RFP CONTRACT RE MED BILLING SVCS W FALCON.PDF

CONTRACT PURSUANT TO PH RFP 15-003
CONTRACT #: 860-15-003
This Contract is entered into this 8 th day of October, 2014 by and between Maricopa County ("County"), a political
subdivision of the State of Arizona, and Falcon Practice Management LLC, ("Contractor") for the purchase of
Medical Billing Outsourcing services.
1.0 CONTRACT TERM:
1.1 This Contract is for a term of two (2) years, beginning on the 8 th day of October, 2014 and ending
the 7th day of September, 2016,
1.2 The County may at its option and with the agreement of the Contractor, renew the term of this
Contract for additional terms up to a maximum of five (5) years, (or at the County's sole
discretion, extend the contract on a Month-to-month basis for a maximum of six (6) months after
expiration), The County shall notify the Contractor in writing of its intent to extend the Contract
term at least thirty (30) calendar days prior to the expiration of the original contract term, or any
additional term thereafter.
2.0 FEE ADJUSTMENTS:
Any request for a fee adjustment must be submitted sixty (60) days prior to the current Contract expiration
date, Requests for adjustment in cost of labor and/or materials must be supported by appropriate
documentation, If County agrees to the adjusted fee, County shall issue written approval of the change.
The reasonableness of the request will be determined by comparing the request with the (Consumer Price
Index) or by performing a market survey.
3.0 PAYMENTS:
3.1 As consideration for performance of the duties described herein, County shall pay Contractor the
sum(s) stated in Exhibit "A."
3.2 Payment shall be made upon the County's receipt of a properly completed invoice.
3.3 INVOICES:
3.3.1 The Contractor shall submit one (1) legible copy of their detailed invoice before
payment(s) can be made. At a minimum, the invoice must provide the following
information:
• Company name, address and contact
• County bill-to name and contact information
• Contract serial number
• County purchase order number
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CONTRACT 4: 860-15-003
• Invoice number and date
• Payment terms
• Date of service or delivery
• Quantity
• Contract Item number(s)
• Description of service provided
• Pricing per unit of service
• Extended price
• Total Amount Due
3.3.2 Problems regarding billing or invoicing shall be directed to the County as listed on the
Purchase Order.
3.3.3 Payment shall be made to the Contractor by Accounts Payable through the Maricopa
County Vendor Express Payment Program, This is an Electronic Funds Transfer (EFT)
process. After Contract Award the Contractor shall complete the Vendor Registration
Form located on the County Department of Finance Vendor Registration Web Site
(http://www.maricopa.2oy/Finance/Vendors.aspx)
3.3.4 EFT payments to the routing and account numbers designated by the Contractor will
include the details on the specific invoices that the payment covers. The Contractor is
required to discuss remittance delivery capabilities with their designated financial
institution for access to those details.
4.0 AVAILABILITY OF FUNDS:
4.1 The provisions of this Contract relating to payment for services shall become effective when funds
assigned for the purpose of compensating the Contractor as herein provided are actually available
to County for disbursement. The County shall be the sole judge and authority in determining the
availability of funds under this Contract. County shall keep the Contractor fully informed as to the
availability of funds.
4.2 If any action is taken by any state agency, Federal department or any other agency or
instrumentality to suspend, decrease, or terminate its fiscal obligations under, or in connection
with, this Contract, County may amend, suspend, decrease, or terminate its obligations under, or in
connection with, this Contract. In the event of termination, County shall be liable for payment
only for services rendered prior to the effective date of the termination, provided that such services
are performed in accordance with the provisions of this Contract, County shall give written notice
of the effective date of any suspension, amendment, or termination under this Section, at least ten
(10) days in advance.
5.0 DUTIES:
5.1 The Contractor shall perform all duties stated in Exhibit "B", or as otherwise directed in writing
by the Procurement Officer.
5.2 During the Contract term, County shall provide Contractor's personnel with adequate workspace
for consultants and such other related facilities as may be required by Contractor to carry out its
contractual obligations.
6.0 TERMS and CONDITIONS:
6.1 . INDEMNIFICATION:
6.1.1 To the fullest extent permitted by law, Contractor shall defend, indemnify, and hold
harmless County, its agents, representatives, officers, directors, officials, and employees
from and against all claims, damages, losses and expenses, including, but not limited to,
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CONTRACT #: 860-15-003
attorney fees, court costs, expert witness fees, and the cost of appellate proceedings,
relating to, arising out of, or alleged to have resulted from the negligent acts, errors,
omissions, mistakes or malfeasance relating to the performance of this Contract.
Contractor's duty to defend, indemnify and hold harmless County, its agents,
representatives, officers, directors, officials, and employees shall arise in connection with
any claim, damage, loss Or expense that is caused by any negligent acts, errors, omissions
or mistakes in the performance of this Contract by the Contractor, as well as any person
or entity for whose acts, errors, omissions, mistakes or malfeasance Contractor may be
legally liable.
6.1.2 The amount and type of insurance coverage requirements set forth herein will in no way
be construed as limiting the scope of the indemnity in this paragraph.
6,13 The scope of this indemnification does not extend to the sole negligence of County.
6.2 INSURANCE REQUIREMENTS:
6.2.1 Contractor, at Contactor's own expense, shall purchase and maintain the herein stipulated
minimum insurance from a company or companies duly licensed by the State of Arizona
and possessing a current A.M. Best, Inc. rating of A-, VII or higher. In lieu of State of
Arizona licensing, the stipulated insurance may be purchased from a company or
companies, which are authorized to do business in the State of Arizona, provided that
said insurance companies meet the approval of County. The form of any insurance
policies and forms must be acceptable to County.
