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lClTY OF SAN BERNtjDINO - REQUEST Fe5I COUNCIL ACTION
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From: Shauna Clark, .City Administrator
Dept: Administration
Subject: Agreement with Advanced Billing Concepts
relating to billing services for the
paramedic subscription program.
Date: November 14, 1991
Synopsis of Previous Council action:
10/24/91 -- Legislative Review Committee recommended approval.
Recommended motion:
Adopt resolution.
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Signature
Contact person:
Shauna Clark
Phone:
5122
Supporting data attached:
Yes
Ward:
All
FUNDING REQUIREMENTS:
Amount:
Source: (Acct. No.!
(Acct. DescriPtion)
Finance:
Council Notes:
75-0262
Agenda Item No. ~ .....or-
"CITY OF SAN BERNQDINO - REQUEST FQc COUNCIL ACTION
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STAFF REPORT
Presently, the city of San Bernardino has a contact with courtesy
Services for billing of our EMS services. Due to a potential for
a conflict of interest, I would like to recommend that we use
another billing service.
By conflict of interest, I am referring to those instances where
insurance companies will only pay one EMS provider. Now that
courtesy has "paramedics" on their ambulances and is charging for
paramedic service, there is a dual provider situation and the city
~ be left out of the payment scheme," especially if Courtesy
submits its bill to the insurance company prior to submitting our
bill.
The Fire Department has found a firm that specializes in billing
for EMS services called Advanced Billing concepts or ABC which is
located in Fountain Valley. Resolution 91-107 sets forth our
contract with courtesy services and provides for a thirty day
cancellation clause. courtesy charges 9.5% for every account
collected. ABC would. charge us 10% on each account collected.
Some advantages to using ABC are as follows:
1. ABC will use a courier or UPS at their cost to
pick up each day's billings and will bill as
soon as possible. Courtesy has one month to
bill our accounts.
2. ABC will provide a weekly report of accounts
billed and of delinquencies.
3. ABC provides monthly reports which include a
management analysis of credit and debit
adjustments to determine where the write offs
are going: analysis and aging of receipts to
view ABC's performance and demographic
characteristics of receipts: aged accounts
receivable summary to view and analyze
outstanding accounts receivable by age and
financial class.
4. ABC is not in the emergency service business.
They are in the billing business and only get
paid on the basis of their success. They have
no internal conflict on what their mission is
nor do they have any conflict of interest
potential involving the city.
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The Legislative Review Committee recommended approval of an
agreement with Advanced Billing Concepts at their meeting held
October 24, 1991.
SHAUNA CLARK
City Administrator
SC/md
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8 greement with the ABC Anesthesii:l, Incorporated DBA Advanced
RESOLUTION
RESOLUTION OF THE CITY OF SAN BERNARDINO AUTHORIZING THE
XECUTION OF AN AGREEMENT WITH ABC ANESTHESIA, INCORPORATED DBA
DVANCED BILLING CONCEPTS RELATING TO BILLING SERVICES FOR THE
ARAMEDIC SUBSCRIPTION PROGRAM.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY OF
BERNARDINO AS FOLLOWS:
SECTION 1. The Mayor of the City of San Bernardino is hereby
uthorized and directed to execute on behalf of said City an
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10 'A" and incorporated herein by reference as fully as though set
illing Concepts a copy of which is attached hereto, marked Exhibit
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orth at length.
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13 greement is rescinded if the parties to the Agreement fail to
SECTION 2.
The authorization to execute the above-referenced
,
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it within sixty
(60)
days
of the passage of this
esolution.
I HEREBY CERTIFY that the foregoing resolution was duly
dopted by the Mayor and Common Council of the City of San
at a
meeting thereof, held on the
day
, 1991, by the following vote, to wit:
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SOLUTION AUTHORIZING THE EXECUTION OF AN AGREEMENT WITH ABC
ESTHESIA, INC., DBA ADVANCED BILLING CONCEPTS RELATING TO BILLING
ERVICES FOR THE PARAMEDIC SUBSCRIPTION PROGRAM
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ABSTAIN
ABSENT
City Clerk
The foregoing resolution is hereby approved this
, 1991.
day
f
W. R. Holcomb, Mayor
city of San Bernardino
pproved as to form
nd legal content:
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AGRBBMBII'l'
THIS AGREEMENT, made and entered into this day of
, 1991, by and between the CITY OF SAN BERNARDINO a
Charter City ("city"), and ABC ANESTHESIA, INCORPORATED,' a
California Corporation doing business as ADVANCED BILLING CONCEPTS
hereinafter referred to as ("Provider"). '
WITNESSBTH:
WHEREAS, City did accept the proposal of the Provider,
NOW THEREFORE, THE PARTIES HERETO AGREE AS FOLLOWS:
L RECITALS
This Agreement is made and entered into with respect to the
following facts:
A. The City has implemented a paramedic subscription program
for its residents and city currently bills those program
subscribers as well as those who use the paramedic
service but are not subscribers1 and,
B. That Provider is qualified to provide such billing
services to the CitY1 and, therefore, the city has
elected to engage the services of Provider upon the terms
and conditions hereinafter set forth.
2. SERVICES
Provider shall perform those services specified in that
certain proposal dated october 4, 1991, hereinafter called
"Proposal", a copy of which Proposal is on file in the Office
of the city Clerk and by this reference incorporated herein
and made a part hereof as though fully set forth herein.
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CITY SUPERVISION
The Fire Chief of the City of San Bernardino, or his designee,
shall have the right of general supervision of all work
performed by Provider and shall be the City's agent with
respect to obtaining Provider's compliance hereunder. No
payment for any services rendered under this Agreement shall
be made without the prior approval of the Fire Chief, or his
designee.
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The term of this Agreement shall be for one year, commencing
on December 15, 1991, and continuing to and including December
14, 1992.
Upon expiration of the term of this Agreement, City shall have
the right to extend the same for an additional one (1) year
period to and include December 14, 1993. Should City elect to
extend the term of this Agreement, City shall so notify the
Provider in writing thirty (30) days prior to December 14,
1992.
TERMINATION OF AGREEMENT
The City shall have the right to terminate this Agreement upon
giving a thirty (30) day written notice of such termination to
Provider.
In the event of such termination, the City
Administrator, or his/her designee, based upon termination,
shall determine the amount of fees to be paid to Provider, for
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such finding by the city Administrator, or his/her designee,
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and approved by the San Bernardino Mayor and Common Council,
shall be final and conclusive as to the amount of such fee.
O. INDEPENDENT CONTRACTOR
Provider shall act as an independent contractor in the
performance of the services provided for in this Agreement and
shall furnish such services in Provider's own manner and
method and in no respect shall ~rovider be considered an agent
or employee of the city.
1. NONASSIGNMENT
This Agreement is not assignable either in whole or in part by
Provider within the written consent of City.
2. INDEMNIFICATION
Provider hereby agrees to, and shall hold City, its elective
and appointive boards, officers, agents, and employees,
harmless from any liability for damage or claims for damage,
for personal injury, including death, as well as from claims
for property damage which may arise from Provider's negligent
acts, errors or omissions under this Agreement.
Provider
agrees to, and shall defend City and its elective and
appointive boards, officers, agents and employees from any
suits or actions at law or in equity for damages caused, or
alleged to have been caused, by reason of any of the aforesaid
negligent acts, errors or omissions.
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EOUAL OPPORTUNITY CLAUSE
Provider shall not discriminate in its recruiting, hiring,
promotion, demotion or termination practices on the basis of
race, religious creed, color, national origin, ancestry, sex,
age or physical handicap in the performance of this Agreement
and shall comply with the provisions of the State Fair
Employment Practices Act as set forth in Part 4.5 of the
Division 2 of the California .~bor Code, the Federal civil
Rights Act of 1964, as set forth in Public Law 88-352, and all
amendments thereto; Executive Order 11246; and all
administrative rules and regulations issued pursuant to such
acts and order.
