Summary of Specifications:
SPECIFICATIONS FOR AMBULANCE BILLING SERVICES & DATA CAPTURE / REPORTING SOFTWARE
I. Background - The Auburn Hills fire department is a full service combination fire department that offers 24/7 fire protection and Advanced Life Saving services to residents and visitors to the City of Auburn Hills. In 2013 the Auburn Hills fire department operated in a Public / Private Contract with a private ambulance service to provide EMS to the city. In 2014 the fire department will discontinue the Public/Private Contract and take over all responsibilities for full ALS transport and billing operations for these services.
A. In 2012 the Auburn Hills fire department responded to 2,055 EMS calls which resulted in 1,610 transports.
B. The City of Auburn Hills is seeking proposals from experienced and qualified vendors to provide an ePCR solution fully integrated with vendors billing system to include: exception handling, inventory management and insurance verification tools.
II. Scope of Work - The City of Auburn Hills is seeking to provide the fire department with a turn-key billing and electronic data capture function that is efficient and effective. The City of Auburn Hills desires to enter into a contractual agreement with a governmental or private sector ambulance billing and data capture service, as a turn-key solution.
A. Objectives - It is the City of Auburn Hills objective to select:
1. A reputable firm to provide an ePCR solution fully integrated with vendors billing system to include: exception handling, inventory management and insurance verification tools for patient services rendered.
2. A reputable firm that within the last five years has been responsible for at least 5 concurrently active public sector ambulance billing and collection projects of similar size as the Auburn Hills fire department.
3. A reputable firm to provide complete and thorough financial reports to be presented to the Public Safety Director upon request.
4. The selected firm shall comply with the privacy obligations applicable to them under the Health Insurance Portability and Accountability Act of 1996 and the regulations issued pursuant thereto, as amended, (HIPAA) to protect the privacy of Personal Health Care Information (PHI) as delivery, collected, processed or obtained.
5. The selected firm shall be able to provide direct deposit of funds into the City of Auburn Hills bank account.
6. The Public Safety Director shall have the ability to review and authorize all accounts, prior to billing and again before being sent to collections if applicable.
III. Experience
A. Comparable Projects / References
1. Proposal provides references verifying exemplary service levels for similar services. References will be contacted to verify service levels and capability of the proposer to provide a thorough solution. Proposers shall provide a list of five (5) concurrent projects of comparable scope and size (integrated billing and electronic data capture) to this request within the last two years in providing ambulance billing and accounts receivable services similar to those described in this document. Include a contact person (name, address, title, responsibility and telephone number).
B. Experience / Qualifications - The ambulance billing service and accounts receivable function which will best address the City of Auburn Hills goals and objectives as set forth in this document. Please provide the following:
1. Years and capacity of the business
2. The number of claims you currently process, in total, that make up your business portfolio; number of clients
3. Business locations and staffing
4. Relative municipal provided ambulance billing, collection; reporting and electronic data capture experience.
5. Certifications and training of personnel assigned to handle the account.
6. Identify any subcontracted firms that will be utilized to fulfill the City’s requirements. Provide scope of work to be performed by the subcontracted firm as well as information relative to experience and qualifications of the proposed company.
7. Provide a summary of all services provided by your company, or any of its affiliates, including collection or ambulance services.
C. Work Program / Methodology - As part of this Request for Proposal, the consultant shall provide a work program that will address the objectives as discussed herein.
1. Your work program shall identify the tasks to be performed by your company and the timeframe to complete them. It must also identify who on the company’s team will be performing the tasks and related experience. Proposals shall include implementation (start-up) strategies, communication and coordination procedures/recommendations and a complete description of the billing, reporting and collection processes utilized by the company.
2. Provide within your proposal the methodology for utilization of electronic programs to streamline the processes, enhance reporting capabilities and increase communication. Identify software programs you currently utilize and those that integrate with your systems.
D. Reporting Capabilities - The following is a list of reports desired by the Auburn Hills fire department:
1. Charge Detail Report (Trip Date) Displays charge details, including trip date, run number, customer name (Lname, Fname), incident number, charge description, quantity, price per unit, and total charge amount. Charges are included based on the trip date.
