EMS Billing Outsource Services

The Vendor is required to provide emergency medical services (EMS) billing services.
- The current call volume is between 20,000 and 24,000 calls per year.
- Also required during the term of the contract are the monthly fees paid to ESO solutions for modules electronic health records, check lists and logistics, personnel management, scheduling, insights, handtevy, and analytics software modules.
- Provide all labor, including Certified Coders, materials and technology necessary to obtain missing patient information from all available sources prior to issuing insurance claims or direct patient billing.
- Electronically file insurance claims and mail direct patient billing upon verification of run ticket information no later than 10 days after receipt of run ticket. File on a CMS 1500 form any claims that are not accepted by electronic methods.
- Provide follow-up billing upon receipt of “new” information received concerning a patient. This includes, but is not limited to, additional insurance information, change of address, or change of responsible party.
- First invoice should be sent no later than 10 days from dispatch date. The Second invoice is to be sent 30 days from initial billing date. A third invoice is to be sent no later than 60 days from the initial billing date. The third statement should include delinquent notice.
- Bills with no payment activity at 91 days will be forwarded to the collection agency by the billing company staff. If a payment plan has been established with the patient that exceeds 91 days, and it is being met, the account will not be turned over to the collection agency.
- Provide 24/7online access to information including notes and hard copy reports required by County, including but not limited to:
•    Run tickets received / billed
•    Payments received
•    Outstanding balances
•    Adjustments and refunds
•    Aging of open accounts
•    Accounts forwarded to Collection agency
•    Status of all accounts
•    Provide listing of all accounts for debt set off
- Provide monthly reports outlining all accounts and their status to include the amount collected during that month.
- Provide regular updates and on-going training to County on changes to billing requirements based on industry standards or requirements of applicable health care laws and regulations.
- Provide the county with a spreadsheet of all accounts Debt Program annually. Additionally, the billing company would incur the cost of printing and mailing the Initial Notification Letter that is statutorily required.
- Access to the company’s latest audit. This audit needs to include an audit of procedures used in billing (including insurance claims) and posting of payments.