HomeMy WebLinkAboutR-86-0908J-86-864
RESOLUTION
N O . 136-908
A RESOLUTION AUTHORIZING
THE CITY MANAGER TO
EXECUTE AN A(PFFIFFNT, IF
SUBSTANTIAL.-LY THE FORM
ATTACHFD TO FF. APPROVED
BY THE LAW DEPARTMENT
BETWEEN THE CITY AND
ADVANCED DATA PROCESSING,
INC. (ADP) FOP COLLECTION
OF A $75 RESCUE
TRANSPORTATION FEE, FOR A
PERIOD OF ONE (i) YEAR AT
AN ESTIMATED COST OF
$37,700 PLUS 28% OF ANY
AMOUNT COLLECTED IN
EXCESS OF 50% OF GROSS
BILLING TO BE PAID FROM
REVENUES COLLECTED FROM
SAID FEE.
WHEREAS, there has been a tremendous
increase in Emergency Medical Responses
making it necessary that more resources be
directed in improving advanced life support
capabilities; and
WHEREAS, the increased number of
citizens requiring advanced life support
techniques has placed the Department of Fire,
Rescue and Inspection Services in a position
where it is unable to respond to all calls
for this advanced life support; and
WHEREAS, the City Commission passed and
adopted Ordinance No. 10079 dated February
13, 1986, establishing a User Fee of $75.00
for Use of the Emergency Medical
Transportation service of the Fire, Rescue
and Inspection Services Department, said user
CITY COXHISSIO1
MEETING OF
NOV 13 1966
ESOLUTION No. ��� �
14
fee being charged to each person receiving
transportation service and to be collected
according to a procedure recommended by the
City Manager and approved by the City
Commission; and
WHEREAS, the City Manager has
recommended that the City enter into an
agreement. with Advanced Data Processing (ADP)
for collection of the $75 Rescue Transport
User Fee, for a period of one (1 ) ,year at a
collection cost of $2.90 per individual
account, With ADP, the Service Provider
receiving 28% of the amount collected in
excess of 50% of gross billing; and
WHEREAS, the anticipated annual cost of
said agreement would be $37,700 to be paid
from projected revenues of $334,000 from the
Transport User Fee;
NOW, THEREFORE, BE IT RESOLVED BY THE
COMMISSION OF THE CITY OF MIAMI, FLORIDA:
SECTION 1. The City Manager is hereby
authorized to execute an agreement, with
Advanced Date Processing, Inc., for a period
of one (1) year commencing November 21, 1986,
and ending November 20, 1987, providing
options for two (2) subsequent annual
renewals, in substantially the form attached
to be approved by the Law Department, for the
collection of the $75 Rescue Transport User
Fee; said fee established for the Use of the
Emergency Medical Service of the Fire, Rescue
PASSED AND ADOPTED this iAth day of
Nev�nt�pr , 1986.
xAVIER L. REZ,
MAYOR
ATT*401.,-
MATTY HIRAI, CITY CLERK
PREP ED AND APPROVED BY:
ROBERT F. CLARY.
CHIEF DEPUTY CITY ATTORNEY
APPROrYFO ,R.3 TO _ZORN AND CORRECTNESS:
LPIA A. DOUGHERkTY
CflTY ATTORNEY
f•
114
AGREEMENT BETWEEN
ADVANCED DATA PROCESSING, INC.
AND
THE CITT OF KTA197 FIFE, RESCUE A INSPECTION SERVICES
THIS AGREEMENT, is mRde sn en4.ered into this day
of , I9S6, by And between the City of
Miami, a MUnicipa] corporation of the Stste of Florida,
hereinafter referred to as the "CITY", and Advanced Data
Processing, Inc., a Florida corporation, hereinafter referred to
as the "SERVICE PROVIDER".
Witness:
WHEREAS, the CITY routinely provides ground transportation of
private individuals to local hospitals in CITY rescue vehicles;
and
WHEREAS, City Ordinance 10079 provides for the charging of a flat
fee for such transportation service; and
WHEREAS, the SERVICE PROVIDER has demonstrated its capability and
its willingness to provide the requested services;
NOW THEREFORE, for and in consideration of the premises and
mutual covenants herein contained, the parties hereto agree as
follows:
1. The CITY will provide the SERVICE PROVIDER with a copy of
the CITY of Miami Rescue Report (or will provide the
information that is on said report on compatible magnetic
computer tapes) for each individual transported by a ground
rescue vehicle. These documents will be forwarded to the
SERVICE PROVIDER by the CITY Fire Department on a weekly
basis. ,
2. Within five (5) business days after receipt of any
particular Rescue Report, the SERVICE PROVIDER shall
initiate and mail to the transported individual an
appropriate invoice.
