Emergency Medical Billing and Collection Services

The Vendor is required to provide ambulance billing, collection from insurance carriers, financial reporting, and analytical services related to EMS Transport Billing.
- EMS agency that utilizes seven (7) Advanced Life Support (ALS) transport units, up to ten (10) ALS Engines, three (3) quick response vehicles, and one (1) mental health response vehicle for the sole purpose of providing pre-hospital emergency medical care and patient transports.
- Billing
•    The firm will commence billing the patient care reports with the start-up date established by the firm and county.
•    The firm will receive on a daily basis the electronic billing data and other related billing information by way of an encrypted ftp file or batch filing process. The firm will be responsible for providing the appropriate software that will be compatible to interface image trend elite ePCR.
•    Process claims within 2 business days of receipt of ePCR information.
•    The firm will be responsible for reviewing each patient contact report (PCR) for content and accuracy for billing purposes. The firm will be responsible for contacting the designated county fire department employee to correct any discrepancies.
•    Records and histories for services processed by the firm shall be available and accessible by authorized county staff through online access to the firm’s billing system.
•    The firm must have access to and will utilize insurance coverage databases to provide billing information when not collected by the fire/ems crews.
•    All client complaints concerning service rendered will be referred to the designated individual within county and tracked in a ticketing system provided by the firm.
- Invoicing
•    All invoicing must be in accordance to the correct rates established by the county.
•    All invoicing must be in accordance with the guidelines and procedures established by the firm and the county.
•    All invoicing must be in accordance with all applicable laws and regulations including those from medicare and medicaid services (CMS)
•    All invoices shall also be billed in compliance with the fair debt collection practices act.
•    Electronic filing is the required method of filing primary medicare, medicaid, and commercial insurance claims. 
•    Electronic filing is the preferred method of filing to all other guarantors, if applicable. 
•    Otherwise, paper invoices may be issued directly to appropriate patient guarantors.
•    The firm shall pre-screen all claims to confirm compliance with guarantors’ guidelines. (i.e. Physician certification statements, assignment of benefit signature forms, medical necessity documentation)
•    The firm shall verify insurance eligibility utilizing available resources and commercial databases prior to the submission of any patient claim for reimbursement.
•    The expectation of the county is that the initial invoices will be processed within two (2) days of the approval by county employees for billing.
•    The county must have the right to audit any reports within a thirty (30) day request from the firm.
•    All data located within the software of contractor's billing system will be provided to the county upon request at no additional cost.
•    The firm must have the capability to completely customize the billing procedure to county expectations.
•    Collect demographic data as needed.
•    Assist with processing of CMS audit(s) and upper payment limit (UPL) payments
•    Ability to process non-ems transport charges such as non-transport fees, extrication fees, or mobile integrated health fees.
•    The firm must demonstrate reasonable collection rates
- Collections
•    Note: all monies will come to the county.
•    The firm shall process all claims according to timelines agreed upon between the county and the firm. 
•    The claims shall be divided into multiple revenue categories: medicare, medicaid, commercial insurance, auto insurance, worker’s compensation and patient pay.
•    Claims shall be appropriately re-categorized after receiving payment from the primary payer. 
•    All denials shall be processed within three (3) business days or receipt.
•    Customer service shall be provided from 8:00 a.m. Until 5:00 p.m. EST using a toll-free phone number. 
•    The telephone systems utilized by the firm must be able to accept voice mail messages and route incoming calls to the appropriate persons. 
•    The firm must make a good faith effort to make return contact to all customers within 24 business hours after initial contact from any customer has been received.
•    The firm will treat all debtors fairly with professionalism, honesty, courtesy and integrity while obtaining the maximum results. 
•    The county will be the final arbitrator of disputes between the successful firm and customers. The county’s decision shall be final. 
•    The firm shall record all incoming phone calls and be able to produce audio files to the county when requested.
•    Act as the advocate for the client with medicare, medicaid and private insurance in an endeavor to optimize payment on behalf of the client.
•    The firm may reserve the right to hold off on any write-offs that are waiting for insurance payments or in the case that a patient is making monthly payments.
•    The county will be the only agency accepting payments. 
•    All checks should come to the county for processing and only then will copies be sent via secure ftp to the appropriate billing firm. 
•    Medicare and medicaid are electronically deposited to the county’s account.
- Accounting and Reporting
•    The county reserves the right to audit the records of the firm related to the county’s billing and collection efforts. 
•    The firm shall make and keep full and complete records and books of accounts or revenue and income, costs and expenses that specifically relate to performance under this contract. Records and books of accounts, together with any of all other memoranda pertaining thereto that may be kept, maintained or possessed by the firm, shall be open to examination during regular business hours by the county or its representatives for the purpose of inspection, auditing, verifying,
•    Or copying the same or making extracts there from. 
•    The firm shall make and keep said records and books of account in accordance with generally accepted accounting principles.
•    Accounting for all billing pursuant to generally accepted accounting principles shall be provided on a daily, monthly, quarterly and annual basis, or as requested by the county. 
•    Such reports and all supporting documentation shall be submitted to the county within five (5) business days after the end of the month.
•    The firm shall provide a secured portal or similar for communication, reports, patient information. 
•    The firm’s portal shall be in compliance with all medicare, medicaid and HIPAA regulations.
•    Detailed below are reports required by the county to monitor the billing and collections process. 
•    The list is not all-inclusive.

- Contract Period/Term: 1 year
- Questions/Inquires Deadline: August 22, 2025