ESBD_369235_1721754660126_C2360-24-013, Ambualnce Billing and Collections Sol.pdf

WALKER COUNTY EMS

REQUEST FOR PROPOSAL (RFPI

c-2360-24-Ot3 Ambulance Billing and Collection Services

DUE DATE:

August 12,2024

WALKBR COUNTY

1301 Sam Houston Ave #235

Huntsville, Texa s 77340 Attention: Cheryl L. Cowarto CTCD, CTCM

WALKER COUNTY PURCHASING OFFICE

Email: bids@co.walker.tx.us * Telephone (936) 436-4943 * www.co.walker.tx.us

REQUEST FOR PROPOSAL

Ambulance Billing and Collection Services

Bid Reference Number: C2360-24-013 Due: August 12, 2024 at3:00 PM (CT)

The Offeror's signature is required for acceptance of Proposal and confirms Offeror has read and understands all requirements concerning this Request for Proposal (RFP) The undersigned affirms they are duly authorized to execute the contract, that this Proposal has not been prepared in collusion with any other Offeror, and that the contents of this Proposal have not been communicated to any other Offeror prior to the official opening. Hand delivered or mailed proposals must be SEALED in an envelope and CLEARLY marked as below:

RFP# C2360-24-013

Due: August 12, 2024 at 3:00 PM (CT)

Delivered/lVlail to: Purchasing Office @ l30l Sam Houston Ave. Suite 235 Huntsville, TX77340 Or

For a printable version please visit our website at co.walker.tx.us/purchasins and click on the tink at the bottom of our webpage for solicitation: RX'P# C2360-24-013

Walker County Point of Contact

Cheryl Cowart, CTCD, CTCM Purchasing Agent ccowart@co.walker.tx. us

(936) 436-4e37

Erica Minor, CTCD, CTCM Purchaser em ino r@co.walker.tx. us

(e36) 436-4e47

CERTIFICATION OF PROPOSAL

Signed By: Title:

Typed/Printed Name:

Company Name Date:

Mailing Address:

Street/P. O. Box City State Zip

Telephone #:

Tax ID Number:

Email

Cell # Fax #:

SECTION I _ RFP TIMETABLE

Release of RFP July 23,2024

RFP Due Date August 12,2024

Tentative Award of Contract August 26,2024

Contract Start Date September 1,2024

SECTION II - INTRODUCTION

Walker County is soliciting proposals from qualified Service Provider to provide ambulance billing and collection services. It is the intent of Walker County to select a single provider to accomplish ail the services outlined in this request. This includes complete management of the billing process from patient transport to account closure. It is the intent of the County to enter into a contract with renewals contingent on the successful performance of the contract.

This request for proposal ('.RFP") defines the minimum scope of services and outlines the requirements that must be met by Service Providers interested in providing such services. Service Providers shall carefully examine the entire RFP and any addenda thereto, and all related materials and data referenced in performing the service. Service Providers are advised to read all sections of this RFP before submitting a proposal. Proposals will be evaluated utilizing the criteria herein.

Submissions must include one (1) original copy, four (4) additional hard copies, and one (1) electronic copy of the complete proposal. The electronic copy must be combined into a single file on a thumb drive.

The proposal must be returned in a sealed envelope bearing the following information on the outside of the submittal envelope: the (1) Name and address of the respondent, (2) "Walker County Ambulance Billing and Collection Services

RFP C-2360-24-013."

Proposals may only be hand delivered in person or mailed to the following address

Walker County, Texas Purchasing Department 1301 Sam Houston Ave., Suite 235 Phone: 936-436-4937

Response packages accepted until Augustl2r2024 at3:00 pm.

Proposals sent by fax or E-mait will not be accepted.

SECTION III _ DEFINITIONS

Definitions In order to simplify the language throughout this request for proposal, the following definitions shall apply:

WALKERCOUNTY EMS- Same as County.

COMMISSIONERS' COURT - Elected officials of Walker County, Texas given the authority to exercise such powers and jurisdiction of all County business the State Constitution and Laws.

CONTRACT - An agreement between the County and a Provider to fumish supplies and/or services over a designatedperiodoftimeduringwhichrepeatedpurchasesaremadeof thecommodity and/or service specifi ed.

COUNTY - The government of the Walker County, Texas

SERVICE PROVIDER- The successful offeror of this request.

EHe- Electronic Health Record, this is a reporting system that is used to document each response, is the permanent patient record of treatment and is stored in electronic format.

BEL - Request for Proposal

SECTION TV - TECHNICAL SPECIFICATIONS

A. GENERALINFORMATION

Background

Walker County is a scenic, sprawling territory of 801 square miles located in the southeastern region of Texas. The county lies roughly 100 miles north of the Gulf of Mexico and midway between the Louisiana state line and the Texas capital in Austin. The County was founded in 1846 and has an estimated population of 78,870. The County provides a full range of services to its citizens. These services include but not limited to public safety and justice, building/maintaining roads and bridges, providing emergency management services and maintaining resident's important and vital records.