3. The SERVICE PROVIDER agrees to generate and mail follow-up
invoices on a set billing cycle. Billing cycles and the
number of invoices will be determined by the financial class
(self -pay, commercial insurance, Medicare, Medicaid, or
Worker's Compensation) of the individual transported.
4. Form and content of the appropriate invoices, as well as
specific billing cycles, have been agreed to by both parties
and are made a part of this Agreement in Attachment "A"
hereto.
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5• the SERVICE PROVIDER agrees to generate and sail necessary
forms to third party payors when appropriate. The SERVICE
PROVIDER understands that it may be necessary to solicit
additional data beyond the information provided an the City
Rescue Report in order to complete the third party invoices
and forms. In such gituationa, the SERVICE PROVIDER agrees
to Solicit: such inforsrat.ion from the transported individual
and/or the appropriate hospital.
6. The SERVICE PROVIDER agrees, upon request., to advise
transported individuals, regarding insurance And other third
party benefits, and to sssist said individuals kith the
preparation and submittal of claims.
7. The SERVICE PROVIDER agrees to abide by the terns of any
remittance agreement or lockbox agreement entered into by
the CITY and its chosen bank. It is agreed that all
payments originated by reason of billings made on behalf of
the CITY by the SERVICE PROVIDER shall be deposited into the
account of the CITY in said depository. The SERVICE
PROVIDER shall so provide for such direct remittance on its
bills and/or statements rendered to transported individuals
(or third parties., as the case may be) on behalf of the
CITY. Said agreement shall provide for the third party
depository to provide the SERVICE PROVIDER with a statement
setting forth the name and atrount of each account making
payment, and such statement shall be provided to the SERVICE
PROVIDER within three (3) business days after receipt.
All transport payments collected by the City Fire Department
Records Custodian are to be deposited into the lockbox
account and a copy of remittance will be forwarded to the
SERVICE PROVIDER.
In addition, said agreement* shall include a standard
procedure to be followed by the third party depository When
checks have been returned for insufficient funds. Said
procedure shall require the third -party depository to
forward such checks to the SERVICE PROVIDER and to list such
checks on the statement as debits.
In the event that a payment is mistakenly transmitted by the
payor to either the SERVICE PROVIDER or the City of Miami
Fire Department, both parties agree to deposit said payment
into the third party depository account.
8. The SERVICE PROVIDER agrees to provide the following reports
to. the CITY on a monthly basis, in a format mutually agreed
to by both parties:
a. Distribution of Charges and Collection.
This report tracks the charges, payments and financial
class mix of all transported individuals for a given
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month, and reports the collections in dollars and
percentages by financial class.
b. Accountr Receivable Suirra ry.
This report 4hovs thR outstanding accounts receivable at
a month end And ssgea all accounts. The second portion
of this report. AgPa All Accounts by financial class.
C. ReK Chi Ill hAbetS.ca,.l LiQt.ing.
This report Ii¢ta all. ,Accounts AlpbAbpticAl.ls by date of
input and mrintAins daily And month-to-dAte totals by
number of trAn=ported individuals And dollars.
d. Transported Individual ClAs4ification Listin .
This report summarizes all nev transported individuals
by financial c1r9As (self pay, Medicare, Medicaid,
commercial insurance, or Worker's Compensation) and
dollar amount.
e. Monthly LU.ment Iai sting.
!^ This report lists all payments, bad checks, and refunds
posted to each account for the month.
f. Check Edit Listing.
List of all transported individuals due refunds due to
overpayment of account.
In addition, the SERVICE PROVIDER agrees to provide an
"Alphabetical Accounts Receivable Listing" (an aged accounts
receivable summary for 30, 60, 90, 120, and 180 days, for
all accounts) upon written request from the CITY. The CITY
agrees to limit such requests to no more than twice
annually.
9. The SERVICE PROVIDER agrees to negotiate and arrange
modified payment schedules for those individuals unable to
pay the full amount when billed.
10. The SERVICE PROVIDER agrees to make available for inspection
and audit all books and records related to the Agreement
upon receipt of three (3) days prior written notice from the
CITY. In addition, all records pertaining to the Agreement
must be retained in proper order by the SERVICE PROVIDER for
at least 12 months following the expiration of the
Agreement.
11. The SERVICE PROVIDER agrees to maintain as confidential all
medical and other patient information and to otherwise
conform with state and local laws or rules related to the
confidentiality of patient information. In the event for a
demand for such information by a person or entity other than
the parties of this Agreement, the patient or any person or.