6.2.2 All insurance required herein shall be maintained in full force and effect until all work or
service required to be performed under the terms of the Contract is satisfactorily
completed and formally accepted. Failure to do so may, at the sole discretion of County,
constitute a material breach of this Contract.
6.2.3 Contractor's insurance shall be primary insurance as respects County, and any insurance
or self-insurance maintained by County shall not contribute to it.
6.2.4 Any failure to comply with the claim reporting provisions of the insurance policies or any
breach of an insurance policy warranty shall not affect the County's right to coverage
afforded under the insurance policies.
6.2.5 The insurance policies may provide coverage that contains deductibles or self-insured
retentions, Such deductible and/or self-insured retentions shall not be applicable with
respect to the coverage provided to County under such policies. Contactor shall be solely
responsible for the deductible and/or self-insured retention and County, at its option, may
require Contractor to secure payment of such deductibles or self-insured retentions by a
surety bond or an irrevocable and unconditional letter of credit.
6.2.6 County reserves the right to request and to receive, within 10 working days, certified
copies of any or all of the herein required insurance certificates. County shall not be
obligated to review policies and/or endorsements or to advise Contractor of any
deficiencies in such policies and endorsements, and such receipt shall not relieve
Contractor from, or be deemed a waiver of County's right to insist on strict fulfillment of
Contractor's obligations under this Contract.
6.2.7 The insurance policies required by this Contract, except Workers' Compensation, and
Errors and Omissions, shall name County, its agents, representatives, officers, directors,
officials and employees as Additional Insureds,
6.2.8 The policies required hereunder, except Workers' Compensation, and Errors and
Omissions, shall contain a waiver of transfer of rights of recovery (subrogation) against
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County, its agents, representatives, officers, directors, officials and employees for any
claims arising out of Contractor's work or service.
6.2.9 Commercial General Liability.
Commercial General Liability insurance and, if necessary, Commercial Umbrella
insurance .with a limit of not less than $2,000,000 for each occurrence, $2,000,000
Products/Completed Operations Aggregate, and $4,000,000 General Aggregate Limit.
The policy shall include coverage for bodily injury, broad form property damage,
personal injury, products and completed operations and blanket contractual coverage, and
shall not contain any provision which would serve to limit third party action over claims.
There shall be no endorsement or modification of the CGL limiting the scope of coverage
for liability arising from explosion, collapse, or underground property damage.
6.2.10 Automobile Liability.
Conunercial/Business Automobile Liability insurance and, if necessary, Commercial
Umbrella insurance with a combined single limit for bodily injury and property damage
of not less than $2,000,000 each occurrence with respect to any of the Contractor's
owned, hired, and non-owned vehicles assigned to or used in performance of the
Contractor's work or services under this Contract.
6.2.11 Workers' Compensation.
6.2.11.1 Workers' Compensation insurance to cover obligations imposed by federal and
state statutes having jurisdiction of Contractor's employees engaged in the
performance of the work or services under this Contract; and Employer's
Liability insurance of not less than $100,000 for each accident, $100,000 disease
for each employee, and $500,000 disease policy limit.
6.2.11.2 Contractor waives all rights against County and its agents, officers, directors and
employees for recovery of damages to the extent these damages are covered by
the Workers' Compensation and Employer's Liability or commercial umbrella
liability insurance obtained by Contractor pursuant to this Contract.
6.2.12 Errors and Omissions Insurance.
Errors and Omissions insurance and, if necessary, Commercial Umbrella insurance,
which will insure and provide coverage for errors or omissions of the Contractor, with
limits of no less than $1,000,000 for each claim.
6.2.13 Certificates of Insurance.
6.2,13,1 Prior to commencing work or services under this Contract, Contractor shall have
insurance in effect as required by the Contract in the form provided by the
County, issued by Contractor's insurer(s), as evidence that policies providing the
required coverage, conditions and limits required by this Contract are in full
force and effect. Such certificates shall be made available to the County upon
48 hours notice, BY SIGNING THE AGREEMENT PAGE THE
CONTRACTOR AGREES TO THIS REQUIREMENT AND UNDERSTANDS
THAT FAILURE TO MEET THIS REQUIREMENT WILL RESULT IN
CANCELLATION OF THIS CONTRACT,
6,2.13.1.1 In the event any insurance policy (ies) required by this
Contract is (are) written on a "claims made" basis, coverage shall
extend for two (2) years past completion and acceptance of
Contractor's work or services and as evidenced by annual Certificates
of Insurance.
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CONTRACT #: 860-15-003
6.2.13.1.2 If a policy does expire during the life of the Contract, a
renewal certificate must be sent to County fifteen (15) days prior to the
expiration date.
6.2.14 Cancellation and Expiration Notice.
Insurance required herein shall not be permitted to expire, be canceled, or materially
changed without thirty (30) days prior written notice to the County.
6,3 WARRANTY OF SERVICES:
6.3.1 The Contractor warrants that all services provided hereunder will conform to the
requirements of the Contract, including all descriptions, specifications and attachments
made a part of this Contract. County's acceptance of services or goods provided by the
Contractor shall not relieve the Contractor from its obligations under this warranty.
6.3.2 In addition to its other remedies, County may, at the Contractor's expense, require prompt
correction of any services failing to meet the Contractor's warranty herein. Services
corrected by the Contractor shall be subject to all the provisions of this Contract in the
manner and to the same extent as services originally furnished hereunder.
6.4 INSPECTION OF SERVICES:
6.4.1 The Contractor shall provide and maintain an inspection system acceptable to County
covering the services under this Contract. Complete records of all inspection work
performed by the Contractor shall be maintained and made available to County during
contract performance and for as long afterwards as the Contract requires.
6,4.2 County has the right to inspect and test all services called for by the Contract, to the
extent practicable at all times and places during the term of the Contract. County shall
perform inspections and tests in a manner that will not unduly delay the work.
