Agreement for Vendor Negotiation and Project Management Services

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					 DEPARTMENT: Regulatory Compliance                 POLICY DESCRIPTION: Certified External
 Support                                           Vendors for Coding Reviews and Related
                                                   Education
 PAGE: 1 of 3                                      REPLACES POLICY DATED: 4/16/99, 8/1/00,
                                                   6/1/02, 3/1/04, 11/30/04 (HIM.COD.011), 3/6/06,
                                                   RETIRED 11/3/09 (replaced by REGS.COD.017)
 EFFECTIVE DATE: January 1, 2009                   REFERENCE NUMBER: REGS.COD.011

 SCOPE: All Company-affiliated facilities including, but not limited to, hospitals and all Corporate
 Departments, Groups and Divisions, including, but not limited to, the following departments:

 Facility Health Information Management Department            Nursing
 Corporate Regulatory Compliance Support                      Ancillary Departments
 Case Management/Quality Resource Management                  Legal
 National Agreements/Materials Management                     Finance
 Ethics & Compliance Officers                                 Service Centers
 Administration

 PURPOSE: To ensure that all ICD-9-CM and CPT coding reviews of medical records for
 outpatient and inpatient services and education related to such reviews performed by external
 vendors are compliant with official coding guidelines, Company coding policies, and other
 regulatory requirements.

 POLICY: ICD-9-CM and CPT Coding reviews performed by external vendors will only be
 completed by vendors who have been certified to meet the quality and business practice standards
 outlined in this policy. Certification of vendors is the responsibility of the Corporate Regulatory
 Compliance Support Department. Contract negotiation is the responsibility of National
 Agreements. This policy does not apply to chargemaster reviews or coding/billing reviews for
 physician professional services.

 PROCEDURE:

 SECTION I: Requesting an External Coding Review

 Any facility, Group, Division, Service Center or Corporate Department requesting a retrospective
 external coding review must choose a vendor from the certified vendor list and follow the process
 outlined below.

 1. The facility should notify a Regulatory Compliance Support Coding Manager of the planned
    review so the need and scope of the review can be clarified/evaluated.

 2. The facility must select a vendor from the certified vendor list for coding reviews. (See the list
    of Certified External Vendors for Coding Reviews on the Company’s Intranet site at:
     http://atlas2.medcity.net/portal/contentuid/f0f3fc5ae5212c37904f5ad29c01a1a0/Certified
     ExtVenCodingRvsREGSCOD011.doc).


1/2009
 DEPARTMENT: Regulatory Compliance               POLICY DESCRIPTION: Certified External
 Support                                         Vendors for Coding Reviews and Related
                                                 Education
 PAGE: 2 of 3                                    REPLACES POLICY DATED: 4/16/99, 8/1/00,
                                                 6/1/02, 3/1/04, 11/30/04 (HIM.COD.011), 3/6/06,
                                                 RETIRED 11/3/09 (replaced by REGS.COD.017)
 EFFECTIVE DATE: January 1, 2009                 REFERENCE NUMBER: REGS.COD.011

 3. Make arrangements for the review through the vendor contact person listed.
      a. All arrangements must be confirmed in writing by completing the Work Order/ Provider
          Agreement for Coding Review Services (See Attachment A ) or other Corporate
          Regulatory Compliance Support-approved work order.
      b. If the selected vendor cannot accommodate the request, select another vendor from the
          list.
      c. If all certified vendors cannot accommodate the request, contact the Coding Vendor
          Project Coordinator.

 4. The facility should notify a Regulatory Compliance Support Coding Manager of review dates
    including the exit conference.

 5. Final reports must be submitted to the facility or other requester and copied to the Vendor
    Project Coordinator by the vendor as agreed upon with the Work Order/Provider Agreement
    within 30 days after the completion of an engagement.

 6. The facility must keep the Work Order and all supporting documentation (e.g., record pull lists,
    review logs) to verify appropriate billing by the vendor.

 7. Payment to a vendor for services rendered shall be handled by the accounts payable department
    of the facility, Market Division, Group, or Corporate Department requesting the services.

 8. Unresolved concerns regarding the vendor should be communicated to the Materials
    Management Customer Service Call Center at 800-265-8422.
       a. Unresolved concerns regarding coding recommendations will be forwarded to the
          Vendor Project Coordinator for resolution.
       b. Unresolved concerns regarding contract issues will be handled by the National
          Agreements contact for resolution.

 SECTION II: Request to Certify a Vendor
 1. The Regulatory Compliance Support Department is responsible for approving all vendors and
    maintaining the certified vendor list. Any facility, Group, Division, Market, or Corporate
    Department wishing to use a vendor not on the certified vendor list to perform external coding
    reviews must perform the following procedure before making review engagement
    arrangements. In addition, vendors requesting to be added to the certified list must contact the
    Coding Vendor Project Coordinator. The facility, Group, Division, Market, or Corporate
    Department must submit a written request to the Vendor Project Coordinator stating the vendor
    name, address, contact person and the reason they are requesting to use the vendor.
1/2009
 DEPARTMENT: Regulatory Compliance               POLICY DESCRIPTION: Certified External
 Support                                         Vendors for Coding Reviews and Related
                                                 Education
 PAGE: 3 of 3                                    REPLACES POLICY DATED: 4/16/99, 8/1/00,
                                                  6/1/02, 3/1/04, 11/30/04 (HIM.COD.011), 3/6/06,
                                                  RETIRED 11/3/09 (replaced by REGS.COD.017)
 EFFECTIVE DATE: January 1, 2009                  REFERENCE NUMBER: REGS.COD.011


 2. Direct requests from vendors to become a certified vendor must be submitted in writing to the
    Vendor Project Coordinator. Direct requests will be considered during open bid periods only.

