CCR2005213.
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COMMON COUNCIL - CITY OF MUSKEGO
RESOLUTION #213-2005
APPROVAL OF SERVICE AGREEMENT BETWEEN
THE CITY OF MUSKEGO AND
NATIONAL EMS BILLING, INC.
BE IT RESOLVED That the Common Council of the City of Muskego, upon the
recommendation of the Finance Committee, does hereby approve the attached Service
Agreement between the City of Muskego and National EMS Billing, Inc. for ambulance
billing services.
BE IT FURTHER RESOLVED That the Mayor is authorized to execute the Service
Agreement in the name of the City.
DATED THIS 22nd DAY OF November ,2005.
SPONSORED BY:
FINANCE COMMITTEE
Ald. Bob Melcher
Ald. Nancy Salentine
Ald. Eileen Madden
This is to certify that this is a true and accurate copy of Resolution #213-2005 which
was adopted by the Common Council of the City Of./,USk~90.
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Cle -Treasurer
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SERVICE AGREEMENT
AGREEMENT made this day of _ ,2005 by and between
NATIONAL EMS BILLING, INC. a Wisconsin corporation, (NEB), and
(Client);
Whereas NEB is a company engaged in the service of handling billing and insurance
claim submittals; and
Whereas, the Client requires that type of service and wishes to retain NEB;
Now, Therefore, for good and valuable consideration, the parties agree as follows:
1. TERM AND RENEWAL: The parties agree that the term oftbjs Agreement shall be for
A period of twelve (12) months unless tenninated as herein provided. The parties agree that
this agreement shall be automatically renewed upon its expiration date for an additional twelve (12)
month period unless either party shall submit, within sixty (60) days of the expiration date, a written
notice to terminate. This Agreement may be canceled at any time during the teÍín ofthis Agreement or
any renewal thereofby either party by giving sixty (60) days written notice.
2. COMPENSATION: NEB shall charge a fee of seven (7%) percent of the net mon:th.ly receipts
(any money received based on the original bí11ing by NEB). The amount shall be due upon receipt of
invoice from NEB. Any amount not paid within thirty (30) days after invoice shall incur a One (1 %)
Percent per month finance charge of the outstanding balance. NEB will have the exclusive right for
billing of all ambulance and rescue services performed by the Tess Comers Volunteer Fire Department
(TC Rescue), and assigned by said department to the City of Muskego for collection during the term of
this Agreement. Monies that the client receives for a period of sixty days (60) after the termination
that pertain to the covered period of the contract shall be charged at the normal service fee.
3. REPRESENTATION OF NEB: NEB will provide insurance claim submittals and monthly
patient statements. NEB will provide aging of accounts on a semi-annual basis. NEB will provide
answers to billing questions and will provide an 800 pbone service where applicable.
4. REPRFÂENTAT10NS OF CLiENT: Client agrees to direct all billing questions to NEB.
Client agrees to direct all mail, rejections, manuals and updates relating to insurance to NEB.
Client shall grant permission to NEB to negotiate payment arrangements with patients. Client
shall provide NEB on a timely basis all information necessary to bill and collect the related services.
5. OBLIGATIONS OF NEB AND CLIENT: All money and material clirected to NEB will be in the
Client's name. Client shall have a choice as to whether the money is deposited in the bank of Client or
the Client can choose to receive the money and send copies of the deposits and EOMB's to NEB. Any
patients turned over to the Credit Bureau or a collection agency shall be cleared with the Client.
6. GENERAL: Upon termination of this Agreement, copies of all run/route slip infonnation shall be
returned to the Client on whatever media is currently used if the client desires.
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7. GOVERNING LAW: This Agreement and the rights of the parties hereunder shall be interpreted
in accordance with the laws of the State of Wisconsin.
8. ENTIRE AGREEMENT: This Agreement is the entire agreement between the parties hereto
regarding the subject matter hereof. This agreement may only be amended in writiIlg signed by all
parties to the Agreement.
9. EFFECT OF THIS AGREEMENT: Except as herein expressly provided to the contrary, this
agreement and all of the tenns and provisions hereof shall be binding upon and inure to the benefits of
all of the parties, their personal representatives, heirs, sùccessors and assigns.
10. COPIES: This Agreement may be executed in one or more copies, each of which shall be for the
purposes, deemed to be an original, but all of such copies together shall constitute but one and the
same instrument.
11. ASSIGNMENT OF AGREEMENT: This agreement is not assignable by NEB.
IN WITNESS WHEREOF, the parties have set their bands and seals hereto as of the date fIrst above
written.
NATIONAL EMS BILLING, INC.
BY:
(NEB)
(CliENT)