Request for Proposals Ambulance Transport Billing and Collection Services

RFP-26-00324

RFP-26-00324 Page 1

IMPORTANT! PLEASE READ CAREFULLY BEFORE SUBMITTING PROPOSAL

SOLICITATION TYPE: Competitive Sealed Proposals

SOLICITATION NUMBER: RFP-26-00324

SOLICITATION TITLE: Ambulance Transport Billing and Collection Services

BRIEF DESCRIPTION: The Hillsborough County Board of County Commissioners (County) is seeking competitive sealed proposals from experienced and qualified Contractors to provide ongoing and as-needed ambulance transport billing and collection services for the Hillsborough County Fire Rescue Department (HCFR). Services shall include, but are not limited to, a fully comprehensive and automated billing system, training, and technical and administrative support to HCFR. The Contract resulting from this request for proposal document will be in effect for a five (5)-year period.

DUE DATE & TIME: August 4, 2026, 2:00 P.M. Eastern Time (as recorded by the County’s Electronic Bidding System)

ISSUING DEPARTMENT DIRECTOR:

The Director of Procurement is considered the issuing department director for the purpose of Section 2-567(c) of the Hillsborough County Procurement Protest Policy and Procedures Ordinance.

PROPOSAL SUBMISSION: The County will only accept proposals submitted through its electronic bidding system (Euna Procurement). Proposals that are submitted or delivered by non-electronic means (hard-copy paper), facsimile, electronic mail (e-mail), electronic file, or means other than through the County's electronic bidding system (Euna Procurement) will not be accepted or considered. Please visit our vendors webpage (hcfl.gov/vendors) for information regarding vendor registration, electronic bid submission, procurement opportunities, and other important resources.

TIMELINESS: To preserve the integrity of the competitive sealed proposal process, proposals submitted after the due date and time listed above, unless otherwise amended, cannot and will not be accepted. Please do not wait until the last minute, hour, or day to submit your proposal, as you may encounter technical difficulties or issues that cannot be resolved before the due date and time. When preparing to submit your proposal, please read and follow all instructions regarding formatting and other details related to the form(s) to be used. Again, please do not wait until it’s too late for

RFP-26-00324 Page 2 assistance. We value and need your participation, so the last thing we want is for you to miss this opportunity.

QUESTIONS: ● Questions regarding technical difficulties or errors encountered while submitting proposals through Euna Procurement must be directed to Euna Procurement Support at 1-844-226-3862 or support.bonfire@eunasolutions.com.

● Questions regarding the specifications or solicitation document must be directed to Procurement Services using the “messages” section in Euna Procurement for this particular procurement.

● To be given consideration, such requests must be received no later than 14 calendar days after the date of Solicitation issuance in Euna Procurement, site visit, or pre-proposal conference, whichever is later.

● Questions regarding vendor registration, training, or general questions must be directed to the Supplier Engagement Team at (813) 272-5790 or iSupplier@HCFL.gov.

CONE OF SILENCE: A Cone of Silence is in effect for this procurement; therefore, no proposer, interested party and/or their principals, officers, employees, attorneys, or agents shall communicate with County employees, the Hearing Master assigned to hear the applicable protest appeal and/or members of the Board of County Commissioners, including their aides and employees regarding this procurement and/or a related protest, except as otherwise provided in the Hillsborough County Procurement Protest Policy and Procedures Ordinance. The Cone of Silence does not prohibit a proposer from communicating with the Director of Procurement, staff in the Procurement Services Department, or the County’s attorney assigned to this procurement. Violating the Cone of Silence may disqualify the proposer from consideration for award. Please refer to the Instructions for complete details about the Cone of Silence.

INSURANCE: Insurance coverage is required for this procurement. Please see RFP-26-00324 Insurance Requirements Attachment and Special Terms and Conditions.

SURETY (BONDS): Proposal, performance, and/or payment surety is not required for this procurement.

E-VERIFY: The Department of Homeland Security's Image Program and E-Verify apply to this procurement. Please see General Terms and Conditions for complete details and requirements.

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DIGITAL ACCESSIBILITY COMPLIANCE:

Any and all information and communications technology developed, provided, procured, maintained, or otherwise made available under this Contract and intended for public access or use, shall comply with various accessibility standards. Please see General Terms and Conditions for complete details and requirements.

INSTRUCTIONS TO PROPOSERS:

Please see Sections 1.7., 1.8., and 4. for various instructions for Proposers.

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1. SPECIFICATIONS

1.1. Scope

The Hillsborough County Board of County Commissioners (County) is seeking competitive sealed proposals from experienced and qualified Contractors to provide ongoing and as-needed ambulance transport billing and collection services for the Hillsborough County Fire Rescue Department (HCFR).

Services shall include, but are not limited to, a fully comprehensive and automated billing system, training, and technical and administrative support to HCFR.

1.2. Objectives

1.2.1 The intent of this Request for Proposals is to provide support for the day-to-day operations, functions, and activities of the operational and management staff of HCFR in the use, analysis, and maintenance of patient accounts, including billing for services to the patient, responsible party and/or insurance provider. This will include, but is not limited to, Fire Rescue Advance Life Support (ALS) services and Fire Marshal inspections as required.

1.2.2 The County is seeking a comprehensive medical billing and collection system which shall provide new solutions that meet all the requirements of Medicare, Medicaid, Certified Public Expenditures (CPE), Medicaid Managed Care Supplemental Payment Program (MCO), other governmental insurance programs, and commercial insurance companies (collectively referred to as Insurance Providers).

