Emergency Medical Transport Billing and Associated Services

The Vendor is required to provide operates a comprehensive emergency medical services system providing Advanced Life Support (ALS) and Basic Life Support (BLS) transport services.
- The system supports a high volume of emergency responses and relies on a combination of career and volunteer personnel, integrated dispatch and reporting systems, and coordination with State-regulated entities.
- The County processes approximately sixty thousand (60,000) emergency medical transports annually, each of which represents a potential billable event requiring accurate documentation, coding, claim submission, reimbursement tracking, and financial reconciliation.
- Provide all billing-related data and reporting necessary to enable the County to independently perform financial reconciliation and accounting functions.
- Provide all personnel, systems, software, and operational support necessary to ensure accurate billing, timely claims processing, and effective revenue collection.
- Provide a comprehensive, fully integrated, turnkey Emergency Medical Services (EMS) billing and revenue cycle management solution.
- Provide comprehensive EMS billing and revenue cycle management services covering all activities required to process, manage, and reconcile billing for emergency medical transport services.
- Shall be responsible for the complete lifecycle of each billable EMS encounter, including claim creation, submission, tracking, collection, and reporting.
- Shall manage all aspects of EMS revenue cycle operations, including insurance verification, coding, claims submission, accounts receivable management, denial resolution, and patient billing.
- Shall ensure that claims are submitted accurately and in a timely manner and shall implement processes to track and resolve unpaid claims.
- Shall maintain a comprehensive denial management process and shall ensure that all appeals are submitted within required timeframes.
- Provide a dedicated Client Support Team, including Account Manager, Operations Lead, Coding/Clinical Support, and Interface/Technical Support.
- Response times shall be defined as follows: critical issues – same day/high priority within 24 hours, and standard requests within 48 hours. Regular meetings shall include weekly operational, monthly performance, and quarterly executive reviews.
- Shall actively manage all accounts receivable to ensure timely collection of outstanding balances.
- Shall analyze denial trends and shall implement process improvements to address root causes of denials, including documentation deficiencies, coding errors, and submission issues.
- Shall actively manage all accounts receivable to ensure timely collection of outstanding balances.
- Shall monitor accounts receivable aging on a continuous basis and shall implement follow-up procedures to address unpaid claims.