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entity authorized by the patient or by law to obtain such
information, the SERVICE PROVIDER agrees to notify the CITY
of the demand and to withhold relesae of the requested
information until such time as release is sutborired by the
CITY.
12. The SFRVICF PROVIDER ehal_I indemnify end ppira the CITY
harmless from Any and all claims, Ii.AbiIjty, 10Fse¢ and
causes of action which Msy arise out of the fulfillment of
the Agreement. The SERVICE. PROVIDER Phall pay all claim@
and losses of any nature whatever in connection therewith,
and shall defend allsuits, in the name of the CITY when
applicable, And shall pay all costs and judgements which may
issue thereon.
13. The SERVICE PROVIDER agrees to abide by the Federal Debt
Collection Practices law and all similar State of Florida
laws and rules.
14. The SERVICE PROVIDER agrees that it shall not discriminate
as to race, sex, color, creed, national origin, or handicap
in connection with its performance under this Agreement.
Furthermore that no otherwise qualified individual aha11,
solely by reason of his/her race, sex, color, creed,
national origin, or handicap, be excluded from the
participation in, be denied benefits of, or be subjected to
discrimination. under any program or activity receiving
federal financial assistance.
The SERVICE PROVIDER agrees to post in conspicuous places
available for employees and applicants for employment, such
notices as may be approved by the City of Miami and the
Department of Personnel Management.
The SERVICE PROVIDER acknowledges that it has been furnished
a copy of the Minority Procurement Ordinance of the City of
Miami, and agrees to comply with all applicable substantive
and procedural provisions therein, including any amendmeics
thereto.
15. The SERVICE PROVIDER agrees to provide the CITY with a
listing, or a computer tape which is compatible with City
equipment, of all accounts past due 180 days or more (exce t
where a modified pay -out schedule has been arranged ,
including all pertinent facts regarding attempted collection
efforts. (At the CITY's option, accounts due 180 days or
more may be withdrawn from the SERVICE PROVIDER and returned
to the CITY for further collection efforts)
16. The SERVICE PROVIDER agrees to prepare responses to all
inquiries concerning invoices received by transported
individuals, commercial insurance forms, health plan claim
forms, all governmental agency claim forms, Worker's
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Compensation claim forme, and such other forms and reports
as may be required from time to time to be prepared,
submitted, filed or otherwise provided by the CITT to any
entity in connection vith the operation of its ground
transport billing and collection business,
17. The SFRVICF PPOVJDFR agrees t.o provide and furnish aa11
material and personnel required for the performances of the
Agreement,
18. SERVICE FROVTDER and its employees and agents shrill be
deeded to be independent contractors, aand not ngetnta or
employees of CITY, and shall not Attaain any rights or
benefits; under the Civil Service or Pension Ordinances of
CITY, or any rights generally afforded c1aaeaified or
unclassified employees; further he/she shall not ben deemed
entitled to the Florida Workers' Compensation benefits as an
employee of CITY. The SERVICE PROVIDER shall supply
competent and physically capable employees and the CITY may
require the SERVICE PROVIDER to remove an employee it deems
careless, incompetent, insubordinate or otherwise
081 objectionable.
19. For the provision of all services described in this
Agreement, the CITY agrees to pay the SERVICE PROVIDER a
single flat fee of $2.90 for each individual account turned
over to the SERVICE PROVIDER for collection. In addition, _
the CITY agrees to compute and provide incentive payments on
a monthly basis. Computation of such incentive payments
will be based on the cumulative total of collections, and
the CITY agrees to pay the SERVICE PROVIDER 28% of the
amount collected in excess of 50% of gross billings.
20. The CITY reserves the right to withdraw any individual
account from the SERVICE PROVIDER, if it determines that a
Casualty Form was mis-coded by rescue personnel, and
therefore, mistakenly forwarded to the SERVICE PROVIDER for
billing. In such cases, the CITY will notify the SERVICE
PROVIDER in writing, specifying name of transported
individual, incident number, and reason for withdrawal. For
such withdrawn accounts, the CITY agrees to pay the regular
$2.90 flat fee and both parties agree that the transport
charge will be deducted from the total gross billings.
t
21. The SERVICE PROVIDER will submit monthly invoices to the
CITY. Such invoices will be produced on the 15th day of
each month for services rendered during the preceding month.
