EMS Billing Services

The Vendor is required to provide in ambulance billing services.
- Responsible for providing comprehensive billing and collection services for transport clients and/or their insurance carriers, as well as financial reporting, insurance carrier certification and accreditation, and analytical services related to ambulance transport billing.
- County personnel involved in the EMS Billing process to go over the implementation and transition process, performance of the current account’s receivables, identifying outstanding issues, and discuss any strengths, weaknesses, and opportunities for improved performance.
- Responsible for providing software that is fully compatible with our current ePCR system, ESO, and capable of receiving electronic billing data in real time.
- Responsible for reviewing each Patient Care Report (PCR) for content and accuracy. PCRs with discrepancies must be returned to County for clarification or correction prior to submission for reimbursement. County should be notified of billing holds within 48 hours of the PCR being submitted.
- Shall pre-screen all claims to confirm compliance with the guarantor’s guidelines (i.e. physician certification statement, assignment of benefit signature forms, medical necessity documentation) to prevent claims being unnecessarily denied.
- Must reliably submit claims within seventy-two (72) hours of receipt of the final digital file.
- Shall prepare invoices according to the rates, guidelines, and procedures established by the County as well as meet all applicable laws and regulations including those for Medicare and Medicaid.
- shall participate in the County’s annual fiscal year audit in a timely manner.
- Claims shall be appropriately re-categorized after receiving payment from the primary payer. All denials shall be processed within three (3) business days of receipt.