Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Amendment to the Agreement with Regulatory, Risk, Compliance Specialists, Inc. for Regulatory Consulting Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Regulatory, Risk, Compliance Specialists, Inc., for regulatory consulting services, extending the term through December 31, 2018 and increasing the amount by $500,000 to an amount not to exceed $600,000.
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BACKGROUND:
San Mateo Medical Center (SMMC) provides medical services to the safety net population within the County, and some of those services are supported by state and federal funding sources. In order to properly bill for reimbursement for such services, the SMMC Resource Management Department (RMD) works with providers and staff at SMMC to ensure that patient medical records contain all information necessary for reimbursement. Due to the complexity and ever-changing nature of state and federal regulations regarding patient billing, it is necessary to provide training and other compliance-related services to SMMC and to the RMD in particular. In April 2017, the SMMC Chief Executive Officer approved an agreement with Regulatory, Risk, Compliance Specialists, Inc. (RRCS) to assist the RMD with its review of documenting the medical necessity for certain patient services, as well as to begin conducting staff training regarding appropriate documentation practices. The goal of this work with RRCS is to maximize revenue collection, to avoid any over-billing, and eventually to help reduce the number of administrative days.
DISCUSSION:
SMMC has identified a need for RRCS to continue working with the RMD in order to ensure the most compliant documentation of patient care and the long-term adoption of best practices in t...
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