1-RFQ031040 - EMS Billing.docx

City of Columbus Department of Public Safety Emergency Medical Services Billing Detailed Specifications

RFP031040 - Emergency Medical Services Billing

1.0 SCOPE AND CLASSIFICATION

1.1 Background: The City of Columbus, Ohio (hereinafter “City”) is soliciting a contractor to provide: emergency medical services billing; hardware devices; hardware installation and associated equipment as specifically outlined in Attachment “A”; third party billing auditor services of Page, Wolfburg, and Wirth as outlined in Attachment “B”; provide and maintain billing interfaces with local hospitals, lockbox interfaces with the city’s lockbox provider, ePayment interfaces with the city’s ePayment provider, emergency facility EPCR interfaces, Public Consulting Group / Ohio Ambulance Supplemental Payment interfaces, and collection interfaces with the City’s debt collector; data conversion, migration and readiness services; and an onsite Support Technician in order to implement a seamless integration and transition in connection to EMS billing. Billing must begin on April 1, 2026 at midnight as the expiration of the current contract is March 31, 2026. These needs and requirements are detailed below.

1.2 Size of City and Division of Fire, EMS Run Volume, and Billing Overview:

A. Columbus, Ohio Columbus is Ohio’s state capital and largest city, and the 15th largest city in the United States. The geographic size of Columbus is approximately 226 square miles. Columbus has a population of over 900,000 within a greater Columbus metro region of approximately 2.5 million. The City of Columbus is frequently cited as one of the fastest-growing cities in the United States. Moreover, the greater Columbus region is projected to undergo unprecedented growth over the next quarter century.

The City operates and is governed by its charter and is subject to the general laws of Ohio that are applicable to all municipalities. The Columbus City Charter provides for a mayor-council form of government. The Mayor is the chief executive officer and City Council is the legislative body. These officials oversee a large array of services and assets with an operating budget of $1.2 billion with over 10,000 employees.

Additional information about the City of Columbus, including detailed information about missions and operational budgets, is available at https://www.columbus.gov/.

B. Columbus Fire Department The Columbus Division of Fire (CFD) provides fire and Emergency Medical Services (EMS) for the City of Columbus, Ohio. CFD is a Center for Public Safety Excellence (CPSE) accredited organization and an International Standards Organization (ISO) Class I fire department.

CFD responds to approximately 175,000 incidents per year from 35 fire stations. The 35 stations house 42 transport vehicles (additional vehicles are also used for special events) providing all levels of emergency care and transport to one of 28 local hospitals and/or emergency facilities. Additionally, Columbus Fire Station 36 is currently being constructed with a projected opening in mid-2026.

The Division of Fire has a complement of approximately 1,660 firefighters; with approximately 53% trained as EMT B and 47% trained as EMT P. Additionally, the Division employs approximately 113 civilians.

C. EMS Billing Overview The 2025 EMS transport charges are as follows: BLS is $754.76; ALS is $989.38; ALS2 is $1,285.57; and mileage is billed at $16.34. These charges are generally annually adjusted in accordance with the Ambulance Inflation Factor as issued by the Centers for Medicare and Medicaid Services.

The revenue received by the City and monies paid to our EMS vendor from 2017 to June of 2025 are depicted in Attachment “C”. Likewise, the number of EMS transports during this period is depicted in Attachment “D”.

Contractors’ base revenue is calculated on a percentage of all cash receipts received and posted on a monthly basis. In addition to base compensation, Contractor will also be entitled to receive Incentive Compensation as noted in greater detail below.

Various ending year summary financial reports are attached from the last three calendar years. Specifically, please see Attachment “E” to review the Finance Officer Summary, Administrative Summary, and the Executive Summary for the years 2002, 2023, 2024, and the first six months of 2025.

You will note that the financial data contained in City produced Attachment C and the current contractor’s Attachment E do not exactly mirror one another and this is of course due to time or the billing and posting lag.

In reviewing data from 2024 you will note a very significant drop off of revenue collection.

On February 21, 2024, our current EMS billing contractor, Change Healthcare, a subsidiary of United Health Group, became aware of an unprecedented deployment of ransomware in its computer system. The magnitude of this ransomware attack was unprecedented and led to a widespread impact on a substantial portion of people in American health care and on health care providers, such as emergency medical service (EMS) providers like the Columbus Division of Fire. Once discovered, Change Healthcare quickly took steps to stop the activity, disconnected and turned off systems to prevent further impact, began an investigation, and contacted law enforcement.