1.3. Background

1.3.1 HCFR billing operations are characterized by a high volume of relatively moderate dollar amounts. In Fiscal Year 2025, HCFR transported 66,000 patients by ambulance. Attachment A - Historical Statistics and Information has been provided for your reference and use.

1.3.2 HCFR Standard Reports. Attachment B - Standard Reports has been provided for your reference and use.

1.3.3 HCFR transports patients from incident scenes to hospital emergency rooms or from medical facility to medical facility, in certified advanced life support ambulances. Patients are charged a base rate, mileage fee, and an oxygen or nitrous oxide fee, if administered. The base rate covers all medical services except oxygen/nitrous administration. Multiple patients transported in the same unit are each charged the appropriate base rate. Attachment C - Fire Rescue Fee Schedule has been provided for your reference and use. This schedule is subject to change.

1.3.4 HCFR Fire Marshal inspections are characterized by a high volume of relatively small dollar amounts. Attachment D - Fire Marshal Fee Schedule has been provided for your reference and use. This schedule is subject to change.

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1.3.5 HCFR Sample Survey. Attachment E - HCFR Sample Survey has been provided for your reference.

1.4. Applicable Publications, Terminology, and Acronyms

The following publication(s) of the issue in effect on date of this solicitation, forms a part of this specification:

1.4.1 Generally Accepted Accounting Principles (GAAP)

https://www.freshbooks.com/hub/accounting/generally-accepted-accounting-principles

1.4.2 Hillsborough County Health Insurance Portability and Accountability Act (HIPAA) requirements https://hcfl.gov/residents/community-resources/official-records/hipaa https://assets.contentstack.io/v3/assets/blteea73b27b731f985/blt2457bdc0adc263ab/HIPAA_N otice_of_Privacy_Practices.pdf https://assets.contentstack.io/v3/assets/blteea73b27b731f985/bltb72895db3505f058/HIPAA% 20Notice%20of%20Privacy%20Practices%20SPANISH.pdf

1.4.3 Type II System and Organization Controls (SOC) Audit Report (SSAE18) https://ssae-16.com/soc-2/soc-2-report-trust-services-principles/

The following terminology forms a part of this specification:

1.4.4 Ambulance Billing shall mean the total annual dollar amount collected of medical billing submitted to the Contractor either via electronic reporting system or using paper medical encounter report forms. (This excludes all Medicaid Claims which shall be defined separately.)

1.4.5 Fire Marshal Billing shall mean the total annual dollar amount collected of all electronic invoice forms used by the Hillsborough County Fire Marshal's office.

1.4.6 Medicaid Claims shall mean a set per claim fee for total claims billed to and paid by Medicaid.

1.4.7 Certified Public Expenditures (CPE) Program shall mean the total annual dollar amount collected based on the Medicaid cost settlement determined through the Medicaid cost report.

1.4.8 Medicaid Managed Care Supplemental Payment Program (MCO) shall mean the total annual dollar amount collected based on the Medicaid cost settlement determined through the Medicaid cost report.

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The following acronyms forms a part of this specification:

ALS Advance Life Support ASPP Ambulance Supplemental Payment revenue Program BLS Basic Life Support CPA Certified Public Accountant CPE Certified Public Expenditures EMS Emergency Management Services GAAP Generally Accepted Accounting Principles MCO Medicaid Managed Care Supplemental Payment Program MER Medical Encounter Report NSF Non-Sufficient Funds POB Post Office Box SOP Standard Operating Procedure SSAE Statement on Standards for Attestation Engagements SSN Social Security Number

1.5. Minimum Qualifications

1.5.1 The Proposer or principal thereof shall demonstrate recent experience in providing substantially similar services.

1.5.2 The Proposer shall, at the time of submission and throughout the term of the resulting contract, possess the financial stability, viability and capacity required to meet the requirements of this request for proposal.

1.5.3 The Proposer’s pricing shall include all expenses necessary to support billing and related accounts receivable services such as forms, mailers, stationary, postage, envelopes, and other items inherent and necessary to billing and accounts receivable operations. Printing, mailing, and tracking of HIPAA Privacy Rights Notices shall also be included in the base proposal pricing.

1.5.4 The Proposer shall have, at the time of bid submission and throughout the term of the resulting contract, documented system security and disaster recovery plans. The plans shall include specific and detailed information regarding encryption of electronic data or otherwise securing data during transmission. Disaster recovery plan methods shall be able to preserve the integrity of applications and data and shall provide immediate system and data recovery to maintain a 99.9% uptime to the application according to the following industry standards:

1.5.4.1 Standard Number 1: Have multiple locations, with a separate data recovery site.

Higher Standard: Have disaster recovery sites in geographically disparate areas.

1.5.4.2 Standard Number 2: Support offsite backups. Higher Standard: Support a site that replicates the primary site and is "ready to go" at any time.

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1.5.4.3 Standard Number 3: Have a documented business continuity plan. Higher Standard:

Ensure the human factor is included.

1.6. Minimum Requirements

1.6.1 HCFR shall perform, at a minimum, semi-annual on-site visits to the Contractor’s location to monitor and/or audit records.

1.6.2 Pursuant to Florida Statutes 409.913(10), the County cannot accept billing and collection services on Medicaid accounts based on a percentage fee. The Contractor shall charge a flat rate, which shall be included on the Proposal Pricing Table.

