Interim To: Board of Supervisors
From: Dr. Ori Tzvieli, Interim Health Services Director
Report Title: Amendment Agreement #23-878 with Experian Health, Inc.
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Interim Health Services Director, or designee, to execute on behalf of the County Amendment Agreement #23-878 with Experian Health, Inc., a corporation, in an amount not to exceed $2,000,000 for electronic claims and remittance software and services for Contra Costa Health (CCH) for the period June 30, 2025 through June 9, 2030, and for successive 12-month terms thereafter until terminated.
FISCAL IMPACT:
This Amendment Agreement will result in contractual service expenditures of up to $2,000,000 over a five-year period and will be funded 100% by Hospital Enterprise Fund I.
BACKGROUND:
This Amendment Agreement meets the needs of CCH by providing an electronic claims and remittance software and services solution. Since 2001, CCH Patient Accounting has used Experian Health revenue cycle products to simplify claims processing and expedite receipt of payments. Experian Health offers solutions like the ClaimSource Claims Management System, which automates and streamlines the claims process for healthcare providers. This system helps reduce denials, increase revenues, and manage the entire claims cycle efficiently. It includes features like customizable edits, error checking, and integration with electronic medical records systems.
On October 11, 2022, the Board of Supervisors approved, and the Purchasing Services Manager executed, a purchase order with Experian Health, Inc., in an amount not to exceed $906,060 for the provision of a software subscription to Experian’s Electronic Claims and Remittance Systems Software, for the period July 1, 2022 through June 30, 2025.
This Contractor was approved by the Public Works Department’s Purchasing Division on March 12, 2025. Contra Costa Health will monitor measurable service contract deliverables with outcomes required of the Contractor. Access to the subscribed services (such) as ClaimSource Claims Management System will be monitored by the department in compliance with Section III(B)(7) of the Purchasing Policy. This Amendment Agreement was approved by CCH Personnel to ensure no conflict with labor relations.
Under this Amendment Agreement #23-878, the parties will execute an amendment to redocument County’s access to existing and new product concerning Experian Health’s ClaimSource Claims Management System. Under the agreement, Experian Health Inc’s liability is limited to the amount County has paid to Experian Health in the twelve months preceding the claim.
Approval of this Amendment Agreement #23-878 allows (approves funds) for the Contractor to provide services through June 9, 2030. Thereafter, the Amendment Agreement renews for successive twelve twelve-month terms until terminated under the agreement.
CONSEQUENCE OF NEGATIVE ACTION:
Failing to renew the subscription to Experian Health could lead to challenges like increased manual work, higher claim denial rates, slower reimbursements, and reduced operational efficiency. Without tools like ClaimSource, the department may also miss out on valuable analytics and dedicated support, which are critical for streamlining the claims process and managing payer compliance effectively.