REQUEST FOR PROPOSAL. Ambulance Billing Services

REQUEST FOR PROPOSAL Ambulance Billing Services Dallas County Iowa Government (the “County”) is requesting proposals from qualified Vendors (“Vendor”)...
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REQUEST FOR PROPOSAL Ambulance Billing Services Dallas County Iowa Government (the “County”) is requesting proposals from qualified Vendors (“Vendor”) to provide ambulance billing collection, financial reporting, and analytical services. This includes complete management of the billing process from patient transport to account closure. This request for proposal (“RFP”) defines the scope of services and outlines the requirements that must be met by Vendors interested in providing such services. Vendors shall carefully examine the entire RFP and any addenda thereto, and all related materials and data referenced in performing the service. Vendors are advised to read all sections of this RFP before submitting a proposal. The County will receive sealed responses up to 9:00 a.m., on MARCH 20, 2012, addressed to Brad Golightly, Chairman, Dallas County Board of Supervisors, 121 North 9th St., Adel, Iowa 50003. Responses received after this time will not be accepted. Responses will be publicly opened at the Dallas County Board of Supervisors meeting on MARCH 20, 2012, at 902 Court Street, Adel, Iowa 50003. The offers will be identified, by name only, at that time. All interested parties are invited to attend. Questions concerning the scope of work, response submittal, or process should be submitted in writing to: Mike Thomason, Assistant Director Dallas County EMS 512 10th Street Perry, Iowa 50220 515-465-3595 Office [email protected] The County reserves the right to reject any and all responses and to wave any irregularities and informalities. We look forward to receiving your response.

Brad Golightly, Chairman, Board of Supervisors Dallas County Iowa 1

Table of Contents 1.

INTRODUCTION .................................................................................................................................... 3

2.

PROPOSAL TIMELINES.......................................................................................................................... 3

3.

SCOPE OF SERVICES ............................................................................................................................. 3

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PROPOSAL INSTRUCTIONS: .................................................................................................................. 5

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ADDITIONAL REQUIRED INFORMATION:............................................................................................. 6

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CONTRACT PERFORMANCE STANDARDS: ........................................................................................... 7

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SELECTION PROCESS ............................................................................................................................. 8

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QUESTIONS AND ADDENDUMS ........................................................................................................... 8

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Dallas County Request for Proposal EMS Billing and Collections Services

1. INTRODUCTION Dallas County EMS has operated for the past years under a 28e with West Des Moines Iowa. The Board of Supervisors are ending that 28e and seeking a billing service that will serve their needs.

2. PROPOSAL TIMELINES Release And advertise the RFP: March 6, 2012 Sealed Proposal due: March 20, 2012 Opening of RFP: March 20,2012 Vendor Selection: March 27, 2012 Contract effective Date: April 16th, or a date mutually agreed upon by both parties, but no later than May1.

3. SCOPE OF SERVICES This Section outlines the minimum contract requirements for billing, collection, financial reporting and analytical services. The County desires to pursue partnerships to build an optimal revenue cycle. The minimal requirements that may or may not be described below. A. Billing 1. Retrieve the electronic billing file and other billing related information from the County via a web-based patient care reporting software or equal, or a process approved by Dallas County EMS. 2. Prepare and submit accurate and complete insurance claims according to the rates established by the County, guidelines and procedures established by the Vendor and the County, and all applicable laws and regulations including those for Medicare, Medicaid, and any other applicable carriers including both commercial and private insurances. Patient Care Reports submitted with complete and accurate information will be filed with third party entities within two (2) days of receipt from the County. The first contract shall include submittal of retro-active billing at a date to be determined. 3. Verification and Missing Information Follow-up: The Vendor will provide all labor, materials and equipment for verification of the downloaded transport 3

