Tour Minutes.pdf
PDF 73 KB Posted
- Attached to
- MEDICAL BILLING
- Solicitation number
- BD-15-1098-NSJ-SDS03-00000002889
- Issued by
- Suffolk County, Massachusetts
About this file
This document is the Tour Minutes from a walkthrough of the facility where Medical Coding & Billing Review Services will be performed for the state of Massachusetts. The walkthrough was attended by potential contractors including Sargent & Associates, Maxim Healthcare Services, and Diskriter, Inc., as well as representatives from the Department's Medical Services and Financial Services. The scope of work covered accessing the inmate tracking system, reviewing medical records in the CorEMR electronic system, completing the billing claims process, and working within the limited on-site work space. Questions were addressed regarding whether services could be performed remotely, responsibilities for claims/billing calls, expected hours of work, and the current level of care provided at the facility.
The current services are being performed by Department staff, and the contractor will be responsible for challenging any claims to ensure proper billing. There is no plan to reduce hours or terminate the services once the contractor is caught up on claims, as the services are ongoing. The contractor may propose their own schedule as long as it is feasible, and may request to perform services at irregular hours, typically after 3:00 PM when medical staff presence is lower. The expected time to complete each claim can vary greatly in complexity from 5 to 20 minutes.
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Other files
| File | Type | Posted |
|---|---|---|
| RevNewMass_W9.pdf | ||
| EFT_FORM.pdf | ||
| vendorProfile.pdf | ||
| Contractor Authorized Signatory.doc | DOC document | |
| CommTermsConditions.pdf | ||
| References.docx | DOCX document | |
| Prompt_Pay_frm.pdf | ||
| Medical Billing Ad.doc | DOC document | |
| RFQ Medical Billing A.pdf |
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Text version
Medical Coding & Billing Review Services
Tour Minutes – Feb. 24, 2015
Present for the Tour were:
1. Sargent & Associates
2. Maxim Healthcare Services
3. Diskriter, Inc.
Representing the Dept:
1. Cheryl Callahan, Medical Services
2. David Moy, Financial Services
Cheryl Callahan (CC) guided us up to the 5th floor Medical offices where she showed us one of the work-stations where the services could be done. CC showed us how the contractor would use the inmate Tracking System (Lock & Track) to see if the inmate was “housed” (under our care) on the date(s) of service indicated on the claim. CC went on to discuss CorEMR (our electronic medical Record) that is replacing paper medical records and is used to hold all medical information as well as scans of any outside medical records, paperwork, etc., and if no scan were available where the actual paper records are kept. CC went over the entire scope of work needed in order to complete one claim, as described in the RFQ.
CC stated that “work-space” where services could be completed was “tight” and that the contractor may have to move from one area to the next, day to day, depending on “activity” in the Medical Unit.
CC mentioned a 2nd work-station in the 4.1 Unit.
CC indicated that a 3rd work-station could be added at a later date.
CC mentioned a new Inmate Tracking system soon to be on-line replacing Lock & Track.
CC stated that due to HIPAA laws, the Dept. cannot allow remote access to CorEMR or Lock & Track (the inmate database).
From the Medical offices, we then went down to the 4.1 (new Man) Unit where CC showed us another location where there was a computer where services could be performed.
Questions asked during the tour:
Q: Do the services have to be completed on-site or can they be completed remotely?
A: Other than the need to be at the facility to access the inmate database or view the medical records, the contractor is free to choose where to perform its other obligations under the Contract.
Q: Who will be responsible for taking “calls” regarding claims/billing?
A: The Contractor will be the initial point of contact for these calls.
Q: Once the contractor gets “caught-up” on the claims, would this then become a “Part-time” job?
A: No. The services are on-going.
Q: Who is the current contractor performing these services?
A: Staff members are currently completing the services.
Q: Would the contractor be responsible for “challenging” any claims?
A: Yes. That would be a major responsibility of the contractor to ensure that we are being properly billed.
Q: How many hours per week is the contractor expected to be performing the services?
A: The Contractor may propose its own schedule as long as it is feasible.
Q: What “level” of care is provided at the Jail, presently?
A: Jail Medical provides “Community standard of Care” (the same care a patient would receive out in the community) with onsite X-ray, EKG and Lab services. Jail Medical does not have an infirmary nor does it provide “one on one nursing”, or surgical services.
Q: May the Contractor have 2 people working together performing the services?
A: Yes, as long as only one person at a time is actually using the computer. One may be looking up records while the other is on the computer.
Q: When the Contractor is “Caught up” on claims, will the expected hours of work be reduced, or the services terminated?
A: No. The services are on-going.
Q: How many hours per week is expected to be performed by the contractor?
A: That will be determined by the contractor.
Q: How long does it take to “complete” one claim?
A: It may take 5 minutes, or it may take 20. Each claim can differ greatly from the next in complexity.
Q: May the Contractor be performing services at irregular hours?
A: Yes. The Contractor may request a schedule when less medical staff is present. Normally, this would be after 3:00PM.
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