UNAUTHORIZED ALIENS
Provider hereby promises and agrees to comply with all of the
provisions of the Federal Immigration and Nationality Act (8
USCA 1101, et seq.), as amended; and, in connection therewith,
shall not employ unauthorized aliens as defined therein.
Should Provider so employ such unauthorized aliens for the
performance of work and/or services covered by this contract,
and should the Federal Government impose sanctions against the
city for such use of unauthorized aliens, Provider hereby
agrees to, and shall, reimburse City for the cost of all such
sanctions imposed, together with any and all costs, including
attorney's fees, incurred by the City in connection therewith.
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1 AGREEMENT WITH ABC ANESTHESIA, INCORPORATED DBA ADVANCED BILLING
CONCEPTS FOR BILLING SERVICES.
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IN WITNESS WHEREOF, the parties have executed this Agreement
Approved as to form
and legal content:
AMES F. PENMAN,
city Attorney
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city of San Bernardino
By:
W. R. Holcomb, Mayor
Provider
ABC ANESTHESIA, INC. A
California corporation DBA
ADVANCED BILLING CONCEPTS
By:
President
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ADVANCED BILLING CONCEPI'S
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166110 Harbor BMI.. Suite A
lWntaln W1ey. CA 9Il708
(7141889-ll787
(1113) Ii94-6789
October 4. 1991
San Bernardino Pire Department
Pireatation 110
502 S. Arrowhead
San Bernardino. CA 92346
ATTN: Dana Austin
Dear Dana.
Thank you for tbis opportunity to provide Tbe City of San Bernardino
with Aabulance Billinl Services.
I'a sure that you will find that ABC is well qualified for tbe job at
band. liven our experience and backlround. While we are tbe 2nd
larlest Pull service Medical Billinl Alency in Southern California.
we provide our clients with the one on one attention tbat we feel is
an important part of our success.
We have tried to keep tbis proposal brief. If there are any
questions. please don't hesitate to call eitber me or Mary
Boyajian.
What Pollows,
I. A short backlround on ABC. Mary Boyajian tbe founder. and Cathy
Loyd our General Manaler. These Resuae's bave been left out of
the body of the proposal.
2. The proposal. indexed.
3. Samples
Lookinl p~~ward to bearinl fro. you.
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Gonzalez
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The ABC Story
Advanced Billinl Concepts was founded IB years alo by Mary Boyajian,
wbo reaains tbe coapany's president. In tbe belinninl, tbe primary
focus centered around bospital-based pbysicians. However, over tbe
years, ABC's capabilities bave expanded to accomaodate office based
pbysicians and even entire medical centers and foundations. Today,
ABC is Soutbern California's second larlest full-service aedical
billinl alency. Fro. individual practices to larle facilities, ABC is
ready to meet tbe cballenges of today's medical professionals.
Tbrougbout tbe years, we bave never lost Silbt of tbe importance of
maintaininl personal client relationsbips. We let to know eacb
client, bis or ber procedures, and even tbe individual patients as
tbey beco.e familiar to your billinl specialist. Tbis provides us witb
tbe capability to act as an extension of you- followinl your
procedures and serving to improve tbe overall efficiency of your
entire billinl process.
Personnel
Continuinl education at ABC is a way of life. All billinl specialists
attend industry seainars that serve to keep tbea up to date on any
industry policy cbanles. ABC's reputation has always been one of
expertise. Mary Boyajian is recognized as a leadinl autbority on tbe
subject of tbird party billing. The manalement tea. at ABC bas an
averale tenure of nine years. With virtually no manaseaent turnover,
each member of the team has the opportunity to become faailiar with
every aspect of the billing process, and this overlapping in knowledle
provides for tbe stable flow of day-to-day business affairs. We're
very proud of our team, and those who lead tbem. We feel sure that
you will find both their knowledge and dedication to be on the hlgbest
level.
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Mary Boyajian. President
"Ny pbilosopby bas always been to ,et to tbe beart of tbe proble. -and
then solve it."
Mary belan her career as a nurse. but found that her real expertise
lay in her business savvy. As President of ABC and its subsidiaries.
she has lonl been recolnlzed as a hilhly knowledleable leader in the
Southern California private practice coapensation aethods. Mary
possesses a level of expertise in billinl. codinl. feeinl. and
coapensation that is unrivaled in Southern California. Today. Mary
still heads ABC on a daily basis.
Mary has participated in. and lectured to. international syaposi~s on
Medicare and third party billlnl. with invitations to speak coainl
froa aajor universities in Southern California. includinl UCLA and
USC.
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Cathy Loyd. General Manaler
"Keepin, up with the chan,in, re,ulations is wbat .ates ABC stand
out."
Cathy has been with ABC for over 13 years. directly iaaersed in all
phases of private practice billinl. Cathy has learned about and
serviced the chanlinl needs of the Southern California aedical
coaaunity durinl her tenure at ABC. As an expert well versed in all
phases of billlnl froa codinl and feeinl to advanced collection
techniques. Cathy has earned recolnition for hilh level perforaance.
Utilizlnl her first hand knowledle. Cathy has iapleaented aany of the
procedures. systeas. and policies that enable ABC to consistently
operate at aaxiaua efficiency. She perforas as a tenacious aanaaer
who follows throulh and sees that the job is finished correctly.
Jaaes McCaulley. MIS Manaler
"Understandin, the needs of tbe end user is the best startin, point."
Jia belan his career in coaputers beinl recruited by IBM soon after
earninl his dearee. Gainlnl his tenure as a talented systeas analyst
and top notch prolraaaer. Jia went on to establish an enviable track
record in health care data processina aanaaeaent. Be caae to ABC
after years.of health care database aanaleaent at soae of Southern
California'.laraest corporations. Jia's insiaht into the needs of
medical Iroup~. alonl with that rare talent to understand the user's
needs. keeps us ahead of the ever-chanainl aedical billinl world.
Robert Martin. CPA. Controller
"Keep every thin, in its place and current, and accountin,
beco.eseasy."
Bob brinls aany years of both public and private accountinl experience
includinl havinl been an instruaental participant at ICM
pharaaceuticals in their arowth years. Throulhout his career a8 a
CPA. Bob has developed a keen sense for avoidinl unneeded risks. while
aaintaininl systeas that flow at a proaresslve standard. Be is an
intelral part of ABC's aanaleaent teaa. keepinl our accountinl systeas
runnina smoothly and without error.
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07-0CT-91
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San Bernardino Fire Depa~nt
page i
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Request Por Proposal . . .
Background 1 Approach.
Methodology. . . . . .
Work Plan. . . . . .. .......
Proposed Services Organization 1 Staffing.
Related Experience . . . .
Proposed Services Schedule
Cost Data. ...
Conclusion . . . . . . . .
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07-OCT-91
table of contents
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07-OCT-91
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San Bernardino Fire Depa~ent
page 1
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1: Request For Proposal
1.1: Background' Approach
San Bernardino Fire Department provides paramedic emergency
services, and will be implementing City owned ambulance
transportation servicesThere is a paramedic subscriber service.
1.1.1:
Our Understanding
Currently The City only bills for its paramedic services,
and is utilizing courtesy ambulance service for this
process. The City is seeking an outside agency to reduce
potential conflicts of interest, increase billing control,
increase revenues, and reduce the ageing of receipts.
1.1.2:
Objecti ves
We seek to increase the recovery rate from present levels.
and decrease the average receivables ageing. In addition
ABC believes that we can be instrumental with the process
of beginning a transportation service. We seek to build a
relationship with The City, resulting in a smooth flow of
information and ideas to benefits both parties.