Walker County EMS was founded October l, 1975, and became a department of the County in 2003 Current operations include 5 BLS with MICU capability ambulances.

B. FISC,A OPERATIONS INF'ORM TION:

The approximate amount billed in fiscal year 2023 (October l,z}22through September 30,2023) was 59,812,213. The approximate amount collected for fiscal year 2023 was $1,2g0,245. For Octobei 202+ through Jurrre 2024 $7,685,761in Total Charges less contractual adjustrnents of $3,332 ,440 for a Gross net charges of $4,353,521.

The approximate payer mix run count for the curent year to date is:

Private 501

Medicare 1873

Medicaid 393

Facility Runs 888

Commercial Bundled 128

Commercial Unbundled runs 610

Totalruns 4393

The Walker County EMS transports primarily to Huntsville Memorial Hospital with transports to HCA Contoe, the closest Level II Trauma Center. Walker County EMS will also-transport to The Woodlands, TX to hospitals specializing in a higher level of care for trauma, cardiovascular, strole and pediatric patients when patient condition deems necessary.

C. SCOPE OF WORK

This section outlines the minimum contract requirements for ambulance billing, collection, financial reporting, and analytical services. Walker County desires to pursue a partnership to build an optimal revenue cycle. The minimal requirements are listed in this RFp.

Walker County is requesting proposals from qualified Service Providers for the billing and collection of ambulance fees. It is the intent of the County to contract with a Service Provider for theiequested services.

The resulting contract shall remain in effect with fixed prices for the duration of the contract. The performance of the selected provider shall be reviewed annually unless specified otherwise. The results of the review of services rendered shall be submitted to the Commissioners' Court for evaluation and comment. The County shall have the option of extending this contract for up to four (4) additional one-year periods, subject to approval of funding and review of the services provided. The Contract can be extended upon mutual agreement of both the Service Provider and the County. Proposals shall include a sample of the Service provider,s standard services contract for County review. The contents of any resulting contract shall be subject to negotiation and consent on the part ofboth parties.

The Service Provider shall include satisfactory assurances under the 'obusiness associate" provisions of the Health Insurance Portability and Accountability Act (HIPAA) privacy regulations that the Service Provider will safeguard the County's protected health information in accoidance with the standards set forth in the privacy rule.

The Service Provider will use National Emergency Medical Service Information System (NEMSIS) compliant electronic health record (EHR) system of the County's choosing during the course of this contract. Currently the County uses ESO Solutions EHR for all patient care reports. The Service Provider must have prior experience with the County's current EHR Compiny, ESO.

The Service Provider will charge a flat percentage, all-inclusive fee for billing services.

D. In and Liabilitv rements

Contractors providing goods, materials and services for the County of Walker shall, during the term of the contract with the County or any renewal or extension thereof, provide and maintain the types and amounts of insurance set forth herein. All insurance and certificate(s) of insurance shall contain the following provisions:

1. Additional Insured: Name the County, its officers, agents, representatives, and employees as additional insured as to all applicable coverage with the exception of workers compensation iniurance.

2. Cancellation, Non-Renewal, Material Change: Provide for at least thirty (30) days prior written notice to the County for cancellation, non- renewal, or material change of the insurance.

3. Waiver of Subrogation: Provide for a waiver of subrogation against the County for injuries, including death, property damage, or any other loss to the extent the same is covered by the proceeds of insurance.

Insurance Company Qualification: All insurance companies providing the required insurance shall be authorized to transact business in Texas and rated at least 'oA" by AM Best or other equivalent rating service.

Certificate of insurance: A certificate of insurance evidencing the required insurance shall be submitted with the contractor's RFQ or response to proposal. If the contract is renewed or extended by the County, a certificate of insurance shall also be provided to the County prior to the date the contract is renewed or extended.

Type of Contract Type of Insurance Amount of Insurance

Professional Services Commercial General Liability $1,000,000

Automobile Liability Combined single limit $300,000

Workers' Compensation Statutory

Professional Liability (E&O, Malpractice) s1,000,000

E. Billine and Collections

The Service Provider will be responsible for providing billing, accounts receivable and account collection services for the County's Emergency Medical Services (EMS). Any use of a subcontracted collections agency for delinquent accounts by the Service Provider will be at the Service Provider's expense.

(initial)_

Walker County will submit to the selected Service Provider non-billed ambulance calls with a date of service of September 1,2024 and later. The Service Provider shall invoice ambulance calls submiued by the County from that date forward. Walker County reserves the option to bill State, Local and Hospital accounts in-house. (initial)_

The Service Provider will review the previous two years of EMS billing activities and make recommendations to the County on their ability to place outstanding bills and data into their new billing system from our current EHR Vendor. (initial)_

The Service Provider will charge a one-time all-inclusive fee for performing this service if applicable listed out separately in RFP. (Initiat)_

The Service Provider will review the County's current ambulance billing activities and rate schedules and make recommendations to the County to increase revenue. Adopting current regional rates and assisting our participation in the (ASPP) Ambulance Supplemental Payment Program should maximize revenue.