information and patient information. The Vendor will promptly notify Dallas County EMS, regarding the missing information required to complete the billing process. The Vendor will file any claim reviews and represent Dallas County in Medicare/Medicaid appeals up to and including cases before and ALJ (Administrative Law Judge). The Vendor will also respond to any billing and collections questions. 4. Prepare and mail invoices to patients/parties responsible for co-pays and/or deductibles, private pay, and uninsured patients, or as directed by Dallas County. 5. Post payments to the appropriate accounts and provide payment posting and revenue reports to the County. Vendor will ensure that all checks are scanned by a bonded employee and sent electronically to the bank of Dallas County’s choice. Copies of the checks and EOBs are given to the Dallas County account manager to be posted and reconciled to the patient accounts. Please explain your process. 6. Provide the County with an itemized report of all invoices and claims billed, monies collected and outstanding balances on a monthly basis to and in a format required by the County. 7. Provide the County with additional reports regarding write-offs and payment plan status on a monthly basis and in a format required by the County. 8. The Vendor will Invoice the County monthly for services rendered on a percentage of monies collected. The County will pay by VISA only. 9. Provide EMS personnel with appropriate training concerning documentation. The Vendor will act as a consultant regarding EMS billing and collection services. 10. Customer Service: The Vendor will provide a staff of Customer Service Representatives who will provide the patient account information Monday through Friday , during normal business hours, excluding holidays recognized by the Vendor. These hours shall be 8 a.m. to 5 p.m. A local or toll free customer service number must be provided. ( The number should be listed on all correspondence) 11. The Vendor acting on behalf of the County will remain respectful and mindful of the needs of the County’s citizens and patients. Weekly and monthly installment payments can be made available. 12. The Vendor agrees to employ Certified Ambulance coders/billers. The Vendor also agrees to provide a account manager for Dallas County. 13. The Vendor will provide collections services up and including: representing the County when claims are denied or under paid. 4

14. The County reserves the right to recall accounts from the Vendor upon written notice. 15. Patients will receive a bill each month for three (3) months. If a bill has not been paid within 120 days, the patient and the County shall be notified of the delinquent amount. The Vendor will report which accounts have been determined to be uncollectible to the County, the criteria for uncollectible accounts will be approved by the County. 16. The County reserves the right to return accounts from the Vendor if the Vendor has failed to file proper insurance or follow up on outstanding insurance claims. 17. Vendor is required to be Certified in Fair Debt Collection Practices Act. 18. The Vendor is responsible for providing all materials and resources required for the performance of the contract including, but not limited to, facilities, equipment, statements, postage and personnel.

4. PROPOSAL INSTRUCTIONS: The proposal response must address the items included in the Scope of Work and any additional information requested in this RFP. It is expected that the RFP conform the following format: Proposals should be prepared simply and economically, providing a straightforward, concise description of the capabilities of the Vendors offering. Proposals should be organized in the order in which the requirements are presenting in the RFP. All pages of the proposal should be numbered. Each paragraph in the proposal should reference the paragraph number and sub-number, and repeat the text of the requirements as it appears in the RFP. (Eg. 5.1 The Vendor must provide a history of the company…”) Information that the Vendor wishes to present that does not fall within any of the requirements of the RFP should be inserted at the end of the proposal and designated as additional materials. Each copy of the proposal should be bound or contained in a single volume where practical. All documentation submitted with the proposal should be contained in that single volume. Proposals should be as thorough and as detailed as possible so that Dallas County can properly evaluate your capabilities. The County reserves the right to contact references other than, and/or in addition to, those furnished by the Vendor.

