ACCOUNTS_RECEIVABLE_MANAGEMENT_SERVICE_FOR_MANCHESTER_FIRE_DEPARTMENT.pdf

REQUEST FOR PROPOSAL

24/25-30

ACCOUNTS RECEIVABLE MANAGEMENT SERVICE FOR

MANCHESTER FIRE DEPARTMENT

Town of Manchester

Lincoln Center

Manchester, CT 06040

RELEASE DATE: January 16, 2025

DEADLINE FOR QUESTIONS: January 30, 2025

RESPONSE DEADLINE: February 6, 2025, 11:00 am

RESPONSES MUST BE SUBMITTED ELECTRONICALLY TO:

https://secure.procurenow.com/portal/townofmanchester https://secure.procurenow.com/portal/%7bproject.government.code%7d

Town of Manchester

REQUEST FOR PROPOSAL

24/25-30

ACCOUNTS RECEIVABLE MANAGEMENT SERVICE FOR MANCHESTER FIRE

DEPARTMENT

I. INTRODUCTION

II. INSTRUCTIONS TO BIDDERS

III. STANDARD INSTRUCTIONS TO BIDDERS

IV. PROJECT DETAILS

V. INSURANCE AND INDEMNIFICATION REQUIREMENTS

VI. LIVING WAGE ORDINANCE

VII. EVALUATION CRITERIA

VIII. VENDOR SUBMISSIONS

Attachments:

T - Manchester living wage certification

Request For Proposal #24/25-30 Title: ACCOUNTS RECEIVABLE MANAGEMENT SERVICE FOR MANCHESTER FIRE DEPARTMENT

1. INTRODUCTION

1.1. Summary

The Town of Manchester is soliciting proposals from qualified entities to provide Accounts Receivable

Management Service (ARMS) for The Manchester Fire Department in accordance with the requirements and specifications outlined in the RFP for ALS Billing for Privately Insured, Uninsured, and Non-Medicare

Insured Ambulance Patients. Additionally, works closely and cooperatively with transport service on bundle-billing agreement.

1.2. Contact Information

Cora Narracci

Purchasing Agent

494 Main Street

Purchasing Division

Manchester, CT 06040

Email: cnarracci@manchesterct.gov

Phone: (860) 647-3033

Department:

Manchester Fire Department

Department Head:

Daniel A. French

Fire Chief

1.3. Timeline

Release Project Date January 16, 2025

Question Submission Deadline January 30, 2025, 4:00pm

RFP Opening Date and Time February 6, 2025, 11:00am mailto:cnarracci@manchesterct.gov tel:(860)647-3033

2. INSTRUCTIONS TO BIDDERS

2.1. ELECTRONIC BIDDING INFORMATION

Submitting Proposals

Specifications and proposal forms must be obtained online at Town of Manchester Procurement Portal

(opengov.com). The exclusive means by which all prospective bidders may obtain proposal packages, direct inquiries, request and receive addenda and supplemental information, and submit bids and proposals, shall be through the Town of Manchester’s OpenGov portal.

Proposals may be received up to the deadline date and time listed in the solicitation documents, via the

Town’s e-Procurement Portal. The Town e-Procurement Portal Clock is the official clock for the determination of all deadline dates and times. Without exception, responses will not be accepted after the submission deadline regardless of any technical difficulties such as poor internet connections. The

Town of Manchester strongly recommends completing your response well ahead of the deadline.

Addenda Notification and Acknowledgement

Addenda Notification: Bidders are required to register for an account via the Town’s e-Procurement

Portal hosted by OpenGov. Once the bidder has completed registration, you will receive addenda notifications to your email by clicking “Follow” on this project. Ultimately, it is the sole responsibility of each bidder to periodically check the site for any addenda at Town of Manchester Procurement Portal

(opengov.com)

Submitting Questions and Receiving Responses

Proposers shall submit all inquiries regarding this RFP via the Town’s e-Procurement Portal. Please note any deadline for submitting inquiries. All answers to inquiries will be posted on the Town’s e-

Procurement Portal. Bidders may also click “Follow” on this RFP to receive an email notification when answers are posted. It is the responsibility of the bidder to check the website for answers to inquiries.

When applicable, state bids will be considered for this service.

The Purchasing Authority reserves the right to waive any informality or reject any and all bids. In addition to the bid specifications, all bids are subject to the terms, provisions and conditions of the

Manchester Charter, Code of Ordinances, and Purchasing Guidelines. By bidding on the proposed purchase, the bidder agrees to such terms, provisions and conditions.

An Equal Opportunity/Affirmative Action Employer

2.2. BID OPENING INFORMATION

Proposals must be received by the date and time indicated in the bid documents.

2.3. RULES AND REGULATIONS FOR COMPETITIVE BIDDING

These rules and regulations have been adopted by the Board of Directors of the Town of Manchester pursuant to Section 5-22 of the Town Charter. They are standard for all competitive bidding proposals https://procurement.opengov.com/portal/townofmanchester https://procurement.opengov.com/portal/townofmanchester https://procurement.opengov.com/portal/townofmanchester issued by the Town of Manchester, Connecticut for contracts of all types where labor, materials, and necessary equipment to complete work is to be furnished to the Town, where the Town is to purchase supplies, materials, and equipment, where the Town is to sell surplus materials and equipment, or where the Town is to sell real estate. These rules and regulations shall be binding upon all prospective bidders and the Town of Manchester.