(Initial)_

The Service Provider is required to maintain current certification through a nationally accredited program such as the National Academy of Ambulance Coders. Also, any coder/biller assigned to the County's account should be Certified Ambulance Coder (CAC) coders. (Initial)_

The Service Provider shall file initial client billings and customer insurance claims within five (5) working days from receipt of transport information from Walker County EMS. The Service Provider shall not have the right to refuse to bill and collect any EMS fee. (Initial)_

Information for ambulance billing is often gathered under urgent conditions and may be incomplete. The Service Provider shall obtain any missing data necessary for billing through telephone or e-mail queries from an appropriate source. (Initial)_

The Service Provider shall provide a proposed billing procedure including sample bills, letters, notices, language and timelines. The successful Service Provider shall work with the County to formalize and implement County authorized billing and collection protocol. (nitial)_

The Service Provider shall be responsible for rebilling the insurance company for its portion of a bill if the claim is not paid in accordance with the County's terms. If correspondence with the insurance company is required, a copy of the correspondence should be sent to the customer. (Initial)_

The Service Provider shall describe in detail how transports between medical facilities accounts are managed. (Initiat)

The Service Provider shall describe their general billing process how accounts are managed to ensure there is follow up on the accounts to ensure timely collections. (Initiat)_

To obtain prompt payment of accounts the Service Provider shall request patients, insurance carriers or other responsible parties to pay any outstanding balance within thirty (30) days of the billing date. (Initiat)_

The Service Provider shall agree to implement new fee schedules from time to time as directed by the County. (Initial)_

The Service Provider will suspend the billing and collection efforts on any EMS fee upon written notice via email to do so by the EMS Chief or his designee and write off the balance of an account without cost to the county. (Initial)_

The Service Provider will bill at set rate for County employees utilizing the current Walker County tnsured Benefit policy. (Initiat)_

The Service Provider must have the ability to work with different fee schedules for county residents and non-county residents. (Initial)_

The Service Provider will be required to bill the patient's secondary and tertiary insurance carriers (if applicable). (Initial)_

The Service Provider shall bill in accordance with county adopted rates and manage write-offs and collection within the county adopted policy, recommending changes to the county write-offs and collection policies for review. (Initiat)_

The Service Provider shall work with Walker County in establishing a process for accepting credit card payments. Walker County will set up two accounts in our local depository, one for cash payments and one for credit cards. Describe generally how the accepting of payments on behalf of Walker County will be handled by the Service Provider

The Service Provider shall bill in accordance with the County adopted rates and manage write-offs and collections within the County adopted policy

The Service Provider shall work with Walker County in establishing a process for accepting credit card payments. (Initial)_

The Service Provider shall provide the process for accepting payments on behalf of Walker County.

(Initial)_

The Service Provider must be fully compliant with all rules related to all forms of medical billing. Service Provider must also provide proof of a compliance program adhering to proper billing guidelines, Service Provider shall provide a copy of the companies' policies and procedures, Service Provider shall denote the existence of a compliance officer for the company, internal auditors if retained, Office of Inspector General (OIG) compliance procedures, billing enforcing standards and quality assurance and control program. In addition, the Service Provider shall provide proof of an audit program that satisfies the rules established by Centers for Medicare and Medicaid services (CMS). (Initial)_

The Service Provider will be responsible for timely submittals to Insurance Companies, Medicare and Medicaid. If the Service Provider fails to bill Insurance Companies, Medicare and Medicaid in a timely manner which leads to lost collections, the Service Provider may be held liable for reimbursement to the County for the amount of the lost collections. (Initial)_

The Service Provider shall be equipped with computer operations to receive and send data electronically. The Service Provider shall have the capability of electronically transmitting claims to Medicare. Service Provider will indicate if they are filing electronically for any service at this time and how other types of insurance filing will be handled. (Initial)_

The Service Provider shall work with the County staff to implement and maintain procedures which facilitate the electronic exchange of all data necessary to accomplish the billing, collection and reporting requirements of this RFP. (Initial)_

The Service Provider shall work with the County staff to maintain compliance with all insurance filings.

The Service Provider shouldprovide constant Quality Improvement (QI) and Quality Assurance (QA) with our field level employees to maintain comprehensive education of the billing process and ways to improve our documentation. (Initial)_

The Service Provider shall use the National Provider Identification (NPI) number for Walker County EMS (Initial)_

The Service Provider will work with Walker County to ensurs that all requirements of HIPAA are met.

