REQUEST FOR PROPOSAL Sycamore Ambulance and Fire billing 2015

Transcription

1 REQUEST FOR PROPOSAL Sycamore Ambulance and Fire billing 2015 RECEIPT OF PROPOSALS Sealed Proposals for the City of Sycamore Ambulance and Fire Billing 2015 are invited and will be received by the Sycamore Fire Department, 535 DeKalb Avenue, Sycamore, IL on or before, but not later than 10:00 A.M. Local Time on Wednesday, September 16, Proposals will not be publically opened and read aloud. Each Proposer shall be required to submit one original and two copies of their respective Proposal in a sealed envelope or box. Sealed envelopes or packages containing Proposals shall be marked or endorsed: Proposal for City of Sycamore Ambulance and Fire Billing 2015 GENERAL DESCRIPTION OF WORK The City of Sycamore is looking for an outside billing service to collect monies for Ambulance and Fire services rendered by the City of Sycamore for Advanced Life Support ( ALS ) and Basic Life Support ( BLS ) calls and fire / rescue / hazmat related calls. Please see the City of Sycamore - Detailed specifications for ambulance billing RFP. QUALIFICATION OF PROPOSERS It is the intention of the City of Sycamore to award a contract only to the Proposer who furnishes satisfactory evidence that they have the requisite qualifications and ability and that they have sufficient capital and facilities to enable them to complete the work successfully and promptly, and to complete the work within the time named in the detailed specifications. The City of Sycamore may make such investigations as it deems necessary to determine the qualifications and ability of the Proposers to perform the work, and the Proposers shall furnish to the City of Sycamore all the information and data for this purpose as the City of Sycamore may request. The City of Sycamore reserves the right to reject any and all Proposals if the evidence submitted by, or investigation of such Proposers fails to satisfy the City of Sycamore that such Proposers is properly qualified to carry out the obligations of the contract and to complete the work contemplated therein. Conditional Proposals will not be accepted. PROPOSAL QUESTIONS All comments or concerns regarding this Proposal shall be addressed to the Fire Chief Peter Polarek via at ppolarek@cityofsycamore.com or at All such questions must be received no later than seven (7) days before the Proposals are due. AWARD OF CONTRACT The City of Sycamore reserves the right to award a contract which in its judgment is in the best interest of the City of Sycamore. The City of Sycamore reserves the right to select which items shall be included in the contract, including the right to accept or reject any or all Proposals, or any part thereof; waive any minor defects, irregularities; and to decide not to award any contract. INSTRUCTIONS TO PROPOSERS 1. Proposers shall at the time of making its Proposal, and as part of its Proposal, submit a list of all the subcontractors and equipment suppliers with whom it proposes to contract, and the class of work or equipment to be performed or furnished by each. Such list shall not be added to, nor altered, without the written consent of the City of

2 Sycamore. The City of Sycamore reserves the right to approve any and all subcontractors and no subcontractor shall be allowed to do work unless they are listed in the Proposers Proposal, or in a subsequent written statement to the City of Sycamore. 2. Proposer shall not under any circumstances be relieved of its liabilities and obligations as set forth in the Contract documents. All transactions of the City of Sycamore shall be with the Proposers. Subcontractors shall be recognized only in such capacity. 3. Proposer is to provide a detail of the Proposers experience in performing Ambulance and Fire Billing. 4. Proposer shall provide with the proposal three (3) local Illinois government references. Comparable Illinois located Fire Department references preferred, if available. 5. Proposer shall submit a detailed response to the detailed specification requirements. 6. The City of Sycamore reserves the right to reject any and all Proposals, to waive any informality in Proposals, or accept the Proposal that, in its opinion, will serve its best interests. 7. Each Proposer shall submit with its Proposal a statement of the address of its permanent place of business. 8. Any Proposer may be required by the City of Sycamore to submit additional data to satisfy the City of Sycamore that such Proposer is prepared to fulfill the Contract, if it is awarded to them. 9. Proposers shall inform themselves of all the conditions under which the work is to be performed. 10. The Proposer to whom a contract is awarded will not be allowed any extra compensation by reason of any matters or things concerning which the Contractor did not inform itself prior to submitting its proposal. The successful Proposer must employ, so far as possible, such methods and means in the carrying out of his work as will not cause any interruption or interference with any other Contractor.