2.4. GENERAL RULES

1. The Purchasing Authority may delete or modify any of the instructions to bidders for a particular proposal, indicating such change in the appropriate section of the proposal documents. The Purchasing

Authority may insert special instructions in any special contracts which are subject to competitive bidding.

2. The proposal is signed by the proposer with full knowledge of, and agreement with, the general specifications, conditions, and requirements of this proposal.

3. The town has transitioned to electronic bidding. Vendors should submit solicitation responses electronically via the Town of Manchester Procurement Portal. Vendors will be asked to register and should do so prior to submitting proposal documents.

4.This proposal and any addenda will be issued on the Town of Manchester website bidding portal. It shall be the responsibility of the proposer to download this information. THE TOWN OF MANCHESTER

WILL NOT MAIL A SEPARATE HARD COPY OF ADDENDUM TO PROPOSERS. Failure of any proposer to receive any such addendum or interpretation shall not relieve such proposer from any obligation under his RFP as submitted. All addenda so issued shall become part of the Contract Documents.

5. Proposal prices may not be withdrawn by bidder for 90 days after bid opening.

6. Proposals received later than the time and date specified will not be considered. Amendments to, or withdrawals of proposals received later than the time and date set for submission deadline will not be considered.

7. All deliveries of commodities or services hereunder shall comply in every respect with all applicable laws of the Federal Government and/or the State of Connecticut.

8. Purchases made by the Town of Manchester are exempt from payment of Federal Excise Taxes and the Connecticut Sales Tax and such taxes must not be included in bid prices. Federal Excise Tax exemption certificates, if requested, will be furnished.

9. The Proposer, where applicable, shall insert/include the price per stated unit and extend a total price for each item. In the event there is a discrepancy between the unit price and the extension, the unit price will govern. The total cost shall be the sum of the extended prices.

10. Proposer shall, where applicable, submit terms for payment in spaces provided in the proposal form, showing the amount of cash discount which shall apply to proposal prices when paid within the stated number of days in the proposal.

11. All inquiries shall be submitted within the time limitations specified in the bid documents and shall be requested via the online portal Q&A. All information given by the Town other than through the

OpenGov Portal shall be informal and shall not be binding upon the Town nor shall it furnish a basis for legal action by any proposer or prospective proposer against the Town.

11A. The Town reserves the right to reject any and all proposals, to waive technical defects, and to make such awards including accepting a proposal, although not the lowest cost, as it deems in its sole discretion to be in the best interest of the Town. The Town reserves the right to reject any proposal if the proposer, any officer of the proposer, or any other company owned in whole or in part by any officer(s) of the proposer, is delinquent in the payment of any taxes or fees owed to the Town. The

Town reserves the right to require a disclosure statement from the proposer listing the name(s) of all officers of the company.

11B. In the event the Town determines that a contractor is delinquent in any payment due the Town, then the Town may offset the delinquent amount due to the Town against the sums owed the contractor.

12. The Town of Manchester may make such investigation as deemed necessary to determine the ability of the proposer to discharge a contract. The proposer shall furnish the Town with all such information and data as may be required for that purpose. The Town reserves the right to reject any proposal if the proposer fails to satisfactorily convince the Town that he is properly qualified by experience and facilities to carry out the obligations of the contract and to satisfactorily complete the work called for herein, or if the proposal is conditional in nature.

13. Except where otherwise provided, a contract between the Town and a successful proposer shall consist of the Request for Proposal, Specifications, Plans, Proposal, and Acceptance by the Town and these Rules and Regulations. Acceptance by the Town may be by purchase order for the portion of the work awarded to a contractor.

14. All Requests for Proposal shall be publicly advertised in a newspaper having a general circulation within the Town of Manchester, Connecticut.

15. The Request for Proposal shall be made available on the Town of Manchester Purchasing Web Site via the OpenGov Portal.

16. Any act or acts of misrepresentation or collusion shall be a basis for disqualification of any proposal or proposals submitted by such persons guilty of said misrepresentation of collusion. In the event that the Town enters into a contract with any bidder who is guilty of misrepresentation or collusion and such conduct is discovered after the execution of said contract, the Town may cancel said contract without incurring liability, penalty, or damages.

17. In the event that any proposer wishes to protest the potential award of a proposal, the proposer must make it’s protest in writing, identify the protesting party, the RFP number, title and shall include a factual summary of the basis of the protest including any documents that shall be considered and request a conference with respect thereto. Said protest must be received in the Town of Manchester

Purchasing Office, within FIVE (5) business days after the award decision.

18. A conference with respect to said protest shall be scheduled by the Purchasing Authority and shall be attended by the Purchasing Authority or their designee and such other persons as the Purchasing

Department and the Town Manager shall require attend. The subject matter of said conference shall be limited to the reasons for the protest specified in the written request for said conference. Said conference shall also include a discussion of all possibilities for a resolution of dispute. The Town shall make a decision in writing within three (3) business days after said conference and notify protesting bidder.