The Service Provider will distribute Privacy Notices, in the form required by the County, to all EMS customers. (Initial)_

The Service Provider will be required to collect the patient's signature in cases where the County's EMS personnel were unable to obtain the patient's signature during transport. The record of this signature shall be maintained by the Service Provider for review by Medicare and County Auditors. (Initial)_

The Service Provider shall make and document no less than two attempts to obtain the patient's signature (Initial)_

The Service Provider must make every reasonable effort possible to make collection within 180 days of initial billing without jeopardizing the goodwill of the County. (Initial)_

The Service Provider may authoize self-pay patients to liquidate any outstanding balance on an installment basis. No interest shall be charged to patients for these extended terms. Patients making payments on an installment basis shall be tracked by the Service Provider. Any patient making prompt, regular installment payments shall not be tumed over to a collection agency

I

As part of the collection of accounts receivable, the Service Provider will be required to pay for all postage, computer equipment, billing software, computer supplies, envelopes, address labels, letterhead, insurance claim forms, Privacy Notices and all other supplies needed to collect the amount due. (Initial)_

The County recognizes that under Medicare guidelines, the County can only bill the Medicare patient the amount that the Medicare Explanation of Benefits sheet indicates as the patient's responsibility. The remainder of the balance may be billed to secondary or tertiary insurance policies that the patient may have. (Initial)_

The County recognizes that under Medicaid guidelines, the County cannot pursue the Medicaid recipient for any balances remaining after Medicaid has made payment.

The Service Provider will be responsible for processing all returned mail that originates from their mailings.

The mail must be opened and processed within five (5) working days. (Initial)_

The Service Provider will post the payments to the patient accounts within five (5) working days from receipt of information. (Initial)_

F. Reports and Data

The Service Provider shall be required to submit monthly reports no later than the 6ft business day of e a c h month for the preceding month. The County reserves the right to request additional reports at any time. The Service Provider shall work with the County staff to implement and maintain procedures which facilitate the electronic exchange of all data necessary to accomplish the billing, collection and reporting requirements of this RFP. (Initial)_

Service Provider shall clearly describe their reporting systems and reports available, and provide an example of each. (Initial)_

Service Provider shall clearly identify how data outside of reporting will be made available to Walker County including the options for supplying data to Walker County in ftp, csv exports for use in Excel Power Queries, Dashboards, exports to Azure sql databases, SnowFlake, or on-premise databases etc.

(Initial)_

The reports to be requested are, but not limited to:

An Accounts Receivable History report for selected account(s) that identifies the Run Number, Run Date, primary payer, each invoicing type transaction with transactions codes and groupings, each payment or transaction that reduces the balance, and the payer code, grouping and narne, the applicable transaction date for reporting purposes, the system creation date ofthe transaction, and a record that shows the date the invoice was sent. Total of transactions for the account should equal the balance due, Selection criteria and filters must be available for the report. (Initiat) (attach example of report)

CSV file export of the above of the report menu (Initial) (attach example of export) a a a Activity file showing follow up action on an account that identifies the Run Number, Run Date, primary payer, activity description, the system creation date of the transaction. (Initial) _ (attach example of report) Aging of Accounts Receivable, to include (at a minimum) payer code, date of service, account number, total amount due aged in thirty (30) day intervals from current to 180+ days.

Monthly Credit Detail report showing all payments recorded in the prior month, to include (at a minimum) patient's n€une, date of service, account number, total amount paid, date of payment, narne of company or individual that made the payment.

Monthly Charge Detail report showing all invoices issued in the prior month, to include (at a minimum) patient's name, date of service, account number, company or individual to whom the invoice was sent, number of miles billed, and total charges.

Monthly Summary Charge report showing total number of calls and total amount b i I I e d by company, i.e. Medicare, Medicaid, private insurance companies, individuals, Tricare, etc.

Year-to-date Patient Detail Report to include (at a minimum) patient's narne, date of service, account number, total charge, total credits to date, balance due.

Monthly Adjustments Report showing all adjustments booked during the month, to include (at a minimum) patient's name, date of service, account number, amount of adjustment.

Monthly Refunds Report (Credit Balance Report) to include (at a minimum) patient's name, date of service, account number, and amount of overpayment. The report will be accompanied by supporting documentation of payments received on each account and any required write offs.

A Charge/Credit Analysis Report showing the percentage of collections, amount billed, amount adjusted, amount collected and amount due by month for a minimum of a l2-month period.

Listing of all invoices listed alphabetically by patient name.

Report of accounts must be sent prior to being sent to Collections to include transaction and activity history.

The County's fiscal year begins October 1 and ends September 30. On a monthly, selected period range, andlor fiscal year basis, the Service Provider shall provide annual fiscal year financial and statistical reports. (See Example included) Required statistical and financi al datamay include, but not be limited to, the following:

o Total number of transports for the fiscal year.

o Total amount billed for the fiscal year.

o Total collections for the fiscal year.

o Comparison of current year to prior years (when data is available to Service Provider).

o Percentage of total transports which were Medicare, Medicaid, Private Insurance and Self pay o Amount billed broken down by Medicare, Medicaid, Private Insurance and Self Pay.

o Total amount collected from Medicare, Medicaid, Private Insurance and Self Pay.

o Average amount paid by Medicare, Medicaid, Private Insurance and Self Pay per transport.

r Total amount of write-offs for the fiscal year for Medicare, Medicaid and Private Insurance.

o o a o a a o a

G. Analvtical Services

The Service Provider shall be required to provide analysis and expertise in all issues related to ambulance billing and operations. This analysis shall include developing trends within the EMS Operations and other pertinent issues that may develop. The Service Provider shall provide other analytical services as requested or required by the County.