1.6.3 The Contractor’s fee’s for all other services shall be a percentage of the actual dollars they collect on HCFR accounts that the Contractor processes during each monthly billing period.

Monthly invoices shall be provided to HCFR by the 10th of the month following the last day of the month in which collections are posted. Contractor fee adjustments for refunds shall be shown on the monthly invoice submitted to HCFR.

1.6.4 The Contractor’s automated system shall include, but not be limited to, the following:

1.6.4.1 The capability to render invoices, fully manage accounts receivable, and maintain auditable books and records.

1.6.4.2 Software Crash Tolerance: Server and client software shall maintain its integrity in case of power failures and abrupt shutdowns.

1.6.4.3 Restart/Recover: The system shall be capable of restart and recovery after system failure with no loss of data or software components.

1.6.4.4 File Protection: This feature shall provide the capability to limit the types of operations (e.g. read, write, delete) that can be performed by individual users on given data or program files.

1.6.4.5 Integrity checking Feature: The system shall provide the capability of identifying the existence of program and/or system discrepancies.

1.6.4.6 Hardware Redundancy: Implementing backup drives for database, application, and network servers.

1.6.4.7 The capability to interface with and receive data from the HCFR’s records management system, FireWorks.

1.6.5 The Contractor shall perform, at a minimum, an annual test of it’s “Disaster Recovery Plan” and submit to the HCFR, by Email, written documentation of said test as follows:

1.6.5.1 Date of test.

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1.6.5.2 Results of test including, but not limited to:

1.6.5.2.1 Pass/fail determination and plans to correct any failures, including a timeline.

1.6.5.2.2 Updates and associated outcomes, if applicable.

1.6.6 The Contractor shall provide a process flow and Standard Operating Procedure (SOP) for the billing and collection process to the County PM within ninety (90) calendar days of Contract anniversary date.

1.6.7 The Contractor shall meet with County staff quarterly (in person or electronically at the County's sole discretion) to discuss all contract performance related issues.

1.6.8 The Contractor shall assist County staff with all billing and collection reconciliation issues that arise between the Contractor's system and the County's system.

1.6.9 Collection of past due accounts may be enhanced through local ordinances, and the Contractor shall be expected to facilitate actions to maximize recovery of billing and collection.

1.6.10 The Contractor shall provide billing and related accounts receivable services for HCFR. All data entry and posting shall be accomplished by the Contractor within two (2) business days of receipt of the billing transmission from FireWorks.

1.6.11 The Contractor shall attempt to collect all balances due for services provided by HCFR including, but not limited to, balances after insurance, co-payments, and deductibles.

1.6.12 The Contractor shall be subject to the same requirements, in handling public money, as are required in section 219.02, Florida Statutes. The Contractor’s billing system shall conform to GAAP requirements.

1.6.13 The Contractor shall practice segregation of duties. The same individual shall not be able to enter billing, adjust billing, post payments, and deposit funds.

1.6.14 The Contractor shall report all staffing changes assigned by the Contractor to the HCFR within 48 hours. HCFR reserves the right to request removal of unsuitable Contractor staff members from the account.

1.6.15 Please note: Under no circumstances shall subcontracting of any services described herein be permitted.

1.6.16 The Contractor shall report any security breach to the County’s Project Manager within 24 hours of said breach.

1.6.17 The Contractor shall safeguard all payments held in their possession pending deposit to the HCFR bank account and shall be liable for the replacement of any funds lost or stolen while in the possession of the Contractor.

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1.6.18 The Contractor shall provide HCFR "read only" access to HCFR accounts maintained in the Contractor’s automated system, with flexible inquiry capability, (e.g. SSN, address, incident numbers, etc.). Inquiry capability in a " read only" access level through a secure web site may also be required for separate quality assurance purposes within Hillsborough County Government and is subject to HIPAA limitations before access is provided and/or allowed.

1.6.19 The Contractor shall perform, at a minimum, an annual “vulnerability assessment” against systems and applications that are being used for the County's purposes.

1.6.20 The Contract shall perform, at a minimum, an annual “penetration test" against systems and applications that are being used for the County's purposes.

1.6.21 Reporting

1.6.21.1 The Contractor shall be responsible for providing standard reports in accordance with and in the timelines defined in Attachment B - Standard Reports.

1.6.21.2 The Contractor shall be able to produce the latest “vulnerability assessment” report at the request of the County and provide a report on a recurring basis as requested.

1.6.21.3 The Contractor shall be able to produce the latest “penetration test” report at the request of the County and provide a report on a recurring basis as requested

1.6.21.4 The Contractor shall submit a newly completed Type II SSAE18 audit (independent "Service Auditors Report") within two (2) years of receipt of a Standard Purchase Order (SPO).

1.6.22 Fire Rescue Ambulance Medical Billing

1.6.22.1 The Contractor shall implement, upon notice from HCFR, any Fire Rescue Fee Schedule changes. Refer to Attachment C - Fire Rescue Fee Schedule.

