1-6172-26S.RFP.pdf

REQUEST FOR PROPOSALS

NO. 6172-26S

EMS BILLING, COLLECTION, AND

POSTING SERVICES

Barrett J. Tolbert

Contracts and Procurement Director Lonnie Hamilton, III Public Services Building

4045 Bridge View Drive, Ste B250 North Charleston, SC 29405-7464

Telephone: 843.958.4750

Fax No. : 843.958.4758

County of Charleston Procurement Department

4045 Bridge View Drive, Suite B250

North Charleston, SC 29405

PROJECT OVERVIEW

DATE:

April 28, 2026

SOLICITATION NUMBER: RFP NO. 6172-26S EMS Billing, Collection, and Posting Services

DESCRIPTION OF WORK: Provide billing, collection, and posting services for the Charleston County

Emergency Medical Services (CCEMS) Department.

DUE DATE FOR WRITTEN

QUESTIONS:

May 13, 2026 at 12:00 p.m. (Eastern Time)

Questions or clarifications concerning this solicitation should only be directed to the Charleston County Procurement portal on the County website at https://charlestoncounty.bonfirehub.com/portal/?tab=openOpportunities

Please submit all questions in a single message through the “Vendor Discussion” tab of the project on the County’s Procurement Portal. Please avoid sending each question as a separate message.

DUE DATE/TIME: June 03, 2026 at 3:00 p.m. (Eastern Time)

Jared Snead, Buyer

Tel: 843-958-4766

Email: jtsnead@charlestoncounty.org https://charlestoncounty.bonfirehub.com/portal/?tab=openOpportunities

RFP NO. 6172-26S

REQUEST FOR PROPOSALS

TABLE OF CONTENTS

SECTION PAGE

General Terms and Conditions 4

Attachment A: Special Instructions, Terms and Conditions, Submittal Requirements 10

Attachment B: Scope of Work/Specifications 15

Attachment C: Sample Contract 28

Attachment D: Sample Forms 41

• Insurance Requirements

• Drug-free Workplace Certification

Attachment E: Required Forms 48

• Submittal Form(s)

• Non-Collusion Oath

• Compliance with Illegal Immigration Act

• Equal Employment Opportunity Certification

• Subcontractor Data Form

REQUEST FOR PROPOSALS (RFP)

GENERAL TERMS AND CONDITIONS

1. GENERAL INFORMATION

A. Rights Reserved: This solicitation does not commit the County of Charleston to award a contract, to pay any cost incurred in the preparation of proposals, or to procure or contract for the services.

The County reserves the right to: 1) reject any proposal, all proposals, or any part of a proposal; 2) waive informalities, technical defects, and minor irregularities in proposals received; and 3) award the proposal(s) received on the basis of individual items or groups of items or the entire list of items. The County shall be the sole judge of the suitability of the items or services to be provided pursuant to this Request for Proposals (RFP).

The County reserves the right to cancel in part or in its entirety this Request for Proposals if it is in the best interest of the County to do so.

There is no expressed or implied obligation for Charleston County (hereinafter “the

County”) to reimburse Offerors for expenses incurred in preparing proposals in response to this RFP.

During the evaluation process, the County reserves the right, where it may serve the

County’s best interest, to request additional information or clarification from Offerors or to allow corrections of errors or omissions.

The terms and conditions in this RFP shall prevail unless otherwise modified by the County in an addendum to this RFP. The County reserves the right to reject, in whole or in part, any proposal which does not comply with such terms and conditions.

The County reserves the right to retain all proposals submitted and to use any ideas in a proposal regardless of whether that proposal is selected. Submission of a proposal indicates acceptance by the Offeror of the conditions contained in this RFP, unless clearly and specifically noted in the proposal submitted and confirmed in any resulting contract between the County and the Offeror selected.

B. Required Forms: Offerors must submit requested information on the forms furnished or copies thereof, and must be signed. If erasures or other changes appear on the document, each erasure or change must be initialed by the person signing the proposal.

C. Proposal Submission: Offeror’s must submit an electronic submission through the

County’s Procurement Portal.

D. Late Proposals: Offerors will not be able to submit proposals after the due date and time of the solicitation. “Late Proposals” will not be considered.

E. Withdrawal of Proposal: Proposals may be withdrawn by the submitting Offeror prior to the submittal deadline, but not thereafter.

F. Addendum: Any interpretation, correction or change of the solicitation documents will be made by addendum. It is the Offeror’s responsibility to monitor the Procurement website for any additional information, revisions, or addenda that may be posted.

1. Through the County’s Procurement Portal, Offerors shall promptly notify the

Charleston County Procurement Department, in writing, and no later than the last date and time for the submittal of written questions, of any ambiguity, inconsistency or error which they may discover upon examination of the solicitation documents, the project premises and/or local conditions.

2. Through the County’s Procurement Portal, Offerors requiring clarification or interpretation of the solicitation documents shall make a written request which must be received at the Charleston County Procurement Department no later than the last date and time for submittal of written questions.

G. Substitution: Offerors may request substitutions of products through the County’s

Procurement portal. Notice of acceptance or non-acceptance will be given through an addendum. No substitutions will be considered after the Contract award except by amendment or change order.

