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HomeMy WebLinkAboutResolution #3517r RESOLUTION NO. 3517 A RESOLUTION APPROVING AN AGREEMENT BETWEEN THE CITY OF CANTON AND GRAHAM HOSPITAL CONCERNING A PREFERRED HOSPITAL AGREEMENT FOR OUTPATIENT AND INPATIENT HOSPITAL SERVICES WHEREAS, the City Council of the City of Canton, Illinois has reviewed the terms of the Agreement, a copy of which is attached hereto and made a part hereof as Exhibit A; and, WHEREAS, the City Council of the City of Canton, Illinois has determined that it is in the best interest of the City of Canton to approve said Agreement. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF CANTON, Fulton County, Illinois as follows: 1. That the Agreement which is attached hereto and made a part hereof as Exhibit A, is hereby approved, said agreement to be subject to and effective pursuant to the terms and conditions set forth therein. 2. That the Mayor and City Clerk of the City of Canton, Illinois are hereby authorized and directed to execute and deliver said Agreement on behalf of the City of Canton. 3. That this Resolution shall be in full force and effect immediately upon its passage by the City Council of the City of Canton, Fulton County, Illinois and approval by the Mayor thereof. PASSED by the City Council of the City of Canton, Fulton County, Illinois, at a regular meeting this 18th day of April ~ 2000, upon a roll call vote as follows: AYES: Aldermen May, Shores, Meade, Nidiffer, Phillips, Sarff, Hartford. NAYS: None . ABSENT: Alderman Molleck. AP OVED: Donald E. dwards, Mayor Attest: Nancy Whites City Clerk 03i14i00 19:15 3096740621 MiiTUALMEDICAL 309b740b21 03/14 '00 1b:37 No.925 01/Ob PREFERRED HOSPITAL AGREEMENT `" 7' THIS AGREEMENT is executed this April, 2000, by and between City of Canton. herein referred to as ("Employer") and Graham Hospital, hereinafter referred to a,. ("Hospital"). WITNESSF_TH: WHEREAS, the Employer provides a health care insurance plan for employe~~s for outpatient and inpatient hospital services; and WHEREAS, the Hospital represents that it leas qualified personnel and adequatE facilities to pertorm such outpatient and inpatient services for employees; and WHEREAS, the Employer is willing to designate the Hospital as a pref~;rrcd member hospital under its prepaid health care plan, pursuant to this agreement; NQW, THEREFORE, the Employer and the Hospital agree as follows: 1. Ths Hospital agrees to provide hospital services to employees, upon request anc under the following terms and conditions; (a) The Hospital shall charge its standard rates. The Hospital shall give a 18% discount on eligible Employer Health f3enefrt Plan charge;; for inpatient and outpatient charges. (b) The discvunt described above will only apply when the Employer's Plan is the primary insurance carrier for the membar. Charges for services for which the Employer's Plan acts as a secondary insurance carrier will be handled under the applicable coordination of benefits provisions. {c) The Hospital will use its best efforts to control and monitor th~~ utilization of its resources and services. The Hospital will provide the Employer all records requested, when authorized by employee, for review of resource utilization. Ml1TUALMED]LCAL 309b740b21 03/14 ' 00 16:37 N0.925 02/06 2. The Employer agrees: (a) To inform employees in the area served by the Hospital of tlit availability of the Hospital for services. (b) To remit payment to the Hospital for eligible services within 30 days from the receipt of valid claim. Claims for which questions of eligibiiifi~ of medical justification are unresolved or for which additional information is needed before final approval or denial can be made sh~•~II not be considered "valid" unless and until such approval is granted. (c) To furnish each employee with identification to present to the Hospite~l. Additionally, the Employer will provide the Hospital with facsimiles ~~` the identification materials issued to employees and will notify the Hospital of any changes made in the form of identification. 3. The Hospital agrees that Employer will not be responsible fo-• any charges, costs, or expenses for any services provided to any patient who fails to provide the Hospital with appropriate identification as an employee. 4. CONFIDENTIALITY -This proposal is contingent upon the understanding and agreement that Employer will not share tl~e concepts or specifics contained herein with any other organiz~:tivn or person with the exception of the Pian Administrate or employee. 5. PERM AND TERMINATION (a) This contract will automatically renew at the end crf contract year, unless terminated per 5(b} below. 2 MUTUALMEDICAL 3096740b21 03/14 '00 16:37 N0.925 03/Ob (b) In the event that either party would like to cancel thris agreement, the agreement may be terminated by giving 90 days notice prior to contract year end. IN TESTIMONY WHEREOF, the parties hereto have caused this a~~reement to be executed by their duly authorized officers as of the day and year first above written. City of Canton Graham Hospital BY: BY: TITLE: TITLE: 3 PREFERRED HOSPITAL AGREEMENT THIS AGREEMENT is executed this April ~~'''~2000, by and between City of Canton, herein referred to as ("Employer") and Graham Hospital, hereinafter referred to as ("Hospital"). WITNESSETH: WHEREAS, the Employer provides a health care insurance plan for employees for outpatient and inpatient hospital services; and WHEREAS, the Hospital represents that it has qualified personnel and adequate facilities to perform such outpatient and inpatient services for employees; and WHEREAS, the Employer is willing to designate the Hospital as a preferred member hospital under its prepaid health care plan, pursuant to this agreement; NOW, THEREFORE, the Employer and the Hospital agree as follows: 1. The Hospital agrees to provide hospital services to employees, upon request and under the following terms and conditions; (a) The Hospital shall charge its standard rates. The Hospital shall give a 18% discount on eligible Employer Health Benefit Plan charges for inpatient and outpatient charges. (b) The discount described above will only apply when the Employer's Plan is the primary insurance carrier for the member. Charges for services for which the Employer's Plan acts as a secondary insurance carrier will be handled under the applicable coordination of benefits provisions. (c) The Hospital will use its best efforts to control and monitor the utilization of its resources and services. The Hospital will provide the Employer all records requested, when authorized by employee, for review of resource utilization. 1 2. The Employer agrees: (a) To inform employees in the area served by the Hospital of the availability of the Hospital for services. (b) To remit payment to the Hospital for eligible services within 30 days from the receipt of valid claim. Claims for which questions of eligibility of medical justification are unresolved or for which additional information is needed before final approval or denial can be made shall not be considered "valid" unless and until such approval is granted. (c) To furnish each employee with identification to present to the Hospital. Additionally, the Employer will provide the Hospital with facsimiles of the identification materials issued to employees and will notify the Hospital of any changes made in the form of identification. 3. The Hospital agrees that Employer will not be responsible for any charges, costs, or expenses for any services provided to any patient who fails to provide the Hospital with appropriate identification as an employee. 4. CONFIDENTIALITY - This proposal is contingent upon the understanding and agreement that Employer will not share the concepts or specifics contained herein with any other organization or person with the exception of the Plan Administrator or employee. 5. TERM AND TERMINATION (a) This contract will automatically renew at the end of contract year, unless terminated per 5(b) below. 2 4 (b) In the event that either party would like to cancel this agreement, the agreement may be terminated by giving 90 days notice prior to contract year end. IN TESTIMONY WHEREOF, the parties hereto have caused this agreement to be executed by their duly authorized officers as of the day and year first above written. City of Cant n Graham Hospital BY: Q~7ts~~'x ~ BY: TITLE: '`~~ TITLE: ~.,..~_ /~ ~.~.,~ 3