Due to the disconnection of computer systems, the processing of EMS billing claims came to a virtual halt from the months of March to September of 2024. During this time period, the City of Columbus should have collected approximately $10,800,000.00, but instead only collected approximately $1,415,360.00.

The various billing systems have now been remediated and restored by Change Healthcare Technology Enabled Services, LLC. These uncollected accounts receivable are hopefully not monies lost; rather, they are monies delayed that are still in the process of being collected. Therefore, in reviewing the attached financial reports you will see a significant increase in collections in the latter part of 2024 and continuing to this day.

Lastly, please note the City does not “balance bill.” In other words, tax revenues are utilized to satisfy patient cost-sharing obligations in accordance with OIG opinions 01-10, 01-11, 04-02 and 13-17. However, should a transported and billed patient receive a direct insurance reimbursement and then fail to forward payment then this person will be referred to the City collection agent.

1.3 Current EMS Billing Contractor is “Change Healthcare,” Prior Contracts and Intent to Negotiate a Performance Based Contract:

The current billing contract Change Healthcare Technology Services, LLC will expire on March 31, 2026. This vendor acquired McKesson Corporation who previously acquired MED3000. The 2019 contract and 2025 extension between the City and this vendor are attached (see Attachments “F” and “G”).

It is the City’s intention to once again negotiate a performance-based contract akin to the attached contracts. Specifically, the City intends to negotiate to convert a portion of the pricing percentage that Contractor bids (see section 4.5 below) into a performance incentive system whereby lump sum payment(s) will be made when the Contractor’s performance meets or exceeds target levels of performance. For example, it is the desire of the City to negotiate incentives akin to that contained within the 2019 contract (see Exhibit E in Attachment “F”). Likewise, it is the intent of the City to again negotiate a “Save Harmless” section akin to that contained in paragraph 12 of pages 4-5 of the 2019 contract (see Attachment “F”). It is the intent of the City to incorporate the Department of Public Safety Information and Technology Terms and Conditions into the contract (see attachment “I”). Lastly, It is the intent of the City to utilize the City Standard Services Agreement as the basis of the contract (see attachment “J”). An updated City Standard Services Agreement is currently being drafted for EMS billing and this document will be published on Bonfire when finalized.

1.4 Hardware Devices, Installation, And Accompanying Equipment:

Contractor shall purchase on behalf of the City the preselected EMS billing computers and associated accessories as specifically outlined in Attachment “A”. Likewise, Contractor shall ensure installation (see Attachment “A” install quote from Parr). Please note that the prices listed are not up-to-date and have only been included as a general reference. Further inquiry regarding pricing may be directed to:

Nathan Webster Indiana-Ohio, Public Sector, Senior Account Manager Panasonic TOUGHBOOK, Cincinnati, OH Cell: 814-571-1212; Nathan.Webster@US.Panasonic.com Again, Contractor is ultimately responsible to implement a seamless integration and transition by April 1, 2026. To ensure seamless transition, the hardware devices and accompanying extra equipment must be delivered to the City no later than February 7, 2026. It will be the responsibility of the Contractor to install the computers into CFD’s vehicles. Likewise, it will be the responsibility of the Contractor to link the computers and ensure access to ImageTrend billing and patient care software onto the computers. Additionally, Contractor shall ensure the computers access other programs dictated by the City, including, but not limited to, Responsoft; Panasonic Utility; camera and other native programs; Zoll Data Retriever; and Beyond Trust (Bomgar).

1.5 Scope: The following must be provided and will be the responsibility of the Contractor and/or the City:

1.5.1 Contractor Duties:

A. Hardware: The City has preselected the hardware devices that the Contractor shall purchase on behalf of the City. The EMS billing computers and associated accessories are listed in attachment “A”. Contractor shall be responsible for on time and without delay delivery of the hardware and accessories by February 7, 2026, as well as the ongoing identity management, authentication, incident response, connectivity, helpdesk, updating, patching, security, data compliance, anti-virus, repair and maintenance of the computers, installed software and hardware throughout the contract. The City shall work with Contractor to coordinate vehicle installation. All necessary computer and accessories patching, releases, updates, and repairs shall be performed within 7-10 business days. The City shall have the right to require Contractor’s Support Technician to install, support, secure and maintain additional applications and peripheral devices on any hardware. All hardware and software changes must first be tested in a test environment and accepted by the City before deployment into the production environment. Contractor shall agree that the City will be the owner of all right, title and interest in all computer hardware and accessories as listed in Attachment “A” at the conclusion of the initial term.

