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FED 141989 <br />TREASURE COAST COLLECTIONS, INC. <br />BILLING SERVICE AGREEMENT <br />BOOK 16 F E 119 <br />This agreement is entered on this 14th <br />day of February , 1989 by and between Treasure Coast <br />Collections, Inc., a wholly owned subsidiary of Indian River Mem- <br />orial Hospital, Inc., and Indian River County Office of Emergency <br />Services. <br />Treasure Coast Collections, Inc. (hereinafter referred to <br />as TCC) provides an insurance billing service for medical providers, <br />and Indian River County (hereinafter referred to as IRC) is in <br />need of such a service for billing insurance companies for charges <br />incurred by patients when those patients are in need of ambulance <br />services. <br />In consideration of the following premises and mutual cov- <br />enants, TCC will provide the insurance billing service for IRC; <br />1. TCC will assist IRC in obtaining provider numbers for <br />Medicare, Medicaid, Blue Cross, and any other insuring <br />agencies which may require distinct provider numbers. <br />IRC accepts full responsibility for completion of any <br />application forms for these provider numbers and is ul- <br />timately responsible for obtaining those needed provider <br />numbers. <br />2. Billing services for ambulance runs by IRC on or after <br />February 1, 1989 will be provided by TCC. <br />3. IRC is solely responsible for setting rates for the ser- <br />vices which they provides. <br />4. IRC is solely responsible for design, printing, and pro- <br />per usage of any forms needed by TCC for the proper capture <br />of charges, medical reports completed by the paramedics, <br />and forms certifying the medical appropriateness of ser- <br />vices provided. <br />5. TCC will. be solely responsible for the printing costs <br />for forms and statements required by insurers. <br />6. Postage expenses for submitting billings to insurance <br />companies are the responsibility of TCC. <br />7. TCC agrees to obtain all insurance information on patients <br />delivered to Indian River Memorial Hospital, Inc. for <br />care. Insurance information on patients delivered else- <br />where is necessary and must be provided by IRC. <br />8. IRC must secure a post office box for payment collection. <br />TCC will pay the rental or lease payments for that box. <br />TCC will have access to that box and arrange for collection <br />of mail from that box five days per week, excluding holi- <br />days. <br />48 <br />