3 City of Sycamore - Detailed specifications for ambulance billing RFP Scope of Service The City of Sycamore, IL is looking for an outside billing service to bill and collect monies for ambulance services rendered by the City of Sycamore, IL for Advanced Life Support ( ALS ), Basic Life Support ( BLS ), and Treat No Transport ( TNT ), Billable calls. The City of Sycamore, IL is seeking a qualified firm to provide ambulance and select fire billing and collection, financial reporting and analytical services for ambulance services rendered by the City of Sycamore, IL for Advance Life Support ( ALS ), Basic Life Support ( BLS ) and Treat No Transport ( TNT ), Billable calls for service. This includes complete management of the billing process from patient transports to account closures. The City of Sycamore, IL maintains two fire stations which serve over 20,000 (U. S. Census). Each year the City of Sycamore, IL emergency personnel transport approximately 1,200 patients. Currently, the City of Sycamore, IL charges for residents are as follows: $423-BLS, $550-ALS1, $750 ALS2, $10 per mile for each transport, $200 ALS or BLS Treat No Transport, Billable. Charges for non-residents are as follows: $575-BLS, $850-ALS1, $1,000-ALS2, $10 per mile for each transport, $200 ALS or BLS Treat No Transport, Billable. In addition to the current established fees, the City of Sycamore, IL reserves the right to modify existing fee schedules or implement other operational support fees during the term of the agreement. The vendor will be responsible to meet any necessary processes due free of charge. Select Fire Billing The City does not currently request payment for Fire related services including but not limited to nuisance fire alarms, car fires, investigations, extrications and scene protection. The City is interested in determining the feasibility of this fee structure, based on the experience of the service provider, and the related costs for the service. The reporting will be similar to the Ambulance Billing structure, but must be able to enumerate the revenue separately. Additionally, the City does bill for certain hazmat (Spiller Pay) incidents under an Ordinance enacted by the City. Billing for these incidents currently is performed internally by Fire Department personnel. The City is interested in including this type of billing with the above fire billing if feasible. General terms of contract The City of Sycamore is interested in considering an incentive-based or a percentage-based compensation system. The contractor shall provide a fee proposal based on an incentive-based or a percentage-based compensation system. The contractor shall provide any innovative fee structure currently in use with other clients. The contractor shall identify and explain any reimbursable expenses for which reimbursement would be expected in addition to the contract fee.

4 Contract to provide Emergency Medical Services (EMS) billing and collection services. The City of Sycamore, IL will award one contract for a firm to provide all services necessary to receive and process patient billing and collection. The term of the contract resulting from this solicitation shall be for a period not to exceed three (3) years with two (2) optional one year extensions at the discretion of the City of Sycamore, IL. All firms interested in providing services to the City of Sycamore, IL must provide detailed responses for each of the requirements and /or questions listed below. Be sure to indicate next to your response the question that is being answered. If the answer is contained within any attached marketing material, please indicate precisely where the response to the particular question is located. Listed below are the minimum requirements the City of Sycamore is specifying for this service. 1. Provide all personnel, materials, and services needed to perform and accomplish all requirements for this proposal. 2. Authorized to bill for EMS services in the State of Illinois and must provide a full-time program manager for the duration of the contract. 3. Ensure all required documentation and agreements with payers are properly filed and maintained on behalf of the City of Sycamore, IL. 4. Obtain pre-approval from the City of Sycamore, IL of all forms used in the execution of this contract. 5. Upon receipt of the ambulance report data, the ambulance billing contractor must prepare and mail invoices to the patient within seven (7) business days and also submit the claim to payor if insurance information is readily available. This mailing shall include all necessary forms for payment processing, along with a return envelope. 6. Upon receipt of the patient claim information, if required, the ambulance billing contractor must electronically submit Medicare, Medicaid, and other insurance claims within 3 business days. Manual submission of claims is acceptable only if electronic submission is not available, and must also be accepted by those insurance companies. 7. Ensure proper security and confidentiality of patient information and records, including, but not limited to executing a business associate agreement as required by the Health Insurance Portability & Accountability Act of 1996 (HIPAA). 8. Provide all labor, materials and technology necessary to obtain missing patient information from all available sources prior to issuing insurance claims or direct patient billing. 9. Utilize current diagnostic coding to ensure compliance with federal, state, and local regulations. 10. Resubmit or resolve denied or disallowed claims within the allowed time frame. 11. Accept responsibility for patient billing inquires and complaints during regular business hours (M-Fri, 8AM - 5PM). 12. Provide the tracking of submitted claims to ensure timely payments. 13. Provide monthly statements to allow patients to be aware of outstanding balances. 14. Maintain generally accepted accounting procedures (GAAP) for the reconciling of all financial transactions. 15. Provide access to the City of Sycamore, IL staff to monitor, change or correct billing activities accounts receivable for all accounts under this contract. 16. Facilitate the posting of revenues and provide documents to the City of Sycamore, IL s banking institution. 17. Reports and billing shall clearly differentiate between resident and non-resident patients. 18. Requests for refunds must include the patient s payment information along with a detailed explanation of why the refund is requested and all information necessary to submit the refund. 19. Provide prompt, accurate reporting which shall include as requested: A detailed report showing each activity that has taken place during the day including receipts, charges and adjustments in