1.6.22.2 HCFR shall prepare and transmit to the Contractor, within five (5) business days of transport, a HIPAA approved electronic file of a Medical Encounter Report (MER) for each patient, including, but not limited to, the following:

1.6.22.2.1 Approximate charges

1.6.22.2.2 Medical, Personal, and Financial information

1.6.22.3 If hard copies of the MER’s are necessary, the Contractor shall be responsible for picking up said copies by 4:00 P.M., daily, from the HCFR Public Safety Operations Complex (PSOC) located at 9450 E Columbus Dr., Tampa, FL 33619, using Contractor employee(s) or contracted courier at Contractor's expense. For this paragraph, daily basis shall mean Monday through Friday excluding any County holidays or furlough days as directed by the County Project Manager.

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1.6.22.3.1 Shall there be a need to use hard copies; the HCFR shall prepare MERs for the Contractor to pick up within five (5) business days after the transport date. HCFR shall be responsible for obtaining all MERs from the point of service.

1.6.22.3.2 Items moved by courier shall remain in the sole possession of that single courier for deliveries between HCFR and the Contractor. The transfer of items to other third-party couriers shall not be permitted. Please see links provided in Paragraph 1.4 (Applicable Publications, Terminology, and Acronyms), Sub-Paragraph 1.4.1, above, for more information related to County HIPAA requirements.

1.6.22.3.3 The Contractor shall be responsible for knowledge of and compliance with the most current HIPAA guidelines.

1.6.22.4 The Contractor shall use the MER for billing and accounts receivable operations.

Note that the document is the patient's medical record and is protected in the same manner as all other medical records.

1.6.22.4.1 HCFR shall be the records custodian for the master file of patient records and shall be the point of contact for the release of records other than insurance filings actioned by the Contractor (e.g., patient requests, legal requests, subpoenas).

1.6.22.5 The Contractor shall mail initial billings to patients within five (5) business days after obtaining the MERs from HCFR along with the HCFR Customer Services Survey (See Attachment E - HCFR Sample Survey) and HIPAA – Notice of Privacy Practices.

1.6.22.5.1 HCFR reserves the right to approve the invoice statement mailer. A report shall be provided to the Contractor indicating the total number of medical responses for each calendar day.

1.6.22.5.2 The Contractor shall be solely responsible for the medical coding of all charges based on the current regulations applicable at the time of service. All data entry and HCFR receivable posting shall be accomplished by the Contractor within two (2) business days of receipt of the MER.

1.6.22.5.3 If there is, at any time, audit findings that require the County to refund any portion of previous payments, the Contractor shall be responsible for refunding their percentage of collection on said funds they were paid, plus any penalty payment due or assessed as a result of the audit findings. The Contractor shall assume responsibility for said fines and penalties as a result of Medicare/Medicaid, CPE and MCO programs audits, unless audit findings are a result of inaccurate reporting documentation provided by the County.

1.6.22.6 The Contractor shall provide insurance filing services for all patients who have insurance coverage regardless of the type of insurance. This applies to both primary and secondary insurance. Types of insurance include, but are not limited to, Medicare, FL

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Medicaid, Champus, auto, HMO's, PPO's, worker's compensation, County Indigent Health Care, etc.

1.6.22.6.1 Insurance information not available on the MER shall be obtained, by the Contractor, using the insurance form contained in the statement mailer, or by telephone.

The Contractor shall follow up promptly on rejected claims and claims where the insurer does not respond within 30 Calendar Days. The Hillsborough County Indigent Health Care letter of understanding has a fixed rate of $190.00 for the ALS service.

1.6.22.7 The Contractor shall apply contractual adjustments to government insurance programs at the time of payment using the explanation of medical benefits or similar voucher documents as backup (e.g., Medicare, Medicaid, Tricare, Hillsborough County Indigent Health Care, Medicare HMO's if complies with Medicare rates). No other adjustments are permitted.

Full payment of 100% is expected from all other programs. HCFR does not have contracts with any health care insurers to be a part of their medical network and is entitled to 100% payment

1.6.22.8 The Contractor shall file a claim to Medicare in accordance with all Medicare rules, regulations, pamphlets, guidance documents, etc. A claim shall be filed for all Medicare eligible patients. An original patient signature is required or an executed copy of an "Unable to Sign" form.

1.6.22.9 The Contractor shall file Medicaid in accordance with all local Medicaid program rules, regulations, pamphlets, guidance documents, etc.

1.6.22.10 The Contractor shall use the MER as documentation backup for each insurance claim filed by the Contractor. Each paper claim shall be filed with a copy of the MER for audit trail purposes. All entries on claims shall be supported by MER documentation.

1.6.22.11 The Contractor shall mail statements to patients every 30 Calendar Days when either of the following conditions is applicable. All notices, invoices, and letters shall be in a form approved by the County.

1.6.22.11.1 The Account has a balance of $5.00 or more, and is not under insurance processing, until there has been no activity on the account for at least 180 Calendar Days;

or

1.6.22.11.2 There has been activity on the account since the last statement was mailed, regardless of activity amount, account balance, or account age (not including write-off activity). This includes activity in the inactive file of delinquent accounts. Aging of accounts shall not be affected while insurance filings are in process.

1.6.22.12 The Contractor shall consider account balances as delinquent when they exceed one (1) year from date of transport with insurance processing activity, or six (6) months from

RFP-26-00324 Page 12 date of transport without insurance processing activity. Delinquent account access shall include the capability to be exported to Microsoft Office Suite.

1.6.22.12.1 Exceptions to a delinquent status are those accounts that were delayed in processing through no fault of the patient, legal or estate pending accounts, time payments (when regular payments are received), and documented indigents.

Questionable accounts shall be referred to HCFR Fiscal Section for final resolution.

