ADDENDUM NO. 1. February 15, 2016

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1 Office of the Mayor-President Purchasing Division City of Baton Rouge Parish of East Baton Rouge 222 Saint Louis Street, Room 826 P.O.Box1471 Baton Rouge, Louisiana Patti J. Wallace, CPPB Director of Purchasing 225/ FAX 225/ ADDENDUM NO. 1 February 15, Third Party Medical Billing Services Proposal submission deadline: February 29, 2016 Proposal Closing Time: 2:00 p.m. (Local Time) Your reference is invited to Solicitation No: Third Party Medical Billing Services which is scheduled to open at 2:00pm, on February 29, 2016, for Third Party Medical Billing Services for the City of Baton Rouge-East Baton Rouge Parish. 1. This addendum provides the attached responses to all questions received by the RFP deadline. This addendum is hereby made a part of the RFP for Third Party Medical Billing Services and should be acknowledged. 1 P age

2 Q: Total EMS responses? A: 41,256 written responses Q: Total Billable EMS Transports? A: 33,710 billable transports Third Party Medical Billing Services: Q&A Q: Payer Mix (in either numbers or percentage) for 2014? A: Medicaid 22.0% Medicare 36.0% Other 3.0% Self-Pay 26.0% Commercial Insurance 13.0% Q: Payer Mix (in either numbers or percentage) for 2015? A: Medicaid 23.0% Medicare 36.0% Other 3.0% Self-Pay 25.0% Commercial Insurance 14.0% Q: In 2014, the transport payer mix CHARGES are as follows: A: Medicaid 22.9% Medicare 32.0% Other 2.7% Self-Pay 30.0% Commercial Insurance 12.4% Total Gross Charges for the calendar year 2014 = $26,883, Q: In 2015, the transport payer mix CHARGES are as follows: A: Medicaid 22.8% Medicare 32.0% Other 2.5% Self-Pay 29.7% Commercial Insurance 13.0% Total Gross Chargers for the calendar year 2015 = $28,970, Q: In 2014, the transport payer mix PAYMENTS are as follows: A: Medicaid 25.0% Medicare 37.0% 2 P age

3 Other 5.0% Self-Pay 8.0% Commercial Insurance 25.0% Q: In 2015, the transport payer mix PAYMENTS are as follows: A: Medicaid 26.0% Medicare 38.0% Other 3.0% Self-Pay 6.0% Commercial Insurance 27.0% Q: In calendar year 2014 and 2015, what was your gross revenue for EMS transports? A: Year Total Gross Revenue 2014 $9,999, $9,984, Q: What are your total adjustments in dollars for the calendar year 2015? A: Bad Debts = $204, Q: What are your total mandatory adjustments in dollars for the calendar year 2015? (Mandatory adjustments include Medicare, Medicaid, Worker s Compensation, VA, bankruptcy, intercept, Gunderson, Alliance, Blue Cross/Blue Shield, HIRSP, WEA Trust, Not Medically Necessary, Medical Associates, Tri-Care, and interest offset) A: Total Mandatory Adjustments = $9,910, Q: Call type break down for 2013? (in either numbers or percentage) A: ALS calls ALS calls BLS 7580 calls Q: Call type break down for 2014? (in either numbers or percentage) A: ALS calls ALS calls BLS 7793 calls Note: These stats are excluding canceled trips Q: Call type break down for 2015? (in either numbers or percentage) A: ALS 1 26,555 calls ALS calls BLS 8,090 calls Note: These stats are excluding canceled trips 3 P age

4 Q: Current Billing Fee? A: 4.95% of Monthly Collected Revenue Q: Current Billing Company? A: Digitech Computer, Inc. Q: How are these services being funded, now that they also include epcr? A: Currently, the third party billing vendor charges EMS a percentage of the collected fees for their service. EMS pays the epcr vendor, ImageTrend, for the use of their program. Right now, these two systems are separate and are run by separate vendors. With this RFP, prospective third party billing vendors will provide a new epcr program, to specifications as outlined, to EMS as part of their service. Vendors will take the cost of that epcr program into account when creating their proposal and will reflect that in what percentage (of total collected by EMS) that they will charge. Q: How much is this anticipated to cost the agency? A: The awarded vendor will propose a cost, which will be a percentage of the collected fees for services rendered by EMS. Q: Is there an up-front cost or is it just funded through fees collected for the services? A: The costs associated with the Third Party Billing Vendor will be at a percentage of the collected fees for services rendered by EMS. This cost should be included in the vendor s proposal. Q: Also, do you happen to know how many emergency vehicles EMS operates? A: EMS operates 13 Stations (ambulances) from 7:00 AM 7:00 PM. Starting at 7:00 PM and going until 7:00 AM the next morning, the number of stations drops to 11. This cycle repeats every day. On each 12 hour shift, there is a Shift Supervisor and Deputy Shift Supervisor that are on duty, running/jumping calls in a SUV that is capable of ALS, but not transporting. Also, depending on staffing, there may be multiple Unit Commanders and other Deputy Shift Supervisors running/jumping calls in an SUV that is capable of ALS, but not transporting. At any given point, there may be more than the regular assigned station ambulances on duty, depending on special events or full staffing. EMS has multiple vehicles in its fleet, but not are all operating at the same time. Q: How does EMS secure their ambulance billing and epcr data currently? Is there some sort of data security/hippa compliance software or solution that they use? A: All data is secured and encrypted based on current HIPPA standards. Data for billing is housed and certified secure/encrypted by the current third party billing vendor, Digitech Computers, Inc. The current epcr vendor, ImageTrend, houses all epcr data and certifies that the data is secured and encrypted to HIPPA standards. All transmission of both billing data and epcr data is also secured/encrypted by the vendors. Q: Does the Agency desire to discontinue the use of Image Trend epcr or is the Agency satisfied with that solution? A: The Agency wishes to explore different options for an epcr program at this time. 4 P age

