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4 a. <br />� 1, <br />pow'IndapvndaiF kevlilrmrm s . <br />a. NaphCare will be responsible for billing the responsible contract agency for off -site treatment, <br />As previnus €y mentioned, NaphCarewiil flag an inmate's electronic medical record upon Intake to <br />Indicate their status with a specific contract agency, Le. ICE, US Marshal, These flags within the <br />system ensure out ability to Identify where an inmate came from in order to expedite further medical <br />information Ina timely manner and track designations separately for ease of billing, Wetrackthese <br />inmates to ensnare appropriate financial liability for off -site medical services Within TechCore' off -site <br />claims are separated based on dassificationides gnation and forwarded to the appropriate entity for <br />payment. We have valuable experience in this form of billing; we perform this service for several of our <br />client ]ail facilities and provide extensive balling services to our Federal Bureau of Prisons clients, <br />Please see Exhibit C under Required Forms for details on cost of billing services. <br />NAPHCARE'S CLAIMS ADJUDICATION <br />SERVICES <br />NapnCare's Claims Department has the <br />V NaphCare's Clai si Departmentaai]udnates <br />latest technology available in the market <br />'" elean claims" within an average of4S hours. ' <br />today, which enables our staff to handle <br />your claims In the most efficient manner. <br />✓ Average cost savings on re- priced clalma are <br />The accurate and rapid processing of <br />0% off usual and customary charges; <br />claims is a fundamental part of keeping <br />costs down, and It also maintains our <br />V Promptturnaround time with Pon- <br />posltive relationships with community <br />electronically received claims keyed within 24 <br />providers, hospitals, and specialists. We <br />hours., <br />ensure timely payments, accurate <br />evaluation of claims based on approved <br />services, and payments on claims only for inmates <br />that are eligible at the time of service. <br />Our Director of the Claims Department, Lee Williams, has over 24 years of experience in claims <br />management, including i years with McKesson, where she managed a departmentt hat processed over <br />400,000 claims per year, WilIlams currently manages NaphCare's claim's department of over 30 <br />employees Dedicated to customers ervice, NaphCare assigns each of our clients a Point of Contact <br />(PQC) who is familiar with their facility, preferred provider network., and unique needs bur clients get <br />fast answers and knowledgeable assistance. <br />Cliti s Processing System <br />Our methods for processing claims and hospital /provider discounts focus' -on listening to clients' needs. <br />We adhere to high standards of accountability and quality that set us apart from the competition, All <br />claims are reviewed for accuracy and proper treatment, as well as correct coding and billing. <br />Claims are acijuditated using the software system McKesson, Managed Care Optimization (h CO), <br />specifically designed for the managed care industry, We pay claims promptly and accurately by applying <br />all applicable payment rules; Through this system, the submitted claims are correctly analyzed for <br />accuracy. <br />MCQ, linked with the EMR system TecahCorer", is the perfect combination to manage inmate eligibility <br />and ensure that only claims on eligible inmates are paid, Information from the client's inmate <br />management system goes through the EMhsystemtoMCO. The integration ofMCO and TechCare'"" <br />Inmate Medical Services <br />City of Santa Ana <br />25H -79 <br />RrP No. 14-034 <br />7S <br />