EMS Billing Services

The vendor is required to EMS billing provide ambulance and response billing, collection, financial reporting and analytical services.
- Ambulance billing
•    Compliance with all HIPAA and other applicable laws and regulations governing privacy shall be strictly followed in all phases of the ambulance billing process.
•    Retrieve the electronic patient care reports (EPCR) and related information from the department record management system (first due).
•    Promptly notify the designated department member regarding any issues that impact, or missing information required to complete, the billing process. 
•    Work with department staff to ensure all required information is obtained to ensure the billing process can be completed from initial EPCR submission to account being considered paid in full or uncollectable.
•    Prepare and submit accurate and complete insurance claims, using rates established and provided by department, guidelines and procedures established by vendor and department, and all applicable laws and regulations including those for medicare and Medicaid, as well as any other applicable carriers including both commercial and private insurance.
•    File any claim reviews and represent the department in medicare and Medicaid appeals.
•    Provide and staff a toll-free phone number for any billing and collections questions. 
•    Number must be staffed during normal business hours (8:00 a.m. to 4:00 p.m. MST) Monday through Friday, excluding holidays. 
•    Any voicemail messages (if used) shall be replied to within one business day. 
•    Post this number on all correspondence and bills.
•    Prepare and mail invoices to patients and parties responsible for co-pay and deductibles, private pay, and uninsured patients, or as directed by the department fire chief.
•    Post all payments to the appropriate accounts and provide reports to the department fire chief as described below. 
•    Ensure that all payments are deposited into a city specified bank account, and the vendor shall send an electronic confirmation of the transaction to the department fire chief that includes a scanned copy of the deposit slip, and all checks deposited.
•    Deposit timing - specify the expected timing of deposits (e.g., daily, weekly within 48 hours or receipt).
•    Deposit reconciliation report – in addition to scanned deposit slips, the billing vendor needs to provide a reconciliation report that clearly ties the deposit amounts to the individual payments and accounts posted, for audit trail and transparency and upon request reports to the finance staff, to support reconciliation and audit process.
•    Assist with, and manage if appropriate, the establishment of the ability to accept credit and debit cards for payments.
•    Provide the following reports, at a minimum, via email to the department fire chief on a monthly basis (due date to be established by vendor and department fire chief after award):
o    Monthly invoice listing
o    Monthly call summary
o    Change detail
o    Change summary
o    Credit detail
o    Credit summary
o    Aging detail
o    Aging summary
o    Accounts receivable balance
o    Audit support
•    Afford the ability to provide guidance on and generation of additional customized reports designed to strengthen the department billing process and analytics.
•    Provide department with additional reports regarding uncollectable accounts and payment plan status as required by and in the format required by the fire chief.
•    Provide guidance, advice, and consulting to the department on all aspects of ambulance billing, including, but not limited to, procedures for setting billing rates, optimizing collections, tuning accounting procedures, etc.
•    Provide training annually, highlighting common issues seen with department personnel and other client documentation and ways to optimize billing success.
•    Provide training, if necessary, to the city administrative staff and fire chief on best practices for optimizing the efficiency in the internal workflows of ambulance billing, reconciliation, etc.
•    Act as consultant to city and fire chief regarding selection of collection service. 
•    Consultation will include a presentation and discussion on types of collections (pre­ collections and soft collections, full collections, etc.), advantages and disadvantages of each, and advice on selection.
•    Provide annual review of department notices of privacy and other patient confidentiality handling for compliance with current requirements and best practices.
•    As necessary for extreme hardship cases, contact the party responsible, collect financial information, and present the fire chief requests for adjustment or relief of charges incurred.
•    Utilize only national academy of ambulance coders (NAAC) certified ambulance coders in processing bills and agree to maintaining a certified ambulance compliance officer on staff. 
•    All certified coders and compliance officers shall remain current on billing practices and attend relevant routine training.
•    Conduct daily back-ups of all data with protection of individuals' personal health information that is created, received, used, or maintained in compliance with HIPAA security rule, 45 cfr part 160 and subparts a and c 
•    Bill outstanding accounts and patients once a month for 3 months. 
•    If not paid within 120 days of first bill, notify patient of the delinquent amount. 
•    Report these "uncollectable" accounts to the fire chief and provide advice on subsequent actions.
- The main documents for this RFP are not available on our website.