Next week, the County Commission will consider another contract for the Cascade County City-County Health Department to handle tasks previously handled by what is now Alluvion Health.

Commissioners will consider a “business associate agreement” with Office Ally for and electronic health record system.

The agreement will cover the handling, usage, storage and transmission of HIPAA protected information for CCHD clients. The agreement will also provide an electronic health record/practice management system for the prevention and family health service divisions at CCHD, according to the staff report.

Office Ally was recommended by Big Sky Billing, a local company that the county contracted with earlier this month to handle CCHD’s billing since Alluvion quit doing it at the end of October.

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The agreement is month to month and is $29.95 per month per provider. PracticeMate, a software suite for medical practice management, is another $35 per month per provider.

Earlier this month, commissioners unanimously approved a contract with Big Sky Billing and Office Management to handle CCHD’s billing.

CCHD’s billing was previously handled by Alluvion Health, which split from the county effective Jan. 1 and quit handling billing on Oct. 31.

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The county has not had anyone doing CCHD billing since Oct. 31.

Alluvion used eClinicalWorks for its billing and the county looked at continuing with that company but it was too expensive, according to county officials.

The county looked at another vendor used by other health departments in the state, but it was also too costly, and Big Sky Billing, which is based in Great Falls.

Since the contract amount is under $80,000, Commissioner Jane Weber said the county didn’t need to go out for bids for the contract. State law requires any government purchase over $80,000 be open for bids.

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Under the contract, which was given an effective date of Nov. 18 through Nov. 17, 2020, the company will take a base fee of 6 percent of net collections, postage charges, a $750 initial set up fee or $500 per provider enrollment.

CCHD is only enrolling one provider.

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The company also offered to do backbilling to Nov. 1 for CCHD and will charge the 6 percent base fee plus $2 per claim for dates prior to the contract date.

Weber said in a Board of Health meeting earlier this month that the company could catch CCHD up on its billing.

The billing is used primarily for insurance billing for services CCHD provides.

Weber told The Electric that the county is starting fresh and building a new database with Big Sky Billing and not trying to transfer its data from the system Alluvion took with it in the split.

Alluvion had done billing for CCHD from Jan. 1 through Oct. 31 and earlier this year, county staff noticed a significant issue with the billing revenues that as of September, about $355,000 hadn’t been paid to the county.

Alluvion made several weeks of payments to the county in November, but CCHD staff said in this month’s Board of Health meeting that the agency had missed a week of payments.

The Electric asked county officials if Alluvion had made more payments and for how much had been paid back. County officials did not provide the information, but referred the question to the county attorney’s office. The county attorney asked The Electric to fill out a public information request form.