The Service Provider shall schedule quarterly meetings with the County to review performance. Also, at a minimum, a written report reviewing the performance of the account receivable shall be prepared, identifying among other issues, the strengths, weaknesses and opportunities of the performance. Also, key issues that might arise in the future should be identified, along with strategies to address the issues. This report should be prepared monthly or as deemed necessary by the County.

The Service Provider will provide a Quality of Care survey, at least annually, which meets or exceeds the County's requirements. The Service Provider must also be able to provide revenue projections based on previous collections, as determined by the amount the Service Provider expects to collect per trip.

H. Technolosv Requirements

The Service Provider shall provide the necessary software associated with the billing and collections. A description of the software to be used shall be identified and described and must communicate with applicable software in use by Walker County EMS Operations.

The Service Provider shall provide a system that will ensure complete and unintemrpted flow of service via back-up systems and a data recovery project plan/system should a disaster occur.8 Upon awarding of the bid, the Service Provider shall provide a copy of a written plan for review by the County's Information Technology Division. The Service Provider shall provide a database backup to the County on a scheduled basis.

Records shall be retained according to the Texas State Records Retention Schedule.

The Service Provider shall provide sufficient HIPAA compliance training to all employees dealing with applicable information.

The Service Provider will be expected to enter into the County's standard "Business Associate" agreement under HIPAA and HITECH rules. In the event that the Service Provider experiences a violation. Security or Privacy Rule, the Service Provider will be responsible for any required notifications or corrective measures.

I. Trainino of EMS Personnel

The training shall include all necessary visual training aids and handout materials that personnel may reference at the conclusion of any training session.

The Service Provider shall provide, at a minimum, an initial training of County EMS.

personnel three Compliance and Documentation sessions. The first training session shall be at least two

(2) weeks prior to the Service Provider commencing billing and collections on behalf of the county. The second, supplemental training session shall be provided within one month after the completion of the first quarter.

The Service Provider shall provide the EMS Chief an in-depth analysis identifying any deficiencies in documentation guidelines or CMS regulations. This supplemental training shall include a strategy to resolve any deficiencies.

J. ASPP Prenarati and Submittal

The Service Provider will prepare and submit all reporting necessary to successfully claim available funds through the Ambulance Supplemental Payment Program. Submission of the forms needed in order to claim all available funds shall be submitted to the State of Texas Health and Human Services (HHSC) department under the direction of the Service Provider or a third-party Service Provider representing the Service Provider. Such documentation may include but not be limited to Cost reports, Cost Settlement reports, and any future changes that would make the Walker County eligible to receive any and all funds that are available through this program. There shall be at least one face to face meeting between the team performing the preparation and Walker County EMS billing department. This team is typically a contracted third party hired by the Service Provider. (Initial)_

K. Additional uirements

The Service Provider may be asked to address the Commissioners' Court and respond to their questions.

(Initiat)_

The Service Provider shall maintain records as required by Medicare, Medicaid and all other applicable govemment agencies and/or regulations. (Initiat)_

The Service Provider must have at least 25 clients of similar size agencies as Walker County with preference given to Texas based companies. (Initia

The Service Provider will designate a single point of contact for handling the County's account.

(Initial)_

Upon request, the Service Provider shall make available to the County's internal and/or external auditors all records that pertain to the County's business. The Service Provider will be required, upon notice, to allow the County and its authorized agents the right to audit, inspect and copy all such records and documentation as often as the County deems necessary during the contract period established; and during the period of five (5) years thereafter. Such activity shall be conducted during normal business hours and at the expense of the County. The County shall retain ownership of all such records. Service provider must provide detail transactional and activity data in an agreed format to the Walker County Internal Auditor. (Initial)

The Service Provider will be expected to adhere to generally accepted accounting principles in order ensure the establishment of an efficient billing, collection and recording system that is easily understood and audited. (Initial)_

InCompliancewithTAC 157.11,the ServiceProvider will keep and maintain adequate records of work, information, expenses, costs, invoices, materials provided and services performed pertaining to the County's EMS ambulance transport billing. These records shall be maintained fortheminimumof 10 years.

Thosepatientsthatareunder 18 attimeoftreatment shall be maintained until the patient reaches 2l or for seven years from the date of last treatment, whichever is longer. (Initiat)_

The Service Provider must provide and maintain a local or toll-free telephone number for the purpose of processing customer account inquiries. Voice mail, fax number and e-mail or website address shall also be provided to customers. Under no circumstances shall customers pay the cost of the call. The Service Provider must be able to handle customer inquiries Monday through Friday, 9:00am - 5:00pm at a minimum (excluding holidays). The Service Provider shall also provide avenues of communication for non- English-speaking individuals. (Initial)_

All written or verbal communications between the Service Provider, the EMS customers (patient or legal guardian) and insurance representatives will be conducted in a professional and courteous manner.

