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 Crossroads Health LLC to Provide Overpayment and Credit Balance Resolution Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Crossroads Health LLC to provide overpayment and credit balance resolution services, for the term of April 1, 2026 through March 31, 2029, in an amount not to exceed $2,630,000.
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BACKGROUND:
In accordance with Medicare and Medicaid program integrity provisions, credit balances on accounts receivables must be identified, and an overpayment resolution initiated to return the funds to the payor within 60 days after discovery. San Mateo Medical Center (SMMC) is responsible for achieving its goals relating to the compliant, accurate, and timely resolution of credit balances and overpayments. In December 2025, SMMC completed a Request for Proposals, and Crossroads was elevated due to their documented effectiveness in resolving overpayments and credit balances.
DISCUSSION:
SMMC continues to have a critical need for overpayment and credit balance resolution services. Crossroads will be providing SMMC with both credit balance resolution and overpayment correction, which includes any associated audit and Claims Inquiry Form (CIF) requirements. CIF is the process required by State Medi-Cal in order to recoup overpayments. This agreement is going to this Board late due to prolonged negotiations with the vendor.
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 component of this agreement.
It is...
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