1.2:
1.2.1 :
Methodology
Team Approach
The City's work will be handled within our Paramedic
Billing Team. OUr existing methods and work plan are
outlined under Work Plan.
1.2.2:
Controls
From the moment a charge comes into the building to the
collection of the last penny. every detail is tracked an
accounted for. All reports balance to the penny, and all
charges and receipts are accounted for.For money handling,
the staff works with duplicate check copies only and has to
balance each day. In working with charges, all charges are
tracked within the ABC mainframe computer, and accounted
for from beginning to finish. Reports are stored on-site at
ABC's central production facility in fountain Valley for 3
years. Once each account has been completely collected on,
the original materials are sent back to The City. At any
time, all can be accounted for.
,
Disaster Recovery, Security
At Advance Billing Concepts, computer system back-ups
are performed on a daily basis. Data is backed up on
industry standard IBM 9 track magnetic tape. Back-ups
are then transported daily off site to a data storage
vault. Reports are also stored off site in microfiche
form for three years. This system enables us to
continue processing your work immediately after
disaster.
n7-Clr.T-!I1
Reauest For Proposal
page 1
07-0CT-91
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San Bernardino Fire Depa~ent
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Conf ident ial ity
ABC always maintains the highest confidentiality, and
security. Our personnel are all trained in
confidentiality measures. ABC is well aware of the
laws governing privacy, and uses the information given
to ABC only for the purposes of medical billing and
recovery, within the laws.
Bilingual Personnel
In our Paramedic Team, we maintain bilingual billing
employees.
Location
All work will be performed and managed out of our Fountain
Valley central production facility where our Mainframe
computer and management personnel are.
Performance Time Line
Since ABC does not receive compensation for work done until
we actually get the money in, we have an interest in .
working quickly. The actual time line with significant
dates is in the following section. ABC is always looking
for ways to improve our speed, and hence your collection
speed. We utilize computer automation wherever possible.
With our in-house programming department, we are able to
adapt quickly, and devise systems that mean efficiency to
us and our clients. We are the innovators of the auto
'Tracer Form', and were one of the very first agencies to
work with Medicare on Electronic Transmission. This way we
free up valuable labor to get on the phone, and do
collection work, and less 'busy work. 'At ABC, you get the
clout of our volume. By combining many of our client's
delinquent accounts for each delinquent carrier, third
party payers stand up and take notice when we call with a
large volume of late accounts. You get attention you never
thought possible from third party payers. Internally, ABC
uses weekly management reports to stay abreast of our work
flow and maximize performance.
Reporting Emphasis
In an idea unique among the larger agencies, we involve our
customers in assessing our performance on an on-going
basis. Our standard reports summarize average collection
time, and volume of work for our clients to see.AII detail
is laid out, and we are always open to third party audits,
or review of accounts.
Work Plan
Defining Transfer of Information and Controls
Since ABC has many years of experience in the field of
Paramedic and Ambulance billing, we understand that
sometimes good patient demographic information can be hard
to obtain. Throughout the years, we have found that a good
working relationship with the fire department is our best
Reouest For Prooosal
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07-0CT-91
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07-0CT-91
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San Bernardino Fire Dep~ent
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tool. ABC will work The City's personnel including
providing training and batching materials to ensure a
smooth flow of complete information to ABC. The
information needed includes; reason for pickup,
origination, destination, miles, Emergency Medical Services
Report, charge detail, patient demographics & insurance,
patient subscription information, and hospital face sheet.
A system to control and ensure that the transfer of all
runs has been received and acknowledged should be
implemented. The ABC standard month end reports offer a
simple method to review charge activity for a given
calendar month. (see attached samples) We suggest that The
City keep a simple log of volume of charges by date
transferred to ABC, aRd reconcile once a month with our
month end reports. This ensures that all charges have been
entered into ABC's mainframe IBM computer and entered into
the billing-follow-up procedures outlined under the
Proposed Services Schedule Section.
Initial Billing Procedures
The day that batches are received in house. they are logged
into the "ABC Tracking Syste.... Within 2 working days;
Batches are prepared for billing; Charge and ICD coding is
applied, as well as insurance carrier information. Within 3
working days. charge detail is then entered into ABC's
Mainframe computer. and printed bills are produced. If
some of the charges are missing sufficient billing
information, they will be held out of the batch and noted
in the ABC tracking System. Within 5 working days, bills
are mailed out with proper attach.ents. Missing
information is requested from The City or the admitting
hospital in either in writing or verbally as requested by
The City Within 7 working days, the patient is sent an
initial statement, unless the missing information is
patient address. This initial statement lets the patient
know immediately that we are billing the insurance carrier
and what they owe. The initial statement can have a
message specific to The City as requested as well.
Automated Follow up procedures
Each Month, unless otherwise requested by The City, the
patient gets a monthly statement with messages specific to
a financial class under the name of The City Of San
Bernardino. Verbiage just for The City of San Bernardino
can be added to statements if desired. All correspondence
is sent out with post office regulation "Address Correction
Requested," We pay the post office fees for the
corrections, updates our records immediately and send new
statements to the patient(s} as appropriate. If the
Patient is a "skip" and leaves no forwarding address,
tracing is attempted at ABC, and The City is notified for
possible referral to a licensed collection agency. If
there is no payment activity 45 Calendar days after initial
billing, red ABC tracer forms with attachments are
Request For Proposal
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07-0CT-9!
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07-0CT-91
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San Bernardino Fire Depa<:)ent
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automatically generated and mailed to third party payers.
For cash accounts, a statements urging contact are sent.
Tracer Sample attached.
Delinquent Acoount Prooedures
15 days after tracers are sent, if there is no payment
response from oarriers, the ABC mainframe computer
generates reports by carrier and phone calls are made.
Patients are involved and encouraged to complain to
carriers who are not paying, and reminded that they are
ultimately liable for oharges inourred. After 3 patient
statements, cash accounts are called, and individual
letters are sent. In at least 180 days .from date of
billing, or as soon as our oollection efforts are
exhausted, delinquent aocounts are referred to The City of
San Bernardino for direction as to further action.
Colleotion Accounts
If The City chooses, ABC will refer the delinquent account
to a licensed collection agenoy of their ohoosing. ABC
does not earn any fees on funds reoeived from aooounts
referred out to a collection agency, or other party. ABC
does maintain a working relationships with oolleotion
agenoies and oan recommend and provide gUidance in this
area. ABC does not own or participate financially in any
collection agency as we feel it is a conflict of interest.
Our goal is our customer's satisfaction.
Reporting
lIeekly
ABC provides weekly revenue reports as standard. lie
also deliver requests for direction on collection
accounts and requests for information on a weekly
basis.
Monthly
Standard month end reports are attached here. ABC
reports and balances to the penny, all activity
including; oharges posted, reoeipts, write offs, exact
oost of services, and a reoap of weekly revenue
reports. Additionally, standard reports include:!.
Management analysis of credit and debit adjustments to
help determine where the write offs are going.2.
Management analysis and ageing of receipts to view
ABC's performance and demographic charaoteristics of
receipts.3. Aged accounts receivable summary to view
and analyze outstanding aocounts reoeivable by age and
financial class.
Monthly Specific to Ambulance Services
In addition to standard ABC reports, Ambulance
acoounts can elect to receive management reports on
run statistics developed just for ambulance
bi II ing.
Request For Proposal
page 4
07-0CT-91
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San Bernardino Fire Depa<:)ent
page 5
This reporting provides;
I. Summary reporting by destination showing number
of trips.
2. Number of types of trips (dry run, normal run,
cancelled run), minutes. and miles by unit.
Annual
ABC reports accumulate annual revenue, write off and
charge figures adjusted to your fiscal year.
Additionally management analysis of ageing of
receivables and analysis of credit and debit
adjustments are accumulated on a year to date basis.
