REQUEST FOR PROPOSALS. For AMBULANCE BILLING SERVICES. For the. North Metro Fire Rescue District Broomfield, CO September 25, 2015

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1 For AMBULANCE BILLING SERVICES For the Broomfield, CO September 25, 2015 NORTH METRO FIRE RESCUE DISTRICT 101 SPADER WAY BROOMFIELD, CO

2 is accepting Proposals for. There is no express or implied obligation for the District to reimburse any prospective Bidder, or any other person or entity, for any expense incurred in preparing or submitting a Proposal in response to this Request for Proposals (RFP). During the evaluation process the District reserves the right, where it may serve the District's best interests, to request additional information or clarifications from the Bidder, or to allow corrections of errors or omissions. At the discretion of the District, prospective Bidders may be requested to make oral presentations as part of the evaluation process. Proposals will be accepted at District Headquarters located at 101 Spader Way, Broomfield, Colorado 80020, at which time and place all Proposals will be publicly opened. If mailed or delivered, Proposals are to be sent to 101 Spader Way, Broomfield, Colorado Proposals must be received at District Headquarters prior to 5:00 p.m. (our clock) on Friday, October 9, Any necessary interviews will be conducted during the week of October 12, with final selections being made by Thursday, October 15, All questions regarding this RFP should be directed to Lisa Mehrhoff, Chief Financial Officer. Questions must be in writing and can be ed to lmehrhoff@northmetrofire.org or faxed to A copy of the RFP may be obtained from: 1. The District s Website at or 2. The District s Headquarters located at 101 Spader Way, Broomfield, CO P age

3 REQUEST FOR PROPOSALS FOR AMBULANCE BILLING SERVICES Background Information September 25, Spader Way Broomfield, CO is dedicated to providing quality service to its residents through fire protection, emergency medical services, hazardous materials response and specialized rescue. Formed in 1946, the District now covers 63 square miles with a population of approximately 111,000 people including the City and County of Broomfield, the City of Northglenn and unincorporated areas of Boulder, Adams, Weld and Jefferson Counties. Nature of Services Required A. General The District respectfully requests proposals for the from qualified consultants ( Consultants ). The selected Consultant will assist the District s Staff on the project that is discussed further in this request for proposal (the RFP ). To be considered, a proposal must be received by Lisa Mehrhoff, Chief Financial Officer,, 101 Spader Way, Broomfield, CO 80020, by 5:00 p.m. on Friday, October 9, Any necessary interviews will be conducted during the week of October 12, with final selections being made by Thursday, October 15, The current ambulance user fees are as follows: $768 for Basic Life Support (BLS) level care $855 for Advanced Life Support (ALS) Care Level 1 $875 for Advanced Life Support (ALS) Care Level 2 $15 per mile transportation charge $73 for Oxygen therapy $88 for Intravenous (IV) therapy $88 for Ortho/Spinal Immobilization $175 for Care Rendered/No Transport 3 P age

4 $108 for Disposable Medical Supplies According to the 2014 analysis report, charges for ambulance services were $5,525,511, and payments received were $2,185,580; end of the year collection rate to include mandated writeoffs was 60%. This percentage takes into account the mandated write-offs. North Metro Fire Rescue District has a large population of Medicare and Medicaid residents. Therefore, approximately 41% of charges have been attributed to Medicare/Medicaid. accepts minimal payment plans for clients unable to pay the entire amount of their ambulance bill. Accounts sent to collections are sent to a third-party collection agency, chosen by the District, to work in conjunction with the ambulance billing company to produce all necessary documents for collection purposes. The District provides an ambulance membership program to its citizens. Annual membership cost for an individual is $25, a senior family membership is $25 and a family membership is $35. There are approximately 731 individual memberships, 1,235 senior family memberships and 46 family memberships. There are a total of 2012 members as of December 31, 2014 that fall under the umbrella of the Ambulance Membership Program. These members do not receive a bill for the first $1,500 annually of their portion of any transport bills. The members must possess medical insurance or Medicare, and their claims are submitted for payment by the insurance company. B. Required Professional Services 1. Billing a) The Consultant shall use a software interface between the Zoll Data Systems, epcr Suite, and the billing program used by the District. b) The Consultant shall be able to prepare invoices according to the rates established by the District, guidelines and procedures established by the Consultant and the District, all applicable laws and regulations including those for Medicare and Medicaid services (CMS). The Consultant shall also bill all non-emergency transports according to applicable laws established by Medicare, Medicaid and other applicable agencies. c) The Consultant shall be able to prepare membership renewal invoices using the District s form letter and member list. The Consultant shall be able to provide the cost of the ambulance transports that were written off for member transports. The 4 P age