H. Irregular Submittal Cause for Rejection: Failure to submit a proposal in the format and on the forms requested or inclusion of any alternates, unit prices, conditions, limitations or provisions not called for, will render the proposal irregular; and shall be considered sufficient cause for rejection of a proposal. Failure to complete entries in all blanks on the

Submittal Form shall be considered cause for rejection of a proposal.

I. Single Vendor and Joint Venture: The County prefers a single, qualified company or entity to be responsible for providing the work (hereinafter “Work”) described herein.

Therefore, any one proposal submitted in response to this RFP by more than one business entity will be deemed to be a proposal for a joint venture between or among the companies so submitting, unless the proposal clearly and unequivocally describes that only one firm proposes to act as principal and the other firms’ contractual position is clearly defined. The firms submitting as a joint venture will be held jointly and severally responsible for the work in its entirety, and will not be permitted to limit their liability, individual or collective, to the County. This provision may be waived if a solution is agreed upon whereby the

County will have a single source for contract complaints, problem resolution, and responsibility.

J. Competitive Procurement: It is the intent and purpose of the County that this RFP permits competition. It shall be each Offeror’s responsibility to advise the County if any language, provision, or other requirement, or any combination thereof, inadvertently restricts or limits the satisfaction of the specifications stated in this RFP to a single source.

Such notification must be submitted in writing and must be received by the County’s

Procurement Department no later than the deadline for receipt of written questions. Any such notification shall be reviewed by the County's Contracts and Procurement Director.

K. Disclaimer Of Liability: The County, or any of its agencies, will not hold harmless or indemnify any Offeror for any liability whatsoever except as may otherwise be specified in this RFP.

L. Ownership Of Documents: All proposals and supporting materials, including all data, material, and documentation originated and prepared for the County pursuant to this RFP and including correspondence relating to this RFP, shall, upon delivery to the County, become the property of the County.

2. PUBLIC ACCESS TO PROCUREMENT INFORMATION

Subject to the requirements of the Freedom of Information Act, commercial or financial information obtained in response to this RFP which is deemed privileged and confidential by the

Offeror will also not be disclosed after the award. Such privileged and confidential information includes information which if disclosed, might cause harm to the competitive position of the

Offeror supplying the information. All Offerors, therefore, must visibly mark as

"CONFIDENTIAL" each specific part of their proposal which it considers to contain proprietary or other privileged information. Additionally, all Offerors shall be solely responsible for identifying as exempt from the Freedom of Information Act and for visibly marking as "EXEMPT

FROM FREEDOM OF INFORMATION ACT" each specific part of their proposal which they deem to be so exempt and shall further be solely responsible for any consequences that might be related to arise from the nondisclosure of any information that is subsequently determined not to have such an exemption. Do not mark the entire proposal as confidential or exempt from disclosure. Doing so will necessitate an independent determination of confidentiality by the County pursuant to applicable law. The County hereby disclaims any responsibility for not disclosing information identified by any Offeror as exempt from the Freedom of Information Act; for any information which is disclosed as a result of a Offeror’s failure to visibly mark it as

"CONFIDENTIAL"; and for any results of an independent verification of confidentiality necessitated by the marking of an entire proposal as confidential or exempt from disclosure.

3. OFFEROR’S REPRESENTATIONS AND RESPONSIBILITIES

Each Offeror by submitting a proposal represents that:

A. The Offeror has read and understands this RFP (including all specifications and attachments) and that their proposal is made in accordance therewith.

B. The Offeror has reviewed the RFP, has become familiar with the local conditions under which the work is to be performed, and has correlated personal observations with the requirements of the proposed Contract Documents.

C. The proposal is based on the terms, materials, systems and equipment required by this RFP, without exception.

D. The Offeror is qualified to provide the services and equipment required under this RFP and, if awarded the contract, will do so in a professional, timely manner using Offeror's best skill and attention.

E. Offeror’s Responsibility:

Each Offeror shall fully acquaint itself with conditions relating to the scope and restrictions attending the execution of the work under the conditions of this RFP.

The failure or omission of the Offeror to acquaint itself with existing conditions shall in no way relieve it of any obligation with respect to the proposal submitted by the Offeror or to any contract resulting from this RFP.

F. Conditions Affecting the Work: The Offeror shall be responsible for having taken steps reasonably necessary to ascertain the nature and location of the work, and the general and local conditions which can affect the work or the cost thereof. Any failure by the successful

Offeror to do so will not relieve the Offeror from the responsibility for successfully performing the work without additional expense to the County. The County assumes no responsibility for any understanding or representations concerning conditions made by any of its officers, agents or consultants prior to the submission of a proposal or the execution of any contract related thereto, unless such understandings or representations by the County are expressly stated in the Contract Documents.

4. SUBCONTRACTORS

A. If any subcontractors will be used for this project, the successful Offeror shall provide to the Contracts and Procurement Director a list of names of any of the intended subcontractors, the subcontractor's applicable license number(s), and a description of the work to be done by each subcontractor on the Subcontractor Data Report Form included in the Attachment E, Required Forms.

B. The successful Offeror shall not substitute other subcontractors without the written consent of the Contracts and Procurement Director.

C. The successful Offeror shall be responsible for all services performed by a subcontractor as though they had been performed by the successful Offeror. Responsibilities include, but are not limited to, compliance with any applicable licensing regulations.