19. In the event that any protesting proposer wishes to take legal action against the Town, they must first fully comply with all of these Rules and Regulations, including those which have been changed by the Purchasing Authority pursuant to paragraph 1 herein.

20.Except for special instructions inserted in special contracts by the Purchasing Authority pursuant to paragraph 1 herein, in the event of any conflicts between these Rules and Regulations and the terms and conditions of any document these Rules and Regulations shall prevail.

21. All Awards shall be made by the Purchasing Authority.

22. The Town of Manchester is an equal opportunity employer and requires an affirmative action policy for all of its Contractors and Vendors as a condition of doing business with the Town, as per Federal

Order 11246. By signing the Proposal form for this proposal, all vendors and contractors agree to this condition of doing business with the Town, and should the Town choose to audit their compliance, the vendor agrees to cooperate fully.

23. The contractor shall not transfer, sublet, or assign the contract by Power of Attorney or otherwise to any person, firm, or corporation, or in any way vary the terms of the contract without written permission from the Town. The Town has the right to terminate with a thirty (30) day written notice to the contractor. The Town reserves the right to terminate the contract at any time during the contract period. Such termination shall be effective immediately after giving written notice to the contractor that the Town is terminating the contract.

2.5. Important Instructions for Electronic Submittal

Proposers shall create a FREE account with Open Gov Procurement by signing up at https://secure.opengov.com/portal/townofmanchester. Once you have completed account registration, browse back to this page, https://procurement.opengov.com/portal/townofmanchester and click on

"Submit Response", and follow the instructions to submit the electronic bid.

2.6. Instructions to Bidders

In accordance with the provisions of the Town Charter, sealed proposals will be received through the

OpenGov Portal, not later than the date and time set forth above, for furnishing the commodities and/or services listed herein. Proposals must be executed in accordance with and subject to instructions and specifications contained herein.

3. STANDARD INSTRUCTIONS TO BIDDERS

3.1. STANDARD INSTRUCTIONS TO BIDDERS – SUPPLIES, MATERIALS &

EQUIPMENT

These instructions are standard for all proposals issued by the Town of Manchester, Connecticut, for the purchase of all supplies, materials, and equipment. The Town of Manchester may delete, supersede, or modify any of these standard instructions for a proposal by indicating such change in the section headed

“Special Instructions to Bidders.”

1. Unless otherwise stated, deliveries must consist of new merchandise.

2. Prices quoted shall be net delivered prices to the Town.

3. The Town may withhold acceptance of, or reject any merchandise which found, upon examination, not to meet the specifications’ requirements. When rejected, it shall be removed by the Contractor

(vendor) within ten (10) days after notification of rejection.

4. When the schedule indicates that an item to be purchased is to be specified, or equal, the bidder may offer an article which is certified to be equal in quality, performance, and in other essential characteristics to the bid standard. Bidder must furnish any information, such as specifications, test results, etc., which will help in determining whether an item is equal or superior to the Town’s bid standard. If a bidder fails to name a substitute, the specified item must be furnished.

5. Bidders agree to comply with all of the latest Federal and State safety standards and regulations and certify that all items furnished in this bid will conform to and comply with said standards and regulations. Bidder further agrees to indemnify and hold harmless the Town for all damages assessed against the Town as a result of the bidder’s failure to comply with said Standards and/or Regulations.

6. The Town reserves the right to make an award by item, total or by group, as may be in the best interest of the Town. If a Bidder desires to bid on an “all or nothing” basis, he shall so indicate on the bid schedule and the Town reserves the right to make an award as may be in the best interest of the Town.

7. The Bidder shall pay all royalties and license fees. He shall defend all suits or claims for infringement of any patent rights and shall save the Town of Manchester harmless from loss on account thereof except that the Town of Manchester shall be responsible for all such loss when a particular manufacturer, product, or process is specified by the Town of Manchester.

3.2. Overview:

The Town of Manchester (Town) desires to engage a contractor to provide the services in support of the

ACCOUNTS RECEIVABLE MANAGEMENT SERVICE FOR MANCHESTER FIRE DEPARTMENT.

Incorporated as part of the RFP are the #Attachments, #Scope of Work . The Project includes, but is not limited to, Invitation to RFQ/RFP, Instructions to Bidders, Supplementary Instructions to Bidders, RFQ/RFP Form, Standard Form of Agreement Between Owner and Contractor.

https://procurement.opengov.com/portalownofmanchester/projects/23771?section=187364 https://procurement.opengov.com/portalownofmanchester/projects/23771?section=187367

3.3. Description of Project:

ACCOUNTS RECEIVABLE MANAGEMENT SERVICE FOR THE MANCHESTER FIRE DEPARTMENT

3.4. Services Required:

The Town is seeking to engage a contractor to provide ACCOUNTS RECEIVABLE MANAGEMENT SERVICE

FOR MANCHESTER FIRE DEPARTMENT The Town reserves the right to modify or amend these documents in such manner as is acceptable to the Town.

