Inter-Departmental Correspondence

San Mateo Medical Center



October 9, 2003


October 28, 2003



Honorable Board of Supervisors


Nancy J. Steiger, Chief Executive Officer



Agreement with CHIS, Inc.



Adopt a resolution authorizing the President of the Board to execute an agreement with CHIS, Inc.



San Mateo Medical Center (SMMC) contracts for outside coding services to complete coding for inpatient and Long Term Care discharges, Emergency Department (ED) visits, and ambulatory surgery. This is to ensure appropriate payment for services. Billing regulations require that we apply ICD-9-CM/CPT codes to diagnoses activities and procedures in order to bill for services. In addition, new regulations for outpatient Medicare billing went into effect August 1, 2000. These stringent coding guidelines require that the Medical Records Department have access to the highest level of expertise in order to maximize the billing process and ensure that all state and federal regulations are met. Correct coding benefits SMMC as it has a direct impact on the amount of reimbursement the Hospital receives for services.

CHIS has provided high quality coding services to the Hospital since 1998. CHIS, Inc. codes SMMC's and the clinics' medical records' admissions and discharges using the ICD-9-CM coding system. CHIS also provides clerical support for purging and screening of medical records.



The coding contract has a major impact in maintaining the revenue collection at San Mateo Medical Center. A Request for Proposals (RFP) was conducted in July 2003. Proposals were received from CHIS, Care Communications, and Lexicode. CHIS, Inc. was selected from among the three vendors that responded to the RFP. CHIS, Inc.'s rates per procedure are lower and are fixed for the term of the agreement. In addition, CHIS, Inc. has no travel, lodging or personal expense charges. Fees are based on services provided. CHIS is the only company, of those who responded, located in California.


The request for Proposals generated a volume of questions from a number of vendors. Some issues required extensive responses involving a considerable amount of definition and clarifications regarding the medical records department coding process. This caused a delay in processing this agreement.


County Counsel and Risk Management have reviewed and approved this agreement.


Vision Alignment

This agreement with CHIS, Inc. reflects the County's commitment to Responsive, effective and collaborative government along with goal number 20: Government decisions are based on careful consideration of future impact, rather than temporary relief or immediate gain. This agreement contributes to this commitment and goal as coding has a direct impact on the amount of reimbursement San Mateo Medical Center receives and the agreement will maximize San Mateo Medical Center's billing process and ensure that all state and federal regulations are met.


Fiscal Impact

The term of this agreement is September 1, 2003 through August 31, 2006. The maximum amount of the agreement is $575,000. Funds are included in the San Mateo Medical Center's FY2003-04 Adopted Budget and will be included in future year requests.


Exhibit A


General Description of RFP

CHIS provides coding and abstracting of medical records data. This company provides certified coders approved by American Health Information Management Association.


List key evaluation criteria

    1. Cost per medical record/encounter form coded

    2. Certified Coders

    3. Past positive experience with company

    4. No travel cost


Where advertised

Not advertised


In addition to any advertisement, list others to whom RFP was sent



Total number sent to prospective proposers



Number of proposals received



Who evaluated the proposals

Deborah Pines, Medical Records Manager,

Mary Cruz, Assistant Medical Records Director

Christina Garvey, Medical Office Supervisor


In alphabetical order, names of proposers (or finalists, if applicable) and location

Care Communications Inc.

205 Wacker Drive, Suite 1900

Chicago, Illinois


74333 Highway 111, Suite #105

Palm Desert, CA 92260


P.O. Box 190

Ballentine, SC 29002