25-15 Attachment - RevGuard Contract.pdf

To the extent that any receipts are deposited by RevGuard, they shall be segregated, held in trust for the sole benefit of the Client, and the proceeds thereof shall be immediately remitted in their entirety to the Client. 2.6 Processing Requirements. Client shall forward a copy of all call intake sheets, field paperwork and CMN’s to RevGuard, preferably on a weekly basis, which may be provided in electronic or digital formats to the extent possible. Client shall separate, identify or distinguish those trips that are being submitted for Statistical purposes only from those that are intended to be fully processed, billed and collected. For those accounts that are being presented for full processing, the trip report shall, to the extent reasonably obtainable, contain at a minimum the following information: 2.6.1 Patient Information. Patient name, complete mailing address, telephone number, age, insurance information. 2.6.2 Trip Information. Type of Service (i.e., BLS/ALS), type of call (.e., 9-1-1/scheduled transports), mileage of odometer readings, times, treatment rendered, diagnosis or chief complaint, medical condition observations and supplies used, if there were to be billed. 2.7 Rejections. In the event that a trip report is submitted without such information as is reasonably obtainable and required for submission to Payers, the trip report will be rejected and returned to Client. Field paperwork that does not adequately document medical necessity cannot be billed to Medicare. 2.8 Back-up. Client shall maintain a Copy of all trip reports forwarded to RevGuard, for the purposes of compliance with New Jersey Department of Health requirements. RevGuard shall not be held liable for any damages that are directly attributable to the Client's failure to maintain back-up information. 2.9 Liaison. Client shall designate an individual to act as liaison who will be readily available to assist RevGuard in the resolution of daily operational issues. 3