EMS Billing and Collection Services

The vendor is required to provide EMS patients and their insurance carriers, for EMS patients treated, and transported via ambulance to health facilities by the department.
- Requirement:
•    Including the number of contacts and procedures that will be taken to secure payment for the service.
•    This shall include research methods of patients’ ability to pay, and efforts to locate and correct any incorrect billing address for billable patients.
•    Provide 2017, 2018, and 2019 analysis of transport volume and payer mix.
•    Provide detailed information on how it will handle incomplete patient data.
•    Provide electronic patient care records (EPCR) by providing access to our EPCR software.
•    The software and hardware billing system should ensure complete and uninterrupted backup systems and a data recovery plan/ and system should a disaster occur.
•    Provide all software and hardware associated with the billing and collections process.
•    Responsible for reconciling EPCRs compared with cad and image trend elite data to ensure the following: a) there are no missing EPCRs, including EPCRs for each patient in a multiple patient incident, b) EPCRS meet minimum content criteria necessary to generate the appropriate fee schedule, c) fee schedules are accurate, d) billing codes are appropriate, e) reports are reviewed to capture itemized charges.
•    EMS staff to identify data input gaps, errors, or other data needs, and describe a means of obtaining solutions to these problems.
•    The ability to bill electronically on the firm’s secure server for the various claim types: medicare, Medi-Cal, commercial insurances and private payers following all guidelines of centers for medicare and Medicaid (CMS).
•    Responsible for obtaining demographic and insurance information from receiving hospitals.
•    Obtaining “assignment authorization”, also known as “lifetime signature”, which allows CMS to pay the provider directly.
•    Provide postage for the mailing of all correspondence of the billing operation.
•    EMS billing practices, as well as a grasp of EMS industry standard practices, and decision-making authority for problem resolution.
•    Monitor all billing and regulatory changes impacting reimbursement and adjust its system to ensure regulatory compliance; and update the city of such changes with an explanation of how it will affect the city and its customers.
•    Provide the city with the following procedures: general billing, coding and charge entry, credit balances and overpayments, hardship waivers, collections and write offs, patient signatures, denials, patient communications, patient confidentiality, records management and retention and quality assurance or continuous quality improvement.
•    Quality assurance would ideally include a random 10% chart review by the supervisor for billing discrepancies.
•    Provide in the proposal, detailed process of customer complaint resolution.
•    Provide to the city a monthly report on the status of each account including; account number, patient number, call number, customer name, date of service, the amount received, the charges waived, the balance due and date of last payment, and the actions taken on the account.
•    Include the description of insurance, percentage of total for medicare, Medi-Cal, private insurance, and self pays with total amounts.

- Contract Period/Term: 3 years
- Questions/Inquires Deadline: November 6, 2025