Explanation
Background:
The City of Columbus recently solicited responses to a formal Request for Proposal for a third party medical and dental claims audit: to identify potential claims payment errors by United Health Care of Ohio (UHC) and Aetna respectively; recover overpayments; and ensure plans are administered in accordance with negotiated contracts. Employee Benefits and Risk Management conducted an analysis of responses, from local and national companies, to assess their ability to perform an electronic screening and analysis, and a claims administration statistical sample field audit. A number of factors were considered including the companies' fee structure, experience in the audit industry, and reporting capabilities. Claim Technologies, Inc. (CTI) was selected to provide an audit of medical and dental claims for the period of October 1, 2004 through September 30, 2006 due to its ability to perform a comprehensive audit at the lowest audit fees.
Six vendors responded to the formal RFP. The committee evaluated all candidates using the criteria set forth in Columbus City Code 329.12.
This ordinance is being requested as an emergency measure to expedite the audit.
Contract compliance number is 42-1414040.
Fiscal Impact:
To enter into contract with Claim Technologies, Inc (CTI). The maximum obligation for this contract will include an audit fee of $69,500 that includes all expenses. Payments will be made from the Employee Benefits Fund in the Human Resources Department.
Title
To authorize the Director of the Department of Human Resources to enter into contract with Claim Technologies, Inc. (CTI) to provide the City of Columbus an audit of UHC medical claims and Aetna dental claims and to authorize the expenditure of $69,500 that includes all expenses; and to declare an emergency. ($69,500)
Body
WHEREAS, it is in the best interest of the City of Columbus to enter into a contract to provide an audit of UHC medical claims and Aetna dental claims for the time period of October 1, 2004 through September 30, 2006; and
WHEREAS, it is necessary to authorize the expenditure of $69,500; and
WHEREAS, an emergency exists in the usual daily operations of the Department of Human Resources in that it is immediately to enter into the contract and to pay the associated costs to expedite the audit, thereby preserving the public health, peace, property, safety and welfare; now, therefore
BE IT ORDAINED BY THE COUNCIL OF THE CITY OF COLUMBUS:
SECTION 1. That the Human Resources Director be and is hereby authorized and into contract with Claim Technologies, Inc. (CTI) to provide an audit of UHC medical claims and Aetna dental claims adjudicated from October 1, 2004 through September 30, 2006.
SECTION 2. That the expenditure of $69,500. from Fund No. 502, Department of Human Resources, Division No. 46-02, Object Level One 3, Object Level Three 3336, OCA 450882 is hereby authorized and directed.
SECTION 3. That for the reasons stated in the preamble hereto, which is hereby made a part hereof, this ordinance is declared to be an emergency measure and shall take effect and be in force from and after its passage and approval by the Mayor, or ten days after passage if the Mayor neither approves nor vetoes the same.