 3. Upon successful completion of contract negotiations, the facility or other requester of a vendor
    review will be notified and a contract may be initiated.

 4. Regulatory Compliance Support will update the Certified Vendor for Coding Reviews Policy
    and Procedure and all attachments as changes occur and communicate these changes throughout
    the Company following the policy and procedure revision process.




1/2009
                                               ATTACHMENT A

                      PROVIDER AGREEMENT FOR CODING REVIEW SERVICES

                                        HCA Management Services, LP
                                             Services Agreement
                                       Vendor ______________________
                                        Date______________________
Vendor:



Provider:



1.        The above named “Vendor” hereby agrees to provide to the above named “Provider,” an
          affiliate of HCA Management Services, LP (“HMS”), coding review services (“Services”) in
          accordance with the terms of the Business Office Services Agreement between Vendor and
          HMS dated ________, ___ (“Service Agreement”).

2.        Vendor agrees to provide Services in accordance with the following schedule:

          Services Commencement Date:

          Services Conclusion Date
          (i.e., date of exit conference):

          Location:                          On Site at Provider ___________
                                             Off Site on Vendor’s premises ___________

          Type of Review Services:           Inpatient     ________
                                             Outpatient    ________

          Bill Status:                       Pre-bill      _________
                                             Post-bill     _________

          Sample Type:                       Random      _________
                                             Focused     _________
                                             Combination _________

          Review Frequency:                  Preliminary   _________
                                             Concurrent    _________
                                             Bi-monthly    _________
                                             Quarterly     _________
                                             Other         _________


                                                                                Attachment to REGS.COD.011
      Other Parameters (if applicable):

      Are HCA Regulatory Compliance Support reporting tools &
      template required?         Yes    ________
                                 No     ________



      Estimated Sample Size: _______________________



      Final Report Delivery Date:       ________________________



      Are review logs, worksheets, and
      other papers to be included with
      final report?                  Yes      ________
                                     No       ________

3.    Provider shall pay Vendor based on the total number of charts reviewed according to the
      fees set forth in Attachment A in the Services Agreement. Provider shall also pay the
      Vendor pre-approved expenses incurred in provide Services. All fees and expenses must
      be paid no later than sixty (60) days from the conclusion of the Services performed and
      delivery of the Final Report. Fees and approved expenses may be paid:

              _____in a single lump sum, or
              _____in installments according to the following schedule:

                               Date                 Amount
                               ______               _______
                               ______               _______

4. Report shall be sent to: __________________________________
                                  __________________________________
                                  __________________________________


         Copy to:              Coding Vendor Project Coordinator
                               Regulatory Compliance Support
                               One Park Plaza
                               PO Box 550
                               Nashville, TN 37203




                                                                          Attachment to REGS.COD.011
5.    Invoices shall be sent to:
                                   __________________________________
                                   __________________________________
                                   __________________________________

6.    Key Person(s) include the following individuals:
                                __________________________________
                                __________________________________
                                __________________________________

7.    Notices to Provider shall be sent to the following:
                                 __________________________________
                                 __________________________________
                                 __________________________________
                                 ATTN: ___________________________

8.    A copy of this completed Provider agreement in its entirety shall be sent to:

              Coding Vendor Project Coordinator
              Regulatory Compliance Support
              One Park Plaza
              PO Box 550
              Nashville, TN 37203

9.    Anticipated Vendor Expenses:

      Items                              Amount

      ________________________           _________

      ________________________           _________

      ________________________           _________

      ________________________           _________

10.   All terms, conditions and fees in the Agreement, shall be applicable to this Provider
      Agreement and are incorporated by reference, and together constitute the entire
      understanding between the parties with respect to the subject matter hereof. This
      Agreement may not be modified except pursuant to an amendment expressly stating a
      purpose to amend the terms of this Agreement, and signed by authorized representatives
      of both parties hereto.

11.   If this Provider Agreement is in effect when Provider is either sold to an unrelated third
      party or its shares of stock (or the shares of stock of its parent corporation) are spun off to
      shareholders of HCA Inc., this Provider Agreement and all rights and obligations of



                                                                             Attachment to REGS.COD.011
      Provider and Vendor under this Provider Agreement shall continue to remain in effect in
      accordance with the terms and conditions herein.

12.   This Agreement shall not be effective until signed by authorized representatives of both
      parties and fully executed copies of such are delivered to each party.
      VENDOR                               PROVIDER



      By:                                  By:

      Name:                                Name:

      Title:                               Title:

      Date:                                Date:




                                                                       Attachment to REGS.COD.011

				
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