Contactual Agreement and Evaluation

Employee: Position:

Date of Initial Contract: Check One: __ Direct Service Position __ Non-Direct Service Position Date of Annual Review of Contract: Supervisor (if appropriate):

Role and Scope of Work:

The medical biller and coder company provides billing and collection services to Alivio Health Centers within the guidelines defined by The State of Texas and Alivio Health Centers, participating in monetary funding for the organization.

Core Clinical Competencies:

1. 2. 3. 4. 5. 6. Establishes and maintains effective an effective billing and collection working system. Communicates appropriate with the organization director on billing and collection status, recommendations and/or needs to improve performance. Coordinates objectives and meets deadlines for the organization. Ensures that all billing matches documentation for services render Manage the coordination and oversight of all billing and coding procedures and monitoring of all reconsiderations and outstanding billing. Ensure that he maintain constant communication with carriers on case status

IM PROVI NG PEOPLES LI VES C.A.R.F. Accredited ALIVIO HEALTH CENTERS 9515 Gateway Ste N, El paso TX 79925| Office(915) 778-7778 Fax (915)549-9991

Core Organizational Competencies:

1. 2. 3. Communicating Effectively: Conveying information and ideas in a clear, meaningful, and timely manner; providing information to ensure understanding; soliciting input from the audience during the communication. Contributing to Team Success: Actively participates as a committed member of a team and works with other team members to help complete goals and deliverables. Valuing Diversity: Acknowledging similarities and differences of others and using this knowledge to work effectively on a team or with individuals of varied backgrounds, cultures, styles, and views in an effort to improve performance and increase productivity.

Evaluation Process (To be initiated and completed one year from date of hire, and annually thereafter): 1. Contract employees will participate in an annual evaluation of performance, according to the requirements, as noted on this contract.

2. The person responsible for the evaluation, as noted on this contract, will review the core competencies, prior to meeting with the contract employee and note any areas that may need improvement. 3. 4. 5. 6. 7. A meeting with the contract employee will be scheduled and include a review of performance over the past year of employment, noting any areas that may be in need of improvement, along with specific job performance information that supports the need for the identified improvements. If any areas of improvement are noted and discussed, they will be noted in the Areas in Need of Improvement for Next Evaluation Period section of the contract. In addition to this evaluation, the contract employee will annually sign the organizations agreement (included in the addendum to this agreement) to adhere to all applicable organizational policies and procedures. Any other areas deemed appropriate for possible changes in the agreement will be discussed, negotiated, and made as appropriate within the contract. After completing the above processes, both parties will sign and date the new annual contract agreement and the employee will be provided a copy of the agreement.

IM PROVI NG PEOPLES LI VES C.A.R.F. Accredited ALIVIO HEALTH CENTERS 9515 Gateway Ste N, El paso TX 79925| Office(915) 778-7778 Fax (915)549-9991

Areas in Need of Improvement for Next Evaluation Period, if applicable:

Initial Contract Agreement: I have reviewed my contract agreement and agree to the terms and conditions: _____________________________________ ___________________ Employee Signature Date ___________________________________ ___________________ Human Resource Director Date __ Initial Agreement Contract Addendum Signed

Annual Evaluation: I have participated in an evaluation of my performance with regard to my contract agreement: _____________________________________ ___________________ Employee Signature Date _____________________________________ Human Resource Director or Supervisor Date of Next Review:___________________ __ Contract Renewed __ Not Renewed ___________________ Date

If not renewed, reason for non-renewal:

__ Annual Review Contract Addendum Signed

IM PROVI NG PEOPLES LI VES C.A.R.F. Accredited ALIVIO HEALTH CENTERS 9515 Gateway Ste N, El paso TX 79925| Office(915) 778-7778 Fax (915)549-9991

Contract Employees ADDENDUM TO INITIAL CONTRACT AGREEMENT

As a contract employee of Alivio Health Centers, I agree to the following as required by organizational policy and procedures: All Contract Employees: 1. 2. 3. 4. 5. __ Participation in employee orientation __ Completion of a W-9 form __ Completion of initial and ongoing training required of all personnel __ Completion of required competency-based health and safety trainings __ Adherence to organizational policies and procedures in the following areas:

__ Corporate Compliance, including ethical and conduct codes __ Health and Safety Practices __ Rights of Persons Served __ Confidentiality __ Organizational Legal Requirements __ Information Management and Performance Improvement Activities __ Human Resource Requirements (Including annual performance review of contract) Direct Service Contract Employees: 1. 2. 3. 4. __ Verification of Credentials __ Completion of All Credentialing Educational Requirements __ Participation in Team Meetings __ Add additional requirements, as needed

_____________________________________ ___________________ Employee Signature Date ___________________________________ ___________________ Human Resource Director Date

IM PROVI NG PEOPLES LI VES C.A.R.F. Accredited ALIVIO HEALTH CENTERS 9515 Gateway Ste N, El paso TX 79925| Office(915) 778-7778 Fax (915)549-9991

Contract Employees ADDENDUM TO ANNUAL CONTRACT AND PERFORMANCE REVIEW

As a contract employee of Alivio Health Centers, I agree to the following as required by organizational policy and procedures: All Contract Employees: __ Completion of ongoing training required of all personnel __ Completion of required competency-based health and safety trainings __ Adherence to organizational policies and procedures in the following areas: __ Corporate Compliance, including ethical and conduct codes __ Health and Safety Practices __ Rights of Persons Served __ Confidentiality __ Organizational Legal Requirements __ Information Management and Performance Improvement Activities __ Human Resource Requirements (Including annual performance review of contract) Direct Service Contract Employees: __ Completion of All Credentialing Educational Requirements __ Participation in Team Meetings __ Add additional requirements, as needed

_____________________________________ ___________________ Employee Signature Date ___________________________________ ___________________ Human Resource Director Date

IM PROVI NG PEOPLES LI VES C.A.R.F. Accredited ALIVIO HEALTH CENTERS 9515 Gateway Ste N, El paso TX 79925| Office(915) 778-7778 Fax (915)549-9991