It is ABC's standard policy to make improvement
suggestions as they become viable.
1.4: Proposed Services Organization & Staffing
Our billing specialists are divided into team units with each team
having one leader who reports directly to upper management. Each
team handles a particular specialty, hospital based or office
based, primary or secondary physicians. You will retain the same
team and primary contact throughout your affiliation with ABC.
This management style helps to soften any unexpected personnel
problems. It means that your work doesn't stop if someone falls
ill, or is called away for other reasons.
1.4.1: Your Main Contact
Our paramedic Team is led by Alice M. Keene. Before Alice
and her husband moved to Orange County in 1984, Alice had
put in over a decade of service managing a large Midwestern
manufacturer's medical insurance claims department. Her
past experience along with passing ABC's 90 day training
school with flying colors, makes Alice a valuable asset to
the ABC billing Team. A hard worker, Alice has
consistently won the ABC attendance awards since her
beginning at ABC. Reporting directly to Cathy Loyd our
general manager, Alice oversees a team of 4 clerical
people. Three of the people have had to pass the ABC
training program as well.
1.4.2: Expected Man Hours Needed
The paramedic team is a four person team. At ABC, we do
what is needed to perform the job properly and do not
'cream' the good work. We seek to inspire our teams with
the pride to follow through, and rewards that come with
attentive work, and good performance. While we expect The
City's current paramedic billing to need 30 hours of
clerical work and 5 hours of supervisor/manager work each
month, we do not provide limits to the proper completion of
a job. With over 50 employees. we have the resources
needed to take care of any ups or downs in the work
flow.Once The City has begun transportation services. we
expect increased clerical and supervisory needs to manage
07-0CT-91
Request For Proposal
page 5
07-QCT-91
1.5:
1.6:
1. 6.1:
07-QCT-91
o
San Bernardino Fire Depar<:)nt
page 6
The City's needs.
Related Experience
ABC has been performing Medical Related billing since its inception
over 18 years ago. Today we are southern California's 2nd.
largest full service medical billing agency. We have been
performing Ambulance billing and collections for over 5 years now.
Ambulance billing clients can be found in the attached reference
listing.
Proposed Services Schedule
Standard ABC Services
Coding - The CPT and ICD codes used in billing will be
determined from the intor.ation provided on the batch
billing information.
*Consultation - Expert fee and coding consultations are
made available.
*Complete all insurance, patient. and other third party
billing, including any required data processing for
billing, collecting and reporting.
*Provide for the electronic submission (ECS) of all
Medicare, Medi-Cal. Blue Cross, Blue Shield, (and other
third party payors, where available), claims, which
expedites processing, hence faster payment.
*Prepare patient balance bills and post payments to their
accounts.
*Constantly track the status of every claim and provide
easy-to- read quantitative monthly reports which will show
accumulated accounts receivable and collections.
*In the event of a denied claim, ABC will react immediately
by reviewing the claim in question for discrepancies,
consulting with the practice, and opening an inquiry into
the justification for denial.
*Use diligence and best efforts to collect all balances -
additional collection efforts of chronically delinquent
accounts to be mutually agreed upon - on a case-by-case
basis.
*Deposit funds directly into The ABC Trust account within
three days of receipt.
*Weekly forward a report reflecting all payments, refunds,
adjustments and balances.
Request For Proposal
page 6
07-0CT-91
o
San Bernardino Fire Depac:.ent
page 7
1.6.2:
Additional Services at No Extra Cost
ABC will provide training of City personnel to increase
awareness of billing needs and increase recovery, and
billing volume. If requested ABC will track dry runs and
mutual aid runs.
1.6.3:
Delivery Service
ABC will provide Delivery service to and from The City.
1.6.4:
Attendance at Meetings
ABC proposes meetings every other month. We realize that
at first more meeting may be indicated, however our
experience tells us that matters of importance are best
handled on the phone tmmediately, and that meetings are
usually good for constructive changes in policy and for
verbal reporting.
1.6.5:
Start-Up
ABC is currently ready to begin providing service to The
City of San Bernardino. We require a I week lead time to
begin operations. This time is needed to set-up the .
transfer of information and fulfil the necessary paperwork
requirements for Medicare and Medi-Cal.
1.7: Cost Data
For all services and reports listed;
10% of Amounts caused to be received by ABC
Note that we do not charge on accounts referred to outside agencies
such as a collection agency.
If The City Desires Custom reports; Custom Programming Work $50./
HourThis Price Schedule is Valid for 90 Days
1.8: Conclusion
ABC appreciates understands and appreciates the challenges of faced
in today's complicated and changing medical compensation market.
Keeping ahead of a constantly changing set or rules while still
handling municipal concerns can be more than a rull time job.At ABC
we are committed to working not merely as your billing "vendor",
but as an extension of your service - the extension that
specializes in third party billing and accounts receivable
management.ABC has years of experience at performing in the area of
ambulance billing. We are large enough to accept the work without
it being a significant impact. We have the existing staff,
materials, computers, systems, and experience to make the
transition a success. We are a company that was built in Orange
County and we understand the area.Given The opportunity, we will
prove to a valuable addition to the paramedic operation.Thank you
ror the opportunity to review this matter. If you have any
questions, please feel free to call either Al Gonzalez pr Mary
Boyajian at (714) 839-2787.
07-0CT-91
Request For Proposal
page 7
o
o
o
o
ADVANCED llILLlNG CONCEl'lS
,
The Following Month End Report Samples
Contain some randomly selected live data.
Patient names. as well as
ABC client names have been blacked out.
These reports are intended only to provide a working example
of print arrangements, summary data Calculations,
detail and emphasis of reporting.
Neither actual performance.
nor actual volume assurr.ptions
can be made from the following samples,
..
.:.,'
.
ABC
1G520 Harbor Dlvd., Suite A
RnUl(nln \hllcy, CA 92708
(714) 8a9.2781
c:naJ 594-6789
o
K L. I". L I . 1\ U L '-
FOR 1I1E PERIOO OF
2/01/91 TIIRU 2/26/91
oj U " " ,I ., .
~\OllNO 5/11.;91 17.jU.'.Y
DATE 3/~
PRAClICE.,
^ L L: U U Ij I ~
CURRENT PERIOD OF YEAR TO DATE PERIOD
2/01/91 TIIRU 2/26/91 1/01/91 THRU 2128/91
ACCOUNTS RECEIVABLE'
OPENING BA~ANCE 282,708.90 382,287.36
PLUS CIIARGES 381.80 253,821.27
PLUS CIIARGE ADJUSTMENT 185.24 7,690.05
MINUS RECEIPTS 5,844.04 165,353.16
MINUS CREDIT ADJUSTMENTS 2,033.68 183,047.30
ACCOUNTS RECEIVABLE
ENOING BA~^"CE 275,398.22 275,398.22
This Executive Summary of ABC's Standard Month
End Rports provides a quick method of tracking
performance and volume numbers.
Since this report was created with random data,
the current month has no real activity.
Note that the Year To Date period is adjusted tp~
your fiscal year.
!,
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H01050 5/14/91 17.51.26 H 0 NT 1I0A C KNOll LEO G E HEN T o F C II A R G E S PAGE
OATE 2/0. 2/01/91 T1IRU 2/20/91
PRACTICE
, ACCT SERVICE
lUMBER PATIENT FC DATE CIlARGE
. J09105050oo1 05 2/10/90 .01
009105160001 05 2/11/90 .01
009105570001 05 2/ 15/90 .01
039044770001 10 12/10/90 350.00
039044770001 10 12/10/90 7.50
009045470001 50 12/16/90 350.00
009045470001 50 12/16/90 30.00
009045470001 50 12/16/90 16.75 This Sample Report
009045790001 57 12/18/90 350.00
009045790001 57 12/18/90 22.50 has had the names of
009045790001 57 12/18/90 16.75 the patients covered.