1.6.22.13 The Contractor shall maintain an inactive file of those delinquent accounts and post inactive patient accounts with payment information received through a monthly statement, provided to HCFR. Payments on delinquent accounts received by HCFR shall be forwarded to the Contractor for processing.

1.6.22.14 The Contractor shall provide electronic access, to the County’s Project manager, to proposed write offs, which are transports in excess of 36 months old, through a secure website, for HCFR review and approval.

1.6.22.14.1 Quarterly write-off reports shall be submitted no later than the 10th business day of the quarter (March, June, September, and December). Those, approved by HCFR for write off, shall be retained by the Contractor for the records retention periods outlined in these specifications. Access to the approved write-off records shall include the capability to be exported, through a secure website, for the duration of the prescribed records retention period.

1.6.22.14.2 Approved write-off records lists shall also include the capability to be exported to Microsoft Office Suite. Those retained for collection shall be maintained in the collection process.

1.6.22.15 All settlement payments, write-offs, and other adjustments to accounts shall be authorized and approved by HCFR, in writing, as required.

1.6.22.16 The Contractor shall provide all patient-related inquiry services and follow up on patient queries and requests, as necessary. The Contractor shall have local and/or toll-free telephone numbers for patient convenience at Contractor expense. Copies of telephonic or mailed complaints and their disposition, received by the Contractor, shall be forwarded to HCFR within five (5) Business Days.

1.6.22.17 The Contractor shall provide a designated point of contact for routine, day-to-day operations, and a managerial contact for policy and procedure problem solving.

1.6.22.18 The Contractor shall be capable of preparation and deposits of financial items to the bank. The Contractor shall process claims to Medicare, Medicaid, private pay, all other insurance companies, bankruptcy claims, return mail, customer service, and refund requests.

All collections/depository documents shall be processed by the billing company each day. The bank deposit slip along with other deposit documentation shall be placed on a secured server

RFP-26-00324 Page 13 to be downloaded by HCFR staff daily. Additionally, Contractor is responsible to pick up all mail from the post office box (POB), and deposit checks in the designated bank daily. The Contractor employee(s) shall pick up and /or receive electronically batches of MERs reports daily from Fire Rescue Headquarters.

1.6.22.19 The Contractor shall pick up regular and certified mail from the POB daily through the Contractor's courier. The Contractor shall use the POB and be responsible for POB security during the entire term of this resulting contract. HCFR shall have access to the POB, located at 2810 E Hillsborough Ave, Tampa, FL 33610.

1.6.22.20 The Contractor shall:

1.6.22.20.1 Process regular mail each business day; and

1.6.22.20.2 Sign for, pick up, and deliver certified mail to HCFR each business day; and

1.6.22.20.3 Rework returned mail for errors and re-mail as necessary. Cross reference books or electronic mail reference websites, at least once, to determine correct addresses from names and/or telephone numbers; and

1.6.22.20.4 Receive any payments sent directly to HCFR which shall be forwarded to the Contractor, with the MER's, through the Contractor's courier.

1.6.22.21 All payments shall normally be mailed to the POB, established by HCFR. The Contractor shall deposit payments to the HCFR bank account and posted to the Contractor's automated system within 24 business hours of pick up from the POB. The total of each day's credits posted to the automated system shall be reconciled to the daily bank deposit of funds to the HCFR account with complete explanations for credit adjustments.

1.6.22.22 All payments for multiple patients from Medicare and Medicaid shall be deposited by the Contractor to the HCFR bank account within 24 hours of receipt and credited to a holding account. Payments shall then be credited to the patient’s accounts and debited to the holding account no later than the end of the month in which the payment is received. The Contractor shall kept copies of all payments.

1.6.22.23 The Contractor shall process payments in a manner acceptable to HCFR, as follows:

All payments for each business day shall be recorded on calculator tape or Excel worksheet showing check number and amount. When all payments are recorded, they shall be given to a different person who then verifies each payment with the correct patient's account and response number. Photocopies of all payment documents shall be made and used as posting documentation. The incident number(s), transaction code(s), and payment amount(s) shall be written on the photocopies, and the photocopies shall then be used as entry documents for terminal input. The total of these documents shall equal the day's bank deposit total and enable a deposit slip for the bank to be prepared. The adding machine tape produced from each day's mail shall be balanced with the bank deposit.

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1.6.22.24 The Contractor shall prepare requests for refunds and forward them to HCFR for refund check processing within 90 Calendar Days of the account reflecting a credit balance.

Refund requests shall be supported by a printout of the patient's account status, copy of the explanation of benefits (if applicable), and a copy of proof of payment(s) within 90 Calendar Days of the account reflecting a credit balance.

1.6.22.25 The Contractor shall provide standard reports (Refer to Attachment B - Standard Reports) as well as customized reports at no additional charge to the County Project Manager through a secure website. The reports shall be in a format capable of being sent electronically that can be downloaded to an Excel spreadsheet. All monthly reports shall be submitted to the County by the fifth (5th) Business Day after month end cutoff. Quarterly write-offs reports shall be submitted to the County no later than the 10th Business Day of the quarter (March, June, September, and December).

1.6.22.26 The Contractor shall routinely maintain records of telephone calls and contacts with patients and their insurance companies. The Contractor's system shall have electronic notepad capability to record items such as checks returned to a patient for lack of a signature.