6.4.3 If any of the services do not conform with Contract requirements, County may require the
Contractor to perform the services again in conformity with Contract requirements, at on
increase in Contract amount. When the defects in services cannot be corrected by re-
performance, County may:
6.4,3.1 Require the Contractor to take necessary action to ensure that future
performance conforms to Contract requirements; and
6.4.3.2 Reduce the Contract price to reflect the reduced value of the services performed.
6.4.4 If the Contractor fails to promptly perform the services again or to take the necessary
action to ensure future performance in conformity with Contract requirements, County
may:
6.4.4.1 By Contract or otherwise, perform the services and charge to the Contractor any
cost incurred by County that is directly related to the performance of such
service; or
6.4.4.2 Terminate the Contract for default.
6.5 NOTICES:
All notices given pursuant to the terms of this Contract shall be addressed to:
For County:
Maricopa County
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CONTRACT #: 860-15-003
Department of Public Health
Attn: Cheryl Rentscheler, Procurement Officer
4041 N. Central Avenue, #1400
Phoenix, AZ 85012
(602) 506-6886
cherylrentscheler@mail.maricopa,gov
For Contractor:
Michelle Logsdon
Falcon Practice Management
525 Lacey Road, Suite E
Forked River, NJ 08731
(609) 242-5088
michellefalconpractice.com
6.6 TERMINATION FOR CONVENIENCE:
The County reserves the right to terminate the Contract in whole or in part at any time, when in
the best interests of the County without penalty or recourse. Upon receipt of the written notice,
the Contractor shall immediately stop all work, as directed in the notice, notify all subcontractors
of the effective date of the termination and minimize all further costs to the County. In the event
of termination under this paragraph, all documents, data and reports prepared by the Contractor
under the Contract shall become the property of and be delivered to the County upon demand.
The Contractor shall be entitled to receive just and equitable compensation for work in progress,
work completed and materials accepted before the effective date of the termination.
6.7 TERMINATION FOR DEFAULT:
6.7.1 In addition to the rights reserved in the Contract, the County may terminate the Contract
in whole or in part due to the failure of the Contractor to comply with any term or
condition of the Contract, to acquire and maintain all required insurance policies, bonds,
licenses and permits, or to make satisfactory progress in performing the Contract. The
Procurement Officer shall provide written notice of the termination and the reasons for it
to the Contractor.
6.7.2 Upon termination under this paragraph, all goods, materials, documents, data and reports
prepared by the Contractor under the Contract shall become the property of and be
delivered to the County on demand.
6.7.3 The County may, upon termination of this Contract, procure, on terms and in the manner
that it deems appropriate, materials or services to replace those under this Contract. The
Contractor shall be liable to the County for any excess costs incurred by the County in
procuring materials or services in substitution for those due from the Contractor,
6.7.4 The Contractor shall continue to perform, in accordance with the requirements of the
Contract, up to the date of termination, as directed in the termination notice.
6,8 TERMINATION BY THE COUNTY:
If the Contractor should be adjudged bankrupt or should make a general assignment for the benefit
of its creditors, or if a receiver should be appointed on account of its insolvency, the County may
terminate the Contract. If the Contractor should persistently or repeatedly refuse or should fail,
except in cases for which extension of time is provided, to provide enough properly skilled
workers or proper materials, or persistently disregard laws and ordinances, or not proceed with
work or otherwise be guilty of a substantial violation of any provision of this Contract, then the
County may terminate the Contract. Prior to termination of the Contract, the County shall give the
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CONTRACT #: 860-15-003
Contractor fifteen- (15) calendar day's written notice. Upon receipt of such termination notice, the
Contractor shall be allowed fifteen (15) calendar days to cure such deficiencies.
6.9 STATUTORY RIGHT OF CANCELLATION FOR CONFLICT OF INTEREST:
Notice is given that pursuant to A.R.S. §38-511 the County may cancel this Contract without
penalty or further obligation within three years after execution of the contract, if any person
significantly involved in initiating, negotiating, securing, drafting or creating the contract on
behalf of the County is at any time while the Contract or any extension of the Contract is in effect,
an employee or agent of any other party to the Contract in any capacity or consultant to any other
party of the Contract with respect to the subject matter of the Contract. Additionally, pursuant to
A.R.S §38-511 the County may recoup any fee or commission paid or due to any person
significantly involved in initiating, negotiating, securing, drafting or creating the contract on
behalf of the County from any other party to the contract arising as the result of the Contract.
6.10 OFFSET FOR DAMAGES;
In addition to all other remedies at law or equity, the County may offset from any money due to
the Contractor any amounts Contractor owes to the County for damages resulting from breach or
deficiencies in performance under this contract.
6.11 ADDITIONS/DELETIONS OF SERVICE:
The County reserves the right to add and/or delete products and/or services provided under this
Contract. If a requirement is deleted, payment to the Contractor will be reduced proportionately to
the amount of service reduced in accordance with the proposal price. If additional services and/or
products are required from this Contract, prices for such additions will be negotiated between the
Contractor and the County.
6.12 RELATIONSHIPS:
In the performance of the services described herein, the Contractor shall act solely as an
independent contractor, and nothing herein or implied herein shall at any time be construed as to
create the relationship of employer and employee, partnership, principal and agent, or joint venture
between the District and the Contractor.
6.13 SUBCONTRACTING:
The Contractor may not assign this Contract or subcontract to another party for performance of the
terms and conditions hereof without the written consent of the County, which shall not be
unreasonably withheld. All correspondence authorizing subcontracting must reference the
Proposal Serial Number and identify the job project.