009045800001 57 12/18/90 350.00
009045800001 57 12/18/90 30.00
009045800001 57 12/18/90 16.75 To illustrate how the
009045830001 10 12/19/90 350.00 report is arranged;
009045830001 10 12/19/90 37.50
009045830001 10 12/19/90 16.75 a broad range of
009045850001 41 12/19/90 350.00
009045850001 41 12/19/90 7.50 service dates were
009045850001 41 12/19/90 16.75 included
009045870001 50 12/19/90 350.00
009045870001 50 12/19/90 7.50
009045870001 50 12/19/90 16.75 The Report is arranged
009045890001 41 12/19/90 350.00 by service date.
009045890001 41 12/19/90 7.50
0090459??oo1 67 12/19/90 350.00
009045900001 67 12/19/90 22.50 Each line item is listed
009045900001 67 12/19/90 16.75 separately, for auditing
009045930001 53 12/19190 350.00
009045930001 53 12/19/90 22.50 purposes.
009045930001 53 12/19/90 16.75
~09045940oo1 90 12/20/90 350.00 The $.01 charges are for
09045940001 90 12/20/90 22.50
~09045940oo1 90 12120/90 16.75 dry run tracking
009045950001 10 12/20/90 350.00
009045950001 10 12/20/90 22.50
009045950001 10 12/20/90 16.75
009045970001 90 12/20/90 350.00
009045970001 90 12/20/90 37.50
, 009045970001 90 12/20/90 16.75
009045900001 50 12/ 20/90 350.00
009045900001 50 12/20/90 15.00
009045900001 50 12/20/90 16.75 .,
009046000001 53 12/20/90 350.00
009046000001 53 12/20/90 15.00
009046000001 53 12/20/90 16.75 .
009046010001 50 12/20/90 350.00
01l9046010oo1 50 12/20/90 7.50
i
,
'.
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.
MB1050 51\4/9\ 17 .S1.2b MOil I 1\ l l i\ L. h." ,-", -'
OATE 21_ 0 2101/9\ lllRU 2/23/91 ~
PR^Cl I cr
". ACCl SERVICE
NUMBER P^ 11 ENl FC DATE CIIARGE
101.6010001 50 12120/90 16.75
."9046030001 10 12/20/90 350.00
- 009046030001 10 12/20/90 7.50
009046060001 55 12/20/90 350.00
009046060001 55 12/ 20/90 7.50
009046060001 55 12/20/90 16.75
009046070001 90 12/21/90 350.00
009046070001 90 12/21/90 7.50
009046070001 90 12/21/90 16.75
009046080001 53 12/21/90 350.00
009046080001 53 12121/90 15.00
009046000001 53 12121/90 16.75
009046100001 10 12/21/90 350.00
009046100001 10 12/21/90 37.50
009046100001 10 12/21/90 16.75
009046120001 52 12/21/90 350.00
009046120001 52 12/21/90 22.50
009046270001 90 12122190 350.00
009046270001 90 12/22/90 15.00
009046340001 90 12/22190 350.00
009046340001 90 12/22190 , 15.00
009046340001 90 12/22190 16.75
009046360001 52 12/22190 350.00
00904636000 1 52 12/22190 15.00
009046390001 10 12/22/90 350.00
009046390001 10 12/22/90 15.00
009046450001 50 12123/90 350.00
009046450001 50 12123/90 7.50
009046460001 52 12/23/90 350.00
009046460001 52 12/23/90 7.50
009046460001 52 12/23/90 16.75
~09046530oo1 10 12/23/90 350.00
09046530001 10 12123/90 15.00
J09046560001 10 12/23/90 350.00
009046560001 10 12/23/90 15.00
009046560001 10 12123/90 16.75
00904620000 1 10 12/24/90 350.00
00904620000 1 10 12/24/90 15.00
009046600001 67 12/24/90 350.00
009046600001 67 12/24/90 15.00
009046600001 67 12124/90 16.75
009046630001 57 12124/90 350.00
'009046630001 57 12/24/90 15.00
00904663000 1 57 12/24/90 16.75 .
009046640001 50 12/24/90 350.00
009046640001 50 12124/90 15.00
00904664000 1 50 12/24/90 16.75
009046600001 10 12/24/90 350.00
I
I
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For The Purpose of Brevity
Pages 3 through 13
Have Been Omited
In This Sample Report
They Would Be Similar to
The Preceding Page 2
'.
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1,\lIL
,.,
MB1050 5/14/91 17.51.26
DAlE 2/07191
PRAClICE 0546
HONTlIlY ACKNO\.lLEDGEMENT Of CllARGES
2/01/91 ll1RU 2/20/91
AceT
NUMBER
'104240001
,0910430001
.J091043oo001
009104320001
009104330001
009104390001
009104470001
009104500001
009104510001
009104520001
009104530001
009104550001
009104610001
009104630001
009104650001
009104670001
009104730001
009104760001
009104010001
009104870001
009104870001
009104870001
009104990001
009105020001
009105110001
009105150001
009105240001
009105270001
009105380001
009105420001
009105440001
'09105470001
.09105590001
009105610001
009105650001
00910560000 1
109105750001
009105810001
009105820001
009105840001
009105890001
_ 009.106150001
,
PATIENT
SALI ZAR
.
PERRY
8UI
NICKlES
JONES
MELENDEZ
.
IIERNANDEZ
8ROIIN
VARELE
MIZE
Doe. JOliN
DOE. JOliN
DOE, JOliN
KEONG
PEREZ, TONY
NO PT
NO PT
NO PT
NO PT
NO PT
NO PT
L1SK, DAVID
NO PT
PEREZ, AOA
NO PT
NO PT
NO PT
ORES, HAY
NO PT
SAIS, TIFFANY
AZADIAN, DIANE
JONES, EILEEN
NO PT
TOTAL
TOTAL TRX
o
SERVICE
FC DATE CIIARGE
05 2/02/91 .01
05 2/03/91 .01
05 2/03/91 .01
05 2/03/91 .01
05 2/03/91 .01
05 2/03/91 .01
05 2/04191 .01
05 2/04/91 .01
05 2/04/91 .01
05 2/05/91 .01
05 2/05/91 .01
05 2/05191 .01
05 2/05/91 .01
05 2/06191 .01
05 2/06/91 .01
05 2/06/91 .01
05 2/07191 .01
05 2/07/91 .01
05 2/00191 .01
90 2/08/91 350.00
90 2/00/91 30.00
90 2/08/91 16.75
05 2/09/91 .01
05 2/10/91 .01
05 2/10/91 .01
05 2/11191 .01
05 2/12/91 .01
05 2/12/91 .01
05 2/ 13/91 .01
05 2/13/91 .01
05 2/14/91 .01
05 2/14/91 .01
05 2/15/91 .01
05 2/15/91 .01
05 2/15/91 .01
05 2/16/91 .01
05 2/16/91 .01
05 2/17191 .01
05 2/17191 .01
05 2/17/91 .01
05 2/10/91 .01
05 2/20/91 .01
74,330.56
666
The number of line items, and the total
volume of charges by value are summarized on
this last page of the report.
