Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Healthcare Cost Solutions, LLC to Provide Hospital and Professional Coding Audits
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Healthcare Cost Solutions, LLC to provide hospital and professional coding audits, for the term of April 1, 2026 through March 31, 2031, in an amount not to exceed $2,000,000.
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BACKGROUND:
Accurate coding is essential for proper billing compliance and revenue capture, in addition to building a comprehensive health database that accurately identifies the acuity of patient care and an accurate case mix index. In order to ensure the accuracy of its coding by employee coders and providers, San Mateo Medical Center (SMMC) has an ongoing need for compliance coding audits. Coding audits are essential to ensure compliance with federal and state healthcare program billing rules.
DISCUSSION:
The proposed agreement was competitively procured following publication of a Request for Proposals in October 2025. Healthcare Cost Solutions, LLC (HCS) was elevated as the top choice by the evaluating panel due to their ability to provide the required services and guidance to the staff coders during exit audits or outside of scheduled audit reviews. In addition, the vendor offers free continuing education units to our employed coders that allow them to maintain their mandatory certifications. HCS also provides both value and a history of quality service.
The County Attorney has reviewed and approved the resolution and agreement 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 Technology Services Department has reviewed and approved the IT com...
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