6.14 AMENDMENTS:
All amendments to this Contract shall be in writing and approved/signed by both parties, The
Public Health Procurement Officer and/or the Office of Procurement Services' Chief Procurement
Officer shall be responsible for approving all amendments for Maricopa County.
6.15 ACCESS TO AND RETENTION OF RECORDS FOR THE PURPOSE OF AUDIT AND/OR
OTHER REVIEW:
6.15.1 In accordance with section MCI 367 of the Maricopa County Procurement Code the
Contractor agrees to retain all books, records, accounts, statements, reports, files, and
other records and back-up documentation relevant to this Contract for six (6) years after
final payment or until after the resolution of any audit questions which could be more
than six (6) years, whichever is latest. The County, Federal or State auditors and any
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CONTRACT #: 860-15-003
other persons duly authorized by the Department shall have full access to, and the right to
examine, copy and make use of, any and all said materials.
6,15,2 If the Contractor's books, records , accounts, statements, reports, files, and other records
and back-up documentation relevant to this Contract are not sufficient to support and
document that requested services were provided, the Contractor shall reimburse Maricopa
County for the services not so adequately supported and documented.
6.15.3 If at any time it is determined by the County that a cost for which payment has been made
is a disallowed cost, the County shall notify the Contractor in writing of the
disallowance, The course of action to address the disallowance shall be at sole discretion
of the County, and may include either an adjustment to future claim submitted by the
Contractor by the amount of the disallowance, or to require reimbursement forthwith of
the disallowed amount by the Contractor by issuing a check payable to Maricopa County.
6.16 AUDIT DISALLOWANCES:
If at any time, County determines that a cost for which payment has been made is a disallowed
cost, such as overpayment, County shall notify the Contractor in writing of the disallowance,
County shall also state the means of correction, which may be but .shall not be limited to
adjustment of any future claim submitted by the Contractor by the amount of the disallowance, or
to require repayment of the disallowed amount by the Contractor.
6.17 SE,VERABILITY:
The invalidity, in whole or in part, of any provision of this Contract shall not void or affect the
validity of any other provision of this Contract.
6.18 RIGHTS IN DATA:
The County shall own have the use of all data and reports resulting from this Contract without
additional cost or other restriction except as provided by law, Each party shall supply to the other
party, upon request, any available information that is relevant to this Contract and to the
performance hereunder.
6.19 INTEGRATION:
This Contract represents the entire and integrated agreement between the parties and supersedes
all prior negotiations, proposals, communications, understandings, representations, or agreements,
whether oral or written, express or implied.
6.20 VERIFICATION REGARDING COMPLIANCE WITH ARIZONA REVISED STATUTES §41-
4401 AND FEDERAL IMMIGRATION LAWS AND REGULATIONS:
6.20.1 By entering into the Contract, the Contractor warrants compliance with the Immigration
and Nationality Act ([NA using e-verify) and all other federal immigration laws and
regulations related to the immigration status of its employees and A.R.S. §23-214(A). The
contractor shall obtain statements from its subcontractors certifying compliance and shall
furnish the statements to the Procurement Officer upon request. These warranties shall
remain in effect through the term of the Contract. The Contractor and its subcontractors
shall also maintain Employment Eligibility Verification forms (1-9) as required by the
Immigration Reform and Control Act of 1986, as amended from time to time, for all
employees performing work under the Contract and verify employee compliance using the
E-verify system and shalt keep a record of the verification for the duration of the
employee's employment or at least three years, whichever is longer. 1-9 forms are available
for download at USCIS.GOV .
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CONTRACT #: 860-15-003
6.20.2 The County retains the legal right to inspect contractor and subcontractor employee
documents performing work under this Contract to verify compliance with paragraph
6.20.1 of this Section. Contractor and subcontractor shall be given reasonable notice of the
County's intent to inspect and shall make the documents available at the time and date
specified. Should the County suspect or find that the Contractor or any of its subcontractors
are not in compliance, the County will consider this a material breach of the contract and
may pursue any and all remedies allowed by law, including, but not limited to: suspension
of work, termination of the Contract for default, and suspension and/or debarment of the
Contractor. All costs necessary to verify compliance are the responsibility of the
Contractor.
6.21 CONTRACTOR LICENSE REQUIREMENT:
6.21.1 The Respondent shall procure all permits, insurance, licenses and pay the charges and
fees necessary and incidental to the lawful conduct of his/her business, and as necessary
complete any required certification requirements, required by any and all governmental
or non-governmental entities as mandated to maintain compliance with and in good
standing for all permits and/or licenses. The Respondent shall keep fully informed of
existing and future trade or industry requirements, Federal, State and Local laws,
ordinances, and regulations which in any manner affect the fulfillment of a Contract and
shall comply with the same. Contractor shall immediately notify both Materials
Management and the using agency of any and all changes concerning permits, insurance
or licenses.
6.21.2 Respondents furnishing finished products, materials or articles of merchandise that will
require installation or attachment as part of the Contract, shall possess any licenses
required. A Respondent is not relieved of its obligation to posses the required licenses by
subcontracting of the labor portion of the Contract. Respondents are advised to contact
the Arizona Registrar of Contractors, Chief of Licensing, at (602) 542-1525 to ascertain
licensing requirements for a particular contract, Respondents shall identify which
license(s), if any, the Registrar of Contractors requires for performance of the Contract,
6.22 CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
6.22.1 The undersigned (authorized official signing for the Contractor) certifies to the best of his
or her knowledge and belief, that the Contractor, defined as the primary participant in
accordance with 45 CFR Part 76, and its principals:
6,2711 are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by any Federal
Department or agency;
6.27.1.2 have not within 3-year period 'preceding this Contract been convicted of or
had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or
performing a public (Federal, State or local) transaction or contract under a
public transaction; violation of Federal or State antitrust statues or
commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property;
6.27.1.3 are not presently indicted or otherwise criminally or civilly charged by a
government entity (Federal, State or local) with commission of any of the
offenses enumerated in paragraph (2) of this certification; and
6.27.1,4 have not within a 3-year period preceding this Contract had one or more
public transaction (Federal, State or local) terminated for cause of default.