(Initiat)_

The Service Provider must have the ability for EMS Customers to pay on their accounts 24 hotxslday 7 days/week using either a toll-free telephone service or preferred website portal. (nitial)_

The Service Provider will, at all times, maintain aprofessional and courteous working relationship with the Walker County departments and divisions. (Initial)_

On an as-needed basis, the Service Provider will be expected to meet with Walker County EMS Department. Meetings will be held on-site or at a mutually agreeable alternate location or by video conferencing. The Service Provider will be responsible for any expenses incurred to attend these meetings.

(Initial)_

The Service Provider shall be responsible for onsite training sessions at time of contract execution and as needed throughout the term of the contract. The purpose of this training will be to ensure that all Walker County EMS personnel are trained regarding documentation, charges, applicable health care laws and regulations as they relate to the billing process. (Initial)_

The Service Provider will be responsible for informing Walker County EMS of any information that is deemed pertinent to ambulance billing (i.e., Medicare/Medicaid billing changes). (Initial)_

The Service Provider must provide the County with24 hour a day, real-time electronic access to account data to include status of payments from insurance companies and Explanation of Benefits. There must be an inquiry capability that allows County personnel to view individual account activity as well as aggregate financial data. (Initial)_ patient and balances due. invoice s. statement- transacti on and activitv data. shall remain the property of WalkerCounty at all times. Further, the Service Provider must agree to surrender any and all information concerning work performed under this RFP (electronic and/or downloadable format) within thirty (30) days of the termination of this contract. Service Provider will also provide the County with final reports and statistics, including all datarequested by the County at that time, within thirty (30) days after the contract ends, The County may agree to extend this time period to accommodate the final billing. (Initiat)_

All work performed under this contract shall be of the highest professional standards and shall in every respect meet or exceed standard industry practice and comply with the Fair Debt Collection Practices Act.

No harassing or "strong-arm" collection tactics shall be employed.

SECTION V_ TERMS AND CONDITIONS

The following instructions apply to all Proposals and become a part of the terms and conditions of any proposal submitted to the Walker County Purchasing Office, unless otherwise specified elsewhere in this proposal request.

1. All proposals are required to be informed of the Terms and Conditions and will be held responsible for having done so. Upon acceptance and approval by the Commissioners' Court, this propo.ul .ff..tt a working contract between Walker County and the successful offeror for the period designated.

2. Proposals must be received in the Purchasing Office no later than the time and date sp-cified. All proposals received after the submission deadline will be considered void and unacceptable and will be retumed unopened. Walker County is not responsible for lateness or non-delivery of mail, carrier, etc., and the date/time stamp in the Purchasing Office shall be the official time of receipt.

3. The County reserves the right to inspect and insure adaptability of the service, accept or reject in part or in whole any and all proposals, to waive any informality in proposals and unless oiherwise specified by the offeror, to accept any service in the bid for the best value to the County.

4. The County reserves the right to accept or reject any or all RFPs as a result of this request, to negotiate with all qualified sources, or to cancel, in part or in its entirety, this RFp if found to be in the best interest of the County. All RFPs become the property of the Walker County. There is no express or implied obligation for the Walker County to reimburse responding Service Providers for any expenses incurred in preparing RFps in response to this request.

5' If either the unit price or extended price is obviously in error the unit price will prevail. Walker County shall not be responsible for any verbal communication between any employee of the County and any potential offeror.

6. Only written specifications and written price quotations will be considered.

7. Walker County reserves the right to reject any proposal that does not fully respond to each specified item.

8. Offeror must include Employer Identification Number or Social Security Number for the proposal to be valid. Should there be a change in ownership or management; the contract shall be canciled unless a mutual agreement is reached with the new owner or manager to continue the contract with its present provisions and prices.

9. Although the cost of service(s) to be provided is an essential part of the Proposal, Walker County is not obligated to award a contract on the sole basis of cost.

10. The Purchasing Agent shall review all proposals that have been submitted and make recommendations to the Commissioner's Court.

1 l. Offerors must furnish ALL information requested and, in the spaces, provided on the proposal invitation form. Further, if specified elsewhere, each offeror must submit cuts, sketches, descriptive literature, and/or complete specifications. Reference to literature submitted previously does not satisfr this provision. Proposals in non-compliance with these requirements will be subject to rejection.

12.Inthe event any Governmental restrictions may be imposed which would necessitate alteration of the material, quality, workmanship or performance of the item offered on this proposal prior to delivery, it shall be the responsibility of the successful offeror to notifu the County Purchasing Office at once, indicating the specific regulation which requires such alterations, including any price adjustments occasioned thereby, or to cancel said contract (See Section W).

13. This agreement shall be governed by the Uniform Commercial Code as adopted in the State of Texas as effective and in force on the date of this agreement.

14. Proposals cannot be altered after due date and time. No proposal may be withdrawn after due date and time without acceptable reason and with the approval of the Purchasing Agent.

