Ambulance and First Responder Fee Billing Services

The vendor is required to provide ambulance and first responder fee billing services
- Billing and Collections
• Timely processing and submission of all EMS transport claims to Medicare, Medi-Cal, private insurance, and patients.
• Management of accounts receivable, including follow-up on denials and unpaid claims.
• Patient invoicing, statements, and customer service support.
• Handling of refund requests and credit balance processing.
• Monitoring of payer regulations and prompt implementation of updates.
- Compliance, Insurance, and Security
• Adherence to all applicable federal, state, and local EMS billing laws and guidelines, including Medicare/Medi-Cal rules and the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Maintenance of secure systems for protected health information (PHI).
• Support for audits and data reviews.
• A minimum of $1,000,000 liability insurance. Have we confirmed with Risk Management that this is enough?
• Payment Card Industry (PCI) data compliance for credit card/electronic transactions.
• Systems and Organization Controls (SOC) 2 reporting requirements for software client tools
• Cybersecurity insurance
- Reporting Monthly Financial Reports including but not limited to:
• Gross and net revenue
• Collections by payer type
• Aging reports
• Ad hoc reporting upon request
• Regular performance reviews with the city.
- Integration and Support
• Coordination with the city and/or the private ambulance transport provider’s (city subcontractor)
electronic health record (EHR) system for secure data transfer.
• Implementation support and training as needed during the transition phase.
- EMS Reimbursement Programs Knowledge and support for EMS reimbursement programs, including, but not limited to:
• Voluntary Rate Range Program (VRRP) - Intergovernmental Transfer (IGT).
• Public Provider Ground Emergency Medical Transport (PP-GEMT).
• Assistance with documentation, application, reconciliation, and audits for these programs.
• Demonstrated understanding of Assembly Bill (AB) 716 and its impact on ambulance billing practices.
6. Customer Service
• Dedicated patient support call center with EMS billing experience.
• Multilingual support, including Spanish.
• Fair and transparent dispute resolution process for patient concerns or hardships.