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CONTRACT #: 860-15-003
6.22.2 Should the Contractor not be able to provide this certification, an explanation as to why
should be attached to the Contact.
6.22.3 The Contractor agrees to include, without modification, this clause in all lower tier
covered transactions (i.e, transactions with subcontractors) and in all solicitations for
lower tier covered transactions related to this Contract.
6.23 GOVERNING LAW:
This Contract shall be governed by the laws of the state of Arizona. Venue for any actions or
lawsuits involving this Contract will be in Maricopa County Superior Court or in the United States
District Court for the District of Arizona, sitting in Phoenix, Arizona
6.24 ORDER OF PRECEDENCE:
In the event of a conflict in the provisions of this Contract and Contractor's license agreement, if
applicable, the terms of this Contract shall prevail.
6.25 AUDIT REQUIREMENTS
6.25.1 If the Contractor expends $500,000 or more from all contracts administered and/or
funded via County, and/or receives $500,000 or more per year from any federal funding
sources, the Contractor may be subject to Federal audit requirements per P.L. 98-502
"The Single Audit Act". The Contractor shall comply with OMB Circulars A-128, A-
I10, and A-133 as applicable. The audit report shall be submitted to the Maricopa
County Department of Public Health for review within the twelve months following the
close of the fiscal year, The Contractor shall take any necessary corrective action to
remedy any material weaknesses identified in the audit report within six months after the
release date of the report. Maricopa County may consider sanctions as described in OMB
Circular A-128 for contractors not in compliance with the audit requirements. All books
and records shall be maintained in accordance with Generally Accepted Accounting
Principles (GAAP),
6.25.2 The Contractor shall schedule an annual financial audit to be submitted to County for
review within twelve months following the close of the program's fiscal year. Contractor
understands that failure to meet this requirement may result in loss of current funding and
disqualification from consideration for future County-administered funding.
6.25.3 The Contractor shall comply with the requirement of the Federal Office of Management
and Budget (OMB) Circular A-133. The Contractor is responsible for having an audit
performed in accordance with, and when required, by OMB Circular A-133, and for
sending a copy of the report issued as a results of the audit to the COUNTY within 30
days of issuance. The County reserves the right to engage an auditor, at the Contractor's
expense, to perform an OMB Circular A-133 audit of the Contractor in the event that the
Contractor shall fail to engage an auditor or the County shall reject or disapprove of the
auditor engaged by the Contractor.
6,25.4 The Contractor must also comply with the following OMB Circulars:
1.0 A-102 Uniform Administrative Requirements for Grants to State and Local
Government.
2.0 A-110 Uniform Administrative Requirements for Grants and Agreement with
Institutions of Higher Education, Hospitals and other non-profit organizations.
3,0 A-122 Cost Principles for Non-Profit Organizations,
4,0 A-87 Cost Principles for State and Local Governments,
5,0 A-21 Cost principles for Education Institutions.
6.26 INFLUENCE
As prescribed in MC1-1202 of the Maricopa County Procurement Code, any effort to influence an
employee or agent to breach the Maricopa County Ethical Code of Conduct or any ethical conduct,
may be grounds for Disbarment or Suspension under MC1-902.
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CONTRACT 86045-003
An attempt to influence includes, but is not limited to:
6.26.1 A Person offering or providing a gratuity, gift, tip, present, donation, money,
entertainment or educational passes or tickets, or any type valuable contribution or
subsidy,
6.26.2 That is offered or given with the intent to influence a decision, obtain a contract, garner
favorable treatment, or gain favorable consideration of any kind.
If a Person attempts to influence any employee or agent of Maricopa County, the Chief
Procurement Officer, or his designee, reserves the right to seek any remedy provided by the
Maricopa County Procurement Code, any remedy in equity or in the law, or any remedy provided
by this contract.
6.27 PUBLIC RECORDS:
All Offers submitted and opened are public records and must be retained by the Records Manager
at the Office of Procurement Services, Offers shall be open to public inspection after Contract
award and execution, except for such Offers deemed to be confidential by the Office of
Procurement Services. If an Offeror believes that information in its Offer should remain
confidential, it shall indicate as confidential, the specific information and submit a statement with
its offer detailing the reasons that the information should not be disclosed. Such reasons shall
include the specific harm or prejudice which may arise. The Records Manager of the Office of
Procurement Services shall determine whether the identified information is confidential pursuant
to the Maricopa County Procurement Code.
6,28 INCORPORATION OF DOCUMENTS:
The following are to be attached to and made part of this Contract:
6.28.1 Exhibit A, Pricing;
6.28.2 Exhibit 13, Scope of Work;
6.28.3 Exhibit C, Office of Procurement Services Contractor Travel and Per Diem Policy,
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CONTRACT 4: 860-13-04A
IN WITNESS WHEREOY', this Contract is executed on the date set forth above.