D. Integration: Contractor shall ensure that hardware and software systems fully integrate field and back-office operations. The back-office operation includes areas such as, but not limited to, the following: the use and transfer of patient care information for billing, patient care reporting; data storage and retrieval; report preparation; data analysis; and quality assurance and quality improvement through the patent reporting software. The data integration transmission between the City, patient care software and billing software must be encrypted at rest and in transit, secure and protected from interception and inspection by unauthorized individuals. All activities must be conducted by Contractor in compliance with HIPAA/HITECH standards, industry cybersecurity standards (see Section 2.0 below), including but not limited to the applicable Privacy and Security regulations, the applicable provisions of the City’s HIPAA compliance policies and procedures, as well as Ohio’s personal information protection laws.

E. Personnel: Contractor shall provide a Support Technician (aka “Field Support Engineer.”

The following is a general description of the duties of this position but is not intended to be a non-exhaustive list of all responsibilities: maintain, repair, and support all aspects of the hardware (computers, components (including pens), and docking stations) necessary for the collection of patient information by front-line crews, deliver hardware to stations and maintain inventory, ensuring an adequate number of devices and components (including pens) are available to support operations, maintain and support all aspects of the software installed on the devices used for the collection of patient information, be on-call at all times to provide support, support other hardware connections, including EKG connectivity, ensure connection to WIFI and cellular services (management of air-cards), perform daily reconciliation and correction of patient care reports (checking for incorrect information, addresses, incident numbers, deleted reports, duplicate reports, and missing reports etc.), assist in troubleshooting report submission and data anomaly issues, act as a liaison between the City of Columbus and the billing department for any issues or concerns, unless another single point of contact is designated.

This position shall work a minimum of forty (40) hours per week. The position shall work on-site between the hours of 7:30 a.m. and 4:00 p.m., Monday through Friday, or at other reasonable times as directed by the City and agreed upon by Contractor. In addition to the on-site hours described herein, hardware support shall be available either by telephone and/or email, 24 hours per day, 7 days-per-week, 365 days-per-year. Technical Support must also be available by telephone, email and/or remote access, as set forth herein, when requested by the City for Priority I or Priority II requests. For purposes of this paragraph, a Priority I request pertains to a problem that “crashes” the system or makes it otherwise unusable. The response to a Priority I request will be via telephone support, email, and remote connectivity, within 60 minutes of notification by the City. For purposes of this paragraph, a Priority II request pertains to a problem that prevents full functionality in the system and there is no workaround. The response to a Priority II request will be via telephone support and remote connectivity, within 120 minutes of notification by the City. The Support Technician shall be knowledgeable and experienced regarding the hardware

This person shall in no manner be considered an employee of the City and is not entitled to any City benefits or compensation. Personnel shall undergo an “FBI/BCI” criminal background check and OIG exclusion check which shall be given to the City who shall have the right to reject the proposed personnel. The Contractor warrants that all such personnel furnishing services to the City shall not be excluded from participation in any state or Federal healthcare program. The City shall provide space for this person to work.

H. Migration of Legacy Data:

i. From current Vendor: Contractor shall migrate data from the current vendor, Change Healthcare, including mapping the current vendor’s data to the Contractor’s schema and testing in a test environment and City acceptance prior to migration, with the goal of helping to achieve billing effectiveness and efficiencies.

ii. Upon termination of this contract: Contractor shall migrate all data in a file format using an industry standard that is reasonably acceptable to the City. Moreover, Contractor shall reasonably cooperate with any subsequent contractor concerning the migration of data.

I. Lockbox: Contractor shall establish and pay for a “lockbox” for deposits to the City. The City’s lockbox solution is JPMorgan Chase. Lastly, it is expected that the lockbox will sweep funds into the City Treasurer’s bank account daily.

J. City Collection Agent: Electronic submission of delinquent accounts to the City’s designated collection agent for individuals who have received insurance payments but who do not forward this payment to the City.

K. Billing Reports: Contractor shall provide to the satisfaction of the City billing reports such as, but not limited to: monthly collections reports and summaries which verifies and reconciles collection posting; Activity Analysis report which summarizes the results of collection efforts used to measure Contractor performance; Medicaid/Medicare/Private Insurer/Self-Pay Report; reports of transports and services received; report of write-offs; past due collections and reconciliation reports; report of accounts sent to collection; annual receivables and ageing report as specified by the City. Lastly, any additional custom and ad-hoc reports as required by the City during the contractual period. Contractor should provide examples of such reports, and any others deemed beneficial to the City.

