BILLING SERVICE1.docx

BILLING SERVICE

EMERGENCY AMBULANCE SERVICE

Town of Westborough

The emergency ambulance service is operated by the Town of Westborough’s Emergency Medical Service and is an Advanced Life Support service to the Paramedic Level. Billing services providers interested in providing the billing service, as set forth in the attached specifications, are invited to deliver two (2) copies of ambulance billing proposal to the Town of Westborough Fire Department, Fire Chief, by November 2, 2018 no later than 12:00 p.m., to which time and place proposals will be opened and read.

All proposals shall be sealed, addressed to the Patrick J Purcell, Fire Chief, Town of Westborough Fire Department, 42 Milk Street, Westborough, MA 01581. Proposers shall submit separate price and non-price (technical) proposals. The price proposal must be signed, placed in an envelope, and sealed. The price proposal will require the fee for the service to be stated as a dollar amount for actual receipts. This envelope is to be clearly marked with the Proposer’s name, date of opening, and titled as follows:

Town of Westborough – Ambulance Billing Price Proposal

The non-price (technical) proposal must contain all information pertaining to the Billing Service, such as method of billing, initiation of billing procedures, application for, and timetable for, the respective applications for provider numbers for Medicare and Blue Cross/Blue Shield, and Medicaid. The proposal much address, at a minimum, each of the issues set forth in the Request for Proposals in order to be considered responsive. Any proposal which does not respond to each issue in the Request for Proposals must be rejected by the Town of Westborough as non-responsive. The non-price proposal shall be signed, placed in a separate envelope, and sealed. All pages that require signatures must be signed where appropriate and submitted as part of the non-price proposal. This envelope is to be clearly marked with the Proposer’s name, date of opening and titled as follows:

Town of Westborough – Ambulance Billing Non-Price Proposal

A Proposer may correct, modify, or withdraw a proposal by sealed, written notice clearly marked as a correction, modification, or withdrawal, and received in the Fire Chiefs Administrative Office prior to the time and date for opening of the proposals.

Proposals that are received after the proposal due date and time will not be accepted.

SIGNING OF PROPOSALS: Statements of Qualifications must be signed as follows:

A. If the Proposer is an individual, by him/her Personally;

B. If the Proposer is a partnership, by the name of the partner, followed by the signature of each general partner; and C. If the Proposer is a corporation, by the Authorized officer, whose signature must be attested to by the Clerk/Secretary of the corporation and the corporate seal affixed. A copy of the corporate vote must also be submitted.

REVIEWING PERIOD: All proposals meeting the minimum requirements and conditions may be held by the Town of Westborough for a period not to exceed sixty (60) days from the date of opening proposals for the purpose of reviewing the proposals and investigating the qualifications of Proposers, prior to the awarding of the contract.

VENDOR SELECTION: Following the procedures previously described, the Town of Westborough will make a decision regarding selection of the vendor whom it wishes to enter into a contract. Proposals will be evaluated upon the basis of the Minimum Qualifications; the Comparative Evaluative Criteria for Selection set forth, prices and other appropriate factors. Massachusetts based company preferred. This may not necessarily be the low bidder.

AWARD: The award of this contract will be made by the Town of Westborough, Fire Chief and/or Chief Procurement Officer, after reviewing recommendations. The contract shall be awarded to the responsible and responsive Proposer submitting the most advantageous proposal, taking into consideration the proposal’s relative merits. The Town of Westborough reserves the right to reject any and all proposals or to waive any informality in the proposals, if it appears in the Town’s best interest. The company that is awarded the bid will be responsible for all bills currently outstanding and will be responsible to retrieve all the data from our current computer system and for entering all previously billed runs that are outstanding in their system at no additional charge to the Town.

PROFILE OF SERVICE: The Town of Westborough’s Medical Service operates an emergency only ambulance service that is licensed for Advanced (Paramedic) Life Support Services. In the last calendar year, the service performed approximately 1,986 EMS calls and 1,100 transports. Three ambulances are in service. The ambulance service for the Town of Westborough has realized a percentage growth annually that averages approximately two percent.

MINIMUM QUALIFICATION CRITERIA

In addition to addressing each of the items in the specifications, the Proposer must submit, as part of his non-price proposal, the following minimum qualification criteria: Initial the appropriate response to each criterion, and include the required documentation in the Non-price (technical) proposal envelope.

1. A Letter of Transmittal signed by the individual authorized to negotiate for and contractually bind the Contractor, stating that the offer is effective for at least sixty (60) calendar days from the deadline for the submission of proposals.