AUTHORIZED SIGNAT1:
MI 416 ItL 141)54)/U CP& C/O '
PRINTED NAME 4" TITLE
,372,P.) M twi4d 13' ft AtIJ 73)
MARICOPA COUNTY
CHAIRMAN, BOARD OF SUPERVISORS DATE
ATTESTED:
CLERK OF THE BOARD DATE
APPROVED AS TO FORM:
LEGAL COUNSEL DATE
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CONTRACT #: 860-15-003
EXHIBIT A
SE1-0.111., (-t; PU mir 15-003
ATTACHMENT A
PRICING S
E01.)Dr71{ NAME r T
F.T,DIVENDOR 0. ;
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BIDDER JL02RESS t, , 4
ADDR ENS,: t - Ir. A:
IIIDDER PHONE fr'7 _.1-L 1/72
11 INIER FAX
COMPANY WEB SITE; vy
COMPANY CONTACT (REPt: t- Jj
IT-MAIL ADDRESS (REP):
i'AYMPI-1 ii CHIOS; E11000T( IS REQUIRED 1 -0 SELECT ONE or Till FOLLOWINUI
TERMS WILL BE CONSIDERED IN DETERMENIJ4G LOW BID,
FAILURE TO CHOOSE A TEELM WILL RESULI" IN A DuF &TAT 'TO NET 30.
BIDDER MUST INITIAL 'II-117 SELECTION BELOW.
NET 10
NFIT 11
NET 20
311
NET 45
NET 60
NE] 90
2% 10 DAY..; NET 30
1% 10 DAYS NET 30
30 DAYS NET 31
1%3[l DAYS NET 31
5% 30 DAYS NET 3!
T:1)M EN.S.A N±T, ELS: RATES
MEDICAL MILLING OLITSOURCENG tlf 1110ZI1L'S calleetell $
M MICA C., littlINC °TITS OT CING — OTHER FEES (Destu..11)0 $ „
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CONTRACT #: 86045-003
EXHIBIT B
SCOPE OF WORK
Original Scope of Work from RFP:
2.0 SCOPE OF WORK:
2.1 The successful Contractor, under this contract, shall provide all services necessary to collect
revenues from insurance carriers for patients seen at MCDPH clinics, These services shall
include but not be limited to;
2.1.1 Receipt of the patient information necessary for billing. This information will come
from the electronic medical record used by MCDPH, eClinicalWorks. The Contractor
will be furnished limited access to the electronic medical record system in order to
obtain the necessary information to create a claim. If the Contractor desires, the
Contractor may obtain (at their own expense) any other software or system interface
that will allow compatibility with eClinical Works for furnishing or converting data
into their own billing system.
2.1.2 Contractor shall be responsible for reviewing each patient claim created for content to
accomplish the following: (a) To check for discrepancies between services provided
and billing codes populated into the claim; (b) to ensure the number of patients seen in
a day match the number of claims generated; (c) ensure that the appropriate claim
forms are completed and the documentation to support the charge is present in the
medical record; and (d) that appropriate billing codes have been assigned to services
based on the documentation, treatment, and chief complaint of the patient,
2,1.3 To the extent possible, Contractor shall provide electronic claims processing and paper
filings to insurance companies. The first invoice will be dated no later than fifteen (15)
days after the date of service (DOS).
2.1.4 The Contractor shall be responsible for the initial collection, generation of any and all
insurance forms, filings, and record maintenance.
2.1.5 Provision of all monthly finance, billing, receivable, and aging reports as stated herein:
215,1 Collections profiles for each month, dating back to the beginning of said
contract;
2.1.5,2 Status of all claims for the current month and total in system;
2,1.5,3 Aging Report;
2.1.5.4 Month end information for Finance;
215.5 Daily Payment logs;
2,1,5,6 Month end payment logs;
2.1.5.7 Any additional reports that MCDPH may need or request will automatically be
formatted to their requirements and sent to the department.
2,1.6 Contractor shall comply with the policies and procedures developed and implemented
by MCDPH in response to the improvement of the department and the privacy act of
HIPAA. The agency will enter into a business associates agreement with MCDPH to
insure all HIPAA policies are adhered to. Any violations of HIPAA by the contracted
billing company will be grounds to terminate all contractual agreements.
2.1.7 Contractor shall comply with HIPAA regarding protected health information (PHI) and
guardian of all record sets and will maintain any and all documentation, records, and
patient information in a safe and secure manner allowing for inspection and/or audit by
the County.
2,1.8 Contractor s h all store all record sets for a minimum of thirty-six (36) months and
then turn them over to MCDPH for permanent storage.
2.1.9 Contractor shall be in compliance with the Final Security Rule of HIPAA and remain
under a business associates agreement during the duration of the contract.
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CONTRACT #: 86O-15-003
2.1.10 Contractor shall provide sufficient customer service representative(s) to in all billing
inquiries in a timely manner, not to exceed three (3) business days.
2.1,11 Contractor shall conduct any follow-up required to obtain necessary insurance
information for payment processing.
2112 All payments will be received by MCDPH.and copies will be forwarded to Contractor
for posting to patient accounts. Payments will be posted to patient accounts within
three (3) business days of receipt of information from MCDPH. Records of posted
payments will be provided to MCDPH on a daily basis.
2.1.13 Contractor shall be responsible for the posting of payments to the appropriate patient
account, updating insurance information on individual patient accounts, insurance
claim processing and general patient account notations. The Contractor shall be
responsible for all inquiries and resolution of insurance denials and rejections. The
Contractor shall contact the appropriate insurance carrier for the resolution, correction
and re-submission of any patient billing If corrected information is received, the
billing record will be updated and submitted for payment to the appropriate insurance
canier.
2.1.14 In the event a billing is denied for any reason except failure to bill in a timely fashion,
and the Contractor is unable to correct and resubmit the claim, the Contractor will
notify MCDPH. If the claim is denied due to failure to bill in a timely fashion, the
Contractor will accept all financial responsibility for administrative costs concerning
the patient's account.
2.1.15 Contractor shall be responsible to follow-up on each medical claim for services
rejected by an insurance provider. The Contractor shall contact insurance providers by
telephone, mail or FAX in order to resolve each rejected claim. The Contractor shall be
responsible to furnish insurance providers with all requested patient information,
medical information and documentation, including the re-submission of the rejected
claim. The Contractor shall, on a weekly basis, prepare and deliver a written report for
all rejected claims detailing the reason for rejection and provide documentation on
each claim resubmitted.
