Pre-Advertisement Notice for EMS Revenue Billing Services

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EMS Revenue Billing Services - Draft Statement of Work
1. Purpose and Background
The City of Atlanta, through the Atlanta Fire Rescue Department (AFRD), seeks proposals from
qualified firms to provide comprehensive Emergency Medical Services (EMS) revenue billing
and revenue cycle management services. This procurement is intended to establish a compliant,
high-performing solution aligned with current operational, regulatory, and financial
requirements.
AFRD operates an EMS transport program utilizing Advanced Life Support (ALS) units and
documents patient care through the ImageTrend Elite ePCR system. The selected vendor will
support AFRD by managing defined components of the EMS revenue cycle while ensuring
compliance with all applicable federal, state, and local laws and regulations.
2. Scope of Services
The Contractor shall provide the following services as a fully integrated EMS revenue billing
solution. Services not explicitly listed are excluded unless identified as Optional Services under
Section 4.
3.1 Billing and Claims Processing
The Contractor shall:
* Receive AFRD-approved electronic patient care reports (ePCRs) from ImageTrend Elite.
* Review ePCRs for billing completeness and accuracy.
* Process and submit claims within two (2) business days of receipt of complete and
approved billing data.
* Submit claims electronically to all applicable third-party payers, including Medicare,
Medicaid, commercial insurers, and other guarantors, in compliance with HIPAA and
CMS requirements.
* Identify documentation discrepancies and coordinate corrections with designated AFRD
staff.

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3.2 Invoicing
The Contractor shall:
* Generate invoices using AFRD-established rates and charge structures.
* Ensure all invoicing complies with CMS regulations, the Fair Debt Collection Practices
Act, and other applicable laws.
* Verify insurance eligibility prior to claim submission.
* Pre-screen claims for required documentation, including medical necessity and
certification requirements.
3.3 Collections Support
The Contractor shall:
* Manage payer follow-up, denials, and appeals across all payer classes.
* Reclassify accounts following payer adjudication.
* Provide customer service support to patients and payers during standard business hours.
* Maintain call recording and ticket tracking for customer inquiries.
* Act as AFRD's advocate with third-party payers to optimize reimbursement.
All payments shall be remitted directly to AFRD. The Contractor shall not accept or retain
patient or payer payments.
3.4 Accounting and Reporting
The Contractor shall provide standardized reporting to AFRD, including:
* Weekly billing and payment activity reports.
* Monthly accounts receivable aging, collections, and reconciliation reports.
* Annual financial and audit-support reports as required.
Reports shall be delivered electronically in City-approved formats. Report definitions and
templates will be finalized during contract implementation.
3.5 Analytics and Performance Review
The Contractor shall:
* Conduct periodic performance reviews of billing accuracy, collections efficiency, and
receivables trends.

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* Provide written analytical summaries at least annually, identifying risks, performance
gaps, and improvement opportunities.
* Participate in review meetings with AFRD as scheduled.
3.6 Technology and Security
The Contractor shall:
* Provide and maintain billing software and secure interfaces required to support the scope.
* Integrate with ImageTrend Elite ePCR without disrupting AFRD operations.
* Maintain HIPAA-compliant data security, disaster recovery, and backup systems.
* Retain records in accordance with an agreed-upon record retention schedule.
3.7 Training
The Contractor shall:
* Provide initial and refresher training to AFRD personnel related to documentation
compliance and billing requirements.
* Deliver all required training at no additional cost.
4. Optional Services (Priced Separately)
The following services, if requested by the City, shall be priced separately and shall not be
included in the Base Scope:
* Expanded analytics or custom reporting beyond standard reports.
* On-demand operational consulting unrelated to routine billing performance.
* Additional training sessions beyond the minimum requirements.
5. Performance Standards
The Contractor shall meet the following minimum standards:
* Claims submission within two (2) business days of complete data receipt.
* Denial follow-up initiated within three (3) business days of notice.
* Customer inquiry response within one (1) business day.
Performance metrics will be monitored and incorporated into contract management and renewal
considerations.
6. Pricing Structure

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Proposers shall submit pricing using the City's standardized cost proposal template. Pricing shall
be:
* Based on a clearly defined percentage of net cash collections, or other City-approved
structure.
* Inclusive of all Base Scope services.
* Transparent, auditable, and capped where applicable.
The City reserves the right to negotiate pricing prior to award.
7. Governance and Oversight
AFRD reserves the right to audit Contractor records related to this contract. The Contractor shall
cooperate fully with audits, inspections, and compliance reviews.
8. Exclusions
The Contractor shall not:
* Accept or process payments on behalf of AFRD.
* Modify billing rates or write off balances without written AFRD authorization.
* Perform services outside the defined scope without an executed contract amendment.
9. Transition and Exit
Upon contract expiration or termination, the Contractor shall:
* Support orderly transition of services to the City or a successor vendor.
* Return or securely transfer all AFRD data.
* Provide transition assistance at no additional cost for up to ninety (90) days.