Ambulance Billing and Revenue Cycle Management Services

The Vendor is required to provide comprehensive emergency medical services (EMS) billing and revenue cycle management services including but not limited to:
1. Billing and claims processing
•    Electronic and paper claim submission
•    Coding verification and validation
•    Charge capture review
•    Claims tracking and denial management
•    Appeals processing
•    Secondary and tertiary billing
•    Medicare, Medicaid, commercial, VA, workers compensation, and auto insurance billing
2. Collections
•    Patient statements and billing cycles
•    Inbound and outbound customer service calls
•    Payment plans administration
•    Credit card and electronic payment processing
•    Self-pay collections
•    Coordination with approved collection agency
•    Compliance with fair debt collection practices act (FDCPA)
3. Reporting
•    Monthly financial reports (charges, payments, adjustments, AR aging, net and gross collection rates)
•    Custom reporting upon request
•    Annual performance summary
•    Real-time dashboard access
4. Compliance and regulatory support
•    HIPAA compliance management
•    Audit assistance
•    Medicare and Medicaid audit response
•    OIG compliance guidance
•    Assistance with rate studies if requested
5. GRAMA fulfillment
•    Timely processing of GRAMA requests
•    Records retrieval and redaction
•    Secure delivery of records
•    Tracking and documentation of requests
6. Customer service
•    Dedicated customer service representatives
•    Toll-free customer service line
•    Spanish-language support
•    Written correspondence management
•    Complaint tracking and reporting
7. Software and integration
•    Compatibility with city ePCR system
•    Secure data transfer protocols
•    Era processing
•    Payment reconciliation services.