The vendor is required to provide emergency (advance life support) and non-emergency (basic life support) ambulance and emergency medical service billing and collection services for the agency.
- Professional services agreement for billing services with a qualified proposer that demonstrates the ability to minimize agency costs, maximizes the use of data and technology, provides excellent client and customer service, and performs thorough and complete preparation and mailing of invoices for emergency medical and ambulance billing services.
- Provide all functions of the billing process including preparing, invoicing, categorizing, recording, monitoring, supervising, and managing the emergency medical and ambulance transportation billing; the contract rate shall cover all costs of processing including postage, data mailers, telephone costs, etc.
- Provide interface capability to collect billing data from image trend elite and to review ePCR records at no cost to agency; the contractor will maintain interface capability if image trend elite is updated to another version.
- Contractor shall have the ability to effect collections in all 50 states.
- Contractor shall provide a secure file transfer program (FTP) to receive account data.
- Contractor shall maintain the FTP platform during the entire term of the contract and ensure any files are properly retrieved by agency prior to closing the FTP site.
- Contractor shall back up its data and have appropriate data recovery systems.
- Once an ePCR is received from OCFA the Contractor shall take steps to ensure correct invoicing to secure payment, including acknowledgement, number of the patient, contacts, research methods, automation and/or individual handling in a reasonable, mutually agreed-upon timeframe to complete each step in the process. Contractor will review both the data import and the individual ePCR to determine accurate invoicing.
- Contractor shall research and follow up on all accounts with inadequate billing information to include:
• Contact administration for missing and/or incomplete information in the ePCR.
• Contact receiving hospital for missing and/or incomplete billing information needed from the admitting/registration records.
• Contact patient family members or emergency contacts for information.
• Refer to zip code/street directions for incomplete/missing address information.
•Make inquiries to the patient via mail, phone, or similar means.
- Contractor shall possess the capability to provide electronic claims processing and filings for various claim types including Medicare, Med-Cal, commercial insurances, worker’s compensation and private insurance.
- Contractor shall adhere to a mutually agreed-upon, appropriate billing and collections schedule.
- Provide customer service representatives that are available at a minimum from 8:00 am to 4:30 pm, Pacific Time, Monday through Friday, excluding major holidays.
- Provide a toll free customer telephone number for billing inquiries.
- Obtain demographic and insurance information from receiving hospitals.
- Adhere to established, agreed-upon procedures to handle delinquent accounts before referring the accounts for bad debt collection.
- Provide a liaison to agency, who will be a full–time employee of the contractor, have extensive knowledge of EMS billing practices, as well as an understanding of EMS industry standard practices, and decision-making authority for problem resolution.
- Contract Period/Term: 1 year
- Questions/Inquires Deadline: February 19, 2025