To: Board of Supervisors
From: Dr. Ori Tzvieli, Interim Health Services Director
Report Title: Contract #23-867 with Inovalon Provider, 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 (1) a Software and Service Agreement and (2) an Order Form with Inovalon Provider, Inc., a corporation, in an amount not to exceed $52,000, for Medicare eligibility data management software and services for Contra Costa Health (CCH) for the period from June 10, 2025 through June 09, 2028 through March 31, 2027, and for successive twelve (12) month terms thereafter until terminated.
FISCAL IMPACT:
This Contract will result in contractual service expenditures of up to $52,000 over a three-year period and will be funded 100% by Hospital Enterprise Fund I.
BACKGROUND:
This Contract meets the needs of CCH by providing a data management platform and (related) services regarding Medicare eligibility verification. Inovalon One(r) Platform, Inovalon's Direct Data Entry (DDE) Verification allows access via a secure online connection for Medicare Part A providers to manage Medicare Part A claims. Inovalon One(r) Platform, a data-driven, cloud-based Software as a Service (SaaS) solution that enables healthcare organizations to improve clinical outcomes and economics by bringing together national-scale connectivity, real-time primary source data access, and advanced analytics, is utilized by CCH for Medicare eligibility verification, including claim status lookup, and online claim correction and enables enterprise usage throughout CCH registration sites, Health Information Management, Utilization Review, Contra Costa Health Plan, Financial Counseling, and Patient Billing.
Since 2016, these services have been procured via Purchase Order (prior PO #029209 FY2023-2024) in compliance with County Administrative Bulletin AB600.3. Section...
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