L. Claims Compliance Audit by Page, Wolfberg, and Wirth: Contractor shall pay, on behalf of the City, and undergo an annual billing compliance audit by the firm Page, Wolfberg, and Wirth, LLC. The purpose of this review of approximately fifty (50) closed transport claims is to help ensure the City that Contractor is complying with best billing practices. The claims review conservatively scrutinizes all aspects and coverage criteria for Medicare reimbursements. It is anticipated that Contractor’s compensation will, in part, be based on successfully passing this annual audit. Please see Exhibit “B” for a brief overview and an estimated, albeit non-binding, cost of their auditing services over the next four years.

M. Financials Compliance Audits: Contractor will maintain full and accurate management of the City related receivables and maintain auditable books and records. The City reserves the right to retain an independent contractor to audit the records of the Contractor to ensure compliance with local, state, and Federal laws as well as best practice industry standard accounting principles and practices. Contractor will provide access to any and all records necessary to conduct the audit.

N. SSAE Requirement: Contractor shall provide the City an annual independent auditor’s report pursuant to the Statement on Standards for Attestation (SSAE) 18. Contractor shall provide, in particular, a Type 2 Service Organization Control Report (SOC1) showing that this standard has been met.

O. Hospital/Emergency Facility EPCR: Contractor shall ensure submission by the computers of defined patient data to the transport hospital/emergency facility prior to the arrival of the medic ambulance.

P. Data Recovery Project Plan and System: Contractor shall have a plan to ensure complete and uninterrupted services and recovery via backup and failover systems should a disaster occur. Such plan shall be in conformance with all applicable HIPAA Security Rule standards. Contractor shall state in their offer their recovery point objective, recovery time objective, service availability, and incident response.

Q. Data Ownership and Security: Title to and ownership of all data shall remain with the City. City data may not be maintained outside the continental United States. Contractor shall ensure their facility, personnel, subcontractors, software, and policies and procedures are comprised of independently attested best industry cybersecurity practice standards as well as compliant with all applicable HIPAA/HITEC and Ohio PII requirements to ensure protection of private patient and financial information.

S. Hospital Interface to Obtain Patient Demographics: Contractor shall establish an electronic interface to extract billing data from hospital records systems. The 28 local hospitals and/or emergency facilities that patients are transported to are overseen by four entities. The four entities to interface with are Nationwide Children Hospital, OhioHealth, Ohio State University, and Trinity Health (i.e. Mount Carmel Hospitals). Should an interface fail to obtain the necessary data then Contractor should consider contracting for a manual review the hospital.

T. Confidential Information: Contractor, and its sub-contractors, shall limit the use of confidential records of care or treatment of patients, payment financial information, and personally identifiable financial information solely for the purpose of processing and collecting claims and shall not release any such information for other purposes unless with the consent of the City. Contractor shall be responsible to assure that all uses and disclosures of the City’s Protected Health Information are done only in accordance with the HIPAA Privacy Rule, payment information in accordance with PCI regulations, and personally identifiable information with Ohio PII laws.

U. Billing Forms: Contractor shall design all forms and correspondence necessary for medical billing. The design and wording of these materials shall be mutually agreed upon by the Contractor and City.

V. Other Relevant Information: Contractor may submit any other relevant information which documents additional expertise and experience you believe may be relevant.

W. Revenue Estimate: Contactor shall provide a revenue estimate of net revenues anticipated for 2026 and 2027. Net revenue estimates shall be expressed in terms of total approved reimbursement, minus refunds and contractual allowances (i.e. mandatory write-offs required by Medicare and other payers). Please provide the basis and assumptions made in calculating this estimate.

X. Enrollment And Credentialing: Contractor shall provide enrollment and credentialing on behalf of the City. This includes Medicare & Medicaid enrollments as well as the prevention of certification lapses, and establishing all major payers on electronic claims and remits and EFTs throughout the duration of the contract.

Y. Monthly Billing Meetings and Designated Client Manager: Contractor shall conduct monthly billing meetings to review revenues and discuss any issues. Contractor shall designate a lead Client Manager to liaison with the City.