The Town reserves the right to award the contract to the contractor deemed to be in the best interests of the Town for the Project after review of the submissions received, not based solely on cost or any other specific factors.

3.5. Qualification Requirements:

1. Firm Description – Provide a description and brief history of the firm. Name firms, location of principal and branch offices; length of time in business; and firm ownership structure.

2. Related Experience – Please provide a list of all projects currently in progress and completed over the last five years. The description should at a minimum provide the project name, location, year of completion, type of contract, renovation cost, size, owner name and reference with telephone number.

3. Organization and Staffing – Provide an organization chart for staff proposed for this project which clearly identifies your proposed management staff for the project (Project Executive, Project Manager, Project Superintendent, etc.). Also include detailed resumes for each person identified.

4. Typical Project Approach – Provide description of services your firm will utilize during each phase of the project to ensure the project is completed on schedule and within budget.

5. Litigation/Arbitration – List information on (a) any involvement in litigation or arbitration with municipal clients; and (b) all clients that have terminated your services prior to completion of any project within the past ten (10) years. Explain circumstances that led to it and describe the resolution.

6. Insurance – Contractor/ Vendor shall agree to maintain in force at all times during the contract the following minimum coverages and shall name the Town of Manchester as Additional Insured on a primary and non-contributory basis to all policies except Workers Compensation.

4. PROJECT DETAILS

4.1. SCOPE

The Town of Manchester is soliciting proposals from qualified entities to provide Accounts Receivable

Management Service (ARMS) for The Manchester Fire Department in accordance with the requirements and specifications outlined in the RFP.

4.2. BUSINESS SERVICES BOND

To ensure the faithful execution of this proposal according to its provisions, the Contractor awarded this proposal must provide the Town of Manchester, at the Contractor’s expense, a Business Services Bond in the amount of ten thousand dollars ($10,000.00). The bond must be issued by a company authorized to write such surety bonds in the State of Connecticut. In lieu of a Business Services Bond, the Town may consider a cash surety or other surety which, in the opinion of the Town Attorney, shall provide sufficient protection to the Town. The Town of Manchester will not be liable for the accrual of interest on any certified or cashier’s check submitted.

4.3. PERMITS AND LICENSES

The proposer is solely responsible for obtaining and maintaining all required permits and licenses, obtaining all necessary inspections and approvals, and satisfying all fees. A list of all up-to-date licenses, certifications, and permits in the proposer’s possession shall be supplied to the Town prior to the RFP being awarded. The Town will verify before awarding this RFP that the company is properly registered and in good standing with the appropriate Secretary of the State's Office.

4.4. FAIR EMPLOYMENT PRACTICES

The Town of Manchester is an equal opportunity employer and requires an affirmative action policy for all its Contractors and Vendors as a condition of doing business with the Town, as per Federal Order

11246. By submitting your proposal, all vendors and contractors agree to this condition of doing business with the Town and should the Town choose to audit their compliance, the vendor agrees to cooperate fully.

The proposer agrees not to discriminate against any employee or applicant for employment in the performance of this work with respect to hiring, tenure, terms, conditions, or privileges of employment due to race, sex, age, religion, national origin, or other condition prescribed by the State or Federal law.

4.5. AWARD OF PROPOSAL

The Town of Manchester reserves the right to accept or reject any, all, or part of proposals, to waive formalities or informalities, and technical defects, and to award the proposal deemed to be in the best interest of the Town of Manchester.

The Town of Manchester will evaluate the proposal award, and negotiate a contract based on, but not limited to the following criteria all on a comparative basis. The lowest-priced proposal is NOT the sole determining factor when awarding this RFP.

• Conflicts of interest

• Vendor Experience

• Appropriate license(s)

• Qualifications and references

• Local or toll-free telephone numbers for contacting the service

• Service’s reputation and character in representing the creditors

• Prompt payment terms (in accordance with Town of Manchester policy)

• Compliance with specifications and/or exceptions taken

• Desirable capabilities

• Performance criteria and required standards

• Cost

• Reporting requirements

• Collection Rates for a comparable service

• Software Interfaces

• Vendor Accessibility

4.6. IMPLEMENTATION

All proposers shall be able to take over Accounts Receivable Management Services within four (4) weeks after notification of the award of the proposal.

4.7. INTENT OF THE SPECIFICATIONS

ALS Billing for Privately Insured, Uninsured, and Non-Medicare Insured Ambulance Patients

The purpose/intent of these specifications is to cover the requirements of furnishing and delivering

Accounts Receivable Management Service for the Town of Manchester, Manchester Fire Department

(Town or MFD) as hereinafter specified. To obtain the most acceptable Emergency Medical Services

Accounts Receivable Management Services (Billing Services), these specifications cover the minimum requirements as to the qualifications, software, networks, background, cycle times, account processing, reporting, testing, ongoing evaluation, communications, and the minimum level of acceptable results anticipated from a contractor.

1. The Accounts Receivable Management Service (ARMS) shall conform to, and maintain, the most current standards and requirements set forth by the State of Connecticut, the State of Connecticut

Office of Emergency Medical Services (OEMS), the Centers for Medicare and Medicaid Services (CMS), and the Health Information Portability and Accountability Act (HIPAA).

