The vendor required to provide EMS billing services to reduce the city’s carbon footprint, expedite processing, and reduce labor required for data entry and transmission of patient data, the city desires to collect patient data on mobile computers in the field, transmit the data via the internet to the billing agency for immediate processing.
- Billing agency will provide the following services
• Invoicing, statement and dunning letter processing; rate adjudication; filling claims on behalf of patients with medicare, Medicaid and third-party insurance companies; the city will collect payment and send receipts to the billing agency to update patient accounts.
• Invoices shall be prepared according to the rates established by the city, according guidelines and procedures established by the city and the agency, and all applicable regulations including those for medicare and Medicaid services (CMC)
• Obtain missing data necessary for billing through available databases, telephone queries from the receiving hospitals or from the patient, using the mail for such inquiries only if the telephone contact numbers are unavailable.
• Electronically file (code) invoices to appropriate parties.
• Process denials for medicare and Medicaid according to the timelines defined by the billing agency and the city.
• Process all refunds and over payments in a timely manner.
• Establish internal controls to ensure that policies and procedures are being followed.
• On approval by the city, establish monthly payment plans for patients to liquidate any outstanding balance on an installment plan.
• The minimum payment on installments shall be $20 per month.
• No interest may be charged to patients.
• Submit an invoice each month to the city of specifying individual account information and collections received, as the basis for the monthly commission and remittance.
• The billing agency shall not have the right to refuse to bill any EMS fees.
• The billing agency shall suspend collection efforts on any EMS bill upon written notice to do so by a specified representative of the city’s department.
• The city’s representative (s) may recall any EMS account at no cost to the city, except for fees earned prior thereto.
• The expectation of the city is that the initial invoices will be processed within three business days of the receipt of EMS run data on the agency’s server.
• Provide, at no cost to the city, a toll-free telephone number, which shall be without cost or expense to the caller, which will be staffed during MST regular business hours by an employee of the billing agency.
• The phone number shall be published on all statements sent by the contractor.
• Make recommendations to the city regarding implementation of any new applicable fees based on the billing agency’s knowledge of current industry standards.
• The billing agency will be expected to meet, as necessary, with fire department or finance department staff to ensure a smooth and continuing operation.
• All cost of such meetings will be the responsibility of the billing agency.
• All billing, fee collection and account status reporting will be in a format acceptable to the city.
• The billing agency’s proposal shall include samples of the proposed reports.
• The billing agency’s proposal shall include proposed report forms and the desired schedule for furnishing each.
• The billing agency must provide a procedure for collecting delinquent accounts; those unpaid 120 days after first billing with no payment or correspondence from the patient, or accounts 90 days in default.
• The billing agency shall secure and maintain throughout the duration of this contract, insurance of such types and in such amount as may be necessary to protect the agency and the city from claims from damages and person injury.
• The successful billing agency shall furnish the city of a satisfactory certificate of insurance which shall be tendered within fifteen (15) days of receipt of contract by the billing agency.