Z. Ohio Ambulance Supplemental Payment (ASPP): The City is participating in Ohio’s newly created program which allows public ambulance providers to receive supplemental Medicaid payments that account for some of the difference between what it costs a department to transport a Medicaid recipient and what the department is paid by Medicaid for that transport. The vendor working on behalf of City for this program is The Public Consulting Group (PCG). The contractor will not be expected to supply ASPP services on behalf of the City. However, the Contractor will be required to provide some ASPP data elements to PCG:

· Billing reports (Units, Charges, Paid Amounts) by procedure code and aggregated by payer.

· Billing details to validate billing reports.

· Additional detail as necessary to support audit response.

AA. Electronic and Digital Payment: Chase provides the city’s electronic and digital payment processing. The Contractor’s solution must integrate with either Paymentech or Paymentus for credit card, ACH, and digital pay processing.

1.5.2 City Duties:

A. Oversight of EMS transports services.

B. Entry by medics of emergency patient transport data reasonably necessary for billing services.

C. Prompt payment of monthly fees to the Contractor over the term of the contract.

D. Provide workspace for the Support Technician as listed above.

E. Acceptance of system and data testing.

H. Testing plan.

I. Go Live Plan J. Statement of roles and responsibilities of Contractor and City.

K. Ongoing Support and Maintenance Plan

1.6 How Contractor Submits Proposal to City: RFP031040 - Emergency Medical Services Billing https://columbus.bonfirehub.com/opportunities/RFQ031040

1.7 Presentation:

After the City reviews the responses to this request for proposal selected vendor(s) may be invited to give a presentation.

2.0 APPLICABLE STANDARDS AND PUBLICATIONS

Any proposed solution must meet or exceed guidelines and standards laid out in the following:

A. SSAE 18: Contractor shall be compliant with Statement on Standards for Attestation (SSAE) 18. Please provide a copy of the most recent SSAE 18, SOC1 compliance report.

B. HIPAA Law and Regulations: Contractor will be a business associate of the City and shall be compliant with the Health Insurance Portability and Accountability Act and associated regulations as amended from time to time. Any final agreement between Contractor and the City requires a business associate agreement in the City’s approved format. A draft of the City’s EMS Billing Business Associate Agreement is attached as Exhibit “L”. Please describe (or attach a copy of) Contractor’s HIPAA Compliance Program, which must include Privacy, Security and Breach Notification provisions.

C. Fiscal Agent: City Code necessitates that the successful contractor be approved as a fiscal agent by the City’s Depository Commission and Treasury Investment Board. Please see Columbus City Code Section 321.11 and Attachment “H” for fiscal agent guidelines. Please affirm and state that Contractor will meet and adhere to the code and guidelines.

D. Compliance With Laws and Regulations:

Contractor shall comply with all applicable statutes, ordinances, and rules of the Federal Government, the State of Ohio, and the City of Columbus.

E. PCI: Contractor shall ensure compliance and independent attestation of compliance.

F. ORC 1347: Contractor shall ensure compliance with Ohio’s laws regarding personally-identifiable information.

G. NIST 800-53 or similar: Contractor shall ensure systems and practices, including those of subcontractors, are compliant with the cybersecurity standards of NIST 800-53 or similar industry cybersecurity standard, and are independently attested at least annually.

H. Department of Public Safety Information Technology Terms and Conditions: See Attachment “I”.

3.0 SPECIFICATIONS And INFORMATION FOR OFFERORS

3.1.2 Written Purchase Order: Written Purchase Orders may be established by the City referencing the terms of this request for proposal contract. Any number of written purchase orders may be issued at the discretion of the City to increase or decrease available funds during the term of the agreement. At no time shall the maximum obligation of the City agency exceed the cumulative dollar amount of associated purchase orders. Any available funds balance not obligated by the City for accounts payable on items/work ordered on or prior to that date shall be cancelled after that date.

3.1.3 Non-disclosure: The Contractor agrees that no information will be disclosed to third parties or published in case studies, advertisements, white papers, customer testimonials, etc. without the written consent of the City.

