EMS Revenue Billing Services

The Vendor is required to provide comprehensive emergency medical services (EMS) revenue billing and revenue cycle management services.
- Requirement:
1. Billing and claims processing
•    Receive department-approved electronic patient care reports (EPCRS) from image trend elite. 
•    Review EPCRS for billing completeness and accuracy. 
•    Process and submit claims within two (2) business days of receipt of complete and approved billing data. 
•    Submit claims electronically to all applicable third-party payers, including Medicare, Medicaid, commercial insurers, and other guarantors, in compliance with HIPAA and CMS requirements. 
•    Identify documentation discrepancies and coordinate corrections with designated department staff.
2. Invoicing
•    Generate invoices using department -established rates and charge structures. 
•    Ensure all invoicing complies with CMS regulations, the fair debt collection practices act, and other applicable laws. 
•    Verify insurance eligibility prior to claim submission. 
•    Pre-screen claims for required documentation, including medical necessity and certification requirements.
3. Collections support
•    Manage payer follow-up, denials, and appeals across all payer classes. 
•    Reclassify accounts following payer adjudication. 
•    Provide customer service support to patients and payers during standard business hours. 
•    Maintain call recording and ticket tracking for customer inquiries. 
•    Act as department advocate with third-party payers to optimize reimbursement.
4. Accounting and reporting
•    Weekly billing and payment activity reports. 
•    Monthly accounts receivable aging, collections, and reconciliation reports. 
•    Annual financial and audit-support reports as required.
5. Analytics and performance review
•    Conduct periodic performance reviews of billing accuracy, collections efficiency, and receivables trends.
•    Provide written analytical summaries at least annually, identifying risks, performance gaps, and improvement opportunities. 
•    Participate in review meetings with department as scheduled.
- Optional services
•    Expanded analytics or custom reporting beyond standard reports. 
•    On-demand operational consulting unrelated to routine billing performance. 
•    Additional training sessions beyond the minimum requirements.