2. The selected proposer must demonstrate an active compliance program that meets or exceeds HIPAA by providing a copy of their HIPAA compliance program including records of staff member's initial and continuing education in HIPAA compliance.

3 Descriptive Material. Descriptive material inclusive of plans, policies, procedures, standard operating guidelines, vendor contract relationships, sample reports, communications documents, bills, late notice statements, and warranties, that will enable the Town to determine the exact quality, design, and understanding of the proposer’s proposal shall accompany the proposal.

4. Each proposer is required to provide a complete and accurate description of their own services along with any necessary hardware and software specifications. These responses shall be in the same sequence as the SPECIFICATIONS for ease of comparison. Any proposal not in this sequence may be disregarded and rejected. Each proposer shall provide a detailed description of the services provided, the software, and the internet connectivity that they propose to use/furnish to establish a safe compliant conduit for the electronic exchange of protected information.

5. Vendor Liabilities. The proposer receiving the award shall defend any and all suits and assume all liability for any and all claims made against the Town or any of its officials for the use of any patented processes, devices, or articles utilized in fulfilling the proposal requirements.

6. The proposer shall have a record of performing Accounts Receivable Management Services in the medical transportation/health care arena for no less than three (3) consecutive years, managing a minimum gross volume of $1.5 million in claims annually.

7. The proposer shall submit copies of all backup policies, relationships, subcontractor agreements for equipment, materials, software, and hardware utilized in fulfilling this contract.

8. It shall be noted that the Town is seeking a service that closely matches the attached specifications. Extensive time has been put into preparing the attached specifications as they relate to the needs of the Town.

9. Specifications contained herein are considered minimum.

10. The following specifications describe an Emergency Medical Services Accounts Receivable

Management Services are suitable to support the Town’s goal of fiscal stability. The specifications are intended to provide a common standard to which all parties may propose. For this reason, the proposers must respond to each individual item by indicating: “YES” = COMPLY or “NO” = DO NOT

COMPLY. Refer to Vendor Submissions for questions.

11. The proposer must indicate compliance by marking yes or no in the Vendor Submissions

Section. General statements taking total exception to these specifications may result in an interpretation of being non-responsive and ineligible for consideration and may be automatically rejected.

12. Any exceptions, variations, deviations, and clarifications to these specifications must be set forth on an attached sheet entitled “EXCEPTIONS TO THE SPECIFICATIONS” and made part of the proposal. They should include the page number and description as they are referred to in the proposal specifications. The Town will evaluate each exception taken. The Town reserves the right to accept or reject each exception taken as it applies to specified item(s). If no exceptions are indicated and the

Town accepts the proposal, the service must be provided exactly as specified.

13. A sample of the proposer’s service contract shall be included with the proposal.

14. Upon request, proposers must submit a copy of a current “Certificate of Good Standing” from the

Secretary of State from which the proposer is based.

15. Proposer shall have an established reputation of permanency and reliability in the field of healthcare/emergency medical services accounts receivable management services. Each proposer shall furnish satisfactory evidence of their ability to provide the services as specified

16. References: Submit a list of no less than five current EMS clients and their contact information. The reference list shall include at least two (2) non-transport fire-based paramedic-level services. References from the State of Connecticut providers are preferred.

17. The vendor’s invoice will appear as it is an official Town of Manchester document. The vendor will elaborate on the invoice that they are operating on behalf of the Town. The Town will have final approval for the invoice appearance. The vendor shall provide a sample invoice for approval.

18. A complete review of the Accounts Receivable Management Service shall be conducted at the end of three (3) six (6) and twelve (12) months. This review will be conducted by both the provider and the

Manchester Fire Department representatives.

4.8. STATISTICAL INFORMATION

ALS Billing for Privately Insured, Uninsured, and Non-Medicare Insured Ambulance Patients

The Emergency Medical Services Industry is regulated by the State of Connecticut. The Regulatory authority restricts system participants through the use of Rate Regulations; the Certificate of Need

Process; and issuing primary service area response (PSAR) franchises to select corporations for the provision of 911 response services.

Rate regulations limit the services and amount an ambulance service can charge. The regulatory process stipulates the way in which charges must be formatted. Each individual service’s rate menus are evaluated and adjusted by the state annually based on the service’s fiscal performance.

The Town of Manchester is 27.2 Square miles, and the Town’s population is approximately

58,000. From January 1 2023 to June December 31st, 2023, MFD responded to 7,121 requests for emergency medical assistance. Of these requests, 3,898 received advanced life support care from MFD paramedics. MFD provides first responder service and non-transport ALS-level care. A private ambulance service provides transportation of the patient and MFD paramedic to the hospital. There is a signed bundle-billing agreement in place between the Town and the private ambulance transport service for ALS services provided by MFD.

Between January 1st, 2023, and December 31st, 2023, our payer mix for billed ALS care or ALS assessment was approximately 52.5 % Medicare, 23% Medicaid, 14.7% private total, and commercial insurance 9%

4.9. PROPOSAL SPECIFICATONS

ALS Billing for Privately Insured, Uninsured, and Non-Medicare Insured Ambulance Patients

Please refer to the Vendor Submissions Section for Questions.