The monthly invoices will include the SERVICE PROVIDER's
flat fee for initial billings originated by the SERVICE '
PROVIDER during the preceding month, as well as the SERVICE
PROVIDER's computation of Incentive Payments owed for the
preceding month. Within one week of receipt of monthly i
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invoices for the SERVICE PROVIDER, the City Fire Department
will review requested amounts. If the Department review
concurs with the SERVICE PROVIDER's calculations, the
invoice wi1.1 be forwarded to the C TV's Finance Department
for paymRnt..
The monthly invoice will also include* A "' t. of " counta
which require refunds due to overpAyment of Account. Said
list vi11 include the trenaported individt),%l`s nAme, the
incident numt,er, the atrount of refund roquirpd, the Address
to which the refund should by R,Ailed, And the resson for
overpayment.
22. The SERVICE PROVIDER agrees not. to assign, transfer, convey,
sublet, or otherwise dispose of the Agreement, or any or all
of its right, title, or interest therein, or its power to
execute such Agreement, to any person, compeny, or
corporation, without prior written consent of the CITY.
23. The SERVICE PROVIDER Agrees that, in case of default of this
Agreement, the CITY may procure the required services from
another source and charge the SERVICE PROVIDER as liquidated
damages any excess cost occasioned thereby, not to exceed
the amount that would have been charged by the SERVICE
PROVIDER, provided that the SERVICE PROVIDER is given five
(5) days from the date of written notice of the default to
remedy the default. No failure of the CITY to insist upon
the strict performance of any term or condition of this
Agreement or to exercise any right or remedy consequent upon
a breach thereof, and no acceptance by the CITY of full or
partial performance during the continuance of any such
breach, shall constitute a waiver of any such breach of such
term or condition. No term or condition of the Agreement to
be performed or complied with by SERVICE PROVIDER and no
breach thereof shall be waived, altered or modified except
by written instrument executed by the CITY. No waiver of
any breach shall affect or alter the Agreement, to each and
every term and condition of this Agreement shall continue in
full force and effect with respect to any other then
existing or subsequent breach thereof.
24. The CITY agrees that during the term of the Agreement, no
other billing service will be employed to bill for CITY Fire
Department ground transports,' nor will the CITY Fire
Department do any direct billing for same.
25. The CITY may at its sole discretion, terminate this
Agreement at any time by giving ninety (90) day prior
written notice to the SERVICE PROVIDER. Upon termination,
the SERVICE PROVIDER will continue to perform all duties
except original billing, for 180 days or until requested to
cease, whichever first occurs, provided that the CITY
continues to convey necessary documents to SERVICE PROVIDER
as provided herein.
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26.
27.
28.
Upon expiration or termination of this Agreement for any
Cause, SERVICE FRO"IDER shall provide all reasonable
assistance to the CITY and shall use its beet efforts to
return to the CITY in an orderly, Rnd.expeditiour manner, but
in no evert later than thirty (30) dayg after the d,-te of
such termination, all dsts, records, docu►rert.s, reports,
information, equipment and other property bel.orging to the
CITY.
Upon execution, this Agreement shall be in effect for t.velve
months. It may be reneged for tvo additional one-year
periods by mutual agreement of the parties indicated in
writing sixty (60) days prior to the expiration date. The
rate of compensation enn be renegotiated for each of the
optional twelve-month extension periods.
In the event that the CITY increases the currant $75.00
transport charge, the CITY agrees to renegotiate the
incentive payments within thirty (30) days of such approved
increase.
Compliance with Federal, State and Local laws: Both parties
shall comply with all applicable laws, ordinances and codes
of federal, state and local governments.
General Conditions.
a. All notices or other communications which shall or may
be given pursuant to *-his Agreement shall be in writing
and shall be delivered by personal service, or by
registered mail addressed to the other party at the
address indicated herein or as the same may be changed
from time to time. Such notice shall be deemed given on
the day on which personally served; or, if by mail, on
the fifth day after being posted or the date of actual
receipt, whichever is earlier.
CITY SERVICE PROVIDER
275 NY 2 Street 1175 NE 125 Street
Miami, FL 33128 Suite 412
North Miami, FL 33161
b.
c.
d.
Title and paragraph headings are for convenient
reference and are not a part of this Agreement.
In the event of conflict between the terms of this
Agreement and any terms or conditions contained in any
attached documents, the terms in this Agreement shall
rule.
No waiver or breach of any provision of this Agreement
shall constitute a waiver of any subsequent breach of
the same or any other provision hereof, and no waiver
shall be effective unless made in writing.