D. If at any time the Contracts and Procurement Director determines that any subcontractor is incompetent or undesirable, the Director shall notify the successful Offeror accordingly, and the successful Offeror shall take immediate steps for cancellation of the subcontract and replacement.

E. Nothing contained in any contract resulting from this RFP shall create any contractual relationship between any subcontractor and the County.

F. It shall be the successful Offeror’s responsibility to ensure that all terms required in the attached Contract are incorporated into all subcontracts.

5. STATE AND LOCAL TAXES

Except as otherwise provided, Contract prices shall include all applicable state and local taxes.

The contractor shall calculate that portion of the Contract which is subject to South Carolina and

Charleston County local option sales and/or use tax, which currently totals nine percent (9%). The amount of sales tax shall be itemized and shown on all invoices, and shall be paid to the South

Carolina Department of Revenue (SCDOR) by the contractor. If the contractor is a non-South

Carolina company, the County will withhold said amount from all invoices and remit payment to the SCDOR, unless the contractor furnishes County with a valid South Carolina Use Tax

Registration Certificate Number.

The contractor shall indemnify and hold harmless the County for any loss, cost, or expense incurred by, levied upon or billed to the County as a result of the contractor’s failure to pay any tax of any type due in connection with this Contract.

The contractor shall ensure that the above sections are included in all subcontracts and sub-subcontracts, and shall ensure withholding on out-of-state subcontractors and sub-subcontractors to which withholding is applicable.

6. PERMITS AND LICENSES

The successful Offeror shall, without additional expense to the County, be responsible for obtaining and maintaining all necessary licenses and permits required by the State of South Carolina, the

County, a municipality, or any other authority having jurisdiction. Prior to execution of a contract, the successful Offeror may be required to provide a copy of any current applicable license issued by the County and/or by the State of South Carolina pursuant to Title 40 of the South Carolina

Code of Laws. Any subcontractor must also comply with the regulations promulgated in Title 40 of the South Carolina Code of Laws as enforced by the South Carolina Department of Labor, Licensing and Regulation. The successful Offeror’s (and/or any subcontractor’s) License Number, Person’s Name and Business Name must all be shown on all required licenses.

7. AWARD

Award shall be made to the responsible Offeror whose proposal is determined to be the most advantageous to the County, taking into consideration the evaluation factors set forth in this RFP.

8. NOTICE OF AWARD OF CONTRACT

The successful Offeror will be notified of acceptance of its Proposal by a written Notice of Award of contract. The successful Offeror shall not undertake any work, and the County will not be responsible for payment for any work whatsoever undertaken by the successful Offeror prior to issuance of the Notice to Proceed.

The successful Offeror shall be required to submit acceptable Insurance Certificate(s) and

Endorsement(s) within five (5) business days after issuance of the Notice of Award.

9. CONTRACT DOCUMENT

The successful Offeror shall be required to execute a formal contract within five (5) business days after issuance of a Notice of Award. Said Contract shall be virtually identical in substance and form to the Contract which is attached and marked Attachment C, Sample Contract. The only anticipated changes in Attachment C, Sample Contract, will be to include additional exhibits, to fill in the blanks to identify the successful Offeror, and terms relating to compensation, or to revise the contract to accommodate corrections, changes in the scope of work, or changes pursuant to addenda issued prior to the proposal opening. Offerors should raise any questions regarding the terms of the Contract, or submit requested changes in said terms, in the form of written questions or submittals, subject to the deadline for questions. Because the signed contract will be substantively and substantially derived from Attachment C, Sample Contract, Offerors are urged to seek independent legal counsel as to any questions about the terms, conditions or provisions contained in Attachment C, Sample Contract, before submitting a proposal. Again, Attachment C, Sample Contract, contains important legal provisions and is considered part and parcel of this RFP.

Failure or refusal to sign aforesaid Contract shall be grounds for the County to revoke any Notice of Award which has been issued, forfeit bid security, and award the Contract to another Offeror.

10. NOTICE TO PROCEED

A Notice to Proceed will be issued after the successful Offeror has executed the Contract and has submitted acceptable performance and payment bonds (if applicable) to the County as well as other submittals specified herein as required to be delivered before the Notice to Proceed is issued.

The successful Offeror shall not deliver any equipment to the work site or commence work until the successful Offeror has received a written Notice to Proceed from the Contracts and Procurement

Director.

11. DRUG-FREE WORKPLACE ACT

The successful Offeror shall comply with the South Carolina Drug-free Workplace Act, Section

44-107-10 et seq., S.C. Code of Laws (1976, as amended). The County requires all successful

Offerors executing contracts for a stated or estimated value of $50,000 or more to sign a Drug-free

Workplace Certification form prior to the issuance of the Notice to Proceed.

12. DAMAGES

The County as defined this section in the Sample Contract.

13. MODIFICATION

The County has defined this section in the Sample Contract.

14. TERMINATION

15. INDEMNIFICATION

16. UTILIZATION BY OTHER PUBLIC AGENCIES CLAUSE

The use of this solicitation and resulting contract shall be made available to other local governmental agencies and agencies established for the public benefit (“Public Agencies”). The parties agree to allow other governmental agencies to enter into separate agreements with the

Contractor under the terms and prices in effect between the County and the Contractor. The parties also agree that any other agency utilizing the terms and prices of this agreement shall not be deemed to be an agent or employee of the County of Charleston for any purpose whatsoever. The parties further agree that any Public Agency will enter its own separate contract with the Contractor.

