HomeMy Public PortalAboutAddendum No. 1 to Contract No. 81 & 82-2016 - City - Reid HospitalADDENDUM TO
AGREEMENT FOR PAYMENT OF HEALTH CARE SERVICES CLAIMS
And
HEALTH CARE SERVICES AGREEMENT
This Addendum to Agreement for Payment of Health Care Services Claims
and Health Care Services Agreement is entered into this day of August,
2016 between Reid Hospital & Health Care Services, Inc ("Reid Health") and the
City of Richmond ("City")
WHEREAS, Reid Health and the City entered into an Agreement for Payment of
Health Care Services Claims effective July 22, 2016 which provided for the
payment of health care services provided between January 1, 2015 and May 31,
2016;
WHEREAS, contemporaneous with the Agreement, the parties also entered into a
Health Care Services Agreement which provides for the payment of health care
services provided between June 1, 2016 and December 31, 2016;
WHEREAS, the City would like to provide additional assistance to its health plan
beneficiaries for the period of June 1, 2016 through August 31, 2016;
NOW THEREFORE, in consideration of the mutual promises and covenants
contained herein, the parties agree as follows:
1. Claims with a date of service of June 1, 2016 through August 31, 2016, will
be adjudicated using the pricing structure set forth in the Health Care
Services Agreement. Those claims will be re -priced by ELAP on the same
basis as the pre -June 1, 2016 claims, and an EOB will be generated which
will establish a patient portion.
2. Benefits Administrative Systems, LLC (BAS)/Group & Pension
Administrators, Inc. (GPA) will issue payment to Reid Health on the repriced
EOB.
Addendum No. 1 to
Contract No. 81-2016 and 82-2016
3. The City will pay to Reid Health, the difference between the bill issued by
Reid Health for the services, and the payment received by Reid Health from
BAS/GPA, less the patient's portion. The patient will remain responsible for
the patient's portion as shown on the EOB.
4. Reid will issue an invoice on or about September 30, 2016 for the amount
owned by the City as a result of the payment by BAS/GPA of less than the
billed amount.
5. It is the intent of the parties that for claims with a date of service of June 1,
2016 through August 31, 2106, Reid will bill those claims pursuant to the
Health Care Services Agreement, and Reid will be paid in full, subject to the
patient's payment or non-payment of the patient portion.
6. Claims with a date of service September 1, 2016 and after will not be
subject to any repricing of any kind but will be billed and paid pursuant to
the terms of the Health Care Services Agreement.
REID HEALTH
By:
Title: Craig C. Kinyon, President/CEO
Date: August 'Z- / , 2016
CITY OF RICHMOND, INDIANA
BOARD OF PUBLIC WORKS AND
Title: President
Date: August l8 , 2016
Approved:
David M. Snow
Title: Mayor
Date: August 1 1 1 2016