BACKGROUND:
The Sourcing Group/Tully Wihr has been a long-time vendor supporting CCRMC with the design, type setting, printing, inventory, and distribution of forms supporting our clinical departments. Since the Sourcing Group maintains our form templates for our patient record documentation, they are able to perform the necessary revisions quickly and accurately to meet regulatory requirements dictated by the Center for Medicare and Medicaid Services (CMS) for Medical Review coding/billing revisions, etc. Relevant patient information must be documented and made available pre- and post-payment for claim review determination. These completed forms contain all the pertinent documentation required for providing a clear picture of the patient’s treatment and claim history.
It was discovered that the Sourcing Group had provided CCHS with three-hundred and sixty-three (363) invoices requiring corrections due to the change in the tax rate. The outstanding invoices had not been revised and updated invoices were not received until April 2022, however, The Sourcing Group/Tully Wihr continued to provide support.
Due to the aforementioned delays the vendor was not paid by CCRMC for services provided in good faith. Therefore, CCRMC has determined that The Sourcing Group/Tully Wihr is entitled to payment for the value of the services provided under the equitable relief theory of quantum meruit. The theory provides that when a vendor has been asked to provide services without a valid purchase order or agreement, and the vendor does so to benefit the recipient, the vendor is entitled to recover the reasonable value of those services.
CONSEQUENCE OF NEGATIVE ACTION:
If this action is not approved, Contra Costa Regional Medical Center will be unable to pay Sourcing Group/Tully Wihr, a sole source provider, for services provided in good faith. Without their assistance, CCRMC would not have the medical forms and templates required to meet regulatory requirements dictated by the Center for Medicare and Medicaid Services (CMS).