1. The ARMS will receive all Patient Care Reports (PCR) completed by the MFD directly through a billing export set up through the Town’s current EPCR service provider (ESO). The ARMS will determine which

PCRs are

a. billable for ALS service

b. billable as ALS assessment or

c. not billable.

1. The ARMS will arrange to receive the billing export at least weekly. The Billing Service will be required to prepare an invoice for each billable PCR provided and document when the bill has been submitted for payment. If the Town makes a change to a PCR, the Billing Service will be notified electronically that a change has occurred. The Town will provide a protocol regarding the proper processing of these changes.

2. The ARMS will work cooperatively with the transport service. Submit PCRs for ALS services billable to

Medicare, to the transport agency for bundle-billing. The ARMS will act on the Town’s behalf in tracking and pursuing payment from the transporting agency for Medicare payments.

3. The Billing Service shall accept assignment on each case per the billing policies of the Town of

Manchester.

4. If the Billing Service disagrees with the level of service identified, the Billing Service shall not process the bill for payment; it shall suspend the processing of that claim and submit it to the MFD Chief assigned to EMS for review.

5. The billing services requested should include full collection services, including correspondence (via

U.S. Postal Service, email, and fax) and telephone contact.

6. The Billing Service will validate a patient’s insurance status prior to classifying the patient and creating a claim. The Billing Service shall describe in detail its claim validation process and how it resolves deficits.

7. The initial invoice shall be sent within two (2) business days of receiving notification of a PCR. The

Billing Service shall forward statements to insured patients/Insurance Providers on a thirty (30), sixty

(60), and ninety (90) day follow-up basis with progressive pre-collection language.

Accounts with no activity (no response to invoices, telephone calls, or payment and communication from the identified insurance company) when the account reaches an age of one hundred and twenty

(120) days will be automatically sent to the Town of Manchester as an uncollectible bill.

8. The Billing Service shall submit follow-up billing to secondary insurance carriers and submit invoices to third-party insurance carriers as required.

9. The Billing Service shall invoice the patient with a cover letter if no insurance information is available.

10. The Billing Service will process all patients determined not to have a primary insurance carrier in the following manner:

a Contact the patient to validate the presence or absence of health insurance.

b Contact the destination hospital to validate the presence or absence of health insurance.

c. The initial invoice shall be sent within two (2) business days of receiving notification of a PCR. The

Billing Service shall forward statements to the patient on a thirty (30), sixty (60), and ninety (90) day follow-up basis with progressive pre-collection language approved by the Town.

Accounts with no activity (no response to invoices, telephone calls, or payment and communication from the patient) when the account reaches an age of one hundred and twenty (120) days will be automatically sent to the Town of Manchester as an uncollectible bill.

11. All claims will be submitted under the Town’s provider number.

12. To ensure the protection of the patient's personal and confidential information, the proposer shall always adhere to HIPAA requirements and, the National Institute of Standards and Technology’s guidelines on healthcare organizations and the use of data encryption to protect patient medical records, also known as Protected Health Information (PHI)

13. The contract may not be subcontracted, contracted out, or assigned without the Town of

Manchester’s prior notification and express consent.

14. The Billing Service shall not negotiate payment reductions resulting from services provided by the

MFD without obtaining the Town’s prior written consent. In each instance that an insurance provider requires a payment reduction, the Billing Service will notify the Town within one (1) business day and provide the Town with supporting documentation.

15. All funds collected are to be remitted directly to the Town Finance Department by the end of each month. Checks shall be made payable to the Town of Manchester and shall include the total of all fees collected. The billing service shall deposit all funds remitted in cash and the billing service shall remit a check to the Town in the amount of such funds.

Each remittance shall be accompanied by a summary report detailing information on the amount of funds remitted. The Town shall approve the report format.

16. The Billing Service shall submit its invoice for services rendered with the monthly reports. Upon receipt and verification of information contained on the monthly report, the Town shall reimburse the billing service for their fee within thirty (30) days.

17. A history of all municipal experience shall be enclosed with the proposal.

18. The status of inactive or late accounts cannot be changed without prior notification and approval of the Town of Manchester.

19. The Billing Service will provide a toll-free telephone number for patients to utilize to discuss their bill.

20. The Billing Service will indicate how it provides effective communication with customers whose primary language is NOT English.

21. The Billing Service shall identify those carriers servicing the Connecticut market and is able to process claims via electronic file transfer inclusive of CMS, Medicaid, HMOs, and private insurers.

22. The Billing Service will produce and forward an initial insurance claim within two (2) business days of receiving a PCR.

23. The Billing Service will state its normal business hours they are available to clients and patients.

24. The Billing Service will provide its established plan or policy to ensure no interruption in Town Billing

Service as the result of ransomware virus, computer or software failure, unusual staff illness/injury/FMLA/turnover/vacation, or earned time utilization.

25. The Billing Service shall describe in detail and provide policies/procedures that outline how the

Town’s account is monitored to ensure maximum productivity of the staff assigned to manage the account and maximization of revenue return.