The County is not otherwise responsible for the Public Agencies’ performance of the Contract between the individual Public Agencies and the Contractor or for any obligation or liability accruing to the Public Agencies in the performance thereof. The Public Agencies and the

Contractor further agree to waive any rights they may have in making the County of Charleston a party to a dispute between a Public Agency and the Contractor.

ATTACHMENT A

SPECIAL INSTRUCTIONS,

TERMS AND CONDITIONS,

SUBMITTAL REQUIREMENTS

REQUEST FOR PROPOSALS (RFP)

SPECIAL INSTRUCTIONS, TERMS AND CONDITIONS,

SUBMITTAL REQUIREMENTS

1. GENERAL DESCRIPTION OF SERVICES:

The County is seeking proposals from Offerors established in the business of providing billing, collection, and posting services.

For the complete Scope of Work, see Attachment B, Scope of Work/Specifications.

2. WRITTEN QUESTIONS DEADLINE:

The last date and time for submittal of written questions shall be no later than 12:00 P.M. (Eastern

Time), on Wednesday, May 13, 2026.

Through the County’s Procurement Portal, Offerors shall promptly notify the County no later than the last date and time for the submittal of written questions, of any ambiguity, inconsistency, error, or clarifications regarding the solicitation.

3. PROPOSAL SUBMITTAL DEADLINE:

Through the County’s Procurement Portal, Proposals are due no later than 3:00 p.m.

(Eastern Time), on June 03, 2026, after which time the names of all Offerors will be publicly identified. No other information will be disclosed at that time.

4. PREPARATION OF PROPOSAL

A. All proposals should be complete and carefully worded and must convey all of the information requested by the County. If errors or exceptions are found in the Offeror’s proposal, or if the proposal fails to conform to the requirements of the RFP, the County will be the sole judge as to whether that variance is significant enough to reject the proposal.

B. Proposals should be prepared simply and economically. All data, materials, and documentation shall be available in a clear, concise form and reproducible upon request

"at cost" for the County's internal use. The County reserves the right to reproduce proposals for internal use in the evaluation process.

C. All proposals shall provide a straight forward, concise description of the Offeror’s ability to satisfy the requirements of the RFP.

D. If any proposal includes any comment(s) over and above the specific information requested in this RFP such comment(s) must be included as a separate appendix to such proposal.

E. The Offeror is solely responsible for all costs and expenses associated with the preparation of their response and of any supplementary presentation (including any oral presentation) requested by the County.

F. Proposals must be made in the official name of the individual, firm, or corporation under which the business is conducted (showing official business address) and must be signed in ink by a person duly authorized to legally bind the business entity submitting the proposal.

G. Proposals shall be typewritten or computer generated. It shall include, but is not limited to, addresses of all firms which would participate in the proposed work. The type of organization of the Offeror whether individual, partnership, corporation, or joint venture among any types of entities shall be stated. Any affiliations, parent-subsidiary relationships, and corporate identities must be fully disclosed and clearly explained.

5. SELECTION PROCESS

A. Following the deadline for submittal of proposals, a selection committee will review, analyze and rank all proposals based on their response to the information requested.

B. The County reserves the right to finalize a Contract based on all factors involved in the written submittal without further discussion or interviews.

C. The County may request oral presentations or discussions with any or all Offerors for the purpose of clarification or to amplify the material presented in any part of the proposal.

However, Offerors are cautioned that this provision is not mandatory; therefore, all proposals, both cost and technical, should be complete and concise and reflect the most favorable terms available from the Offeror.

If the County determines that interviews are necessary to make the selection, they will be scheduled with the Offerors and held at the County offices at 4045 Bridge View Drive, North Charleston, SC 29405.

D. If desired, the selection committee may shortlist the number of qualified Offerors. The

County reserves the discretion to determine the number of Offerors that will be on the short list.

E. The selection committee may conduct discussions with the firm(s) submitting responses regarding the contract and shall select from among them the firm(s) deemed most qualified to provide the required services. At the discretion of the County, the discussions with the firm(s) may consist of written questions and responses, and/or personal interviews with members of the firm(s). If personal interviews are required by the County, the persons proposed to be responsible for performing the work required herein shall attend the interview. If requested, firms should be prepared to submit financial status information, which shall be held in confidence.

F. The County shall select the Offeror submitting the best overall proposal on terms which are considered to be fair and reasonable to the County.

6. PROPOSAL SELECTION / EVALUATION FACTORS:

The County will award a contract to the responsible Offeror whose proposal conforms to the requirements of the RFP and provides the most advantageous proposal (best value) to the County, price and other factors considered.

Representatives of the County will evaluate individual proposals. Any Offeror determined to be technically unqualified, or whose proposal is deemed unresponsive, will not be considered further.

Evaluation Criteria: A selection committee will evaluate each Offeror’s proposal and rank each firm on the basis of the following criteria.

(Note: these criteria are not necessarily listed in order of importance.)