,
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H07020 5f\4/?1 10.19.54 H 0 H I H l Y U t t' U ~ I i 1\ L \,. 1\ I
DAlE "'II 2/01/91 IIIRU 20/82/91
PRACTICE 10
GUARAHTOR
NlR<OER NAME FC DATE RECE IPTS DOT .ADJ. CR.ADJ. DEPOSIT REFUND BALANCE
>0463 90 2/01/91 46.36 46.36'
/1803 74 2/01/91 315.00 .00
J891957 10 2/01/91 315.00 .00
- 00900847 67 2/01/91 295.16 .00
00900847 67 2/01/91 86.59 295.16
00901178 41 2/0 I /91 381 .75 .00
00901698 - 67 2/01/91 295.16 22.50
00901698 67 2/01/91 71.59 317.66
00902126 11 2/01191 50.00 .00
00902171 67 2/01/91 86.59 295.16
00902171 67 2/01/91 295.16 .00
00902191 90 2/01/91 365.00 .00
00902550 21 2/01/91 56.02 .00
00902756 10 2/01/91 50.00 281.75
00902849 67 2/01/91 295.16 .00
00902849 67 2/01/91 86.59 295.16
00902917 10 2/01/91 150.00 181.75
00902965 21 2/01/91 59.14 .00
00902965 21 2/01/91 59.14 59.14-
00903266 67 2/01/91 79.09 295.16
00903266 67 2/01/91 295.16 .00
00903621 10 2/01/91 50.00 315.00
00903672 74 2/01/91 381. 75 .00
00903681 74 2/01/91 374.25 .00
00903745 21 2/01/91 292.00 73.00
00903779 21 2/01/91 300.00 51.50
01892870 99 2/0 I /91 346.75 .00
REF 9101110 PER STEVE HCO
01903044 67 2/01/91 76.71 288.2'1
01903044 67 2/01/91 288.29 .00
01903331 90 2/01/91 .65 57.00
'903624 97 2/0 I /91 357.50 .00
'. ,903637 53 2/02/91 54.52 302.98
-, 00903637 53 2/02/91 218.08 84.90
00903637 53 2/02/91 84.90 .00
00903686 55 2/02/91 248.54 148.21
'~903686 55 2/02/91 86.07 62.14
J903848 50 2/02/91 230.54 143.71
)0903848 50 2/02/91 86.07 57.64 .
00903969 52 2/02/91 219.60 89.38
00903969 52 2/02/91 89.38 .00
00903969 64 2/02/91 56.02 308.98
.00903\196 53 2/02/91 90.80 .00
00903996 53 2/02/91 231.81 90.80
00903996 53 2/02/91 59.14 322.61
00904000 55 2/02/91 225.48 147.02
00904000 55 2/02/91 89.50 57.52
00904006 57 2/02/91 231.81 149.94
This report is delivered both weekly and monthly.
This sample iSja monthly version.' The monthly version.
, '
simply has the 'information for all weeks in the month
.~ .
on one report": This report balances to the penny with
checks deposi~~d, and s~ows any ~rite-off~ (CR.ADJ.),
or refunds. Comments are inserte~ to asist ~n any
auditing efforts.
..
,
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DATE 5t1ir 2/01/91 TIIRU ,0/8,/'1 i -
PRACTICE
GUARANTOR 0 c:::tEPOSIT REFUHO
NLtlBER NAME FC DATE RECEIPTS OBT .AOJ. CR.AOJ. BALANCE
.n904006 57 2/02/91 90.60 59.14
14016 57 2/02/91 90.92 60.64
,04016 57 2/02/91 237.69 151.56
."~904017 55 2/02/91 231.61 149.94
00904017 55 2/02/91 90.60 59.14
00904094 64 2/02/91 54.52 302.96
00904094 52 2/02/91 69.26 .00
00904094 52 2/02/91 213.72 69.26
00904104 52 2/02/91 225.93 90.66
00904104 52 2/02/91 90.66 .00
00904104 64 2/02/91 57.64 316.61
00904106 52 2/02/91 213.72 69.26
00904; 06 64 2/02/91 54.52 302.96
00904106 52 2/02/91 69.26 .00
00904113 52 2/02/91 237.69 90.92
00904113 64 2/02/91 60.64 326.61
00904113 52 2/02/91 90.92 .00
00904127 64 2/02191 57.64 316.61
00904127 52 2/02191 225.93 90.66
00904127 52 2/02/91 90.66 .00
00904129 55 2/02/91 90.60 59.14
00904129 55 2/02191 231.81 149.94
00691368 74 2/04/91 331. 75 .00
00694024 10 2/04/91 20.00 247.50
00901125 10 2/04/91 50.00 261.75
00901624 11 2/04/91 31.25 31.00
00901769 20 2/04/91 56.02 3.14
00903141 41 2/04/91 374.25 .00
00903196 90 2/04/91 200.00 165.00
00690463 74 2/05/91 46.36 .00
00901696 67 2/05/91 22.50 .00
'901942 50 2/05/91 233.23 146.52
901942 50 2/05/91 66.07 62.45
00902112 52 2/05/91 215.03 67.95
00902112 64 2/05/91 54.52 302.96
00902112 52 2/05/91 64.90 3.05
00902921 50 2/05/91 245.06 151.69
~902921 50 2/05/91 66.07 65.62
0903016 74 2/05/91 54.52 .00
~0903016 74 2/05/91 59.14 .00
00903134 50 2/05/91 233.23 146.52
00903134 50 2/05/91 66.07 62.45
00903379 67 2/05/91 286.29 .00
-iJ69CtJ379 67 2/05/91 64.21 266.29
00903455 74 2/05/91 361.75 .00
00903504 50 2/05/91 230.54 143.71
00903504 50 2/05/91 66.07 57.64
00903745 21 2/05/91 73.00 ,00
\
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H07020 5/14/91 18.19.54 HtQHLY DEPOSIT RECAP PAGE 3
DAlE 5/. 2/01/91 TIIRU 20/02/91
PRACTICE
GUARAHlOR
'OER NAME FC DATE RECEIPTS DBT.ADJ. CR.ADJ. DEPOS IT REFUND BALANCE
~3779& 21 2/05/91 57.50 .00
.. ,900662 50 2/05/91 86.07 68.96
01900662 50 2/05/91 249.22 155.03
01903331 . 74 2/05/91 57.00 .00
SUBSCRIBER
02883234 BARi~EfT. CHRISTINA 79 2/05/91 337.50 .00
NSF DIRECT PHT RECEIPTS DR .ADJ. CR.ADJ. DEPOS IT REFUND
UEEK TOTAL .00 .00 9776.17 46.36 5753.04 9776.17 346.75
00883150 10 2/06/91 15.00 64.25
00892093 30 2/06/91 330.00 .00
00893411 30 2/06/91 331.75 .00
00900427 11 2/06191 365.00 .00
00901450 11 2/06/91 25.00 24.50
00901709 20 2/06/91 3.14 .00
00901892 86 2/06/91 .25 .00
00901974 52 2/06/91 . 242.37 31.02
00901974 64 2/06/91 31.02 .00
00902002 74 2/06/91 62.69 .00
SUBSCRIBER
00902071 30 2/06/91 145.91 .00
00902074 10 2/06/91 30.00 335.00
00902422 10 2/06/91 365.00 .00
00902422 79 2/06/91 365.00 365.00
00902443 50 2/06/91 203.86 145.21
00902443 50 2/06/91 86.07 59.14
00902443 86 2/06/91 3.31 . 349.07
00902647 90 2/06/91 317.40 79.35
00903061 90 2/06/91 212.00 153.00
903140 41 2/06/91 59.14 .00
.903164 74 2/06/91 3.31 59.02
00903164 21 2/06/91 59.02 .00
'903308 84 2/06/91 .01 57.64
.033 20 2/06/91 57.64 .00
09033 74 2/06/91 31.02 31.82
.J09033 74 2/06/91 31.82 .00
009034 90 2/06/91 381. 75 .00
. 009034 30 2/06/91 374.25 .00
009034 74 2/06/91 365.00 .00
0090363 21 2/06/91 57.64 .. .00
00903644 10 2/06/91 100.00 211.75
00903873 30 2/06/91 365.00 .00
00904024 90 2/06/91 357.50 .00
00904052 30 2/06/91 372.50 .00
00904156 30 2/06/91 381. 75 .00
01881398 10 2/06/91 25.00 65.00
"
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For the Purpose of Brevity
Pages 4 Through 38 Have Been Omited
~
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DATE 5/iIa 2/0\191 IJ\RU 2u/e,n I ~
PRACllcr 0
"'~o QJARANIOR '"
NLtlBER NAME . FC DATE RECE IPIS OBI .AOJ. CR.IIOJ. BALANCE
""l(J0587 90 5/06/91 381. 75 141.75'
3161 11 5/06/91 387.50 310.00'
J3956 10 5106/91 30.00 297.50
. 00904129 74 5/06/91 59.14 .00
00910161 30 5106/91 322.50 .00
00910161 30 5/06/91 50.00 322.50
00910239 90 5106/91 396.75 .00
00910368 74 5/06/91 60.27 .00
00910249 67 5/07/91 235.22 16.75
00910249 67 5/01/91 129.78 251.97
NSF DIRECT PHT RECEIPIS OR.AOJ. CR.AOJ. OEPOS IT REFUND
UEEK IOTAL .00 .00 5844.04 55.24 2033.68 5844.04 130.00
lOlAL PRACTICE .00 .00 147949.10 4763.21 131340.93 147949.10 2211.79
This last page of the Monthly Deposit Recap.
