EMS Billing RFI

Agency: City of Sidney
State: Ohio
Type of Government: State & Local
NAICS Category:
  • 561110 - Office Administrative Services
Posted Date: Sep 4, 2019
Due Date: Sep 18, 2019
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EMS Billing RFI

The City of Sidney is accepting proposals for the EMS Billing RFI service until 4:00 p.m. on Wednesday September 18, 2019. For questions please contact Fire Chief Brad Jones at 937-498-2346.

RFI

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City of Sidney
201 W. Poplar Street
Sidney, OH 45365
937-498-2346 / fax: 937-498-8119
REQUEST FOR INFORMATION
EMERGENCY SERVICES BILLING
TO: Prospective Vendors
The City of Sidney, hereinafter referred to as “City,” is planning to select a billing service to facilitate
the billing activities for the City’s Emergency Medical Services (EMS). It is necessary to separate
billings for the City’s residents and non-residents.
Carefully review this Request for Information, it provides specific technical information necessary to
aid participating firms in formulating a thorough response. Should you elect to participate and would
like to submit paper copies, complete four (4) copies of the attached PROPOSAL RESPONSE FORM
and return in a sealed container/envelope to the City on or before 4:00 pm, local time, Wednesday
September 18, 2019. Late or incomplete responses will be disqualified.
Because purchases or contractual agreements of this nature require the expenditure of public funds, the
successful vendor shall understand that portions (potentially all) of their proposal (including any final
contracts) will become public record after its acceptance by the City.
ABOUT THIS DOCUMENT
This document is a Request for Information. It differs from a Request for Bid/Quotation/Proposal in
that the City is seeking a solution that meets the City’s needs, as described on the cover page and in
the following Background Information section, not a bid/quotation meeting firm specifications for the
lowest price. As such, the lowest price proposed will not guarantee an award recommendation.
This Request for Information will be evaluated based upon criteria formulated around the most
important features of a product or service, of which quality, testing, references, availability or
capability, may be overriding factors, and price may not be determinative in the issuance of a contract
or award. The proposal evaluation criteria should be viewed as standards, which measure how well a
vendor’s approach meets the desired requirements and needs of the City. Those criteria that will be
used and considered in evaluation for award are set forth in this document. The City will thoroughly
review all proposals received. The City will also utilize its best judgment when determining whether to
schedule meetings or interviews with vendors, after receipt of all proposals. A Contract will be
awarded to a qualified vendor submitting the best proposal. The City reserves the right to select, and
subsequently recommend for award, the proposed equipment/service which best meets its required
needs, quality levels, and budget constraints.
BACKGROUND INFORMATION & BILLING DATA
The City of Sidney Department of Fire & Emergency Services is a full-time career department
providing fire and EMS transport service to 20,000 residents plus the surrounding township area. The
Department operates with 38 full-time personnel from two stations. In 2015, the Department
responded to 3855 emergency incidents; 2977 EMS calls and 878 fire calls
Current Billing Provider; Ambulance Medical Billing (AMB) is our current billing provider
Current billing fee; 7.05% of amounts received
Current billing policies; only bill resident’s insurance companies and soft bill non-residents
Current ePCR software; ESO for EMS & Emergency Reporting for Fire operations/prevention
Current EMS billing provider pays all annual software maintenance fees (ESO & Emergency
Reporting), and provides EMS field tablets/computers, and the corresponding data fee for the tablets.
Current charge rates for 2019
BLS - $516
ALS1 - $909
ALS2 - $1137
Mileage - $11.73 per loaded mile
Number of billable transports for 2018
BLS 1321
ALS11107
ALS2 15
EMS transport vehicles
4 total - 3 front line ambulances and 1 reserve ambulance
Current payer mix 2018
Anthem 15%
Medicare 49%
Medicaid 15%
Self-Pay 12%
Others 10%
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2018 Data
Gross Charges billed in 2018 $1,768,135.55
Gross receipts $754,407.25
Less: Refunds $433.07
Net receipts $573,910.76
Medicare Receipts $366,703.68
Medicaid Receipts $47,483.00
Anthem Receipts $45,914.20
Self-Pay Receipts $3,313.13
Other Receipts $110,496.75
Discounts issued in 2018 $735,103.49
Adjustment/Write Offs processed in 2018 $278,624.81
SELECTION PROCESS
The selection process will be based on the responses to this Request for Information, and any proposal
review sessions. A committee comprised of members from the Department of Fire & Emergency
Services and the Finance Department will judge each vendor’s response as determined by meeting the
following criteria:
1. Meeting all Request for Information Conditions and miscellaneous instructions as outlined
herein, and the clarity, completeness and comprehensiveness of the proposal.
2. Providing references (which will be contacted) of past (all customers who have terminated
services during the past two calendar years) or current customers within the State of Ohio of the
proposed services verifying service levels and capability of the vendor’s to provide a thorough
solution.
3. Proposing the medical billing service and accounts receivable which will best address the
City’s goals and objectives as set forth in this document. This shall include:
a. Having experience with services of comparable scope and size to this request within the
last two years in providing billing for agencies similar to those described in this
document to fire departments. This includes the ability to separate billing for City
residents from non-residents.
b. Providing references verifying exemplary service levels for similar/same services.