5 relation to each patient by name and date of service and total accounts receivable. This report must also note any exception that may change or pre-approved amounts. 20. Prepare a monthly report showing all transactions that affect the General Ledger. This report must be available in either detailed or summarized form. Provide prompt, accurate customized monthly reporting which shall include the gross charges billed for the date of service month, minus contractual allowances, write-offs (abatement, dismissals, bankruptcies and settlements), refunds, and payments (indigence cost of care rolling up to the net ending accounts receivable) balance due in relation to each patient by name and date of service. Also, include on this report are 1.) the number of trips per month, 2.) the number of patients per month, 3.) the gross charges per trip, 4.) the cash collected per trip and 5.) the net collection percentage per trip. Custom reports are to be generated and delivered to the City within 7 days of the close of the month unless otherwise specified. 21. Prepare a financial summary showing period to date and year to date totals for charges, receipts, adjustments, net accounts receivable, total accounts, receivable and collection percentages, and aging reports. 22. Forward monthly reports, including account status, to the City of Sycamore. 23. Utilize Billing and Data systems compatible to the City of Sycamore, IL Patient Collections software and ZOLL Tablet PCR. Billing contractor to provide (City selected) five tablets or laptop computers, software, and mobile hotspot connections for remote patient care reporting at the initiation of the contract. These upfront costs to be recovered from billing revenue received during the two years of the contract. Billing contractor can submit a contract proposal with this listed as an option. 24. Ensure that all data collection, reporting, and billing methods comply with all current State and Federal Regulations. 25. Bills with pending insurance payments will be held over the 120 days. Bills with no payment activity at 120 days will be forwarded to the City of Sycamore in XML format. If a payment plan has been established with the patient that exceeds 120 days for non-insurance bills, and it is being met, the account will not be turned over to the collection agency. 26. Provide online access to information and hard copy reports required by City of Sycamore, IL, including but not limited to: a) Ambulance transport patients and Treat No Transport, Billable patients received / billed; b) Payments received; c) Outstanding balances; d) Adjustments and refunds; e) Aging of open accounts; f) Bad Debt Accounts forwarded to the City of Sycamore; and g) Status of all accounts. 27. Provide regular updates and on-going training to the City of Sycamore, IL on any changes to billing requirements based on industry standards or requirements of applicable health care laws and regulations. 28. Ambulance billing contractor must have certified Ambulance Coders on Staff certified by the National Academy of Ambulance Coding (NAAC) 29. Provide list of clients similar in size and scope to the City of Sycamore, IL as well as other client lists. These references must include contact names and telephone numbers. Be prepared to discuss and provide information on clients that are no longer with your firm. 30. Provide or be prepared to enact a sample implementation plan with projected activities and timelines, including all scheduled milestones. Identify the most critical issues that must be satisfactorily addressed to assure this contract will be successfully implemented. The proposing company shall be prepared to work with the City of Sycamore, IL s existing medical billing staff in order to allow for a seamless transition of ambulance billing services.