2. Charge Type Summary Report Displays a count of all charges in each charge type and the total dollars. Charges are included based on trip date.
3. Credit As Type Summary Report (deposit date) Displays a count of credits and total amount, grouped by Credit As category. Credits are included based on the deposit date.
4. User Activity Report – Credits- Displays the credits posted by each user, and sorted by Credit As category. Includes trip date, run number, customer name (Lname, Fname), credit description, deposit date, check #, and total credit amount. Credits are included based on the post date.
5. Trip Detail (Current Payor) Displays a trip list, grouped by trip date and sorted by current payor. All charges and credits are displayed for each trip, regardless of the actual payor. Payor is defined as the person or persons responsible for paying for all or part of the EMS services provided to the patient.
6. Aging Detail Report (Patient/Aging Date) Displays aging, grouped by customer (Lname, Fname), and sorted in alphabetical order. Amounts are listed in the aging categories based on the aging date. Trips are included based on trip date and are listed.
7. Aging Summary By Current Payor Displays aging, grouped by current payor. Amounts are listed in the aging categories (Current, 31-60, 61-90, 91-120, 121-180, over 180) based on the aging date. Trips are included based on trip date.
8. Payment Credits By User (Deposit Date) Displays the credits posted by each user, and included trip date (date of service), run number, customer name (Lname, Fname), credit description, check #, amount and deposit date. Credits are included based on the deposit date.
9. Payor Summary (Credit as Type/Deposit Date) Displays a count of credits and total amount, grouped by Credit As category and payor (for whom the credit was posted). Credits are included based on the deposit date.
E. Costs
1. The Cost Proposal for ambulance billing system to include: exception handling, inventory management, insurance verification tools, reporting and data capture services.
2. Proposal shall provide a percentage fee based on an amount equal to a percentage of the amount collected each month for medical billing services. Any additional amounts for set-up, hardware, software, reports, collection fees or other fixed or percentage based fees must be included in the cost proposal. The City of Auburn Hills requires a complete cost proposal for all applicable services.
3. Shortlisted proposers will be asked to provide a presentation to the review committee during the evaluation period. No negotiations, decisions, or actions shall be initiated by any firm as a result of any verbal discussion with any City of Auburn Hills employee prior to the opening of responses to this document. City of Auburn Hills reserves the right to select, and subsequently recommend for award, the proposal which best meets its required needs, quality levels, and budget constraints.
4. The City of Auburn Hills may award a contract based on initial offers received, without discussion of such offers. Proposer’s initial offer should therefore be based on the most favorable terms available from a price and technical standpoint. The City of Auburn Hills may, however, have discussions with those proposers that it deems in its discretion to fall within a competitive range.
F. Contract Period & Payment Terms
1. A formal contract (submit sample copy with proposal) will be used and shall be subject to specifications, requirements, and conditions contained herein. A contractual period will begin following City of Auburn Hills Council approval of the recommended proposal, with a minimum 3 year contract with options to renew for up to 3 years.
2. Payment shall be made on a monthly percentage collection basis. The percentage of the 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.
G. Mandatory Requirements - These guidelines are provided to assist consultants submitting in response to this Request for Proposal in formulating a thorough response. The successful firm ensures and understands that:
1. All licenses required by the State of Michigan are to be maintained by the firm during the course of the contract. The consultant will comply with the regulations, laws, ordinances and requirements of all levels of government applicable to this project. The company will represent that all tasks will be performed in accordance with generally acceptable professional standards.
2. All required insurances are to be maintained by the firm during the course of the contract.
3. The company will ensure completion of the work in accordance with the proposed time line as proposed.
H. General Conditions - Additional information to this proposal from prospective firms may be requested.
1. All costs incurred in the preparation, submission, and presentation of this proposal, in any way whatsoever, will be wholly absorbed by the prospective firm. All supporting documentation will become the property of the City of Auburn