1. Revenue Performance (Ability to collect and manage A/R)

2. Compliance and Risk (Data security and regulatory adherence)

3. Technology and Reporting (System integration and data access)

4. Operational Capacity (Staffing levels and implementation plan)

5. Patient Experience (Customer service quality and professionalism)

6. Cost

7. SUBMITTAL REQUIREMENTS:

Submittals must include:

• a transmittal letter,

• one (1) complete Technical Proposal, (consolidated electronic copy)

• one (1) complete Redacted Technical Proposal, (consolidated electronic copy)

• one (1) complete Cost Proposal (consolidated electronic copy)

File Naming Format: 6172-26S_Vendor name_Technical_Proposal

6172-26S_Vendor name_Redacted Technical_Proposal

6172-26S_Vendor name_Cost_Proposal

The File format should be PDF (preferred) or Microsoft Word, unless otherwise requested such as

Microsoft Excel.

Offerors shall address all items as specified in this section. Failure to adhere to this format or to address all items specified may disqualify an Offeror from further consideration.

Offerors are also encouraged to include any additional information they wish to be considered.

Format: Submit proposals in the following format.

A. Title Page

Title page must show the RFP’s subject; the Offeror's name; the name, address, and telephone number of a contact person; and the date of the proposal.

B. Table of Contents

Provide a Table of Contents to aid the evaluation of the proposal.

C. Transmittal Letter

A signed letter of transmittal briefly stating the Offeror's understanding of the work to be undertaken, the commitment to perform the work within the time period, a statement why the Offeror believes it’s firm to be the best qualified to perform the work and a statement that the proposal is a firm and irrevocable offer for ninety (90) calendar days. The County reserves the right to request the Offeror to extend the time period for the firm and irrevocable offer.

D. Technical Proposal

The purpose of the Technical Proposal is for the Offeror to demonstrate their qualifications, competence, and capacity to provide billing, collection, and posting services to the County in conformity with the requirements of this RFP.

Offeror shall submit a proposal for this as project meeting the requirements listed. Address each item listed in the General Specifications based on the ability of your firm to provide those services as required. Offerors should address all the points outlined herein.

E. Cost Proposal

The Cost Proposal shall be detailed on the enclosed Cost Data Form. The Cost Data Form, and Non-Collusion Oath and other required forms, must be submitted on a separate electronic file clearly marked “Cost Proposal”. The Cost Data Form and Non-Collusion

Oath can be found in Attachment E, Required Forms.

8. NON-COLLUSION OATH

Every proposal must be accompanied by a notarized affidavit of non-collusion, executed by the

Offeror or in the case of a corporation, by a duly authorized representative of said corporation. The

Non-Collusion Oath is provided herein.

9. INSURANCE REQUIREMENTS

See Attachment D, Sample Forms. The successful Offeror, at its own expense, shall at all times during the term of the Contract, maintain insurance as required herein and previously incorporated by reference. The County shall not execute the Contract until the successful Offeror has submitted acceptable Insurance Certificate(s) and Endorsement(s), which must be submitted within five (5) business days of receipt of the Notice of Award, and which reflect that the required coverages are in place and that all premiums have been paid. Refusal or failure to submit such Insurance

Certificate(s) and Endorsement(s) shall constitute grounds for the County to revoke its Notice of

Award, forfeit bid security, and award the Contract to another successful Offeror. The County may contact the successful Offeror’s insurer(s) or insurer(s)' agent(s) directly at any time regarding the successful Offeror’s coverages, coverage amounts, or other such relevant and reasonable issues related to this Contract. The successful Offeror shall also require any sub-contractors to carry the same coverages in the same amounts.

Insurance Certificate(s) and Endorsement(s) will be accepted electronically.

The County must be advised immediately of any changes in required coverages.

ATTACHMENT B

SCOPE OF

SERVICES/SPECIFICATIONS

Scope of Services

Emergency Medical Services (EMS) Billing, Collection, and Posting Services

1. INTRODUCTION

The purpose of this Request for Proposal is to establish a contract with the County of Charleston

(“County”) to provide billing, collection, and posting services for the Charleston County

Emergency Medical Services (“CCEMS” or “EMS”).

In addition, the County seeks an optional bid for the management and recovery of supplemental payments under the South Carolina Ambulance Supplemental Payment Program (ASPP). This service must specifically address the Managed Care Organization (MCO) component, which requires managing state – directed payment arrangements and quality measures outlined in the 42

CFR § 438.6 (c) Preprint.

The above optional bid service is referenced in Sections 16 and 17 of this Scope of Services.

2. DEFINITIONS

EHR – Electronic Health Record shall be the term referencing the field documentation by

Charleston County EMS workers on treatment provided individuals requiring emergency medical services.

EMS – Shall mean Charleston County Emergency Medical Services.

INDIVIDUAL(S) – As used herein shall reference a person who received some form of treatment or evaluation by EMS workers that necessitated an EHR.

3. OVERVIEW

EMS transports individuals from varied locations to health care facilities in the emergency medical transport vehicles. Transported individuals are charged a transport fee and a mileage fee. Some patients who are not transported are charged a no-transport fee when indicated. EMS has an approved schedule of transport fees including mileage rates and cost for non-transport fees.

The start date of the new Contract will be August 1st, 2026. The Contractor recognizes there may be a transitional delay due to changes in provider enrollment procedures.

Estimated Fiscal Year 2025 collections were approximately $12.4 million (actual collections amount) with debt setoff of approximately $1 million. Gross charges in a year are approximately

$20 million per year.