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g. Should any provisions, paragraphs, sentences, words or
phrases contained in this Agreement be determined by a
court of competent jurisdiction to be invalid, illegal
or otberwiRe unenforceable under the lava of the State
of Florida or the City- of Kiami, such provisions,
paragraphs, sentences, vords or phrases shall be deemed
nodified to the extent necessary in order to conform
with such lays, or if not modifiable to conform with
such lays, then same shall be deemed severable, And in
either event, the remainir+g terms and provisions of this
Agreement shall remain unmodified and in full force and
effect.
29. Ownership of Document: All documents developed by SERVICE
PROVIDER under this Agreement shall be delivered to CITY by
said SERVICE PROVIDER upon completion of the services
required and shall become the property of CITY, without
restriction or limitation on its use. SERVICE PROVIDER
agrees that all documents maintained and generated pursuant
to this contractual relationship between CITY and SERVICE
PROVIDER shall be subject to all provisions of the Public
Records Lew, Chapter 119, Florida Statutes.
AMN
It is further understood by and between the parties that any
information, writings, maps, contract documents, reports or
any other matter whatsoever which is given by CITY to
SERVICE PROVIDER pursuant to this Agreement shall at all
times remain the property of CITY and shall not be used by
SERVICE PROVIDER for any other purposes whatsoever without
the written consent of CITY.
30. Audit Rights: CITY reserves the right to audit the records
of the SERVICE PROVIDER at any time during the performance
of this Agreement and for a period of one year after final
payment is made under this Agreement.
31. Award of Agreement: SERVICE PROVIDER warrants that it has
not employed or retained any person employed by the CITY to
solicit or secure this Agreement and that it has not offered
to pay, paid, or agreed to pay any person employed by the
CITY any fee, commission percentage, brokerage fee, or gift
of any kind contingent upon or resulting from the award of
this Agreement.
32. Construction of Agreement: This Agreement shall be
construed and enforced according to the laws of the State of
Florida.
33. Successors and Assigns: This Agreement shall be binding
upon the parties herein, their heirs, executors, legal
representatives, successors, and assigns.
34. Conflict of Interest.
A
{
g. the SERVICE PROVIDER covenants that no person under its
employ who presently, exercises any functions or
responsibilities in connection Kith this Agreement has
any personal financial interests, direct or indirect,
with CITT, SkFVICF FFOViPFF further covenAnt= ths!t, in
the perforrAnce of this Agreement, no person having such
conflicting interestshall bC Rjr. pIoya6, Any such
interests or, the part of the S.)1FVICF FF0VIPFF or its
employees, must be disclosed in vriting to CITT,
b. SERVICE FFOVIPFF is aXaro of the conflict of interest
laws of the Cite of Miami )City of Mimmi, Coda Chapter 2,
Article V�, Dade County Florida (Dada County Code
Section 2=,1.1) and the State of Florida, and agrees
that it shall fully comply in all respects with the
terms of said laws,
35• Entire Agreement: This instrument and its attachments
constitute the sole and only Agreement of the parties hereto
relating to said grant and correctly sets forth the rights,
duties, and obligations of each to the other as of its date.
Any prior agreements, promises, negotiations, or
110"N representations not expressly set forth in this Agreement
are of no force or effect.
36. Amendments: No amendments to this Agreement shall be
binding*on either party unless in writing and signed by both
parties.
IN WITNESS WHEREOF, the parties hereto have caused this
instrument to be executed by the respective officials thereunto
duly, authorized, this the day and year first above written.
ATTEST:
CITY OF MIAMI, a municipal
Corporation of the State
of Florida
By:
NATTY HIRAI CESAR H. ODIO
City Clerk City Manager
ATTEST: SERVICE PROVIDER:
By:
Corporation Secretary Title
(Seal)
i
Signature Page Continued ....
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Y
R
WITNESSES:
As to SERVICE PROVIDER
(Dote: If SERVICE PROVIDER
is not a Corporation,
two Yl tnense" must
sign.)
APPROVED AS TO INSURANCE
REQUIREMENTS:
Division of Risk Management
eo*N
APPROVED AS TO FORK AND
CORRECTNESS:
LUCIA A. DOUGHERTY
City Attorney
"1
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CORPORATE RESOLUTION
WHEREAS, the Board of Directors of Advanced
Data Processing has examined terms, conditions, and
obligations of the proposed contract with the City of Miami
for billing and collecting
WHEREAS, the Board of Directors at a duly held
corporate meeting have considered the matter in accordance with.
the by-laws of the corporation;
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF
DIRECTORS OF Advanced Data Processing , that the
president and secretary are hereby authorized and instructed to
enter into a contract in the name of, and on behalf of this
corporation, with the City of Miami for billing and collecting
, in accordance with the contract
documents furnished by the City of Miami, and for the price and
upon the terms and payments contained in the proposed contract
submitted by the City of Miami.