1.6.22.27 The procedures described in these specifications establish the minimum level of effort required of the Contractor and does not limit in any manner the Contractor's use of proprietary systems or its usual and customary billing and accounts receivable practices, provided they exceed the established minimum levels of service.

1.6.22.28 The Contractor shall be required to perform at a minimum standard of a 50% collection success rate on Fire Rescue Billing fees, for the duration of the contract, when collected payments are compared to net charges (Net charges equal gross charges less contractual adjustments).

1.6.22.28.1 The Contractor’s year one (1) performance shall be evaluated at the end of the third quarter of year two (2) of the resulting contract. The period of the evaluation shall be year one (1) of resulting contract term.

1.6.22.28.2 If the Contractor fails to achieve and maintain this standard for year one (1), the fee for billing and collection services may be reduced by 25%, effective the 10th month of year two (2) and continue until the next evaluation period. Please note: The Contractor shall be required to provide written documentation supporting the lower collection rate.

If the County, at its sole discretion, concurs with the provided documentation, the County shall not reduce the fee for the billing and collection services.

Each subsequent contract year shall be evaluated based on the same criteria.

1.6.22.29 The Contractor shall provide sample copies of all correspondence, form letters, etc.

sent to patients to the Project Manager for approval prior to first use. Any subsequent changes shall be provided to the Project Manager for approval. HCFR reserves the right to amend the wording in any correspondence sent to its patients.

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1.6.22.30 HCFR shall provide the Contractor with information on NSF checks in order to post the NSF check charge and the original check amount to the appropriate patient account.

These charges shall be included in the total value of that day's MER charge total sent to the Contractor. The Contractor shall grant the County "The Right to Review" and/or "the Right to Audit" as deemed necessary by the County.

1.6.22.31 The Contractor shall be required to provide copies of all manuals, system overviews, technical manuals, reports on Proposer controls, such as internal/external audits or regulatory authority reports, when requested by the County.

1.6.22.32 The Contractor shall be responsible for completing the Medicare/Medicaid re-certification application for the County by the required due date.

1.6.22.33 The Contractor shall provide the County with ongoing consulting and costing services for the Florida EMS Continuing Public Expenditure Program (CPE Program), Medicaid Managed Care Supplement Payment Program (MCO Program), and Ambulance Supplemental Payment (ASPP) revenue programs.

1.6.22.34 The Contractor shall pay the County, in full, for all revenues realized by the County from the Certified Public Expenditures (CPE) Program for Emergency Medical Services and Medicaid Managed Care Supplemental Payment Program. The Contractor shall not receive any compensation until the CPE for Emergency Medical Services settlement or Medicaid Managed Care Supplemental Payment revenues are received by the County. Revenue realized as a result of the CPE for EMS and MCO Program shall be determined by the Medicaid cost settlement determined through the Medicaid cost report.

1.6.22.35 The Contractor shall invoice and receive revenue upon the receipt of revenue received by the County for either initiative, meaning revenue does not have to be generated for both the CPE for EMS and the MCO Program, rather revenue simply needs to be generated for either initiative for the Contractor to generate invoices. The Contractor shall invoice the County based on the final CPE for EMS or MCO payments within 45 Calendar Days of receipt of funds by the County.

1.6.22.36 HCFR shall remit payment to Contractor within 45 Calendar Days of invoice receipt.

Additional revenues generated for the uninsured patient populations shall also be invoiced within 45 Calendar Days of receipt of revenues by the County. The contingency fees to be paid associated with generation of incremental Medicaid revenues as a result of the CPE and MCO program for EMS shall be based on the percentage of County revenues for funds received associated with the cost reports submitted each November.

1.6.23 Fire Marshal Inspections Billing

1.6.23.1 The Contractor shall implement, upon notice from HCFR, any Fire Marshal Fee Schedule changes. Refer to Attachment D - Fire Marshal Fee Schedule.

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1.6.23.2 HCFR shall provide an electronic Excel file, by email, with the billable charges for inspections. The file shall include sequentially numbered inspections to include the following:

1.6.23.2.1 Name

1.6.23.2.2 Address

1.6.23.2.3 Date

1.6.23.2.4 Charges

1.6.23.2.5 Type of Service

1.6.23.3 HCFR shall prepare a report of the previous week’s total daily charges.

1.6.23.3.1 If hard copies are necessary, the Contractor shall be responsible for picking up said copies by 4:00 P.M., daily, from the HCFR Headquarters using the Contractor’s courier service. For this paragraph, daily basis shall mean Monday through Friday excluding any County holidays or furlough days as directed by the County Project Manager.

1.6.23.4 The Contractor shall be solely responsible for insuring that their automated system accurately reflects the entry of each inspection and charge for all services.

1.6.23.5 The Contractor shall bill customers within 15 Calendar Days of receiving the inspection reports from the HCFR.

1.6.23.5.1 The Contractor may receive inspection payments before the initial bill goes out for fire inspections and shall coordinate with the HCFR Fiscal Section.

1.6.23.6 The Contractor shall forward statements, including all charges, to Clients at 30 Day intervals, up to a max of 120 Calendar Days. Time payments or other adjustments and settlements shall not be permitted. Final statements shall be sent after the account is paid in full.

1.6.23.7 Inspection records shall be considered delinquent when they exceed 90 Calendar Days from the date of service. The Contractor shall send a monthly report of delinquent accounts to the HCFR Fiscal Section for research.

