Billing, Reimbursement, Collection and Administrative Services

The Vendor is required to provide comprehensive EMS administrative services including EMS clinical, operational, consulting, and billing services.
- Provide the following services:
•    EMS billing, collections and reimbursement reporting services
•    EMS billing and collection consulting
•    EMS patient satisfaction data collection and reporting
•    EMS quality assurance and quality improvement review partnership
•    Cardiac Arrest data collection, database management and reporting
•    Hosted Electronic Patient Care Reporting (ePCR) including data hosting, storage transfer to hospitals including sufficient hardware for regular operations
•    Provide a data surveillance system that automatically detects specifically designated parameters for a range of public health concerns for emergency services when used in conjunction with proposer’s ePCR system.
- The town will review proposals based on experience providing successful related EMS services to other agencies and jurisdictions, experience and ability to administratively support a municipal EMS system and make recommendations using a financial model that sustains the system’s ability to advance.
- unique request for EMS administrative services is to utilize national best practice techniques and improve clinical sophistication in order to provide the best EMS services available.
- Receive patient care reports, face sheets, demographic information, and proper patient signatures from the department and process information on individual parties, insurance companies, medicare and medicaid.
- Verify demographic information prior to billing using available resources including subscription services, hospital verification or information obtained through “face sheet” demographics obtained by department.
- provide follow up billing to include using database searches with subscription services, hospital follow up or phone calls to locate patient information including insurance eligibility in a timely manner.
- prepare monthly reports of all account activity presented in a uniform and easily understood format so that financial, billing and collection data can be benchmarked and financial goals can be reviewed.
- Provide quantitative analysis of current billing functions using industry accepted metrics for periodically measuring, analyzing and controlling the billing and collection functions.
- The consultancy shall fully explain any recommended changes to improve revenues, operations or systematic review methods, including reporting and review schedules.
- Consultancy shall be targeted to system changes and policies that are attainable, measureable, and longstanding
- Consulting services shall include analysis of past practices and recommendations for improvement strategies to improve overall financial health of the Town.
- The patient satisfaction survey responses and data shall not be limited to general system-wide information but rather must be specific and accountable to specific run or call.
- Provide clinical database of all data related to the Cardiac Arrests within the system.