682-Regional Emergency Service ELECTRONIC CLAIMS SUBMISSION SERVICE AGREEMENT
L.P. ("Regional"F, a De imited Partnership, and City of Sanford Fire Department,
Florida ("City").
WITNESSETH:
WHEREAS, City is desirous of retaining Regional to process and submit City's
claims for ambulance services to insurance companies; and
WHEREAS, Regional for compensation and consideration set forth in this
Agreement will process, submit and collect funds owing City for ambulance services;
and
WHEREAS, Regional agrees to abide by and comply with all covenants set forth
herein and wit, h all applicable Florida law,
NOW, THEREFORE, the parties do ~gree as follows:
'i. Claims Processina Services.
1.1 Regional will pick up all claims information from City or their designee
on a weekly basis, unless other arrangements have been made and agreed upon by
both parties.
1.2 Regional will electronically process and submit the City's claims to
the corresponding insurance companies and provide a computer-generated report
ver. ifying their receipt by the insurance companies. City shall owe compensation to
Regional only for primary claims, and shall not be responsible or liable for additional
compensation to Regional for secondary claims.
1.3 Regional shall supply the City monthly reports, which shall contain
Electronic Verification Reports, Patient Aging, Accounts Receivable Reports, Practice
Analysis Reports, Insurance Analysis Reports, Insurance documentation consisting of
follow up, patient documentation on calls and collections and any and all other
information available concerning the claims filed during the month preceding the
monthly report.
1.4 Regional will deposit collected funds into the City's bank account
within two days of receipt of same. Regional shall provide City with validated deposit
slips on a weekly basis. City shall provide Regional with pre-printed deposit slips.
2. Compensation.
2.1 City shall pay to Regional for the services described in section (1
herain the per claim rate of 5.5% of the collected amount. This rate shall be in effect for
twelve (12) months from the date hereof with an option for extension for up to.four (4)
additional years. The invoices ara to be billed on a monthly basis.
3. Term of Aaraement.
3.1 This agreement shall be for a term of one (1) year provided however
that it may be terminated. by the City upon the submission of thirty (30). days written
notice to Regional.
3.2 The City shall have the option to extend this Agreement for up to
four (4) additional years.
3.3 The City agrees to a thirty (30) day trial period during which the
rigfit to terminate this Agraement shall be waived.
4. Code of Ethics and Debt Collection Practices.
4.1 Regional maintains and operates under a "Code of Ethics" to insure
the integrity and confidentiality of City and patients. A copy of this code is attached
herato and incorporated herein by raferance.
4.2 Regional covenants and agraes that it shall comply with, keep and
follow the guidelines, laws and ragulations set forth in Chapter 559, Florida Statutes,
and that it shall not violate Flodda Statutes §559.72 prohibiting certain practices in
collecting consumer debts nor violate any other provisions of the Florida Statutes
concerning consumer or commercial collection. Regional warrants that it is awara of
and fully knowledgeable of the laws ragarding collections practices set forth in Flodda
Statutes Chapter 559 and warrants that it shall at all times ramain knowledgeable of the
laws set forth therain and any amendments thereto.
4.3 The violation by Regional of either the Code of Ethics or any
provision of Florida Statutes Chapter 559 shall be grounds for City's immediate
termination of this Agraement upon Regional's receipt of notice from City without the
thirty (30) day waiting period.
5. Indemnification.
5.1 City, its officers and employees shall not be deemed to assume any
liability for the acts, omissions, and negligence of Regional, its officers and employees.
Regional shall indemnify and hold the City and its officers and employees harmless
from any and all liability, claims, causes of actions, costs or expenses either direct or
indirect including attorney's fees incurred as a result of or arising under this Agreement
or the provision of services hereunder.
6. Insurance.
6.1 Regional shall be responsible for maintaining a general liability
insurance policy covering all actions taken by Regional in connections with either its
duties under this Agreement or its relationship with City. The general liability policy
shall have a minimum coverage of One Million Dollars ($1,000,000.00) per occurrence
and One Million Dollars ($1,000,000.00) aggregate. Regional shall name City as an
additional insured on all insurance policies obtained. Regional shall provide to City a
Certificate of Lnsurance on the aforementioned policy immediately upon execution of the
Agi-eement.
7. Assignability. This Agreement' is not assignable by either party.
8. Severability; Florida Law. If any part of this Agreement is adjudged
invalid, all other parts herein shall remain valid and enforceable. Florida law shall
govern this Lease Agreement.
IN WITNESS WHEREOF, the parties hereto have signed by their duly authorized
officers as of the day and year set forth above. -'
CITY OF SANFORD "
Approved as to form and legality:
City Attorney