15. Proposals must be submitted on this form and the envelope must be clearly marked. Proposals will not be considered if submitted by telephone, fax or any other means of rapid dispatch, nor will a proposal be considered if submitted to any other person or department other than specifically instructed.

16. In the event of a needed change in the specifications sent to the offeror, it is understood that all the foregoing terms shall apply to the addendum or addenda.

17. All delivery and freight charges (FOB Walker County) are to be included in the proposal price.

18. Any interpretations, coffections or changes to this Request for Proposal will be considered for award.

Offerors taking exception to the specifications, or offering substitutions, shall state these exceptions in the section provided or by attaching as part of the proposal. The absence of such a list shall indicate that the offeror has not taken exceptions and Walker County shall hold the offeror responsible to perform in strict accordance with the specifications or the invitation. Walker County Commissioner's Court reserves the right to accept any, all or none of the exception(s)/substitution(s) as the Commissioner's Court deems the best value to the County.

19. Any interpretations, corrections or changes to this Request for Proposal and specifications will be made by addenda. Sole issuing authority of addenda shall be vested in the Walker County Purchasing Department. Addenda will be posted on the Walker County website under Purchasing and will be emailed or faxed to all that are known to have received a copy of this Request for Proposal.

20. At the request of Walker County, offeror must supply, a list of at least three references where like services have been supplied by its firm. References shall include name of firm, address, telephone number and name of representative.

21. Walker County, Texas is exempt from State of Texas Sales Tax and a Tax Exemption Certificate shall be furnished by Walker County, Texas to the successful offeror upon request.

22.The successful offeror shall not deliver products or provide services without a Walker County Purchase Order, signed by an authorized agent of the Walker County Purchasing Department. A purchase order must be issued by the Walker County Purchasing Department prior to work beginning.

Invoices not bearing a purchase order number may be delayed for payment.

23. Funds for payment have been provided through the Walker County budget approved by the Commissioner's Court for this fiscal year only. State of Texas statutes prohibits the obligation and expenditure of public funds beyond the fiscal year for which a budget has been approved. Therefore, anticipated orders or other obligations that may arise past the end of the current Walker County fiscal year shall be subject to budget approval.

A. ETHICS. The offeror shall not offer or accept gifts or anything of value nor enter into any business arrangement with any employee, official or agent of Walker County.

B. CONFLICT OF INTEREST. FINANCIAL INTEREST PROHIBITED. No public official shall have interest in this contract in accordance with Vernon's Texas Codes Annotated, Local Government Code, Title 5, Subtitle C, Chapter 171. Contractor shall ensure (except for eligible administrative or personnel costs) that no person who (i) is an employee, agent, consultant, officer, or elected ofhcial or appointed official of the Contractor or of a subcontractor of Contractor, and (ii) who exercises or has exercised any functions or responsibilities with respect to the activities assisted under this Agreement or is in a position to participate in a decision making process or gain inside information with regard to such activities, may have an interest in or benefit from the activity or have any interest in the Agreement or a subcontract for the Agreement, during the persons tenure with Agreement or a subcontract for the Contractor and for at least one year thereafter. Contractor shall apply the requirements of this subsection to employees, agents, consultants, officers, and elected and appointed official and any subcontractors of Contractor as well as any member of such person's immediate families, their partners, and any organization that employs, or is about to employ any of the above.

contractor shall comply with chapter l7l, Texas Local Govemment code.

*The Contractor shall include the substance of this Section in all subcontracts.

Conflict of Interest Ouestionnaire. (ATTACHMENT C) Effective January l, 2006, Chapter 176 of the Texas Local Government Code requires that any proposer or person conducting business or wishing to conduct business with a county, complete a "Conflict of Interest Questionnaire". By law, this completed questionnaire must be filed with the County Clerk for the County of Walker. The Walker County Clerk's mailing address is: 1100 University Ave., Room #201, Huntsville, TX 77340 A person commits an offense if the person violates Section 176.006, Local Govemment Code. An offence under this section is a Class C misdemeanor. Any questions concerning this form should be addressed to the Texas Ethics Commission;201East 14th St., 10ft Floor; P.O. Box l2070,Austin, Texas, 78711-2070; 1-800-325- 8506; fax 5121463-5777; or web site www.ethics.tx.us.

1295 FORM. (ATTACHMENT D)

*The Texas Legislatwe passed IBl295 in their last legislative session which added section 2252.908 to the Texas Government Code that now requires that a governmental entity receive a Certificate of Interested Parties Texas Ethics Commission Form 1295 before entering into a contract with Walker County. A notice to the appropriate local governmental entity that the following local government officer has become aware of the facts that require the officer to file this statement in accordance with chapter 17 6, Local Government Code.

