Agenda

Return

C. 50

To:	Board of Supervisors
From:	Anna Roth, Health Services Director
Date:	May 17, 2022

Contra

Costa

County

Subject:

Amendment Agreement #77-317-2 with Availity, LLC

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 05/17/2022

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
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	Sharron Mackey, 925-313-6104
cc:	Noel Garcia Marcy 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: May 17, 2022
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 Amendment Agreement #77-317-2 with Availity, LLC, a limited liability company, effective June 1, 2022, to amend Contract #77-317-1, to modify the service plan to meet the Department of Managed Health Care (DMHC) requirements to continue to provide Contra Costa Health Plan (CCHP) and Behavioral Health Service Providers and members with electronic claims processing services, with no change in the original payment limit of $1,100,000, and no change in the original term of March 1, 2022 through February 28, 2023.

FISCAL IMPACT:

Approval of this amendment will not impact the payment limit of the contract or rates.

BACKGROUND:

CCHP has an obligation to provide certain specialized claim processing services for its Providers under the terms of their 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 the amount of $1,100,000, for the provision of electronic claims processing services for CCHP and Behavioral Health Services to reimburse Providers for services rendered to CCHP members for the period from March 1, 2022 through February 28, 2023.

Approval of Contract Amendment Agreement #77-317-2 will not increase the payment limit or the term of the contract and will allow the contractor to continue providing electronic claims processing services, while helping the provider meet the DMHC requirements through February 28, 2023.

CONSEQUENCE OF NEGATIVE ACTION:

If this contract is not approved, electronic claims processing services will not be provided to CCHP Providers under contract with the County.