HomeMy WebLinkAboutR-2013-005 North Kansas City Hospital Agreement for Work Comp ServicesRESOLUTION NO. R — 2013 -005
A RESOLUTION AUTHORIZING AN AGREEMENT WITH NORTH KANSAS CITY HOSPITAL,
NORTH KANSAS CITY HOSPITAL OCCUPATIONAL MEDICINE CLINIC AND WORKERS'
REHAB CENTER TO SERVE AS THE EXCLUSIVE PROVIDER OF WORK- RELATED MEDICAL
SERVICES FOR THE CITY OF RIVERSIDE, EXCEPT IN CASE OF EMERGENCY
WHEREAS, the City of Riverside has an ongoing need to utilize clinic, hospital and
rehabilitation services for drug testing, pre - employment screening and work- related injuries; and
WHEREAS, proposals were received from providers of such services within a five -mile
radius of the City and after thorough evaluation, the proposal received from North Kansas City
Hospital, North Kansas City Hospital Occupation Medicine Clinic and Workers' Rehab Center was
deemed to be the most advantageous for the City; and
WHEREAS, the Board of Aldermen find it is in the best interest of the citizens of the City of
Riverside to enter into an agreement with North Kansas City Hospital, North Kansas City Hospital
Occupation Medicine Clinic and Workers' Rehab Center in substantially the form attached hereto as
Exhibit "A ";
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF ALDERMEN OF THE CITY
OF RIVERSIDE, MISSOURI, AS FOLLOWS:
THAT, the Letter Agreement by and between North Kansas City Hospital, North Kansas City
Hospital Occupation Medicine Clinic and Workers' Rehab Center and the City of Riverside,
Missouri, in substantially the same form attached hereto as Exhibit "A" is hereby authorized and
approved.
FURTHER THAT that the Mayor or Interim City Administrator are authorized to execute the
Letter Agreement and all documents necessary or incidental to the performance thereof, and the
City Clerk is authorized to attest to the same.
PASSED AND ADOPTED by the Board of Aldermen and APPROVED by the Mayor of
the City of Riverside, Missouri, theW8ay of January, 2013.
e
A ST !
Rpbin.LittreB, y Clerk
Mayor Kathleen L. Rose
Approved as to Form:
N clr KpOn,
01/21/2013 16:09 8166912000 PAGE 02/03
2800 Clay Edwards Drive
North Kansas City, MO
64116 -3220
Letter of Agreement
North Kansas City Hospital (the "Hospital ") and North Kansas City Hospital
Occupational Medicine Clinic (the "Clinic ") and Workers' Rehab Center
( "Workers' Rehab ") agree to provide a work- related continuum of emergency,
medical and rehabilitation services to employees of the City of Riverside (the
"Company ").
It is agreed that work - related injuries suffered by employees of the Company
will be billed at a 35% reduction off the Hospital's usual and customary charges
for the services listed below when such services are medically indicated. The
Company agrees to use its best efforts to use the complete work - related
continuum of care offered by the Hospital, the Clinic and Workers' Rehab.
Company shall not be in breach of this agreement by utilizing the services of
another provider in the event of an emergency of other unforeseen
circumstances.
Scope of Services Included
Services subject to the discount off charges include North Kansas City Hospital's:
• Emergency Department services, including all ancillary services;
• Inpatient and Outpatient services related to the worker's initial injury
provided care is initiated as a followup to a North Kansas City Hospital
Emergency Department visit or a North Kansas City Hospital
Occupational Medicine Clinic visit.
Scope of Services Excluded
Services excluded from the discount include:
Physician services, including but not limited to, emergency physicians,
radiologists, pathologists;
• Drug screens;
• Services provided by third -party organizations.
01/29/2013 09:35 8166912000
0112112013 =6:09 8166912000
In the event the Clinic does not offer a medically indicated service, the Company
will be eligible to receive the 35% discount on services available through and
obtained from the Hospital.
Discount Application and Release of LnEormation
The discount will be:
• applied to the Hospital's usual and customary charges in effect at the time
services are rendered;
for claims which the Companv pays directly or to the
workers'compensation u-isurec if t1 he Company is self - insured;
• applied only if the employee informs the Hospital (at the time services are
rendered) of the Company name and that the employee's injuries are job -
related.
In order to release information about the employee's injury to the Company, the
employee must sign a release of information authorization at the time of service.
Term of reem
The Agreement term is three years with an automatic annual renewal. Should
either party seek termination of the Agreement, notification must be made to the
parties below with a 30 day advance notice.
SEEN AND AGREED TO:
North Kansas City Hospital, Occupational
Title: Vice President - Finance do CFO
Date:
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Print Name; Ure i 5
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Date: - Z . 3 01
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Print Name: lim McNey