REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
October 27, 2020
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Agreement with Managed Resources, Inc. for Insurance Defense Audit/Account Audit Services
End
RECOMMENDATION(S)
Recommendation
Approve Agreement with Managed Resources, Inc. for Insurance Defense Audit/Account Audit Services in the amount of $2,500,000 for the five-year period of October 28, 2020 through October 27, 2025.
(Presenter: William L. Gilbert, Director, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
FINANCIAL IMPACT
Approval of the Agreement with Managed Resources, Inc. (MRI) will not result in the use of Discretionary General Funding (Net County Cost) as cost for concurrent chart auditing and defense auditing services are funded by State Medi-Cal, Federal Medicare, private insurances, and other departmental revenue. Sufficient appropriation and revenue are included in the Arrowhead Regional Medical Center (ARMC) 2020-21 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
The agreement with MRI allows for concurrent chart auditing and defense auditing services at ARMC. An auditor from MRI will randomly perform chart audits by reviewing medical records and billing documents in advance of the actual billing to the third party payor (insurance company). An insurance defense audit consist of a representative from MRI and an agent from the third party, verifying that charges billed for patient services have been documented accurately. Both parties review the medical record and all other clinical data to verify the written documentation on the medical bill is a true reflection of services provided to the patient. Chart audits and defense audits ensure that ARMC operates in a fiscally-responsible and business-like manner by...
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