shows how each week is summarized, and the
entire month is summarized as we~l.
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H07020 5/14/91 16.19.54
OATE 5/14/91
PRACTICE.
CUARANTOR
.""'I8ER
~670
.0020
. " 1900397
00901017
00903369
00903359
00903067
00903258
00902124
00901774
H 00 II L Y D E P 0 SIT R E CAP
2101/91 TIIRU 20/62191
FltlAL TOTAlS
~
PAGE
REFUND CIIECKS
REFUNO AHOUIIT
346.75
322.50
360.00
2T4.50
59.14
57.65
369.25
292.00
20.00
130.00
tyPE
PATIENT
INSURANCE
INSURANCE
PATIENT
PATIENT
PATIENT
PATIENT
INSURANCE
PATIENT
HAIIUAL ISSUE
SUMMARY STATISTICS
-EIPTS 147949.10
CIIECKS .00
" .,RECT PAYHENTS + .00
-~UND - 2211.79
~._------_._-
JMHISSIONAOLE AMT 145737.31
.--------.--.-
COMHISSION EARNED .14573.73
"REtEIPTS-" 147949.10 . i
NSF CIIECKS .00 '.
REFUNO - 2211.79 .
------.-.-...
COMMISSION EARNEO - 14573.73
TOTAL DUE 131163.50
========:====
This report is delivered weekly and monthly.
Refunds are listed, and exact commisions are equated.
,
Note that when tefunds or NSF checks are deducted,
we do not earn dny fees or these funds.
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DATE 2/0. foa [lIE PE.RIUO U~ ~
PRACTICE 0 2101/91 TIIRU 2128/91
'-..
CURRENT PER 100 YEAR TO DATE
'C DESCRIPTIONS NO. TRX AMOUNT PERCENT NO. TRX /\llOUNT PERCENT
CREDIT ADJUSTMENTS
20 BLUE CROSS VITII INfO 1 3.14 1 3.14
21 BLUE SlIlElD VITII INfO 2 130.50 .7 4 197.81 .2
30 liMO 2 234.73 1.3 2 234.73 .3
50 MEDICARE ASSIGNED 9 782.79 4.5 21 1,830.51 2.6
52 MEDI/MEOI 19 1,850.60 10.6 32 2,947.42 4.2
53 MEDICARE INS. ONLY ASSIGNED 16 1,172.74 6.7 27 1,985.56 2.8
54 R/R MEDICARE -- ASSIGNED -- I 84.95 .5 4 290.87 .4
55 MEDICARE VITII PVT ASSIGNED 11 974.43 5.6 28 2,373.54 3.4
57 MEDICARE VITII PVT INS. ONLY 8 720.62 4.2 19 1,678.28 2.4
64 MEDICAL ADJ ONLY 22 1,174.70 6.7 34 1,876.52 2.7
67 MEDICAL VITII POE 10 2,932.76 16.8 18 5,278.38 7.6
74 INSURANCE ONLY 21 3,894.67 22.4 42 8,329.60 12.0
79 ' COLLECTION ACCOUNT 5 1,671. 75 9.6 108 38,220.75 55.3
83 PAT lENT DECEASED 2 118.30 .6 4 534.96 .7
84 UNDER PAYMENT 3 8.59 7 9.12
86 BAD DEBT 6 878.45 5.0 17 2,548.90 3.6
88 TRANSfER CREDIT 2 739.25 4.2 2 739.25 1.0
TOTAL 140 17,372.97 100.0 370 69,079.34 . 100.0
DEBIT ADJUSTMENTS
50 MEDICARE ASSIGNED 1 219.39 ' 4.9
53 MEOICARE INS. ONLY ASSIGNED 1 57.64 1.3
74 INSURANCE ONLY 5 1,233.43 32.8 5 1,233.43' 27.6
79 COlLECTION ACCOUNT 2 730.00 19.5 3 1,037.50 23.2
88 TRANSfER CRED IT 2 739.25 19.7 2 739.25 16.5
90 GROUP INS. 2 702.50 18.7 3 760.02 17.1
99 REfUND I 346.75 9.2 3 419.75 9.3
TOTAL 12 3,751.93 100.0 18 4,466.98 100.0
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MB1100 5/14/91 19.31.28A G E 0 ACCOUNT S R E C E I V A B L E B Y F I NAN C I A L I-Aut:.