c. Providing the number of claims you currently process, in total, for each of your clients
that make up your business portfolio.
d. Providing a complete timeline detailing implementation to ensure continuation of
service.
4. Meeting all ‘Request for Information’ mandatory requirements and/or specifications as outlined
herein.
5. Proposing the medical billing and accounts receivable services at the most advantageous cost to
the City commensurate with current budget constraints.
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The review committee will select the proposals, which appear most beneficial. These vendors may be
asked to provide a presentation to the review committee during the evaluation period. All costs
associated with the presentation will be solely the responsibility of the vendor. No negotiations,
decisions, or actions shall be initiated by any firm as a result of any verbal discussion with any City
employee prior to the opening of responses to this document. The City reserves the right to select, and
subsequently recommend for award, the proposed equipment/service which best meets its required
needs, quality levels, and budget constraints.
CONTRACT PERIOD AND PAYMENT TERMS
A formal contract will be used and shall control subject to specifications, requirements, and conditions
contained herein. A contractual period will begin following the City’s approval of the recommended
proposal (term of Agreement). The contract period shall cover a period of two calendar years and be
automatically extended for two (2) additional terms of one (1) year each at the discretion of the City.
Payment shall be made on a monthly percentage of collection basis. The percentage of collection fee
will be based on actual revenue received less refunds on overpayments. Payment will be made to
vendor within thirty days from receipt of invoice.
MINIMUM FIRM QUALIFICATIONS
This section lists the criteria to be considered in evaluating the ability of firms, interested in providing
the services and/or products specified, to be considered for award. Specific responses to each must be
provided in the accompanying Response Form. It is expected that the successful firm will exceed these
qualifications. Firms shall:
1. Be certified/licensed for the types of services specified and proposed and provide copies of all
applicable certifications or licenses;
2. Provide a bank reference statement and/or a copy of the most recent, audited, financial
statement;
3. Have the capacity to acquire all required permits, coordinate with necessary
approving/monitoring agencies;
4. Have provided services similar to those specified herein for a minimum of three (3) years; and
5. Be prepared to discuss any current MCS violations and any ongoing litigation that may cause
conflicts or affect the ability to provide services.
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MANDATORY SERVICE SPECIFICATIONS AND REQUIREMENTS
The City desires the most thoroughly engineered and acceptable service available. The following
specifications outline the minimum requirements of the proposed service. They are provided to assist
vendors in understanding the objectives of the City and submitting a thorough response. Proposals
received must reflect in detail their inclusion and the degree provided. Vendors may propose
methodologies which meet the “spirit” of the listed requirements, but shall note that the proposed
service which meets all, or most closely meets the specifications will be recommended for award
within the listed selection criteria. The successful vendor shall provide a service which:
1. Provides the following bill services: EMS transport billing
2. Utilizes billing software that accepts electronic uploads of patient demographic data from the
Fire Department’s Reporting Management System (RMS). This electronic upload,
accomplished through an interface between the vendors’ billing software and the Fire
Department’s RMS shall electronically upload the patient treatment narrative as written in the
Fire Department’s EMS module as well as all other information deemed necessary by the
billing vendor.
3. Provides an audit system designed specifically for the EMS accounts so all information is made
available to the Department of Fire & Emergency Services to monitor billing activities at the
discretion of the Department of Fire & Emergency Services.
4. Provides on-site training for Department of Fire & Emergency Services staff, at no additional
expense to City
5. Guarantees daily document retrieval through a lock-box arrangement with the City banking
institution to facilitate daily posting of revenue to patient accounts.
6. Provides pre-collection activities on accounts to significantly reduce accounts being deemed
“uncollectible.” At a minimum, this activity should include: three (3) statements sent with no
returned mail, if returned mail—contact “emergency contact,” one (1) telephone contact or
three (3) attempts for telephone contact.
7. Accepts responsibility for all EMS consumer billing inquiries and retrieval of medical records
for affiliated agencies on normal business days from 8:00 am to 5:00 pm.
8. Accepts responsibility for all EMS consumer complaints and compliments by providing this
information to the Department of Fire & Emergency Services administration (hard copy) no
later than the following workday or by computer media.
9. Ensures responsibility for maintaining all software necessary to fulfill this agreement as well as
the computer hardware to the extent that it owns such hardware.
10. Guarantees the ability to define Department of Fire & Emergency Services specific general
ledger accounts for cash, accounts receivable, general adjustments, bad-debt write-off, etc.
11. Supplies the Department of Fire & Emergency Services administration with financial reports on
an as-needed daily basis.
12. Guarantees that EMS administration will receive hard copy documents concerning procedure
changes relating to the Medicare B coverage for ambulance, the Medicaid of Ohio coverage for
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