Coding Service Schedule
CONFIDENTIAL
1. Coding Services. Subject to the terms of this Service Schedule, if Customer has purchased the Coding Services, Company will assign billing codes to each patient visit on the basis of the clinical information and documentation provided by Customer for such visit (the “Coding Services”). Company Coding Services will be performed by certified coders located outside of the United States and will include the assignment of ICD and CPT codes, procedural modifiers and HCPCS codes and regulatory modifiers. All coding services shall conform to currently applicable and published rules and guidelines issued by the American Medical Association, the Centers for Medicare and Medicaid Services, and/or other copyright owners of coding formats. Coding Services shall be incorporated into the RCM Services provided pursuant to the RCM Service Schedule. Company is expressly relieved of any obligation to perform Coding Services if:
a) Complete and legible documentation to support the assignment of codes has not been supplied by Customer;
b) The code(s) to be assigned are not adequately supported by the documentation supplied;
c) Clear and unambiguous coding rules and/or guidelines are not available or are in dispute; or,
d) The identity of the provider of services for whom coding shall be performed is missing or uncertain.
2. Customer Review. Customer shall regularly review the Coding Services being provided by Company. To the extent that Customer identifies any errors in the Coding Services, Customer shall immediately notify Company of such errors and cooperate with Company in the remediation of such errors including, but not limited to, Customer refunding any amounts it received based on the inaccurate or improper assignment of codes.
3. RCM Bundled Fee. Each month during the term of this Coding Service Schedule, the RCM Bundled Fee shall be equal to the RCM Minimum Fee plus the Coding Services Fee. The RCM Minimum Fee and the Coding Services Fee are set forth in the Order Form. All other charges and fees set forth in the RCM Service Schedule shall apply.
4. Limitations of Liability. CUSTOMER’S SOLE AND EXCLUSIVE REMEDY FOR ANY ERROR IN THE CODING SERVICES IS COMPANY’S RE-BILLING OF THE CLAIM WITH THE PROPER CODES. NOTWITHSTANDING ANYTHING HEREIN TO THE CONTRARY, FOR THE CODING SERVICES PROVIDED HEREUNDER, COMPANY’S AGGREGATE LIABILITY TO CUSTOMER ARISING FROM OR RELATING TO THIS CODING SERVICE SCHEDULE (REGARDLESS OF THE FORM OF ACTION OR CLAIM) SHALL NOT IN ANY EVENT EXCEED AN AMOUNT EQUAL TO THE CODING SERVICES FEE PAID BY CUSTOMER TO COMPANY DURING THE THIRTY DAYS PRECEDING THE EVENT GIVING RISE TO THE CLAIM. This Section shall survive termination of the Service Schedule and Agreement.