4. USE OF BILLING INFORMATION

A. The Contractor shall accept receipt of the patient data necessary for billing. The data will come from an ePCR system called ESO.

B. The Contractor shall be responsible for obtaining the appropriate software that will be compatible to interface with our computerized report writing system (ESO) and to enter furnished data into their computerized billing system through secured file transfer.

C. Billing the non-transported patient, when appropriate. County policy will dictate when billing of these individuals takes place.

D. Preparing the required management and financial reports including information on delinquent accounts. Real-time financial information is preferred based on amount billed, paid, and outstanding account balances.

5. SERVICES TO BE PROVIDED BY CONTRACTOR

A. Successfully receive an electronic file of treatment and billing information from the current software vendor (ESO). Preference will be given for integration of charting information to the billing system to reduce duplication of entry.

B. The Contractor shall be responsible for reviewing each PCR for content to accomplish the following:

1. Require reconciliation between PCR export counts and billing system intake counts (daily and weekly) with exception reporting.

2. Review EHRs for information necessary for either a clean claim submission or a determination of lacking medical necessity; and, in a timely manner consistent with permitting timely filing, request of client clarifications or corrections to cure deficient documentation.

3. Assign the appropriate billing procedure code and diagnosis code based on the documentation, treatment, and chief complaint of the patient; all in accordance with health care regulations set for the industry.

4. Obtain current patient insurance information per claim and exercise due diligence in obtaining such information in a timely manner consistent with timely filing requirements: including but not limited to documented mailings, emails, third party services and phone calls to the holder of information.

C. File all insurance claims to the appropriate payer for services, including identifying and billing third party liability claims apart from health insurance claims, and submitting claims appropriately based on proper order of responsible parties and within timely filing requirements.

D. Mail an invoice to each transported individual at the approved rate for transportation services. Unless another method to obtain information is available, or for no other available options remaining, a phone call to the individual to obtain said required information shall be warranted and shall be documented to obtain insurance information.

E. There shall be no offshoring of health care records or of claim submissions under this contract; and shall be deemed a material breach.

F. Have either a local telephone number, or a toll-free telephone number in which customers can contact the billing company for questions and/or concerns. All call centers must be located within the United States of America.

G. Provide required documentation to Medicare, Medicaid, insurance companies or third-party payers by electronic file transfer when applicable.

H. Mail copies of invoices to patients, Medicare, Medicaid, insurance companies or other third-party payers, when requested or required.

I. Follow up on discrepancies in service code, provider certifications, or interpretations which are required to re-file Medicare, Medicaid or insurance claims, as required by the payer to obtain payment in a manner and urgency consistent with timely claim submission requirements.

J. Record customer payments from various electronic uploads (mail/lockbox file, credit card file, etc.) and manual listings (wire receipts).

K. Prepare monthly management, financial, accommodation, performance measures, and any other special reports as needed to include receipt by type (e.g. Medicare, Medicaid, insurance carrier, etc.), accounts receivable balances by type, amounts charged off due to uncollectibility, etc. Access to real-time financial data is preferential through on-demand reporting. “Uncollectibility” due to timely filing failures is preferred to be distinguished from other forms of uncollectibility for client review, though not required.

L. When a billed account has become past due (defined as: no payment made after 180 days from the date of service), notify the County by providing the County with an electronic file of these past due accounts including all pertinent facts regarding attempted collection effort. This file must be in a format which the County can use to obtain information for the

South Carolina Debt Setoff program.

M. Provide the County with an independent auditor’s report regarding the firms’ adequacy of and compliance with their internal controls on an annual basis.

N. Provide annual certification verification of “Certified Ambulance Compliance Officer

(CACO)” and maintain necessary qualifications.

O. Provide evidence of red Flag Identity Theft Compliance as well as Payment Card Industry

Compliance.

P. Training may be requested by Client to provide education to medical staff on documentation and compliance issues on an annual basis. The Contractor may request of the Client time before the medical staff with advance notice to provide education on compliance or documentation.

Q. Describe any services provided by the firm that are not covered by the RFP but would assist

CCEMS in enhancing its collections.

R. Explain how data integration and migration will include the Old (County’s System B), New

(Awarded Contractor), and Current (518) Debt Setoff Program.

1. Provide a summary of how your firm will transition CCEMS from their current provider including timeline and benchmarks for implementation.

S. Contractor is required to have a dedicated Collections Department or process in place for overview due or delinquent accounts.

1. Prior to debt setoff, explain process starting at 60, 90, 180, and greater than 180 days after the first billing.

T. Any other services as agreed to by the parties, in order to effectively collect all fees.

6. RESPONSIBILITIES OF THE CONTRACTOR

A. Contractor will operate under the requirements and guidelines of the federal Fair Debt

Collection Practices Act.

B. Contractor will comply with HIPAA, HITECH, and all applicable privacy and security regulations.

C. Contractor will be knowledgeable of the South Carolina Debt Set-off program and requirements for electronic data submission.

D. Contractor will be able to process South Carolina Debt Set-off program.

E. Contractor will only charge patient fees approved by Charleston County Council.

F. Contractor will only utilize third party payment contracts approved by the County.

G. Contractor will allow Charleston County EMS to approve all letters and phone scripts so that the tone of all communications is consistent with the standards of the County.

