Emergency Medical Services

The vendor is required to provide that emergency medical services (EMS) for include:
a. Compliance with federal and state regulations:
• The contractor must comply with all applicable regulations including, but not limited to, the health insurance portability and accountability act (HIPAA), centers for medicare & Medicaid services (CMS) regulations, and state-specific billing guidelines.
• Maintain required licensure and accreditation as stipulated by state law for EMS billing services
b. billing services:
• Process and manage billing for all EMS transports, ensuring accuracy and adherence to payer guidelines, including private insurance, medicare, Medicaid, Indian health services (IHS) beneficiaries and self-pay patient billing.
• ensure timely submission of claims to avoid delays in reimbursement.
• Provide ongoing follow-up on unpaid claims and denials, utilizing industry-standard practices for reimbursement efforts.
c. Data management:
• Employ a state-of-the-art electronic medical record (EMR) and billing software system that integrates with the city’s current systems and ensures the seamless transfer of data and billing information.
• Provide secure storage and management of patient records, adhering to all privacy laws.
d. Reporting requirements:
• Deliver regular reports on billing performance metrics, including collections by payer type, aging reports, and accounts receivable metrics.
• Conduct audits and submit detailed findings on compliance and financial performances monthly.
e. Customer service:
• Establish dedicated customer service support for questions from patients regarding their bills, ensuring timely responses and resolution of concerns.
• Provide training and support for city staff on processing inquiries related to EMS billing and payment collections
- Provide high-quality services with a commitment to continuous improvement and customer satisfaction.
• The contractor must have expertise in managing EMS billing, including a proven track record of working with municipal emergency services.
• Services must include conducting a comprehensive review of current billing practices, workflows, and technology solutions to identify areas for improvement.
• Provide ongoing training seminars and support to city staff involved in the EMS billing process.
• Implement a streamlined workflow for managing claims from submission through to payment, ensuring that claim denials are addressed effectively.
• Continuously monitor changes in regulations and guidelines impacting EMS billing and provide regular training and update sessions to ensure compliance.
• The contractor will establish and maintain a lockbox at a financial institution for deposit of fees collected.
- Contract Period/Term: 1 year
- Questions/Inquires Deadline: April 14, 2025