Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with TruBridge, LLC to Provide a Claim Editing Software and Management System
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with TruBridge, LLC to provide a claim editing software and management system for the term May 1, 2020 through April 30, 2023, with two one-year options to extend, in an amount not to exceed $1,000,000.
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BACKGROUND:
San Mateo Medical Center’s (SMMC) patient financial services division has been utilizing a third-party software system since 2010. SMMC continues to have a need for such software to fulfill the operational needs of SMMC.
DISCUSSION:
In June 2017, a Request for Proposals was conducted for a software system that would provide claim editing and management and TruBridge, LLC (TruBridge) was selected. TruBridge was chosen for its significant billing expertise, user-friendly software, and the ability to interface with the necessary systems within County infrastructure. In addition, they would be providing patient financial services.
This agreement is going to the Board late due to prolonged negotiations with the vendor.
The agreement and resolution have been reviewed and approved by County Counsel as to form.
The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate).
The Information Services Department has reviewed and approved the IT component of this agreement.
It is anticipated that through using TruBridge’s software, the percentage of clean claim processing without the need to obtain additional information will increase to 93%.
PERFORMANCE MEASURE:
|
Measure |
FY 2019-20 Estimated |
FY 2020-21 Projected |
|
Percentage of clean claim processing without the need to obtain additional information |
65% |
93% |
FISCAL IMPACT:
The term of the agreement is May 1, 2020 through April 30, 2023, with two optional one-year extensions. The amount of the agreement is not to exceed $1,000,000 for the three-year term. Funds in the amount of $55,555 are included in the SMMC FY 2019-20 Adopted Budget. Funds in the amount of $333,333 will be included in the SMMC FY 2020-21 Recommended Budget. Similar arrangements will be made for future years.
Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medically indigent or to those covered by programs that do not meet the full costs of care is covered by the County’s General Fund contribution to SMMC and is within the existing annual appropriation.
ATTACHMENT:
RFP Matrix