The Vendor is required to provide billing services for the county's emergency medical services department.
- Billing
• Commence billing the patient care reports upon the date in the notice to proceed issued by the county procurement services division.
• Assign and identify a dedicated client representative to the county ems account.
• All billers dedicated to the agency account shall maintain certification through the ambulance coders.
• Also bill all non-emergency transports according to all applicable laws established by medicare, medicaid and other applicable agencies.
• All invoices shall also be billed in compliance with fair debt collection practices act.
• Electronic filing is the required method of filing primary medicare and medicaid claims and is the preferred method of filing to all guarantors, if applicable; otherwise, paper invoices may be issued directly to appropriate patient guarantors.
• Pre-screen all claims to confirm compliance with guarantor's guidelines. (I.e. physician certification statements, assignment of benefit signature forms, medical necessity documentation)
• Verify insurance eligibility utilizing available resources and commercial databases prior to the submission of any patient claim for reimbursement.
• Make a good-faith attempt to call each patient when verification of insurance eligibility cannot be obtained by any other manner to ensure accurate guarantor responsibility information.
• The expectation of the county is that the processing of claims will be processed within three (3) business days of the electronic posting of the billing file on the firm's secure server, according to the agreed upon process for various claim types.
- Collections
• 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, private insurance and private pay.
• Claims shall be appropriately re-categorized after receiving payment from the primary guarantor; all denials shall be processed according to the timeline defined by the firm and the county.
- Questions/Inquires Deadline: April 28, 2025