3.1.4 Information for Offerors: Please see Attachment “K” for the City’s contractually binding Information for Offerors.

3.2 RFP Scoring Overview: The Contractor’s response to this RFP should be a clear and concise description of the Contractor’s capabilities and proposed offerings. The RFP will be evaluated using (1) the competence of the Contractor to perform under the contract as indicated by the technical training, education and experience of the Contractor's personnel who would be assigned to perform the work; (2) the quality and feasibility of the Contractor's technical proposal; (3) the ability of the Contractor to perform under the contract competently and expeditiously as indicated by the Contractor's workload and the availability of necessary personnel, equipment and facilities; (4) past performance of the Contractor as reflected by evaluations of the city agency, other city agencies and other previous clients of the Contractor with respect to such factors as quality of work, success in controlling costs, and success in meeting deadlines; and (5) the pricing or cost to the City

3.2.1 Process Summary: The City will appoint an evaluation committee to evaluate proposals received. The committee will evaluate all Contractors and proposals received and rank the Contractors based upon the evaluation criteria specified in the RFP. The committee may then select two (2) or more of the highest qualified Contractors with which to hold additional discussions. The discussions may include, but are not limited to, presentations by the Contractors to the committee to elaborate upon their qualifications, proposals, and/or other pertinent information. Based upon the content of the proposals received including any revisions thereto, and upon any additional discussions with the Contractors the committee shall rank the remaining Contractors based upon the evaluation criteria specified in the RFP. The committee shall submit its ranking of the Contractors along with a written explanation to the Public Safety Director. The Public Safety Director shall select the Contractor(s) with which to enter into contract negotiations. If negotiations fail, negotiations with these Contractor(s) shall be terminated, and the City may enter into contract negotiations with other respective bidders.

3.2.2 RFP Sequence of Events: The following RFP sequence of events represents the City’s best estimate of the schedule that will be followed. Exact times for questions / answers (in Section 3.2.2.1) and due date are noted in this document:

- RFP Issued August 29, 2025

- Deadline for written questions: September 19, 2025, by 11:00am EST

- City response to questions: September 26, 2025, by 4:00pm EST

- RFP Due: October 10, 2025, by 1:00pm EST

- Notification of finalists: October 24, 2025

- Presentations to City: October 29, 2025 – November 7, 2025

- Negotiations begin: November 12, 2025 – November 26, 2025

- Contract signed and submitted at year’s last City Council Meeting: December 15, 2025

- Contract Commencement: April 1, 2026

The City may change this schedule at any time. If the City changes the schedule for events prior to and including proposals due, it will do so through an announcement on the City’s procurement portal on the record for this specific RFP (https://columbus.bonfirehub.com/opportunities/RFQ031040). The announcement will accompany an amendment to the RFP, also available through the portal.

3.2.2.1 Specification Questions: Questions regarding this solicitation must be submitted to the Bonfire portal no later than 11:00 a.m. (EST) on September 19, 2025. Responses will be posted on the Bonfire portal no later than 4:00 p.m. (EST) on September 26, 2025.

3.2.2.2 Communications: During the proposal and evaluation process, Contractors are strictly prohibited from communicating with any City employees or officers regarding this solicitation except through the method stated immediately above during the Question & Answer Period. Any communication from the vendor to the City after the Question & Answer period should be limited to only what is necessary. Necessary communication required by the City will be communicated clearly to Contractors. If any Contractor has a need to communicate with the City regarding this RFP, the communication should come to Richard Metheney. If a City employee attempts to communicate with a Contractor contrary to this provision, the Contractor shall report said incident to the Richard Metheney whose contact information is below. A violation of this section on the part of the Contractor may lead to disqualification.

Richard Metheney Fiscal Operations Supervisor Management Analyst II 614-645-4641 rmetheney@columbuspolice.org

3.2.2.3 Proposal Submittal Guidelines:

All general and updated information regarding this RFP can be found on the City procurement portal at https://columbus.bonfirehub.com/opportunities/RFQ031040. The portal is the primary vehicle for communication back and forth between the City and all Offerors until proposals are due.

Only proposals received via the City procurement portal prior to the due date and time will be reviewed and considered for Contract award. Proposals submitted to the portal after the due date and time will be rejected by the City. Proposals sent or delivered to the City using any other method will not be reviewed.

It is each prospective Offeror’s responsibility to check the portal for current information regarding this RFP and its calendar of events through award of the Contract.

3.2.3 Evaluation Criteria Overview:

3.2.3.1 Criterion One – Competence (10 points): The competence of the Contractor to perform the required service as indicated by the technical training, education and experience of the Contractor's personnel who would be assigned to perform the work. See Section 4.1 below.

