PSA - Memorial Hosp of South Bend - Ambulance Staffing Agreement

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Memorial, whichever is applicable. (i) The parties agree to meet quarterly to ensure competency, driver proficiency, and other such training issues as are necessary to the intent and purposes of this agreement. 4. Responsibilities of the Parties with Respect to Billing Patients Served by the Children's Hospital Ambulances. As compensation for services provided by SBFD pursuant to this Agreement, Memorial shall pay to SBFD a fee of Twenty -Four Thousand Nine Hundred and Fifty Dollars ($24,950) per month for calendar year 2017. Subsequent years this agreement is in force the annual rate increases will generally be 2% and shall not exceed 4% in any given year. The actual amount of increase for the upcoming year will be provided via written notification no later than November in the preceding year of the increase. Increases will take effect on the first day of the calendar year and remain effective for the entire calendar year. Payments shall be made on a monthly basis and shall be due on the tenth (1 Oth) day of each month for as long as this Agreement remains in effect. In addition to the monies received from Memorial, SBFD, or such other department of the City of South Bend as shall be properly designated, shall bill to the patient or the patient=s representative appropriate fees for the operation of the Children's Hospital Ambulance and mileage applicable in the amount set forth in Ordinance 9887-08, which is attached hereto and incorporated by reference as Exhibit A. Any changes in billing shall be approved by Memorial. SBFD shall use its best efforts to collect all appropriate fees. If the amount collected by SBFD in any of the 6 month periods of April through September OR October through March exceeds $65,000, that excess will be paid to Memorial within 90 days (December 31 or June 30 of the respective year). If the amount collected during the 6 month periods of April through September OR October through March fails to meet the $25,000 threshold, SBFD shall notify Memorial in writing by December 15 or June 15 of the respective year of the amount of shortfall and Memorial shall reimburse SBFD for the shortage within 30 days after the notice. SBFD will provide itemized collection and billing report to the Ground Transport Director for each Memorial owned ambulance that includes: Date of Service, Pick up facility, drop off facility, Base amount billed, and mileage billed, and total outstanding billed and total amount collected efforts every 60 days. Memorial agrees to work with SBFD to develop this report. With 30 days' written notice, Memorial shall have the option to remove the Billing practice from the SBFD with no change in contractual monthly (base) rates or repair rates. In the event that Memorial removes the billing ftom SBFD, Memorial agrees to pay, upon invoice, $200 per completed transport. The monthly invoice will specify the number of transports for which the invoice is submitted and will only include transports from the billed month. Any patient transported from airport to hospital or hospital to airport will count as a completed transport for billing purposes. 10