5 Consultant will accept new memberships throughout the year and maintain a database of members to be shared monthly with the District. d) The Consultant shall utilize available resources and databases to obtain billing insurance information on private pay patients. e) The expectation of the District is that the initial invoices will be processed within three business days of the posting of the billing file, according to the agreed upon process for various claim types. f) Assistance in providing documents, preparing responses to, and meeting with auditors from federal or state government or their agents. Assistance with preparing materials in support of an appeal by the District of any adverse findings by such auditor. 2. Collections a) The Consultant shall process all claims according to timelines defined by the District and the Consultant. b) Denials for Medicare and Medicaid shall be processed according to the timelines defined by the Consultant and the District. c) The Consultant must remit to the District all funds collected, less refunds issued. Fees charged by the Consultant for billing and collection services will be based upon net collection. The District regards net collections as total funds collected less refunds issued as a result of overpayments or erroneous payments. d) The Consultant must accept credit cards as a form of payment by customers. 3. Reporting a) Accounting for all billing pursuant to Generally Accepted Accounting Principles shall be provided on a monthly and annual basis, and according to the timelines defined by the District and the Consultant. The accounting for billing shall include detail by call for city and type of insurance coverage. b) Reports should be provided in MS Excel and/or as PDF documents and/or CD when requested. c) Daily bank deposit and credit transactions processed report. d) Monthly reports and all supporting documentation shall be submitted to the District ten (10) days from receipt of final reports. e) A report showing the number and amount of claims filed with Medicare and Medicaid, including the confirmation information from Medicare or Medicaid acknowledging receipt of the claim by District. 5 P age

6 f) A reconciliation report showing the amount of cash receipts posted and how the amount ties to the daily bank deposit. g) A monthly revenue report showing all transports billed. h) Monthly accounting period report for the cash collected each month. i) Summary and Aged Accounts receivable Trial balance. 4. Analytical Services a) The Consultant will be expected to provide analysis and expertise in all issues related to ambulance billing. This includes analysis of trends and other pertinent issues that may develop. b) The Consultant shall schedule quarterly meetings with the District to review performance. Also, at a minimum, a written report reviewing the performance of the accounts receivable shall be prepared, identifying among other issues, the strengths, weaknesses, and opportunities of the performance. In addition, key issues that may arise in the future should be identified, along with strategies to address the issues. C. Minimum Scope of Services All respondents are requested to provide the information cited below, as well as any supplemental information that you feel provides a comprehensive view of your organization, the proposed design team and your approach to this project. Information should be presented in a clear and concise manner. Proposals shall include the following information: 1. A one-page statement of interest and qualifications for this proposal including the Consultant s name, address, and telephone number, including the name, title, address, telephone and fax numbers, and addresses of each contact person for the duration of the proposal evaluation. Identify the local office that will handle this service. 2. A brief (maximum three-page) proposal summary that describes the Consultant s understanding of the RFP and how it intends to meet the stated requirements. Include any concerns regarding scheduling, concept or expectations. 3. Discussion of your organization s specific abilities and expertise to provide the required professional services and qualifications related to the proposal requirements. 4. Provide some detail of the billing system and billing processes utilized as well as the identity of the software utilized and whether this is third-party or proprietary. 6 P age

7 5. Summary of the Consultant s general qualifications, background, number of employees, office locations, etc. Consultants who currently bill for ambulances services are preferred. 6. Describe the relevant experience of your Consultants working with ambulance service billing, during the past five (5) years. Include ability to meet service deadlines, extras added after the contract, service size and a list of at least three clients for which your firm has provided similar professional services in the last three (3) years. Please include current contact information (name, address, phone number, and address) for each reference. 7. Describe the precise scope of work proposed to be accomplished. Clearly delineate any modifications (additions or deletions) to the general scope of services. 8. Describe any services provided by the Consultant that are not covered by the RFP, but would assist the District in enhancing its collections. 9. Provide a list of the information you will routinely require for your work and the extent of the assistance required from the District s support staff. 10. Describe and discuss the Consultant s compliance program and how the program meets or exceeds the requirements of CMS and HIPAA. 11. Provide a list of the current interfaces you have with third-party fire records management systems, and describe the standards utilized for importing patient records from third-party fire reporting software. 12. Provide your indication of payment terms. 7 P age