1.6.23.8 The Contractor shall be required to perform at a minimum standard of a 95% collection success rate on Fire Marshal Inspections fees, when collected payments are compared to net charges.

1.6.23.8.1 If the Contractor fails to achieve and maintain this standard, they shall be given a grace period of 30 Calendar Days to reach the required standard.

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1.6.23.8.2 If the Contractor is unsuccessful in meeting the standard after the 30 Calendar Days, HCFR may recommend termination of the resulting contract, at the County’s sole option, with 60 Days written notice to the Contractor.

1.6.24 The HCFR Fire Marshal’s Office shall be the records custodian for inspections.

1.6.25 The Proposer/Contractor shall implement and maintain a comprehensive cybersecurity program in accordance with Attachment F – Cybersecurity Requirements.

1.6.26 Transition Period

1.6.26.1 Following Contract expiration of its current term, and/or following Contract Termination for Cause by the County, the Contractor shall continue collection services and reporting as listed in this request for proposal for a period of 180 Calendar Days, identified as the "Transition Period."

1.6.26.2 The collection services during the Transition Period pertain to those actual accounts referred to the Contractor prior to the effective date of the resulting contract expiration or following Termination for Cause by the County, in accordance with the terms and conditions of these specifications.

1.6.26.3 At the end of the Transition Period, the Contractor shall return all records in an Excel format through a USB flash drive containing all statement account information detailing individual account history, as determined by the County, in accordance with these specifications.

1.6.26.4 The Contractor shall retain records in accordance with all applicable laws, these specifications, and Paragraph 5.18., Maintenance of Records/Public Records Law.

1.7. Instructions to Proposers

The Proposer shall submit a comprehensive Proposal that meets or exceeds the minimum requirements of these specifications. The Proposer’s response shall include the following:

1.7.1 An Executive Summary, as an attachment, limited to no more than 10 pages and using no less than a 10-point font size which shall include:

1.7.1.1 Cover Page with the following:

1.7.1.1.1 Name, title, address, phone number and email address of the Proposer’s contact representative for the County and Proposer’s engagement manager, if different from the contact representative.

1.7.1.1.2 Proposer’s address

1.7.1.1.3 Proposer’s phone number

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1.7.1.1.4 Proposer’s fax number

1.7.1.1.5 Proposer’s website Link

1.7.1.2 Proposer’s history, date established, overview, and organizational profile, to include number of years in the billing and collections business and other services (if any) the Proposer provides.

1.7.1.3 Experience: A list of at least three (3) references, documenting organization and staff experience in providing services substantially similar in scope and size to Hillsborough County, to include but not be limited to:

1.7.1.3.1 Client Name and Address

1.7.1.3.2 Contact Name and Title

1.7.1.3.3 Contact Email

1.7.1.3.4 Contact phone number

1.7.1.3.5 Brief description of billing and collection services provided.

1.7.1.4 Qualifications: A written summary of Proposer’s organization and staff qualifications that demonstrate the Proposer’s quality of services (general information, license(s), certifications, etc.), to include, but not be limited to:

1.7.1.4.1 General information

1.7.1.4.2 Organizational Chart

1.7.1.4.3 License(s)

1.7.1.4.4 Certifications

1.7.1.4.5 Staff Resumes.

1.7.2 The Proposer’s audited financial statements, as an attachment, performed by a Certified Public Accountant (CPA), demonstrating the Proposer’s financial stability, viability and capacity, as follows:

1.7.2.1 Financial statements including, at a minimum, a balance sheet and income statement for the Proposer’s most recent fiscal year (or the period the entity has been in existence, if less than one (1)-year), identifying the basis of accounting on which the financial statements are reported. Options for complying with this mandatory requirement are as follows. The level of assurance provided by the financial statements shall be considered by the County

RFP-26-00324 Page 19 according to the following priority, in order, beginning with the highest level of assurance first.

1.7.2.1.1 Financial statements accompanied by the audit report of an independent CPA.

1.7.2.1.2 Financial statements accompanied by the review report of an independent CPA.

1.7.2.1.3 Financial statements accompanied by the compilation report of an independent

CPA.

1.7.2.1.4 Financial statements otherwise prepared by a CPA.

1.7.2.1.5 Consolidated financial statements identified, above, of the Proposer’s parent entity together with a parental guaranty assuring the parent entity shall financially support the Proposer/Contractor throughout the term of the prospective contract.

1.7.2.2 As a risk management best practice and part of the responsible proposer determination the County shall review documentation submitted by the Proposer to evaluate the Proposer’s financial stability, viability, and capacity. The extent of the financial review required is based on the perceived level of risk associated with the services procured and term of the contract. The general standard of review is whether the documents provided demonstrate the Proposer has the financial stability, viability, and capacity to perform the services under the contract for the term of the contract. The following criteria shall be integral in applying this general standard:

1.7.2.2.1 Solvency: The ability of Proposer to meet its long-term obligations and remain in business over the life of the contract. Solvency analysis includes comparison of total assets, total liabilities, and owner’s equity. It also may include consideration of the nature and type of a Proposer’s assets and liabilities, and trends in operating results that could affect future solvency over the life of the contract.

1.7.2.2.2 Liquidity: The ability of a Proposer to pay its immediate or short-term obligations. Liquidity analysis includes comparison of current assets and current liabilities. It also may include consideration of a Proposer’s cash flows and cash reserves.

