Ambulance Billing Services and Software

The vendor is required to provide ambulance billing services and software to replace existing software to improve our ability to efficiently submit claims to the following entities; commercial insurance - 13.78%, medicaid - 11.86%, Medicare - 59.73%, customer invoice - 9.77% while using both mail and electronic delivery and maintaining HIPAA compliance. - Ambulance services billing software system to streamline billing functions for the claim management, account management, and reporting functions.
- county based medical billers and outsourced medical billers through another third-party vendor, ems management and consultants (EMSMC), to process our large volume of claims.
- System requirements to include:
• SaaS solution that includes regular software maintenance and updates.
• System data and communications must be secured according to county standards.
• Secure data transfer capability for scheduled backup or real-time duplication to county servers.
1. Operation continuity solution for periods of low connectivity or communication issues with the application servers or data.
• Details regarding disaster recovery and related uptime service level agreement (SLA) options should be provided.
1.Include available alternatives for standard vs. high availability and what configurations and cost may be associated with each.
• Details regarding maintenance windows and other scheduled downtime should be provided.
• Ability to integrate (include description of methodology) with 3rd party vendors who process specified claims on our behalf.
• Integration with the clearinghouse of our choice (currently way star).
• System security and access controls that include configurable role-based profiles.
• Customizable dashboards, alerts, and notifications for managing the claim lifecycle.
• General consolidation reports for each functional group.
1. Accounts receivable - billing services – compliance - administration
• Automated data validation components (spell check, date format, etc.).
• Ability to create custom reporting using third party tools.
• Ability to manage ambulance services membership plans.
• Additional automations which may include:
1.Insurance identification and eligibility
2.List maintenance for icd10 codes
3.Payor list management
4.Customer list management
5.Denial codes and remarks
6.Deductible management
- Security and performance standards:
- Provide application and data security details for the following types of connections:
• Remote internal workers via county VPN
• Remote external workers
• On site workers for county
• On site external workers
• County system administrators (on site or remote)
• County application/data analysts (on site or remote)
- Detail what controls are in place to limit access to system functions and data that may include PHI.
- Contract Period/Term: 2 years
- Questions/Inquires Deadline: February 28, 2025