Inter-Departmental Correspondence

Health System



March 16, 2010


April 13, 2010







Honorable Board of Supervisors


Jean S. Fraser, Chief, Health System
Susan Ehrlich, MD, MPP, Chief Executive Officer
San Mateo Medical Center


Agreement with Provencio Advisory Services, Inc.



Adopt a Resolution:


Waiving the Request for Proposals process; and



Authorizing the President of the Board to execute an Agreement with Provencio Advisory Services to provide an interim Reimbursement Manager for San Mateo Medical Center for the term March 1, 2010 through February 28, 2011, for a maximum fiscal obligation of $200,000; and



Authorizing the Chief of the Health System or designee to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000 (in aggregate), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.



The Reimbursement Manager at San Mateo Medical Center (SMMC) retired. The position of Reimbursement Manager is one of great importance to SMMC and continuity of the function is critical to assure a continued flow of revenue.



There have been significant changes within the Finance Department recently. These changes have included the placement of several new managers, including the CFO. While the new CFO works to realign and improve the functionality of this department it is imperative that the work generated by the reimbursement manager continue.


Provencio Advisory Services, Inc. (Provencio) has extensive experience in the field of healthcare consulting and finance. Specific to SMMC, Provencio can provide the needed depth of experience in areas such as quality assurance, third party settlement, and patient accounts receivables.


A waiver of the Request for Proposals (RFP) process is requested to provide a continuity of coverage for the responsibilities of the Reimbursement Manager while giving Human Resources time to review the classification and complete the recruitment process. Provencio is recommended because of their known quality, experience and abilities in working with SMMC’s Invision patient accounting system and because of their ability to do the work needed to be undertaken before the Reimbursement Manager is hired. Specifically, they will build the model for support of the SMMC patient Accounts Receivable balances in relation to the contractual allowances owed by third-party payors for services to patients. The contract contains a thirty-day cancellation clause to allow early termination should that be necessary or desirable.


The Agreement has been reviewed and approved by Risk Management. The Resolution and Agreement have been reviewed and approved by County Counsel as to form. The contractor has assured compliance with the County’s Contractor Employee Jury Service Ordinance, as well as all other contract provisions that are required by County ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.


Approval of this Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing accurate reporting to government entities and estimating of the financial allowances and reserves used in support of the care-giving activities of SMMC. It is anticipated that 100% of all reports and estimates will be completed within the required reporting period.


Performance Measures:


FY 2008-09

FY 2009-10

Percentage of all reports and estimates completed within required reporting period





The term of the Agreement is March 1, 2010 through February 28, 2011. The maximum fiscal obligation under the Agreement is $200,000. Funds in the amount of $30,000 are included in the SMMC FY 2009-10 Adopted Budget. Funds in the amount of $170,000 will be included in the SMMC FY 2010-11 Recommended Budget.


Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medically indigent or to those covered by programs that do not meet the full costs of care are covered by the County’s General Fund contribution to SMMC.