3.2.3.2 Criterion Two – Quality and Feasibility (30 points): The quality and feasibility of the Contractor's technical proposal. Contractor will demonstrate through the conversion of the RFP technical specifications into detailed line drawings and documents that clearly explain how the Contractor meets the operational needs expressed by the preferences of the technical specifications. The committee will give points to Contractors who clearly demonstrate their compliance with the needs defined in the technical specifications. If the Contractor does not include a specific item preferred in the technical specification, the Contractor will be scored based on its ability to demonstrate how its offer meets the high-quality demands of the City and the feasibility of Contractor’s proposed solution. See Section 4.2 below.

3.2.3.3 Criterion Three – Ability (20 points): The ability of the Contractor to perform the required service competently and expeditiously as indicated by the Contractor's workload and the availability of necessary personnel, equipment and facilities. See Section 4.3 below.

3.2.3.4 Criterion Four – Past Performance (20 points): The past performance of the Contractor as reflected by evaluations of the city agency, other city agencies and other previous clients of the Contractor with respect to such factors as quality of work, success in controlling costs, and success in meeting deadlines. See Section 4.4 below.

3.2.3.5 Criterion Five – Price (20 points): See Section 4.5 below.

4. Evaluation and Contractor’s Response Section: Provide the requested information in a clear, concise manner with the questions or requests below.

4.1 Competence (10 points):

A. Please provide a business history, business structure (e.g. private, for-profit, partnership, etc.), location of corporate offices, support services sites, website, and years in business. Please highlight any Central Ohio office locations.

B. Please provide any former name(s) of your company.

C. Please provide the number of years in operation with a focus on administering emergency medical transport billing services for like size public jurisdictions.

D. Please provide your management structure which includes number of employees (full-time and part-time) and an organizational chart that demonstrates the responsibilities of the Contractor’s employees who will be implementing this contract.

E. Please describe the experience and training and of staff assigned to perform on this project. Please especially highlight the qualifications of the lead project manager assigned to oversee this project. Please identify and describe similar work performed in the past by the lead project manager.

4.2 Quality and Feasibility (30 points):

A. Please provide a detailed explanation as to how Contractor will meet each Contractor Duty as specified above in Section 1.5.1.

B. Please demonstrate step by step what your standard billing, collection and payment procedures are from the time a PCR is received. Please highlight how you confirm patient data is correct and complete. How do you handle any discrepancies noted in an ePCR?

C. Please state your goal timeline for the billing process once a PCR is received. How does this goal compare to your median turnaround time? What is the quality assurance process for measuring billing?

D. How has the trend of higher insurance deductibles and self-pay affected collections and how have you adopted?

E. Please outline how you comply with billing laws and regulations. Please highlight, if applicable, compliance plans, compliance officer, training of staff, and in-house audits. Describe your billing/revenue cycle compliance program and attach a copy of your written compliance plan.

F. Please provide a detailed project timeline or Gantt chart illustrating the steps necessary to implement this project without delay to begin EMS billing.

G. Please describe the method used to coordinate with the project team to update the implementation status and tracking of work performed on task assignments.

H. Provide a detailed business continuity plan that outlines your data security standards, to include but not limited to, defining the physical environment, personnel protocols, location of all host servers, protections against natural and man-made disasters, encryption, transfer, storage, redundancy and recovery of files, the loss of data occurring from criminal actions, as well as other issues that impact data integrity, such as unauthorized data access by contract personnel. Include information regarding policies concerning the protection of Protected Health Information. Please specify which industry security standards framework you are following. List and describe third party certifications/attestations for your security posture.

I. What, if any, electronic billing information access is available for the City to monitor billing information? If electronic access is available, please describe what training is necessary to access and utilize this billing information.

1.0 J. Please provide the Contractor’s step by step procedures and standard timelines for turnover of accounts and information from the previous billing company and how each step is accomplished.

K. Describe your process for evaluating and addressing outstanding accounts receivables from previous years, and anticipated outcomes and typical best practice results from your process.

L. Please describe your insurance coverage? What is the liability limit and who is the insurance company?

4.3 Ability (20 points):

A. Please state your current workload and how you plan to incorporate this proposed increase in workload due to this contract? Please note the current claim per staff ratio and what affect this contract would have on that ratio should you be awarded the contract.

B. If any billing subcontractors are used please identify them and what volume of claims they will be utilized to work on City claims.

C. Please state the availability of necessary personnel and how you plan to incorporate the increase in workload of the City without delay?

D. Please affirm you have the necessary monies to immediately procure upon execution of the contract the hardware and additional equipment and required Support Technician position necessary to perform the contract by the requisite dates listed in this document. How do you intend to finance these expenditures?