IN WITNESS WHEREOF, this day of QCtcll.,,
19 `r3 •
CHAIRMAN, Board of Directors
e
/WITNESS
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__ __ _ ,_
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METRO•DADE FIRE DEPARTMENT
6000 S.W. 97 AVENUE
MIAMI, FLORIDA 33173
TEIEPMONE 596.65/0 . 59645"
Pleaae detach this portion and return with your remittance to Metro•Oade Fire Dept. to insure credit to proper account.
T
DESCRtPttONOFSERVICE
PATIENT
CHARGES
CREDITS
BALANCE
THE ABOVE
CHARGE IS A FLAT FEE.
PROVIDER NO.: AOSMA6059 TAX I.D.: 5WWO-573 MEDICARE CODE:06NO
NOTICE
IF YOU ARE ELIGIBLE FOR MEDICARE AND NEED A FORM, CALL t•600.342-7566. ATTACH LOWER PORTION OF THIS INVOICE
AND THE PINK CASUALTY REPORT TO YOUR COMPLETED MEDICARE FORM AND SEND DIRECTLY TO MEDICARE, P.Q. BOX 2525,
JACKSONVILLE, FL 32231, A FEE OF S3.00 WILL BE CHARGED IF DUPLICATE COPY OF CASUALTY REPORT IS REQUESTED.
ACCOUNT YOUR CANCELLED CHECK IS YOUR RECEIPT PAY THIS
METRO•DADE FIRE DEPARTMENT AMOUNT
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AUTHORIZATION AND ASSIGNMENT
MEDICARE PAYMENTS: A patient's signature requests that payment be made and authorizes
release of medical information necessary to pay the claim. it patient has other health insurance
coverage the patient's signature authorizes releasing of the information to the insurer or agency
shown. In assigned cases+ the physician agrees to accept the charge determination of the
Medicare carrier as the full charge, and the patient is reponsible only for the deductible,
coinsurance, and noncovered services. Coinsurance and the deductible are based upon the
charge determination of the carrier, if this is less than the charge submitted.
MEDICAID RECIPIENT ONLY:
certify that I am a recipient of the Medicaid. Title XIX program, and request that payment of authorized benefits be
made on my behalf. I authorize you to make available to the Florida Division of Family Services any requested
information concerning medical, insurance, and financial records relating to my treatment. I hereby certify all health
insurance shalt be assigned to you for services provided.
INSURANCE ASSIGNMENT:
I hereby assign insurance benefits on all insurance policies otherwise payable tome for this treatment I aulhatize you Io
` submit insurance claims to insurance companies and to apply insurance proceeds to my bill and to make refunds to
insurance companies it refunds are due, under the provision of such insurance policies.
r-
Advanced,
Oata 1175 N.B. 125t:h Street, Suite 412
North Miami, Florida 33161
Processing, Inc. Phone (305) 89"353 / 895-3714
i
Net.e Data Processing Services
On S+t.e IBM Computers
SAMPLE INVOICE
(as of 10/20/86)
28%
Total Total Total Amount
Amount
Prior
Due ADP
Gross Collections Collections over
over
Payments
this
Month
Billings This Month To Date
to ADP
Month
Jan 87
$
400
Feb 87
$
400
(Ail columns to be completed)
Mar 87
$
200
Apr ' 87
$
-0-
May 87.
$
-0-
'" al due
ADP this month for cumlative collections over
50%
$
1,000
For 1,000
new accounts -in May 1987 1% 2.90 per account
$
2,900
Total due
ADP this month
$
3,900
The above
collection figures will be obtained from the "Distribution
of Charges
and
Collections" report. This report is updated monthly and a separate
report printed for
each month of business.
'"1
" PAYROLL • ACCOUNTS RECEIVABLE • GENERAL LEDGER • INVOKING • MAILING LABELS • UST S
Advanced
uata
Processing, Inc.
g Services
On ,ice Vvll co'npul.Prc
I. SELF PAY
I^%
ad
DAYS
1
00
2
15
3
15
4
15
5
30
1175 N.E. 1 25sh Street, Strte 412
North Miwni, Ro ids 33161
Phone (305) 895-8353 / 895-3714
CODE: 001
IF YOU HAVE INSURANCE OR PARTICIPATE IN ANY PROGRAM
WHICH WILL PAY FOR PHYSICIAN'S SERVICES, PLEASE COMPLETE
AND SIGN THE REVERSE SIDE OF THIS BILL AND RETURN IN THE
ENCLOSED ENVELOPE. 071Ml fISE, THIS BILL IS DUE AND PAYABLE
NOW. PLEASE SEND YOUR PAYMENT TODAY.
