Legislation Details

File #: 14420   
Type: Consent Status: Agenda Ready
File created: 6/10/2026 Department: Arrowhead Regional Medical Center
On agenda: 6/23/2026 Final action:
Subject: Contract with RCM Technologies (USA), Inc, dba RCM Healthcare Services for Medical Coding Audit Services
Attachments: 1. ADD - CON - ARMC - 6-23-26 - Contract with RCM Technologies
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REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS

OF SAN BERNARDINO COUNTY

AND RECORD OF ACTION

 

                                          June 23, 2026

 

FROM

ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center 

         

SUBJECT                      

Title                     

Contract with RCM Technologies (USA), Inc, dba RCM Healthcare Services for Medical Coding Audit Services

End

 

RECOMMENDATION(S)

Recommendation

Approve Contract with RCM Technologies (USA), Inc, dba RCM Healthcare Services, including non-standard terms, for the provision of medical coding audit services in an amount not-to-exceed $1,250,000 for the period of July 1, 2026 through June 30, 2031.

(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)

Body

 

COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES

Operate in a Fiscally-Responsible and Business-Like Manner.

 

FINANCIAL IMPACT

Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The cost of $1,250,000 is funded by State Medi-Cal, Federal Medicare, private insurances, and other departmental revenue. Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act. Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) 2026-27  budget and will be included in future recommended budgets.

 

BACKGROUND INFORMATION

The Agreement with RCM Technologies (USA), Inc, dba RCM Healthcare Services (RCM) will allow ARMC to provide data related to inpatient and outpatient encounters per calendar quarter to RCM for the assessment of the documentation and the accuracy of coding assignments, claim submissions, and payment determinations, using coding guidelines set by Centers for Medicare and Medicaid Services (CMS); American Medical Association; American Hospital Association; Medicare National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs); California Healthcare-associated infections, specific infections which hospitals must track and report to the California Department of Public Health which include Central Line-Associated Bloodstream Infections, Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant Enterococci bloodstream infections, Clostridioides difficile infections, and Surgical Site Infections; and ARMC’s coding guidelines.

 

Additionally, RCM will complete Comprehensive Medical Record Review (CMRR) audits, detailed analysis of patient charts, documenting, and coding to ensure accuracy, compliance with regulatory standards, and appropriate billing audits. The CMRR audits will assess the CMRR and coding audit risks, detecting challenges, strengths, weaknesses and/or deficiencies, opportunities, threats (clinical, legal and/or operational risks that could compromise patient safety, harm a legal case, or lead to insurance denials), and validating of medical record and coding accuracy. Audit services will offer visibility into department operations and processes that reflect the true state of hospital clinical documentation, medical necessity, coding, query compliance, security.

 

The Contract is the County standard template, which the parties negotiated to include terms that differ from the standard County contract. The non-standard and missing terms include the following:

 

1.                     RCM’s maximum liability to the County is limited to $5 million, excluding RCM’s liability arising from indemnification, breach of confidentiality, infringement or misappropriation of intellectual property rights, gross negligence, and willful misconduct.

                     The County standard contract does not include a limitation of liability.

                     Potential Impact: Claims could exceed the liability cap and the Agreement amount, leaving the County financially liable for the excess.

 

ARMC recommends approval of the Contract, including non-standard terms, to operate in a fiscally responsible manner. The assessment of coding documentation will ensure the accuracy of coding assignments, claim submissions and payment determinations while improving hospital operations and revenue cycle processes.

 

PROCUREMENT

On January 12, 2026, Request for Proposals No. ARMC126-ARMC-6203 (RFP) Medical Coding Audit Services was released through the County’s Electronic Procurement (ePro) network. Nine proposals were received in response to the RFP. Of the nine proposals received, two were deemed unresponsive, as the proposals did not include information requested in the RFP.

 

Evaluation of the seven responsive proposals was completed by a committee comprised of representatives from Medical Records, Information Technology, Hospital Compliance and Case Management. Proposals were evaluated based on the criteria of qualification, experience, technical review cost, and references. The evaluation committee determined that RCM best met ARMC’s needs and recommended them for a contract.

 

The company names and locations of all proposers who submitted a proposal in response to the RFP are provided below.

 

Proposer

Locations

Alfords Coding and Signing Services LLC

Dumfries, VA

AAPC Audit Services

Salt Lake City, Utah

CorroHealth, Inc.

Plano, TX

GeBBS Healthcare Solutions, Inc.

East Haven, CT

Managed Resources, Inc.

Long Beach, CA

RCM Technologies (USA), Inc. dba RCM Healthcare Services

New York, NY

SourceHOV Healthcare - XBP Global Holdings, Inc.

Lexington, SC

United Audit Systems, Inc.

Cincinnati, OH

Wipfli Advisory LLC

Irvine, CA

 

On May 26, 2026, a tentative award letter was sent to RCM. On that same day, the unsuccessful agencies were notified in writing that they may protest based on the criteria in the RFP by submitting a formal protest letter to the Purchasing Department (Purchasing) within 10 calendar days of the non-selection letters. No protests were received.

 

Purchasing supports this procurement based on the competitive solicitation referenced above.

 

REVIEW BY OTHERS

This item has been reviewed by County Counsel (Bonnie Uphold, Supervising Deputy County Counsel, 387-5455) on May 29, 2026; Purchasing (Veronica Pedace, Buyer III, 387-2464) on June 1, 2026; Risk Management (Noel Cantrell, Admin Supervisor, 386-8890) on June 1, 2026; Innovation and Technology Department (Don Le, Interim Chief Information Officer, 388-5501) on June 1, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on June 2, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on June 2, 2026.