2,1,16 Contractor shall provide initial training for medical provider staff and training for new
medical provider staff in coding and billing in a primary care setting. The Contractor
shall also provide training for medical provider personnel on changes in coding of
services or new requirements for coding as they occur and as they relate to services
provided by medical providers. Training may be onsite, classroom style training, or
may be available to staff online or via the web.
2.1.17 The Contractor shall agree to:
2.1.17.1 Provide follow up on electronically submitted claims for which payment has
not been received between 30 and 45 days following initial submittal. Follow-
up shall be accomplished on all unpaid paper Claims between 45 & 60 days
after initial submittal. Follow-up efforts and results must be documented and
available to the County. Follow-up efforts subsequent to the initial effort must
also be documented and retrievable.
2.1.17.2 Provide MCDPH, after receiving reasonable notification, with all financial
records pertaining to the billing and collection for MCDPH for auditing
purposes.
2.1.17.3 Receive and keep on file all documents associated with the billing process,
including but not limited to, documentation for Medicare, Medicaid, and all
other insurance providers.
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CONTRACT #: 860-15-003
Contractor 's Scope of Work from Response:
SERVICES PROPOSAL! METHODOLOGY
Medical billing is the most important function in Revenue Cycle Management for medical practitioners,
hospitals, medical clinics and surgery centers in both the private and public sectors. Falcon Practice Management
has developed proven strategies to implement better processes, streamline billing operations and maximize revenue
for our clients. We tailor our services to meet your specific needs. Our goal is always to make our client's practice
feel like it's our only practice.
Falcon Practice Management can provide Maricopa County Department of Public Health (MCDPH) with
the quality medical billing services it requires. We routinely submit primary and secondary claims electronically on
behalf of our clients. One of our largest clients, South Jersey ENT Surgical Associates, uses eClinical Works. Our
staff is trained to access the electronic medical record (EMR) system in order to perform our billing services.
We process all claims electronically and our billing platform is ANSI 5010, which is HIPAA compliant.
We will provide paper filings to insurance companies, as required. Our standard service protocol is to thoroughly
review all patient claims for content to (a) identify any discrepancies between the services provided and the billing
codes populated into the claim; (b) verify that the number of patients seen per day matches the number of claims
generated; (c) ensure the appropriate claim forms are completed and the documentation to support the charge is
included in the medical record; and (d) confirm that appropriate billing codes have been assigned to services based
on the documentation, treatment and chief complaint of the patient. Our policy is to generate billing invoices no later
than ten (10) days after the date of service. We will provide a toll free 800 number to assist with all patient billing
issues. We will diligently follow up with all insurance carriers to ensure payments are received.
Our services include generating and filing all insurance forms, maintaining accurate records and providing
monthly finance, billing, receivable and aging reports requested by MCDPH. We will also provide daily payment
logs and month-end payment logs and any additional reports MCDPH may need or request.
All records are electronically stored via scanned files, and are encrypted on secure servers. Files are backed
up, locally and off-site, daily. All record sets will be stored for 36 months and then turned over to MCDPH for
permanent storage.
Falcon Practice Management has built its reputation on providing outstanding customer service. All
inquiries will be addressed by our customer service staff no later than two business days. We will also post all
payments received by MCDPH within three (3) business days of receipt of the information from MCDPH. We
understand the MCDPH will provide records of posted payments on a daily basis. Upon receipt, we will post
payments to the appropriate patient account and update insurance information on individual patient accounts.
. As the medical billing provider for MCDPH, Falcon Practice Management will efficiently handle all
inquiries regarding patient billing matters and resolve all insurance denials and rejections. We will maintain contact
with all insurance carriers, make any necessary corrections and resubmit any patient billing. If corrected information
is received, we will update the billing record and submit for payment to the appropriate insurance carrier, We will
accept responsibility for any medical claim that is denied due to failure on our part to bill in a timely fashion and
accept all financial responsibility for administrative costs concerning the patient's account. While this is a provision
of this solicitation to which we agree, Falcon Practice Management has never had a claim denied for untimely filing
when the work was received in an appropriate time frame from the client.
Falcon Practice Management will provide initial training for medical provider staff and training for new
provider staff in coding and billing in a primary care setting, if necessary. We will also provide training for medical
provider personnel when there are changes in coding or new requirements for coding as they relate to services
provided by medical providers. We will advise the MCDPH of any changes and/or updates in billing/coding
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CONTRACT #: 860-15-003
regulations and guidelines in writing, and will follow up to ensure it has been received. If further training is
required, a training session(s) will be devised to work with MCDPH to accommodate their schedule.
We will follow up on all electronically submitted claims for which payment has not been received within
30 days following submission of the claim. Follow up will be made on all unpaid paper claims 45 days after initial
submittal. We will document all follow up efforts and provide such results to MCDPH. All documented follow up
efforts will be retrievable. Falcon Practice Management will also keep on file all documents associated with the
billing process, including documentation for Medicare, Medicaid and all other insurance providers.
QUALIFICATIONS
Background. Falcon Practice Management was established in March 2005 and began operations with just
two employees and four clients, Since then, we have grown steadily through provider referrals. Currently, we have a
staff of seven employees billing for 12 practices with 22 providers. Our groups range in specialty from surgical to
primary care and hospitals with Otolaryngology, Internal Medicine, General Surgery, Geriatrics, Obstetrics and
Gynecology. Our largest Primary Care practice has six providers and we process about 17,000 visits annually for
them. Our smallest Primary Care Physician has an office in New Jersey and we process approximately 5,000 visits
annually.