26. The Billing Service shall make a statement indicating that it has never lost an account due to concerns of improper billing practices, accusations, or clients concerns of fraud as defined by CMS and other applicable Federal or State authorities; no member of its staff has been accused, disciplined, charged, or convicted of fraud, theft, deception, unethical business practice, or illegal billing practices.

27. The Billing Service shall provide a copy of its Customer Service Plan including the associated training program indicating the initial and refresher training periods for all staff members.

28. It is explicitly understood that all contact with patients or responsible parties shall remain confidential. All information obtained shall be used strictly for the collection of outstanding obligations of the Town. The Billing Service shall use all appropriate means and best efforts to effect prompt and successful collection results on behalf of the Town.

29. The Billing Service shall provide a copy of its HIPAA Compliance Program. It will include copies of its

Business Associate Agreement and a definition of those individuals who are covered by a Business

Associate Agreement. It will further discuss how it will track and maintain records regarding the request, approval, denial, and distribution of medical records in collaboration with the client. It will also provide evidence that its internet system electronic data file transfers and associated billing systems are

HIPAA compliant.

30. The Billing Service shall provide a copy of its current staff's HIPAA compliance orientation program, policies, and procedures for the Town.

31. The Billing Service shall provide evidence that all staff members involved in the management of the

Town’s account have successfully completed the HIPAA compliance training program. This is an annual requirement to ensure that staff receives yearly refresher training that is due at the Town no later than the start of a new contract year.

32. The Billing Service shall provide a detailed description of its current complaint resolution process.

33. The Billing Service shall notify the Town of any account overpayment within five (5) business days of discovering the occurrence. Notification shall be delivered electronically or via fax. The notification shall include the following information:

a The patient’s name b Patient’s address c Date of service d EMS run number e Insurance provider f Amount to be refunded g Name and address of individual/corporation receiving a refund h Reason overpayment occurred.

34. The Billing Service shall provide the Fire Chief and, Fire/EMS Chief with monthly reports within 30 days after month end as outlined below:

a New receivables billed b Receivables collected c Accounts receivable aging status by payer d Account postings e Postings billed f Accounts deemed uncollectible g Status of outstanding payment plan accounts h Monthly sales analysis i Quarterly reporting of statistical data j Self-pay, Insurance pay and bundle-billed k Total percent collected l Other reports as requested by the Town

35. The Billing Service shall submit copies of all checks and money orders received to the Town.

36. The Billing Service shall maintain records and prepare material for the Town’s insurance and financial audits.

37. The Billing Service agrees to develop policies specific to the Town regarding the following A/R functions:

a Medical diagnosis documentation b Rate approval processes c Payer contracting policies d Assignment of benefits e Special situation adjustments and authority f Write-offs g Financial hardship documentation processes h Discounts i Payment plans j Acceptance of credit card payments k Compliance activities l Medical records management

The Billing Service shall include sample policies for the Town’s review with the proposal submission.

38. The Billing Service shall maintain all pertinent financial and accounting records in accordance with generally accepted principles of accounting and other procedures specified by the Town. The Town shall have the right to visit the Billing Service’s office during normal business hours to inspect financial and accounting records.

The service shall grant the Town or its designee access to these records at any time during the contract period and any extension or renewal thereof, and for three (3) years from the termination of the contract.

Access to the financial and accounting records relevant to the billing services conducted for the Town shall be available for examination by the professional audit services employed by the Town during the annual audit of the Town of Manchester.

39. The Billing Service shall have a proven track record of developing, enhancing, and maintaining effective and functional relationships with hospitals to facilitate the transfer of billing-related information. List a minimum of four (4) hospitals which you currently work with.

40. The Billing Service agrees to re-age and re-categorize accounts after receiving funds from a primary payer.

41. In the event of termination of the Contract, all payments due to the Town of Manchester shall be forwarded to the Town Accounting Manager as received. A final status report shall be issued within fifteen (15) days.

42. The Billing Service will indicate how telephones will be answered in support of the Town’s account.

43. The Billing Service, in accordance with the previously defined schedule agrees to turn over identified delinquent accounts to the identified Town. Files turned over to the Town will be formatted to include the following information:

a All patient demographic data b Patient insurance/payment information c Date of service d Point of pick-up and destination e Diagnosis e EMS run number

The information shall be electronically transmitted to the Town at the point the account is deemed transferable as previously defined.

44. The term of this agreement shall be for an initial period of three (3) years with the option of renewing for three (3) additional years. The renewal is subject to the Billing Service receiving a positive annual review from the Town based upon their consistent ability to achieve the following benchmarks:

a Achieve and sustain a minimum 80% collection rate inclusive of contractual allowances.

b Have zero deficits or unresolved allegations of deficits related to HIPAA, ARMS Contractual Compliance

Issues.

45. The Billing Service agrees to provide upon request, additional assistance through the provision of education programs to Town personnel, provide accurate and appropriate medical documentation and include processes to enhance the Billing Service’s ability to collect on accounts from various payers;

provide feasibility studies for revenue projections for any new medical transportation/healthcare endeavor; assist and coordinate the negotiation of managed care contracting as may be required during the term of this agreement.