H. Contractor will adhere to the following performance of billing services (the exception being high-deductible recognition):

1. Process 95% of all billings within 72 business hours.

2. Post 95% of all collections received within 24 business hours.

3. Process 95% of all refunds within 45 calendar days of the refund occurrence.

7. RESPONSIBILITIES OF THE COUNTY

A. The County will provide the Contractor with access to ESO software.

B. The County will provide access to the below:

1. Lockbox account

2. Credit Card account

3. Wire account

All bank charges/fees and credit card processing fees (excluding any convenience fees paid by the online users and retained by the processor) will be deducted monthly from the Contractor’s fee for services (under Section 12 of this RFP). Copies of the monthly bank charge analysis statements will be provided to the Contractor.

8. REQUIRED USE OF ELECTRONIC FILING

A. Contractor must be currently filing Medicare and Medicaid Claims electronically and must transmit Medicare/Medicaid claims via the required National Standard Format (NSF).

B. Contractor must file insurance claims through electronic means, to any payor able to accept the electronic format.

9. REQUIRED BILLING RESEARCH THROUGH HOSPITALS

A. Have the ability to electronically interface through the Healthcare Data Exchange (HDE) with listed hospitals or when available, to obtain information to collect an account on behalf of the County.

1. Access to alternative data-sharing mechanisms (e.g. secure web portals, encrypted emails, and direct provider communication).

2. Compliance with HIPAA and all applicable privacy and security regulations.

3. Coordination with hospitals and County systems to enable fallback processes.

10. STAFFING REQUIREMENTS

A. The County estimates EMS transports approximately 63,000 patients annually (not including several thousand non-transport non-bills not requiring claim processing). The

Contractor is required to have an adequate number of employees necessary to perform activities related to the billing and collection of medical bills within the requirements outlined above in 6.H and in other provisions outlined under this agreement.

B. Provide annual certification verification for active/current Certified Ambulance Coder

(CAC) and ensure appropriate certified personnel are in place to ensure claim submissions are in compliance with federal and state regulations and requirements, as well as industry best practices.

C. Resumes or CVs of proposed project team members will be included in response.

D. The County shall identify at least one (1) point of contact for the vendor who shall coordinate adherence to this agreement. EMS may identify to the Contractor additional personnel assigned to coordinate with the Contractor. The County may request any electronic communication or requests to one include a communication to all designated persons.

11. CONTRACTORS’S REQUIRED NUMBER OF YEARS IN BUSINESS

A. To ensure that the Contractor has a proven record of service and experience, the

Contractors’ company is required to have been operating as the same business entity for a minimum of ten (10) years.

12. FEE

A. The Contractor’s fee for services to be provided through a fee schedule, percentage based, or flat service fee basis.

B. Each Contractor must submit a copy of fee schedule, percentage based or flat service fee-based schedule with their proposal, with the exception of 12.C, on the Cost Data Form provided in Attachment E.

C. Each Contractor should also offer a percentage for collections involving the Debt Set off program. This fee will include total cost of this collection.

13. REQUIRED REPORTS

The Contractor must provide the County with a series of reports to show management and financial information. Accounting for all billing pursuant to Generally Accepted Accounting Principles must be provided on a daily, monthly, quarterly, and annual basis or as requested by CCEMS. A monthly auditing will be completed to ensure accuracy of bills and invoices provided for payment by

CCEMS. The following list of reports is the required minimum. Contractor may submit a report that they use which is equivalent for approval.

A. Collection Statistics: Gross billings by date of incident (transport) month and the related collections to date. Gross billings should not be reduced for returned mail, bad debits, or authorized write offs. The required format would have a minimum of four (4) columns as follows:

1. Number of transports per month

2. Gross billed in transport month

3. Total collected in transport month

4. Percentage of Clean Claims processed

B. Insurance Report

The portion of the actual collections and the accounts receivable, detailed by self, Medicaid, Medicare, and private insurance.

C. Monthly Payment Report

The payments posted to the accounts receivable during the month. The report must show the following information, at a minimum.

1. Date of Service

2. Patient number

3. Patient name

4. Patient complete address

5. Payment amount and type

6. Grand total of all monthly payments

D. Monthly Collection Summary

The monthly payments in 13. C above by original transport month. The columns will be:

1. Incident Month

2. Total billings for month

3. Total collected for month, further broken down by method of payment:

a. Mail/Lockbox

b. Credit Card

c. Wire

4. Total Percentage of collections for month

E. Total Billings by Incident Month

The cumulative number of gross billings and percentages for each month, broken down by payer type (Private, Medicare, Medicaid, BC/BS and other insurance).