OATE 3/. 0 CLASS 0
\, PRACTICE
FC DESCRIPTION TOTAL ALL REC CURRENT OVER 30 DAYS OVER 60 DAYS OVER 90 DAYS
DOLLARS DOLLARS X DOLLARS X DOLLARS X DOLLARS X
FliP CALL .02- .02-
. vj DRY RUN 842.66- 44.75- 1.2 58.56- .1- 739.35- .4,
06 MEDICARE 20X 990.10 226.94- 6.2 92.99 .2 165.12- .8' 1,289.17 .6
10 CASH 59,950.27 141.75- 3.9 5,616.25 9.6 2,985.25 14.2 51,490.52 25.8
11 PATIENT PAYMENT 2,454.98 310.00- 8.5 446.00- .8- 1,053.52- 5.0- 4,264.50 2.1
12 PATIENT REC. INS. CIIK. 1,258.34 1,258.34 .6
2D BLUE CROSS U IT II INFO 2,395.36 314.24 .5 381.75 1.8 1,699.37 .9
21 BLUE SllIElD UITH INFO 1,120.25 374.25 .6 381.75 1.8 364.25 .2
26 RETURN MAil 1,664 .05 1,664.05. .8
30 liMO 10,778.33 2,345.00 4.0 1,096.75 5.2 7,336.58 3.7
31 IIEAlTH NET 374.25 374.25 .2
37 MAXICARE 1,678.50 1,678.50 .8
40 INDUSTRIAl 1,873.82 331.75- 9.1 9.25- 365.00 1.7 1,849.82 .9
41 KAISER 13,458.25 130.00 3.6- 2,231.00 3.8 981.75 4.7 10,115.50 5.1
47 UHP/UATT'S IIEAlTH FOUNDATION 396.75 396.75 .7
50 MEDICARE ASSIGNED 14,122.43 72.77 2.0' 2,971.99 5.1 835.30 4.0 10,242.37 5.1
52 MEDI/MEDI 8,926.55 .07- 4,434.36 7.6 4,492.26 2.3
53 MEDICARE INS. ONlY ASSIGNED 4,757.26 .01- 1,124.29 1.9 5.88- 3,638.86 1.8
54 RIR MEDICARE -- ASSIGNED .- 47.49 47.49
55 MEDICARE UITII PVT ASSIGNED 5,206.23 151.59- 4.2 1,78(.98 3.0 448.76 2.1 3,124.08 1.6
57 MEDICARE UITH PVT INS. ONLY 7,841.62 366.83' 10.1 3,450.83 5.9 432.11 2.1 4,325.51 2.2
59 PVT UITH MEDICARE AS 2ND 1,523.50 1,158.50 2.0 365.00 .2
66 MEDICAl U/O POE 10,476.50 3,433.75 5.8 7,042.75 3.5
67 MEDICAl UITH POE 24,639.83 821.92- 22.6 5,333.25 9.1 309.88- 1.5' 20,438.38 10.3
74 INSURANCE ONlY 18,681.87 315.00- 8.6 6,739.00 11.5 2,683.75 . 12.8 9,574.12 4.8
75 PROF. COURTESY DISCOUNT 603.50' 603.50- 2.9-
78 INS. ONlY'PERSONAl FREINO 15,274.99 .50 3,732.00 6.4 715.00 3.4 10,827.49 5.4
79 COllECTION ACCOUNT 3,145.01 448.50' 12.3 1,408.00- 2.4- .25- 5,001.76 2.5
90 GROUP INS. 62,440.21 686.00- 18.8 15,086.65 25.7 1 I ,466.77 54.6 36,572.79 18.3
01 I NSURANCE X 2 1,010.16 381.75 1.8 628.41 .3
lEGAl UlTIllllT liEN 357.50 357.50 .2
., ">--
TOTAlS 275,398.22 3,641.84' 100.0 58,698.27 100.0 21,017.52 100.0 199,324.27 100.0
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UNIT 72 TRIPS
1/01/,0 IHhU It:.O/)O
~IT 73 TRIF~
OHlER UNIT TRIPS
o
TOTAL TRIPS
80
-,z ,CUlMlTY fKJSPITAL 32 61
~ IlEDICAL CENTER 31 4
MEtIORlAL fIOSPI1AL 2 4
J., IIlSP I
YALLEY 1lE0. CENTER 21 24 3
.. t1EOICAl. CENTER ~ 2
L
lOTAL 89 95 92
:IOENTS 0001 T~U 0375
END OF REPORT
88
93
36
6
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4
276
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,intrA
_ FIRE DEPARTMENT,
RUN STATISTICS
1/01/90 Tfr.U 1/30/90
DATE 11/12/90 PAGE 2
TIME 13.30.38
': [I'RUN
UNIT n
UNIT 73
OTHER UNITS
TOTAL ALL UNITS
..--------------------------------------------------------------------------------------------------------------
TRIPS MIt~JTES MILES TRIPS MINUTES MILES TRIPS MINUTES MILES TRIPS MItlUTES MILES
':r1AL r,uN 89 33l:2 209 95 4013 207 13 156 8 197 7531 ~24
II" 9 RUN 79 1141 79 II~I
H( d r~.!N .'
-:-...---
'AL ALL TYPES 89 :):362 209 95 4013 207 92 1297 B 276 B672 424
muns (1()()\ 111~J 0375
END OF REFURT
i
This report is in addition to fhe standard ABC month end reports
I
There is no ch~r.ge for ~his report
: .~./ . i
The names of the medical.i:ienters ~nd the client name have
been" blacked out
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.)eo:. T C rlNAlION
L\'I[T 7~[PS
r,iJi'j JIHll;)lll..~
11011~0 TKRU 1130190
11I1i; l.S,.iv..J8
>'tJI,H
UNIT 73 TRIPS
o
OHlER UNIT TRIPS
TOTAL TR IPS
B8
COI1I1UNITY HOSPITAL 32 61
MEDICAL CENTER 31 4 I
- tEIXIlIAL HOSPITAL 2 4
HOSP 1
VALLEY lIED. C'..NTER 21 24 3
.I1F.DICll/. CENTER 2 "
4
TOTAL 69 95 92
S [DENTS COO 1 THRIJ 0375
END OF REPORT.
B8
93
~,(,
6
1
48
4
276
. " '}j FIRE DEPARTI1ENT . DATE 11/12/90 PAGE
..... ;;mlll RUN STAlISTlCS TIME 13.30.38
110[/90 TIFU 1/30/90
.- n PE [f RUN lJIllT 72 UNIT 73 OTHER IJllTS TOTAL ALL UNITS
.- --------------------- --------
TRIPS HIIIJTES HILES TRWS HINUTES H[LES TRIPS HINUTES HILES TRIPS HIIIJTES HILES
... o~L RUN 89 3:./,2 209 95 4013 207 13 156 8 197 7531 424
pp.y RlIIl
Il\ olUAL AID RUN 79 1141 79 1141
C. A lULLED RUN
-~
- -rom. ALL TYPES 89 3362 209 95 4013 207 92; 1297 8 276 8m m
.... .
. \ .~, . .
.......
~C(IDENTS 0001 THRIJ 0375 .
END [f REPORT
i
This report is in addition to the standard ABC month end repor~s
\
There fs no c~~!ge for ;his report
.....
The names. of the, medical:.".];enters and the client name have
. beeu' blacked out
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CLIENT REFERENCE LIST
We felt that it might be of assistance to you to have a partial listing of our clients to use as
references in your independent verification of our abilities and our character. With this in
mind we have prepared the following list.
It is important to note, however, that any firm can prepare a list of their "best" clients, but that
would not be a representative sample or even a realistic picture of that firm. We have prepared
our list as a cross section of our entire client base - not just the best-case scenarios.
As our clients will tell you, it is not whether we have made mistakes, it is the manner in which
we have handled our mistakes, and that we have in each case, learned from them. At ABC we
continue to strive for perfection. Looking forward to our continuing discussion.
Client Reference List
o October 7th, 1991
I.otba.r E.R Cramer M.D., Inc.
Cont&ot;: Donna Oramer 01
(213) 698-2196
IDng Drew Medlca1 Foundation, Inc.
Oont&ot;: DanfBl Wooten, M.D.
(213) 603-4683
Ea.stgate 'MAt'll",,] Cent.e>>
Oontacts: Soott; A. Furman
AnnM&l'1e W1nkle
(714) 897-1071
T8l'Zil.1l& .Aneetbesla. Group, Inc.
Contact: Daniel Lavigna M.D.,
(818) 718-7130
Sheldon Rub1nste1n D.P.M.
Oont&ot;: Maz:y Rubinstein
(714) 682-3764
Amlr H. F1hA.h..n(jAh M.D., Inc.
(714) 838-1847
C1W of South Paeetl~ Par<>:me<tl""
Oont&ot: Barbara Jamu
(818) 441-7839
C1W of .Alhambra P&I"':mAt'llcs
Cont&ot;: JulJe NorrlB
(818) 5~17
.
1") We have provided the name of the contact person, where applicable. If no name is shown,
please ask for the physician listed.
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.)~ :rfl'A1'tENTMOSPITALI."''' , ..::.< ":2.,' ....AM8ULA~~J<..;';_"~#i~ 'li. .;f..~ v
~',DiotfGR'SOHtC! "~".,... O...IOt.I~'-OTHE"LOCA'rtOlU-' ...._t~':;<, .
Y' t" IFATlttlt.~~ 1': _ ~. A~ Uld,t=INOE'EHOINT<LAI'O AtoiiV" "K!
__;"". DAY C'Xtt1 FACIliTY IPSV) , et..'f4.:'lioi'" OTHE8 tltfOICA\"SUIroIC~~tLlTV
, _. ..' "N HTtARI: FACILITY IPSVt e~ -- NERGEtIIC'r' "OOM". .~. (~,