1.7.2.2.3 Profitability: The financial results of a Proposer’s operations; the excess or deficit of revenue over expenses. Profitability analysis includes consideration of a Proposer’s recent operating results, trend analysis, and effect on the Proposer’s related solvency.

1.7.2.2.4 Capacity: The financial ability of a Proposer to produce the required goods or services over the term of the contract. Capacity analysis includes consideration of size of the contract to the financial resources available to the Proposer, and to the Proposer’s current volume of business.

1.7.2.2.5 The financial condition or position of the Proposer during the most recent year.

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1.7.2.2.6 The results of operations of the Proposer during the most recent year.

1.7.2.2.7 The cash flow of the Proposer during the most recent year.

1.7.2.2.8 Disclosures regarding subsequent events, contingencies, and litigations.

1.7.2.2.9 Any other information included in the financial statements which could influence the financial stability and viability of the Proposer.

1.7.3 A Plan Summary, as an attachment, of the Proposer’s understanding of the scope and objectives, technical approach, and work plan presented. Summary shall be limited to no more than five (5) pages, using no less than a 10-point font size, and shall include, but not be limited to:

1.7.3.1 A detailed list of services, which shall meet the functional requirements set forth in these specifications

1.7.3.2 Plan to surpass and maintain a minimum of 50% collection rate.

1.7.3.3 Plan to meet monthly reporting requirements to include the five (5) day timeframe.

1.7.3.4 Plan to ensure patient’s refunds are processed withing 90 days.

1.7.3.5 Logistics of how deposits shall be processed within 24 hours.

1.7.3.6 Plan to assist and prepare the Medicaid cost report on behalf of the County.

1.7.3.7 Plan to assist the County in successful completion of the Medicare Cost Survey.

1.7.3.8 Plan for identifying patient’s accounts and applying payments in a timely manner.

1.7.4 A System Overview, as an attachment, of the Proposer’s automated system and its ability to meet the requirements of this solicitation.

1.7.5 A copy of the Proposer’s System Security Plan, as an attachment.

1.7.6 A copy of the Proposer’s Disaster Recovery Plan, as an attachment.

1.8. Proposal Response (Attachments)

The Proposer shall submit as their Proposal the following required attachments only. Note: Euna Procurement has a file size limitation of 1GB.

1.8.1 Submit with Proposal

1.8.1.1 Proposer Requirements/Acknowledgements Questionnaire

1.8.1.2 Deviation(s) Questionnaire (Optional)

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1.8.1.3 Proposer Acknowledgement(s) of Addenda (if applicable)

1.8.1.4 Declaration of documents Exempt from Public Disclosure (Optional)

1.8.1.5 Software License Terms, if requesting changes to the County’s Standard provisions (Optional)

1.8.1.6 Executive Summary

1.8.1.7 Audited Financial Statements

1.8.1.8 Plan Summary

1.8.1.9 System Overview

1.8.1.10 System Security Plan

1.8.1.11 Disaster Recovery Plan

1.8.1.12 AI Security Questionnaire (if applicable)

1.8.1.13 Vendor Security Outsourcing Questionnaire (if applicable)

1.8.1.14 Vendor Security Software Questionnaire (if applicable)

1.8.2 Complete upon County’s Request

1.8.2.1 Business Associate Agreement

1.8.2.2 Insurance Certificate

1.8.2.3 W-9 or substitute W-9

2. SPECIAL TERMS AND CONDITIONS

2.1.1 The County will review and evaluate all Proposals submitted in response to this Solicitation Document. The evaluation process is designed to award the Contract to the Proposer with the best combination of attributes as demonstrated in the Proposal scores. Scores are based on the evaluation of the information contained in Proposer's Proposal which include, but is not limited to, Proposer's responses to the questions set forth in the Requirements Section of this Solicitation Document and any corresponding attachments including a brief description of methodology, qualifications, experience, and the cost of the Services/Work.

2.1.2 Evaluation Procedures

The evaluators will consider how well the Proposer's Proposal meets the needs of the County as described in the Proposer's response to each question in this Solicitation Document. It is

RFP-26-00324 Page 22 important that the responses be clear and complete so that the evaluators can adequately understand all aspects of the response. Please follow all instructions carefully. The Proposal should be submitted according to the instructions/outline specified in this Solicitation Document.

A Proposal that fails to follow these instructions may be considered non-responsive and may be eliminated from further consideration.

2.1.2.1 Based on information acquired through the Proposer's responses and the responses of references (if applicable), the County will award a preliminary score to each Proposal.

2.1.2.2 Based on the preliminary scores, the County may request that the top scoring Proposers conduct an oral presentation and/or submit a Best and Final Offer that may include revisions to Technical Approach, Integration, and/or Cost. Be advised that the evaluators may revise the preliminary scores based on the oral presentations (if applicable), reference inquiries, other information obtained through the County's investigations of past performance and/or submissions of Best and Final Offers (if applicable).

2.1.3 Scoring/Weighting of Questions

The scoring/weighting of Proposals will be accomplished utilizing the evaluation criteria identified in the following table:

Award Criteria Point Value Proposer’s Financial Capability, Stability, Viability, and Capacity. Pass/Fail

Cyber Security Review Pass/Fail Quote/Cost Total. 50 Proposer's understanding of the scope and objectives, technical approach and work plan presented.

Plan Summary System Overview System Security Plan Disaster Recovery Plan

Proposer's…