F. Accounts Receivable

An aged report of the amount owed by all transported patients at the end of the month. The format will be:

1. Gross billings since inception.

2. Less: Payments since inception.

3. Less: Approved adjustments and write-offs since inception.

4. Ending balance of accounts receivable.

5. Ending balance of accounts receivable shall be aged by 30, 60, 90, 120, and over 120 days.

G. Adjustments or Write-Offs

Regarding the details of 13.F.3 above, the report must show:

1. Date of Service

2. Patient number

3. Patient name

4. Adjustment or write-off payment.

5. The cumulative total for 13.F.4

H. Billing Report

1. Date of Service

2. Patient number

3. Patient name

4. Patient address

5. Incident date

6. Amount billed

7. The monthly total of 13.H.6.

8. Additionally, this report must summarize the monthly billing activity as follows:

a. Number of ALS billings and amount billed

b. Number of BLS billings and amount billed

c. Number of mileage billing and amount billed

I. Payment Percentages

Document percentages of patients who have made a payment. Column headings should be:

1. Transport month and year

2. Total patient transported in 13.I.1

3. Number not making payments

4. Number making payments

5. Percent making a payment

J. Refund Listing

Accounts requiring a refund due to overpayment. This report must show:

1. Date of Service

2. Patient number

3. Patient name

4. Patient address

5. Incident date

6. Amount originally billed

K. Monthly Accounts Receivable Reconciliation Report to include:

1. Month

2. Beginning A/R

3. Contractual Allowances

4. Net Charges

5. Revenue Adjustments

6. Payments, further broken down by method of payment:

a. Mail/Lockbox

b. Credit Card

c. Wire

7. Write-offs

8. Refunds

9. Ending A/R

L. Monthly Invoices to include:

1. Beginning and ending dates of the invoice

2. Total amount of collections for the month

3. Percentage rate for monthly receipts

4. Amount paid for outside contracts (e.g. debt set-off)

a. Complete backup documentation to support all charges listed on invoice

b. Invoices incomplete or inaccurate will not be paid until brought into compliance with the contract requirements.

M. Monthly Denial Trend Reporting to CCEMS Support Services

Monthly report to include:

1. Additional documentation feedback and suggestions to support reducing denials.

2. Targeted training offerings tied to denial drivers and documentation gaps.

14. REQUIREMENT FOR ELECTRONIC RECORDS MANAGEMENT

A. Contractor will provide backup to electronic records system on a daily basis and will retain required records as stated in State of South Carolina Records Retention Schedule.

B. Archived records will be provided within a 48-hour period after written request.

C. All records will be returned to the County in the case of default of company.

D. Records that are required to be retained longer than end of contract will be returned to the

County upon termination of contract with company.

E. Records will maintain tracking of all changes made including the date, time, and login identification of person who was responsible for making changes to the record.

15. APPROVED HOSPITALS CHARLESTON COUNTY EMS TRANSPORT TO

A. East Cooper Medical Center

B. Colleton Medical Center

C. Medical University of South Carolina

D. MUSC Kiawah ER

E. MUSC Shawn Jenkins

F. Ralph H. Johnson VA Medical Center

G. Roper St. Francis ED – Moncks Corner

H. Roper St. Francis ED – Northwoods

I. Roper St. Francis – Berkley

J. Roper St. Francis – Downtown

K. Roper St. Francis – Mount Pleasant

L. Roper St. Francis – West Ashley

M. Georgetown Memorial Hospital

N. Trident Medical Center (Main)

O. Trident Brighton Park Emergency

P. Trident Center Pointe Emergency

Q. Trident James Island

R. Summerville Medical Center

16. OPTIONAL CONTRACTOR BID SERVICES

A. Cost Reporting

1. Prepare and submit annual cost reports required by SCDHHS to establish the gap between MCO reimbursements and actual service costs.

B. MCO Coordination

1. Facilitate the collection of supplemental funds distributed through South Carolina’s

MCO reimbursement and actual service costs.

C. Compliance

1. Ensure all data collection and reporting meet CMS standards and state quality measure requirements.

D. Data Integration

1. Seamlessly integrate ASPP cost-tracking with standard ambulance billing and ePCR data

17. OPTIONAL BID SUBMISSION

A. Provide a separate fee schedule on the Cost Data Form provided in Attachment E for ASPP services through a flat annual fee or percentage of recovered supplemental funds.

B. Detail your firm’s specific experience managing MCO - specific supplemental payments in states with similar programs.

18. CONTRACTOR IMPLENTATION REQUIREMENTS

A. Contractor must provide a transitional plan that includes:

1.) Timeline

2.) Milestones

3.) Data migration

4.) Parallel run with go-live

5.) Contingency plan

6.) File transfers, claims, and report validations.

B. Daily telephone communication and status report during transitional phase.

C. Monthly virtual or in-person check-in meetings determined by Charleston County.

D. After implementation is completed, the below status updates are required:

1. Monthly status report

2. Quarterly status report and virtual meeting

3. Yearly onsite meeting

ATTACHMENT C

SAMPLE CONTRACT

STATE OF SOUTH CAROLINA )

COUNTY OF CHARLESTON )

CONTRACT

NO. 6172

EMS BILLING, COLLECTION AND

POSTING SERVICES

THIS CONTRACT (hereinafter the “Contract”) entered into this _____ day of (Month) 20__ between the COUNTY OF CHARLESTON, South Carolina, a public body corporate and politic and political subdivision of the State of South Carolina, (hereinafter the "County") and (NAME OF

COMPANY/INDIVIDUAL), a (State of incorporation) Sole Proprietorship/Partnership/Corporation, Limited Liability Corporation (choose one), the address of which is Street, City, State, Zip (hereinafter the

"Contractor"), (“Party” as to each; collectively the “Parties”).

W I T N E S S E T H:

WHEREAS, the County wishes to contract for Emergency Medical Services (EMS) Billing, Collection, and Posting Services (hereinafter “Services”); and

WHEREAS, the Contractor has represented to the County that its staff is qualified to provide the

Services required in…