2011 006 Ordinance - Laserfiche WebLink

Home Browse Search

Cxh~b;f ~}- APPENDD{ B CLIENT ELECTIONS As set forth in the Billing Services Agreement, Client hereby directs Life Force Management on the following elections by having the official with contracting authority initial the elections selected, which elections may be changed from time to time on advance written notice to Life Force Management. AUTHORIZED COMMUNITY LIAISON OR COMMITTEE Pursuant to Section 2(H), Client shall appoint a primary liaison to Life Force that at all times will have the authority to direct Life Force on behalf of the Client ("the Authorized Liaison"). If Client establishes a Liaison Committee (i.e., comprised of members such as elected officials, community officials, Fire Department officers, and residents), Client shall designate which Liaison Committee member shall act as the Authorized Liaison to Life Force. The Authorized Liaison must review and monitor all billing disputes and procedures and meet with Life Force on a regular basis concerning billing amounts and collection procedures and at all times have the authority to direct Life Force as follows on behalf of the Client: • Refer accounts to a collection agency, • Adjust the amount of the bill, • Establish a payment program for the invoice amount, • Write off the account as "uncollectible" or, • Totally waive the bill. Client appoints the Fire Chief or his designee 2. BANKING AND DEPOSIT METHOD ELECTIONS Pursuant to Section 2(B), Client elects one of the following banking methods: (PLEASE INITIAL ONE ELECTION): Client will utilize a lockbox procedure with a bank of its choice at the sole cost and expense of the Client for the receipt of written billing inquiries, correspondence and payments. X Life Force will provide a P.O. Box at its sole cost and expense to be used as the mailing address for all Patient and Payor written billing inquiries, correspondence and payments. Life Force will deposit any payments it receives in an account in Client's name if the Client's bank so allows. Otherwise, Life Force will forward payments to Client for deposit. Client will receive all payments and correspondence at Client's address and make all deposits. Client will notify Life Force of all collections and forward all supporting documentation, including all denials and correspondence, to Life Force within five (5) days from the date of Client's receipt. REFUND POLICY