CODE: 002
IS THERE ANY REASON WHY PAYrMrr OF THIS ACCOUNT HAS BEEN
WITHHELD? IF SO, PLEASE TELL US. IF NOT► WE ASK FOR PROMPT
PAYMENT AT THIS TBS.
CODE: 003
YOU NEED TO CONTACT OUR OFFICE IMMEDIATELY SO THAT WE MAY
RESOLVE ANY PROBLEMS REGARDING THIS PAST DUE ACCOUNT.
CODE: 004
YOU NEED TO CONTACT OUR OFFICE IMMEDIATELY SO THAT WE MAY
RESOLVE ANY PROBLEMS REGARDING THIS PAST DUE ACCOUNT.
CODE: 005
AVOID FURTHER COLLECTION OR LEGAL ACTION, THIS ACCOUNT MUST
BE PAID.WITHIN 72 HOURS.
• PAYROLL • ACCOUNTS RECEIVABLE • GENERAL LEDGER • INVOICING • MAILING LABELS • LISTS
Advanced
t
N Dat a 1175 N.E. 125th Sb'm.t, 8,*v 412
North O ni, s 33181
Processina Inc. Phone (305) 895-8353 / 89"714
c)tpLp DPLP Processing Services
Dn Site !8nl Comput.ers
II. COFf4ERCIAL INSURANCE
MESSAGE
10
11
12
13
14
DAYS
00
45
15
15
15
CODE: 10
YOUR INSURANCE HAS BEEN FILED. YOU WILL BE NOTIFIED IF YOUR
BILL IS NOT PAID WITHIN 45 DAYS. THE BALANCE WILL THEN BE
DUE AND PAYABLE BY YOU.
CODE: 11
WE F= YOUR INSURANCE CLAIM, BUT HAVE RECEIVED NO PAYMENT.
THE BALANCE SHOWN IS DUE AND PAYABLE BY YOU. THANK YOU.
CODE: 12
YOU NEED TO CONTACT OUR OFFICE Dr-iEDIATELY SO THAT WE MAY
RESOLVE ANY PROBLEMS REGARDING THIS PAST DUE ACCOUNT.
CODE: 13
YOU NEED TO CONTACT OUR OFFICE IMMEDIATELY SO THAT WE MAY
RESOLVE ANY PROBLEMS REGARDING THIS PAST DUE ACCOUNT.
CODE: 14
TO AVOID FURTHUR COLLECTIONS OR LEGAL ACTION, THIS ACCOUNT FIST
BE PAID WITHIN 72 HOURS.
f
/Advanced
Data 1175 N.E. 125rh Street, Stite 412
North Miemi, Pbrids 33161
Cr, ^tPt-7,.P I7At.m Prn�-esrzilg Services
On Site IBN4 cc?mmpot:ers
III. MEDICARE
MESSAGE
20
21
22
23
24
s
Phone JOW;J) 8H5-8353 / 895-3714
MY a
00
45
15
1S
1S
CODE: 20
YOUR MEDICARE HAS BEEN FILED. YOU WILL BE NOTIFIED IF YOUR
BILL IS NOT PAID WITHIN 45 DAYS. THE BALANCE WILL THEN BE
DUE AND PAYABLE BY YOU.
CODE: 21
SATE FILED YOUR MEDICARE CLAIM, BUT HAVE RECEIVED NO PAYMWT..
THE BALANCE SHOWN IS DUE AND PAYABLE BY YOU, THANK YOU.
CODE: 22
THIS ACCOUNT IS PAST DUE II"MMTATE PAYMENT IS REQUESTED.
CODE: 23
YOU NEED TO CONTACT OUR OFFICE IMMEDIATELY SO THAT WE MAY
RESOLVE ANY PROBLEMS REGARDING THIS PAST DUE ACCOUNT.
CODE: 24
TO AVOID FURTHER COLLECTION OR LEGAL ACTION, THIS AC<.'OUNT MEJST
BE PAID WITHIN 72 HOURS.