5 Q: Please confirm the Agency does specify the successful vendor include the costs of the epcr system inside their proposed fee. Said differently the proposed fee should include both billing services and the epcr system. A: The Agency does require that the successful vendor include the costs of both the billing services and the epcr program into their fee. Q: What is the age of the hardware currently deployed for epcr software usage? A: Currently the age of the hardware that is deployed in the field ranges from 5 to 8 years old. New hardware will be deployed by the end of Q: Please provide the transport volume by hospital for calendar year A: Baton Rouge General (Bluebonnet location) 6,976 Baton Rouge General (Mid City) 2,108 Lane Regional Medical Center 3,023 Oschner 3,228 Our Lady of the Lake RMC 18,018 Our Lady of the Lake PEDS 1,579 Woman s Hospital 731 Earl K. Long Q: In calendar year 2015, what percentage of all transports went to each hospital listed in the Solicitation? A: Baton Rouge General (Bluebonnet location) 19.6% Baton Rouge General (Mid City) 5.9% Lane Regional Medical Center 8.5% Oschner 9.0% Our Lady of the Lake RMC 50.5% Our Lady of the Lake PEDS 4.4% Woman s Hospital 2.0% Earl K. Long Q: Please provide total Transports billed for calendar years 2013, 2014, and A: ,037 Transports ,616 Transports ,435 Transports Q: Please provide the average loaded miles for years 2013, 2014, and A: miles miles miles Q: Do you charge for the following services; if so, what are the rates? 5 P age

6 A: ALS1 $ ALS2 $ BLS $ Mileage $14.00 SCT ALS Non-Emergency Air Transport No Transport/At Scene Q: Please provide the contracted rates for Blue Cross for the years 2014 and A: The contracted rates for Blue Cross were the same for the years 2014 and They are as follows: Mileage $11.40 ALS/ALS2 $ BLS $ Q: Please specify which hospitals the current vendor maintains electronic interfaces with for the purpose of obtaining patient demographic and insurance data. A: Currently, none. The Agency is wanting to begin this endeavor with the new vendor. Q: Please confirm all Patient Care Reports for the Agency are maintained in the Image Trend epcr system dating back to How many records are maintained in the Image Trend System? If there are multiple epcr systems utilized dating back to 2008 please specify the name of the vendor and the number of records included in that system. A: All electronic records dating back to 08/17/2009 are in Image Trend. Prior to 08/17/2009, records were done on paper and are stored electronically in a document management system at The Agency s Headquarters. The Agency is requesting that all records starting with 08/17/2009 be imported into the new epcr program and the Awarded Vendor assume responsibility of all requests (billing, medical, etc) of those records. To date, there are 315,000 plus records in Image Trend. Q: How has training on documentation for Paramedics and EMTs been provided to your agency in the past? A: Training had been done in house and by the third party billing vendor. Q: Do the Paramedics and EMTs have the ability to access training through the means of the internet and a Learning Management System? A: All paramedics and EMTs have access to a PC with Internet Access. Q: Has your agency used any third party company other than your billing provider in the past to provide documentation and HIPAA training? Q: Is the City happy with the service and product provided by Imagetrend? 6 P age

7 A: The city is satisfied with what ImageTrend provides. The City also knows that there are other options in other epcr programs that would better fit the needs and requirements of the Agency. Q: Can a billing vendor submit 2 separate bids with different options of epcr software? A: No Q: If the City allows 2 options for epcr software and prefers that a billing vendor offer options of epcr in one solicitation, can a billing vendor submit 2 different Attachment B forms to show what the fee would be for each epcr option? A: Q: Does the City want any hardware for epcr as part of this solicitation? A: No Q: Will the billing vendor be required to mail HIPAA Notices to transported patients? A: No Q: Is your current billing internal or outsourced? A: Outsourced Q: In calendar year 2015, how many patients were transported? A: Approximately 35,435 patients were transported by EMS in Q: Does your vendor currently provide you with delinquent account collections? A: No; delinquent account collections are done in-house Q: Why are you currently going out for bid? A: The Agency wishes to obtain a prospective third party billing vendor that will provide a new epcr program, to specifications as outlined, to EMS as part of their service. The vendor will take the cost of that epcr program into account when creating their proposal and will reflect that in what percentage (of total collected by EMS) that they will charge instead of the Agency paying for the epcr system and third party billing company separately. Q: Are you looking for a new epcr software or would you like to stay with ImageTrend? A: The City knows that there are other options in other epcr programs that would better fit the needs and requirements of the Agency, and hopes to acquire one. Q: Are you looking for new hardware? Q: What is the anticipated start date for this contract? A: May 1, P age

8 Q: What is the current level of care that you provide? A: Advanced Life Support Q: Do you bill the residents and non-residents the same? A: Yes. Q: Do you bill for No Transports? Q: Do you charge a base rate mileage only? A: We charge a base rate and mileage. Q: Does your service itemize other charges? A: Yes. Q: Does your service bill for fire calls? Q: Who is responsible for lock box expenses? A: The awarded Provider Q: The RFP requests financial information that is confidential and subject to being disclosed during an open records request. Would it be permissible to provide the financial information at the interview, if selected for an interview? A: Yes. If selected for an interview, it would be permissible to submit the requested financial information. Q: What kind of access will ImageTrend software provide for the transition? A: To be determined at a later date. Q: Is there a preference for cloud based SAAS or client server model? A: Cloud Based Q: How may epcr end users? A: Q: How many patient charts to be transferred? A: 315,000+ Q: The current contract became effective September 2012, is there a particular reason the Agency elected to bid the contract out at this time? 8 P age