46. The Billing Service shall work cooperatively and collaboratively with the Town in the development, enhancement, and maintenance of an integrated data communications system to facilitate the timely recording and transmission of patient health-related data between the ARMS and the Town and other locations as deemed appropriate by the Town.

47. The Billing Service shall identify all billing software that will be utilized in managing this account. The

Billing Service shall include a listing of all reports the billing software is capable of producing with samples of each report for the Town to evaluate. The Billing Service shall indicate the expected life cycle of the current software program. The Billing Service shall indicate the process it utilizes to bring new software programs online, its communication strategy to its clients, and the process utilized to eliminate or significantly reduce the impact on client claims management cycle time during new software implementation.

48. The Billing Service shall provide a detailed description/discussion with associated policies and procedures outlining the steps it takes to protect and recover the client’s data from cyber attack; loss secondary to a network LAN/WAN failure; long-term power outage; fire. The Billing Service shall include a listing of all contractors and sub-contractors who are involved in this process.

49. The Billing Service shall indicate the length of time it maintains all paper and electronic records created in support of the client’s service agreement.

50. The Billing Service shall indicate if its approach to A/R management is based upon an assembly line theory or if each client has specific individuals permanently assigned to manage specific aspects of the client’s account. The Billing Service shall indicate how it transitions accounts when a staff member terminates employment with the Billing Service. The Billing Service shall also indicate how the client is notified of the transition, and the client is assured of no interruption in cash flow during the process.

51. The Billing Service shall identify how it can assist the Town in developing/refining statistical indicators to monitor regularly to improve individual and organizational performance in its claims management and collections activities. Such processes should include internal and external goals and benchmarks where applicable.

52. The Billing Service will commit to working with the Town to continually review and adapt strategies to respond to regional and national changes to enhance reimbursement.

53. The proposer shall be responsible for completing and submitting the services annual rate application. Each year the proposer will conduct an evaluation to determine which form (long or short) is the most appropriate and in the best interest of the Town for the upcoming year. The proposer will work cooperatively with the Town to obtain the necessary information to complete the forms and submit them on time to the appropriate location.

54. The Billing Service agrees to function as an information source. Payer requirements, rules, coverage parameters, and reimbursement policies change continuously. The Billing Service will keep the Town informed of ongoing changes and notify the Town of these events as they occur. Notification shall be by telephone, electronic means, and periodic dissemination of information from literature and other sources. The Billing Service will provide an example of such communication in their proposal response.

55. At the end of the contract term, the Billing Service agrees to facilitate the transfer of all accounts in process/not yet processed to the Town or its designated agent. The Billing Service will provide the necessary data and account documentation, both hard copy and electronic files to facilitate a smooth transition. The Billing Service will provide training to Town designated personnel assuming the Billing

Service responsibility.

4.10. PRICING

Please upload your pricing proposal in the format below, as a separate document in the Vendor

Submissions section.

1. Year 1 Cost by % of Dollar Collected ___________________________%

2. Year 2 Cost by % of Dollar Collected ___________________________%

3. Year 3 Cost by % of Dollar Collected ___________________________%

4.11. EXCEPTIONS TO SPECIFICATIONS

Please indicate any exceptions taken to the specifications in Vendor Submissions. If "yes," you must submit a detailed description of the exception(s). You may upload it with your cost proposal in the vendor submissions section.

4.12. VENDOR INFORMATION SECURITY QUESTIONNAIRE

The successful proposer must complete and submit the Vendor Information Security Questionnaire. The fillable form is accessible by clicking the link below.

https://us.openforms.com/Form/b3c5e239-b875-4213-9ee9-65af04eb1248

4.13. IMPLEMENTATION

Please indicate if you are capable of implementing this service within the defined time parameters in the

Vendor Submissions section.

4.14. PRIMARY OFFICE LOCATION

Please indicate your primary office location in the Vendor Submissions section.

4.15. REVIEW

A complete review of the EMS billing process shall be conducted at the end of six (6), twelve (12), and twenty four (24) months. This review will be conducted by both the provider of EMS Billing Services and the Town and its representatives. At least one of these reviews shall be an on-site meeting between the respondent and the fire department.

Submit a list of at least five current clients and their contact information. This reference list should include at least two paramedic-level fire department-based non-transport providers. References from in-state providers are preferred.

https://us.openforms.com/Form/b3c5e239-b875-4213-9ee9-65af04eb1248

4.16. CONTRACT TERM OF SERVICE

The term of this agreement shall be for an initial period of three (3) years with the option to renew for three (3) additional years.

The Term of this service agreement shall be initiated and continue, pursuant to the achievement of satisfactory annual performance evaluations as described in the Proposal Specifications Section.

The renewal is subject to the Billing Service receiving a positive annual review from the Town based upon their consistent ability to achieve the following benchmarks:

a Achieve and sustain a minimum 80% collection rate inclusive of contractual allowances.

b Have zero deficits or unresolved allegations of deficits related to HIPAA, ARMS Contractual Compliance

Issues.

At any time during the term of this agreement, the Town reserves the right to terminate this…