Agenda

Return

C. 60

To:	Board of Supervisors
From:	Anna Roth, Health Services Director
Date:	January 10, 2023

Contra

Costa

County

Subject:

Contract #77-317-3 with Availity, LLC

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 01/10/2023

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Ken Carlson, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	Sharron Mackey, 925-313-6104
cc:	L Walker M Wilhelm

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: January 10, 2023
Monica Nino, County Administrator

BY:	, Deputy

RECOMMENDATION(S):

APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract #77-317-3 with Availity, LLC, a limited liability company, in an amount not to exceed $1,000,000, to provide electronic claims processing services for the Contra Costa Health Plan (CCHP) and Behavioral Health Services to reimburse Providers for services provided to CCHP members for the period March 1, 2023 through February 28, 2024.

FISCAL IMPACT:

This contract will result in contractual service expenditures of up to $1,000,000 over a one-year period and will be funded 100% by CCHP Enterprise Fund II revenues. (No rate increase)

BACKGROUND:

CCHP has an obligation to provide certain specialized claim processing services for its providers under the terms of the Individual and Group Health Plan membership contracts with the County. CCHP requires the most current electronic claims processing services to CCHP Providers for expedient and accurate claims processing services for reimbursement to CCHP Providers for services rendered to CCHP members. This contractor has been providing these services since March 1, 2021.

On February 22, 2022, the Board of Supervisors approved Contract #77-317-1 with Availity, LLC, in an amount not to exceed $1,100,000, for the provision of electronic claims processing services for CCHP Providers for reimbursement of services rendered to CCHP members for the period March 1, 2022 through February 28, 2023.

On May 17, 2022, the Board of Supervisors approved Contract Amendment Agreement #77-317-2 with Availity, LLC, to modify the service plan to meet the Department of Managed Health Care (DMHC) requirements with no change in the payment limit or term.

Approval of Contract #77-317-3 will allow the contractor to continue providing electronic claims processing services through February 28, 2024.

CONSEQUENCE OF NEGATIVE ACTION:

If this contract is not approved, electronic claims processing services by a trusted and accurate contractor will not be provided to CCHP providers under contract with County.