E. Please state the availability of necessary equipment and workload and how you plan to incorporate the increase in the workload of the City without delay? Please state the availability of necessary facilities workload and how you plan to incorporate the increase in workload of the City without delay?

F. What is the process for when a billed patient and/or their attorney seeks billing information? Please describe the online billing experience when a billed patient seeks information. Please describe your online payment process for the public. Where is customer service located and is this ever outsourced overseas? How does Contractor respond to patient and/or their attorney billing inquiries and records requests? How does Contractor maintain bilingual support?

G. Is Contractor currently involved with any adverse or potential action, such as but not limited to: litigation, threatened litigation, investigation, unpaid judgements, audit, reorganization, receivership, strike, or any other action or situation that could adversely impact the ability to provide the required RFP needs? If so, provide the nature of the item and the potential impact.

4.4 Past Performance (20 points):

A. How many transports has Contractor billed for in each of the last five years?

B. Please list the jurisdictions that Contractor bills on behalf of.

C. What are the largest three metropolitan fire-based EMS jurisdictions that Contractor currently bills on behalf of in terms of number of billed transports? Please state the number of billed transports for each jurisdiction and provide information for a point of contact or reference for that jurisdiction.

D. Please provide a copy of your contract with the three jurisdictions or entities listed above. Should a jurisdiction be private and you are unable to provide a copy of the contract then provide a copy of the next largest contract to which public records law would permit disclosure.

E. What is the largest jurisdiction that Contractor currently bills on behalf of in Ohio, and especially within the Greater Columbus Ohio Region, in terms of number of billed transports? Please state the number of billed transports and provide information for a point of contact or reference. Additionally, please provide a copy of their contract.

F. Describe where Contractor has previously successfully integrated with the patient reporting software vendor ImageTrend the past.

G. Describe any past similar financial arrangements wherein Contractor has been responsible for procuring computers, hardware, implementing patient demographic billing interfaces with hospitals and providing onsite staff.

H. Please list dates and description of any billing compliance or audit issues against Contractor, including your parent company or subsidiary, within the last 7 years. Discuss their resolution.

I. Does your company provide enrollment and credentialing support during the onboarding process? This includes Medicare & Medicaid enrollments as well as the prevention of certification lapses and establishing all major payers on electronic claims and remits and EFTs throughout the duration of the contract.

J. Please describe any significant cyber security incidents that have occurred and how you are preventing such incidents from occurring in the future.

4.5 Pricing (20 points):

A. Prospective contractors must price their bid as a percentage of net collections made through the City’s accounts receivable.

Net collections mean the total sum of all monies collected by Contractor for services rendered on behalf of the City, less amounts properly refunded or credited as a result of overpayments, erroneous payments, or bad checks, and net of all contractual allowances required by law and/or payer policy. In the event that after paying Contractor the City is required to make any overpayment refunds, credit balance refunds, or is subject to recoupment of amounts paid by any payer on any accounts, the proportional amount of any such fees paid to Contractor on such shall be refundable for all such accounts by Contractor to the City. Any such amounts shall be refunded by Contractor to City within thirty (30) days of notification of same by City. Any amounts not so refunded shall be subject to offset from future payments due the Contractor by the City. When delinquent and/or unpaid accounts are referred to the collection agent, net collections will not include the net amount received by the City through the efforts of the collection agent. Contractor must provide a quote for year one, two, three, and four. If pricing is a different percentage for any of the year’s one through four, the City will take the average of the proposed four years and evaluate the price based on that average number. Please state your bid as a percentage of net collections.

B. Following award of a contract, Contractor shall be paid the agreed-upon percentage only on the realized revenue for which it prepared and submitted the claim on behalf of the City. Contractor shall not be paid a percentage of any revenue realized as a result of the claims filed by predecessor contractor. Contractor’s electronic billing, remittance and posting systems must be able to clearly differentiate the revenue received for claims filed by Contractor from claims filed by predecessor contractor. Please describe your approach to separate payments from the predecessor contractor.

C. If the Contractor believes that a different pricing system would be more advantageous to the City, please describe such a system.

D. Please note that it is the intention of the City in negotiations to convert a portion of the percentage you bid above to a performance incentive system whereby a lump sum payment(s) will be made when the Contractor’s performance meets or exceeds target levels of performance. It is the City’s desire to negotiate similar incentives as contained within Exhibit E of the 2019 attached contract with Change Healthcare.

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