House Bill89 Verification. (ATTACHMENT E) Pursuant to Section 2270.00I, Texas Government Code

C. INDEMNIFICATION. Successful offeror shall defend, indemnify and save harmless Walker County and all its officers, agents and employees from all suits, actions, or other claims of any character, name and description brought for or on account of any injuries or damages received or sustained by any person, persons, or property on account ofany negligent act or fault ofthe successful offeror, or of any agent, employee, sub-contractor or supplier in the execution of; or performance under, any contract which may result from proposal award. Successful offeror indemnihes and will indemniS and save harmless Walker County from liability, claim or demand on their part, agents, servants, customer, and/or employees whether such liability, claim or demand arise from event or casualty happening upon or within the occupied premises themselves or happening upon or in any of the halls, elevators, entrances, stairways or approaches of or to the facilities within which the occupied premises are located. Successful offeror shall pay any judgment costs, which may be obtained, against Walker County growing out of such injury or damages.

D. TERMINATION FOR DEFAULT. In the event the successful offeror shall fail to perform, keep or observe any of the terms and conditions to be performed, kept or observed, Walker County shall give the successful offeror written notice of such default. And in the event said default is not remedied to the satisfaction and approval of Walker County within two working days of receipt of such notice by the successful offeror, default will be declared and all the successful offeror's rights shall terminate.

Offeror, in submitting this proposal, agrees that Walker County shall not be liable to prosecution for damages in the event that Walker County declares the offeror in default. The performance of work under this order may be terminated in whole, or in part, by the Buyer in accordance with this provision.

Termination of work shall be affected by the delivery to the Seller of a "Notice of Termination" specifuing the extent to which performance of work under the order is terminated and the date upon which such termination becomes effective. Such right of termination is in addition to, and not in lieu of, rights of Buyer set forth. Walker County reserves the right to terminate the contract for default if offeror breaches any of the terms therein, including warranties of offeror or if the offeror becomes insolvent or commits acts of bankruptcy. Such right of termination is in addition to and not in lieu of any other remedies which Walker County may have in law or equity. Default may be construed as, but not limited to, failure to deliver the proper goods andlor services within the proper amount of time, and/or to properly perform any and all services required to Walker County's satisfaction and/or to meet all other obligations and requirements. Walker County may terminate the contract without cause upon thirty (30) days written notice.

E. PAYMENT/INVOICING. An invoice shall be submitted with the following information:

1. Name and address of Service Provider

2. Name and address of receiving Department

3. Walker County Purchase Order number

4. Description of services rendered

Payment shall not be processed until service has been rendered and a completed invoice is received by the Walker County Auditor's Office. All payments will be made by checkNet 30 days from when the correct invoice(s) are received by Walker County. Original invoices can be submitted by Mail to: P.O.Box1260,Huntsville,TXTT32\,handdeliveredtol30lSamHoustonAve,HuntsvilleTexas 2nd floor, Auditor's Office or emailed to payables@co.walker.tx.us. Any invoice, which cannot be verified by the contract price and/or is otherwise incorrect, will be returned to the bidder for correction. Under term contracts, when multiple deliveries and/or services are required, the bidder may invoice following each delivery, day, or job and the County will pay on invoice. Prior to any and all payments made for good andl/or services provided under this contract, the bidder should provide his Taxpayer Identification Number or social security number as applicable (W9). This information must be on file with the Walker County Auditor's office. Failure to provide this information may result in a delay in payment and/or back-up withholding as required by the Intemal Revenue Services.

Should your remittance addresses change during this contract, it will be up to the offeror to notiff the auditor's office of this change at payables@co.walker.tx.us. Invoice may be emailed to the County Auditor at the web address provided above. Or when email is not available, invoice may be mailed to County Auditor Office at P.O. Box 1260, Huntsville, TX77342

F. TERM OF CONTRACT. The initial term of this contract shall be for work performed for the fiscal year September l, 2024 tfuotgh September 30, 2025. Walker County reserves the right to extend this contract through written mutual consent of both parties at the same terms, conditions and prices as stated in the Request for Proposal at one-year intervals not to exceed four consecutive extensions.

The term of this contract shall be for work performed for the period of September 1,2024 through September 30,2025.

Renewal contract periods for the following fiscal years:

October 1,2025 through September 30,2026.

October I,2026 through September 30,2027.

October 1,2027 through September 30,2028.

October I,2028 through September 30,2029.

G. REDUCTION IN PRICE. If during the life of the contract, the successful offeror's net prices to other customers for items awarded herein are reduced below the contracted price, it is understood and agreed that the benefits of such reduction shall be extended to Walker County.

H. PLACE OF DELIVERY. The place of delivery shall be that set forth on the purchase order.

I. DELIVERY TERMS. Proposal must show number of days required to place material in receiving agency's designated location under normal conditions. Unrealistically short or long delivery promises may cause proposal to be disregarded. Consistent failure to meet delivery promises without valid reason may cause removal from offeror list. An accurate delivery date must be quoted on the "Proposal Form". When there are various items, a delivery date must be included with each item quoted. Freight and shipping charges to Walker County must be included in the proposal price. Final location will be supplied to the Service Provider on award of proposal, F.O.B. destination. Delivery locations will be:

Various County locations. Delivery days after receipt of order (ARO).