License and Insurance. Falcon Practice Management is licensed and insured in the state of New Jersey.
As a medical billing company licensed to perfortn services in the state of New Jersey, we are able to provide billing
service remotely in other states as well. Our liability carrier has advised us that they are covered in the state of
Arizona. We have already started the bonding process so that we are ready should you accept our proposal.
Certifications. Falcon Practice Management has five medical billers, some of whom are certified through
the AAPC with Certified Professional Coder (CPC) credentials. They have 50 years of combined experience in the
medical billing field, Our COO Michelle Logsdon has multiple certifications, from AAPC Certified Professional
Coder (CPC) and Certified Professional Biller (CPB) to AH1MA Certified Coding Specialist, Physician Based
(CCS-P). Ms. Logsdon has over 20 years of experience in billing, coding, auditing and training in the medical
billing field. She has been a guest speaker at coding events and a featured resource for "The Coding Alert," which is
a monthly publication regarding medical billing and coding issues. Kimberly Krenza is also certified through AAPC
as a Certified Professional Coder (CPC).
Electronic Billing, Falcon Practice Management currently utilizes electronic billing for claims to Medicare
and Medicaid for the states of New Jersey and New York. We will apply for appropriate submitter numbers for the
state of Arizona, which will be through Noridian Healthcare Solutions, LLC for Jurisdiction F with Medicare,
Falcon Practice Management will also submit CMS Form 855B Section 8 to add our billing agency to the Medicare
Record. Falcon Practice Management also submits claims to hundreds of PPO, HMO, POS and EPO commercial
carriers. Our company processes well in excess of 10,000 visits per year.
Training. Falcon Practice Management can provide training on site or remotely. Based on the needs of
MCDPH, training will be designed to be efficient and provide minimal interference with daily operations. Web-
based training is available and one-on-one training can be done remotely. Falcon Practice Management is already
very familiar with eClinical and will be able to access the database and determine the information necessary to
perform the billing functions with little assistance from MCDPH,
Proposed Staffing. For the MCDPH project, Falcon Practice Management will assign two of the
company's certified billing and coding specialists—COO Michelle Logsdon and Kimberly Krenza. Each of these
individuals will devote 50% of their time to the MCDPH account. Should additional resources be required, we are
prepared to make additional assignments as necessary. Resumes appear on the following pages.
Additional Services. Falcon Practice Management also offers credentialing services when a new doctor is
added to your staff or when a new insurance provider is added.
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CONTRACT #: 860-15-003
EXHIBIT C
OFFICE OF PROCUREMENT SERVICES CONTRACTOR TRAVEL AND PER DIEM POLICY
1.0 All contract-related travel plans and arrangements shall be prior-approved by the County Contract
Administrator.
2.0 Lodging, per diem and incidental expenses incurred in performance of Maricopa County/Special District
(County) contracts shall be reimbursed based on current U.S. General Services Administration (GSA)
domestic per diem rates for Phoenix, Arizona. Contractors must access the following internet site to
determine rates (no exceptions): www.ua.gov
2,1 Additional incidental expenses (i.e., telephone, fax, internet and copying charges) shall not be
reimbursed. They should he included in the contractor's hourly rate as an overhead charge.
2.2 The County will not (under no circumstances) reimburse for Contractor guest lodging, per diem or
incidentals,
3.0 Commercial air travel shall be reimbursed as follows:
3.1 Coach airfare will be reimbursed by the County. Business class airfare may be allowed only when
preapproved in writing by the County Contract Administrator as a result of the business need of
the County when there is no lower fare available.
3,2 The lowest direct flight airfare rate from the Contractors assigned duty post (pre-defined at the
time of contract signing) will be reimbursed. Under no circumstances will the County reimburse
for airfares related to transportation to or from an alternate site.
3.3 The County will not (under no circumstances) reimburse for Contractor guest commercial air
travel.
4.0 Rental vehicles may only be used if such use would result in an overall reduction in the total cost of the
trip, not for the personal convenience of the traveler. Multiple vehicles for the same set of travelers for the
same travel period will not be permitted without prior written approval by the County Contract
Administrator.
4,1 Purchase of comprehensive and collision liability insurance shall be at the expense of the
contractor. The County will not reimburse contractor if the contractor chooses to purchase these
coverage.
4.2 Rental vehicles are restricted to sub-compact, compact Of mid-size sedans unless a larger vehicle
is necessary for cost efficiency due to the number of travelers. (NOTE; contractors shall obtain
pre-approval in writing from the County Contract Administrator prior to rental of a larger vehicle.)
• 4.3 County will reimburse for parking expenses if free, public parking is not available within a
reasonable distance of the place of County business. All opportunities must be exhausted prior to
securing parking that incurs costs for the County. Opportunities to be reviewed are the DASH;
shuttles, etc. that can transport the contractor to and from County buildings with minimal costs.
4.4 County will reimburse for the lowest rate, long-term uncovered (e.g. covered or enclosed parking
will not be reimbursed) airport parking only if it is less expensive than shuttle service to and from
the airport.
4.5 The County will not (under no circumstances) reimburse the Contractor for guest vehicle rental(s)
or other any transportation costs,
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CONTRACT #: 860-15-003
5.0 Contractor is responsible for all costs not directly related to the travel except those that have been pre-
approved by the County Contract Administrator. These costs include (but not limited to) the following: in-
room movies, valet service, valet parking, laundry service, costs associated with storing luggage at a hotel,
fuel costs associated with non-County activities, tips that exceed the per diem allowance, health club fees,
and entertainment costs. Claims for unauthorized travel expenses will not be honored and are not
reimbursable.
6.0 Travel and per diem expenses shall be capped at 15% of project price unless otherwise specified in
individual contracts.
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