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5. ADDITIONAL REQUIRED INFORMATION: 1. The Vendor must provide a history of the Company, qualifications and years of experience in Ambulance billing. 2. The Vendor must describe their capability to provide automated claims submission to applicable insurance carriers. 3. The Vendor must also provide references from five (5) current EMS Service providers who submit their runs to the Vendor via a firewall protected electronic interface. These references will include the name, address and telephone number of billable transports submitted electronically in 2010 and 2011. 4. The Vendor should provide information on the availability and descriptions of reports that can be generated on request via a secure connection to the Vendor’s Internet site. If applicable, please also indicate whether said reports can be saved to a variety of formats (MS Word, Excel, PDF format) and provide samples. 5. The Vendor should confirm that they have developed and implemented a compliance plan to insure billing procedures comply with all local, state and federal laws, rules and regulations.. Further, the Vendor provider shall provide the name and title of their compliance officer. 6. The Vendor shall confirm that, to the best of their knowledge, they are not presently the subject of any federal or state investigation involving fraudulent or abusive billing practices, and if such investigations are ongoing or have occurred within the past five (5) years, the Vendor shall provide the nature and outcome of such investigations with the response to this RFP. 7. Indicate whether or not you as a Vendor has had a contract terminated in the last five (5) years, and describe the nature and circumstances. Termination for default is defined as notice to stop performance due to the vendor’s nonperformance or poor performance and the issue of performance was either (a) not litigated due to inaction on the part of the vendor, or (b) litigated, and such litigation determined that the vendor was in default. 8. Please list the software used, how often it is updated, and method of training staff. 9. The County or its agent reserves the right to audit the records of the Vendor during normal business hours upon giving reasonable notice of intent to do so. 6

10. The Vendor, by virtue of the proposal, agree to hold Dallas County EMS harmless from liability incurred in the performance of the contract, additionally, Vendors agree to comply with all laws as applicable for work with a County government. 11. A certificate of bond or liability coverage not less than $500,000. 12. The Vendor shall describe their internal audit program. 13. The Vendor shall describe their staff and their Credentials and training. 14. A Non-Collusion Affidavit, by which the signer of the proposal declares that all persons, companies or parties interested in the contact as principals are named therein; that the proposal is made without collusion with any other person, persons, company or parties submitting a proposal; that it is in all respects fair and in good faith without collusion or fraud; and that the signer of the proposal has authority to contractually bind the Vendor. 15. The contract shall be for a period of one (1) year from the initial date of signing with the option to renew at the discretion of the County for a two (2) additional year term. 16. Describe any value added services provided by the Vendor that are not covered by the RFP, but would assist the County in enhancing its collections. Include examples of these services. 17. A written fee structure to provide services required in this RFP

6. CONTRACT PERFORMANCE STANDARDS: The County will evaluate all proposals in accordance with the Evaluation Criteria contained herein. Should the County determine that only one Vendor is fully qualified, or that one Vendor is clearly more qualified and suitable than the others under consideration, a contract may be awarded to that Vendor. This request does not commit the County to pay any costs incurred in the preparation and submission of proposals or in making necessary studies or designs for the preparation thereof, nor to procure or contract for services. The Vendor will be considered the sole point of contact with regard to all stipulations, including payments of all charges and the meeting of all requirements. The County will authorize payment to the Vendor on the basis of satisfactory performance and receipt of Vendor’s correct invoice for services rendered. All invoices shall be sent to:

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Dallas County Operations Administration 801 Court Street Adel, Iowa 50003 It is the County’s expectation that the contract between the Vendor and the County will be a performance based contract. During the contract development, the County will work with the chosen Vendor to establish these standards.

7. SELECTION PROCESS • Qualification and experience of the Vendor • Ability to comply with the Scope of Work • Use of technology • Reference checks and evidence of collections rates • History of compliance with accepted billing practices

8. QUESTIONS AND ADDENDUMS Vendors shall carefully examine this RFP and any addenda. Vendors should seek clarification of any ambiguity, conflict, omission or other error in this RFP writing. All questions and responses will be shared with other known Vendors submitting RFPs. For information regarding RFP contact: Mike Thomason, Assistant Director, Dallas County EMS, 512 10th Street, Perry, Iowa. 515-465-3595. [email protected]. If the answer to any question materially affects the RFP, the information will be incorporated into an addendum and distributed to other vendors. Oral comments do not form a part of this RFP.

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