation of Medicaid Managed Care (MCO) patients for a net amount of $874,565.66. Approximately $40,000 of this amount was allocated for insurance clearinghouse, discovery and demographic verification services. The remaining amount needed for this purchase is already a part of the adopted budget. Based on FY19 transport volume and projected FY20 transport volume, the vendor estimates the annual costs for services is $58,658.
The initial agreement is for 36 months and will automatically continue thereafter on a month-to-month basis until terminated.
The Pro Forma invoice (attached) reflects the amount that will be invoiced after the execution of the agreement.
001.54.5450.526.54.00
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Background:
Since 1999, the Medical Billing Office has contracted for electronic claims processing services. In 2014, the insurance eligibility and clearinghouse services became integrated into the Respond Medical Billing Software with Trizetto Software Services. Trizetto is one of only two clearinghouse and eligibility software programs that integrates with the Medical Billing Respond Software. The agreement with the current vendor, Trizetto, ended in FY19. The County and Trizetto were unable to come to an agreement to continue existing services or establish a new agreement for additional services. The other integrated software vendor, Zoll, submitted a quote for insurance clearinghouse and eligibility services, as well as services for insurance discovery and demographic verification.
The insurance discovery product checks across the major health insurance carriers in our region. We currently do not have resources to accomplish this and rely on patients to provide insurance. In addition, the recommended product includes a demographic verifier to assist in obtaining accurate addresses. We anticipate this will significantly reduce the amount of returned mail that has to be reviewed and analyzed. Other expenditures may be reduced as a result of this purchase (i.e. postage, Accurint skip-tracing services, etc.) and will be monitored for future reduction. The projected net revenue from the PEMT programs is sufficient to cover the estimated recurring cost increase to add the additional services; however, it is anticipated that the additional revenue generated from increased collections, as a result of the service, will cover future-year costs.