• PAYROLL • ACCOUNTS RECEIVABLE • GENERAL LEDGER • INVOICING • MAILING LABELS • LISTS
Yv}
!>L
A,
2
i e
Advanced
llata F
1175 N.E. 125th Street, Suite 412
North Man* Rohde 33161
Processing, Inc. Phone (305) 895-8353 / 895-3714
Complete Drns Proressiriq Services
On Site ISM CornputP--,
IV. WORKMAN'S COMPENSATION
M SSME
30
31
32
32
Mys
00
05
60
30
CODE: 30
VIE HAVE FILED THIS CLAIM ON THE PROPER PM- WOULD YOU PLEASE
BE SURE THAT YOU HAVE FI'.ED A "FIRST REP= OF INJURY"
THANK YOU.
CODE: 31
MR. EMPLOYER, HAVE YOU SENT THIS CIAU4 TO YOUR WORKMEN'S
COPuISATIQN CARRIER AS REQUIRED BY Lilt r. IT IS 60 DAYS PAST'
DUE. PLEASE CHECK WITH YOUR CARRIER.
CODE: 32
MR. EMPLOYER, IF THIS ACCOUNT IS NOT RUMVED IN 15 DAYS, WE
SHALL REPORT IT TO THE IrdDUSTRIAL OO I.SSION ASKING THEM FOR
ASSISTANCE. •
• PAYROLL • ACCOUNTS RECEIVABLE • GENERAL LEDGER • WVOCING • MAILING LABELS 0 LISTS
A
CITY OF MAIAMI, I LOR'IlMA
IMTCR-00rFICK 01461001RANOU
A
Honorable Mayor and Members oam NOV 5 1 Me!
of the City Commission Resolution Authorizing
BUOXECT: the City to Enter into an
Agreement for Collection
of $75 Fepcup Transport
Cesar H. Odio Fee
fRQMR[FER[NC[*+
City Manager For City Commission
cNCLOSUP99: Meeting o f
November 13, 1986
RECOMMENDATION:
It is respectfully recommended that the City Commission adopt the
attached resolution, proffered by the Department of Fire, Rescue and
Inspection Services, in a form found acceptable to the Law
Department, authorizing the City Manager to enter into a contractual
agreement with Advanced Data Processing, Inc. (ADP) for the
collection of a $75 Rescue Transport User Fee, for a period of one
(1) year with options for two (2) subsequent annual, renewals at an
estimated cost of $37,700.plus 28% of any amount collected in excess
of 50% of gross billing.
BACKGROUND:
Pursuant to Ordinance No. 10079, dated February 13: 1986, and based
upon the recommendation of the Department of Fire, Rescue and
Inspection Services a User Fee of $75 for use of Emergency Medical
Transportation Services of the Fire, Rescue and Inspection Services
Department was established. The User Fee went into effect April 1,
1986, and is charged to each person receiving such service. From
April 1, 1986, until November 20, 1986, Gottlieb's Financial Services
is under contract to provide billing and collection service.
With respect to continuation of collection services for the User Fee
three firms were contacted by the Department of Fire, Rescue and
Inspection Services; Advanced Data Processing, Inc. (ADP), Gotlieb's
Financial Services (GFS) and Santana Investigations. Only ADP and
GFS submitted proposals, of which ADP's was the lowest.
ADP agreed to provide this service at a cost of $2.90 per individual
account plus 28% of the amount collected in excess of 50% of gross
billing. GFS proposed a $6.00 flat charge per patient transported.
In anticipation of approximately 13,000 transports annually an
agreement with ADP would cost approximately $37,700, plus 28% of any
amount collected in excess of 50% of gross billing. Projected
revenue for one year after deduction of collection cost is estimated
to be $334,000.
Honorable Mayor and Members -2-
of the City Commission
The Transport Fee will be charged to each patient who is transported
by a City of Miami Rescue Unit. The collection policy will be based
on third party billing wherein Medicare/Medicaid Insurance Companies
will be billed directly. No extraordinary collection efforts will be
directed toward ci-tizens unable to pay this fee.
The Departments of Finance and Computers have also analyzed their
requirements to do the billings and collections of the Transport User
Fee.
The Finance Department cost, computed in April. 1986, is as follows:
Three Clerks to do billing and collections
including investigation of use information,
such as correct name, address and insurance
coverage. Updating data base with collections
and adjustments (includes fringe benefits). $ 60,000
Office Supplies and Postage $ 12,500
Total Finance Department Costs $ 72,500
It is estimated that recruiting of above personnel will take at least
one month.
The Department of Computers will require two full-time _Analyst/Pro-
grammers to complete the project in three months.
At the present time, the impact of this development will negatively
affect the implementation of the new Financial Management System and
the Solid Waste Billing System. The earliest the Department of
Computers can undertake this project without affecting ongoing plans
is in May of 1987.
Attachments:
Proposed Resolution