COMPLY __________ DO NOT COMPLY __________

2. A list of Massachusetts municipalities or ambulance services for which the contractor has provided ambulance billing service. A minimum of three (3) is required. This list is to include a current name, address and phone number of references for the selection committee to access. Any negative information generated by a reference check shall be cause sufficient to dismiss the proposal as unacceptable. Negative information that shall be considered grounds to render the proposal unacceptable shall be information that shows the service operated in a fashion that reflected negatively on the community served. Illegal or unethical methods of collection, repeated instances of inappropriate treatment of recipients of the service such as rudeness or any other behavior that generates complaints from the public shall be viewed as negative information.

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3. A dishonesty bond for the minimum amount of $250,000 and an errors and omissions (E+O) bond for the minimum amount of $2,000,000 naming the Town of Westborough as an additional insured are to be included with the proposal. If the proposal is accepted these bonds must be kept in effect for the life of the contract.

COMPLY __________ DO NOT COMPLY __________

4. The Town of Westborough established a philosophy of billing that essentially states that no person shall be forced to pay a bill if there is an indication of inability to pay. To that end the billing agency must recognize that, in their dealings with the recipients of ambulance service, every effort with the recipients of ambulance service, every effort towards a courteous and compassionate handling of patients will be the rule.

The billing agency will have made every attempt to determine if primary and/or secondary insurance exists through inquiry to recipients of the service and computer screening, prior to bills being sent to individuals, and the primary and secondary insurance carriers billed where appropriate. Every bill mailed to other than insurance companies shall be accompanied by a letter explaining the waiver policy. All applications for waiver must be signed, filled out and returned to the billing agency. The billing agent will turn over all requests for abatement to the Town of Westborough for action. The service must show an understanding of this policy in its response to the request for proposal.

COMPLY __________ DO NOT COMPLY __________

5. Bidders must provide a toll free number for the Town’s use and for the use of citizens making inquiries.

COMPLY __________ DO NOT COMPLY __________

6. List any litigation, with the appropriate explanation, against your firm in the past five years from 2002 through the present.

COMPLY __________ DO NOT COMPLY __________

7. Bidders must provide documentation of licensing as a collection agency under Massachusetts laws and function as a collection agency as well as an ambulance billing company including reporting delinquent patients to a credit bureau, if approved by the service (Fire Dept.).

COMPLY __________ DO NOT COMPLY __________

8. Prior to 9/08 the billing service must have software and trained in-house staff to support the bridge programming and import of a NEMSIS compliant EMS data files, NO EXCEPTIONS.

COMPLY __________ DO NOT COMPLY __________

9. The billing service must provide a secure site to drop the Town’s data files; otherwise known as a Secure FTP site. This is a requirement of HIPPA, NO EXCEPTIONS.

COMPLY __________ DO NOT COMPLY __________

10. To be in compliance with the Office of the Inspector General’s advisory, the billing service MUST have an active internal quality assurance program in place, must subject the Company to a professional, outside annual compliance audit, have an EMS attorney on retainer to support billing company and client questions and review carrier contracts as required. NO EXCEPTIONS.

COMPLY __________ DO NOT COMPLY __________

11. The billing service shall subscribe to an established insurance verification service and actively use it as part of their processes and procedures. NO EXCEPTIONS.

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12. The billing service shall insure that phones are answered by a trained billing specialist who can help the caller promptly, competently, and courteously between the hours of 8 a.m. and 9 p.m. EST. Automated attendant or voice mail as a primary phone coverage tool is not acceptable. NO EXCEPTIONS.

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13. The billing service shall submit its annual Statement on Auditing Standards, SOC1 report (formerly known as SAS No. 70, Service Organizations report) with its proposal. The SOC1 must have been performed by a CPA firm in accordance with auditing standards developed by the American Institute of Certified Public Accountants (AICPA). The SOC1 must be performed annually for the duration of any contract with a copy provided to the Town annually. NO EXCEPTIONS.

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14. The billing service must have trained in-house staff to setup and administer all provider contracts (Medicare, Medicaid and others…) on behalf of the Town as directed by the Town. NO EXCEPTIONS

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15. The billing service must have trained paramedics on staff to support the billing function and provide clinical and operational feedback to both the client and the internal billing team. NO EXCEPTIONS.

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16. The billing service must be able to accept payment on behalf of the Town via the services secure website for payers using credit cards, debit cards or ACH from their checking accounts. NO EXCEPTIONS.

COMPLY __________ DO NOT COMPLY __________

17. The billing service must have at least 10 staff members with active certification from the National Academy of Ambulance Coding (NAAC).

COMPLY __________ DO NOT COMPLY __________

I hereby state that I understand the minimum evaluation criteria and that I have initialed all of the appropriate sections, and further, that I have attached the required information to the summary sheet located at the back of this document.

Company Name____________________________________________

Authorized Signature________________________________________