Q_A Document 1 (38).pdf
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- Attached to
- Emergency Medical Services Billing
- Solicitation number
- PE-64800-NONST-2026-000000054
- Issued by
- Douglas County, Georgia
About this file
This document is a Questions & Answers file for Solicitation 25-019 for Emergency Medical Services Billing and Collection, issued by Douglas County. The solicitation seeks a vendor to provide comprehensive EMS billing and collection services, with a proposal closing date of September 10, 2025 at 2 PM and an anticipated contract start date of January 1, 2026. The contract award is expected 60-90 days after evaluation completion by the Board of Commissioners. The current vendor will likely work out existing accounts receivable during the transition, and a bid bond of 5% is required with the proposal submission.
The financial details reveal that Douglas County's current EMS services generate approximately $9,027,588 in gross charges annually, with $4,127,068 in total adjustments and $2,612,158 sent to collections in 2024. The current fee schedule includes rates for various service levels, such as A0429 at $767.00, A0427 at $929.00, and A0433 at $1,152.00, with mileage charged at $13.20. The county is seeking a new billing vendor due to declining collection rates and coding issues, and is proposing a 30% fee increase starting September 1, 2025. The average transport is 6-7 miles, with an average revenue of $342.02 per call, and patients are primarily transported to Wellstar Douglas Hospital (60%), Wellstar Cobb Hospital (20%), and other facilities.
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Questions & Answers - 1
Solicitation 25-019 - EMERGENCY MEDICAL SERVICES BILLING AND COLLECTION
Buying Organization Douglas County
No Question/Answer Question Date
Q1 Question: County Lockbox for Payments
Does the County receive payments at a lockbox?
Answer: We do not currently use a lockbox.
08/11/2025
Q2 Question: Notice of Privacy Practices
How do you provide patients with a Notice of Privacy Practices currently?
Answer: It is received and signed for when they sign their patient care report.
08/11/2025
Q3 Question: Fees by Level of Service
Can you provide the fees charged for each level of service and mileage?
Answer: A0429 - 767.00
A0427 - 929.00
A0433 - 1,152.00
A0425 - 13.20
08/11/2025
Q4 Question: Average Loaded Mileage
What is your average loaded mileage?
Answer: 6-7 miles is average loaded miles
08/11/2025
Q5 Question: Revenue by Payor Category
Can you please provide your gross and net revenue by payor category?
Answer: See attachment provided
08/11/2025
Q6 Question: Existing AR
Will you have your current vendor work out open AR when the new contract begins (highly recommended)?
Answer: Open to discussion but more than likely, yes.
08/11/2025
Q7 Question: Net Gain Marketing Questions
How are fees currently being billed by any incumbent(s), by category, and at what rates?
Answer: A0429 - 767.00
A0427 - 929.00
A0433 - 1,152.00
A0425 - 13.20
Two invoices sent before sending to collections
08/12/2025
Q8 Question: Net Gain Marketing Questions
What estimated or actual dollars were paid last year, last month, or last quarter to any incumbent(s)?
Answer: YTD = 124,000 paid to current incumbent.
08/12/2025
No Question/Answer Question Date
Q9 Question: Net Gain Marketing Questions
What were your annual gross charges last year or for the last 12 months?
Answer: $9,027,588.24 were gross charges for 2024
08/12/2025
Q10 Question: Net Gain Marketing Questions
What were your annual total adjustments for last year or for the last 12 months?
Answer: $4,127,068.95 was our adjusted charges for 2024
08/12/2025
Q11 Question: Net Gain Marketing Questions
What were your annual contractual allowance write offs for last year or for the last 12 months?
Answer: ($2,137,750.56) were our adjusted charges for 2024.
08/12/2025
Q12 Question: Net Gain Marketing Questions
What were your annual gross collections last year or for the last 12 months?
Answer: We have a third party that handles our collections. (I'm not sure if this is what you are referring too). $2,612,158.26 were sent to collections in 2024.
08/12/2025
Q13 Question: Net Gain Marketing Questions
What are your per-mile ground transport charges?
Answer: A0425 - 13.20
08/12/2025
Q14 Question: Net Gain Marketing Questions
What are your advanced life support charges?
Answer: A0429 - 767.00
A0427 - 929.00
A0433 - 1,152.00
A0425 - 13.20
08/12/2025
Q15 Question: Net Gain Marketing Questions
What are your advanced life support emergency level 1 charges?
Answer: A0429 - 767.00
A0427 - 929.00
A0433 - 1,152.00
A0425 - 13.20
08/12/2025
Q16 Question: Net Gain Marketing Questions
What are your advanced life support emergency level 2 charges?
Answer: A0429 - 767.00
A0427 - 929.00
A0433 - 1,152.00
A0425 - 13.20
Q17 Question: Net Gain Marketing Questions
What are your basic life support charges?
Answer: A0429 - 767.00
A0427 - 929.00
A0433 - 1,152.00
A0425 - 13.20
08/12/2025
Q18 Question: Net Gain Marketing Questions
What are your basic life support emergency charges?
Answer: A0429 - 767.00
A0427 - 929.00
A0433 - 1,152.00
A0425 - 13.20
08/12/2025
Q19 Question: Net Gain Marketing Questions
What are your specialty care transport charges?
Answer: A0429 - 767.00
A0427 - 929.00
A0433 - 1,152.00
A0425 - 13.20
This is our fee schedule.
08/12/2025
Q20 Question: Net Gain Marketing Questions
What are your treatment without transport charges?
Answer: No fee for treat and release at present.
08/12/2025
Q21 Question: Net Gain Marketing Questions
What is your average per-trip charge?
Answer: $774.83 is average charge per transport
08/12/2025
Q22 Question: Net Gain Marketing Questions
When were the last changes to your transport rates, and are you considering raising any of the rates currently charged?
Answer: Rates were last changed July 2024. We are requesting a 30% increase to the fee schedule and this is being presented to the BOC mid August 2025
08/12/2025
Q23 Question: Net Gain Marketing Questions
Are there any other charges you assess not otherwise covered by our questions?
Answer: No. Our fee schedule has been attached in a previous question.
Q24 Question: Net Gain Marketing Questions
What percentage of your patients are residents versus non-residents, and do you charge the two groups differently?
Answer: We do not track or trend this data and charges are not accessed differently.
08/12/2025
Q25 Question: Net Gain Marketing Questions
Do you operate any shared services agreements with any other municipal or county governments in the region and, if so, with whom?
Answer: We have a service delivery agreement with the City of Douglasville. This was updated last year. (Douglas County provides EMS services to the city)
08/12/2025
Q26 Question: Net Gain Marketing Questions
What were your transports per year for advanced life support for last year or for the last 12 months?
Answer: 6,015.00A0427 - Advanced Life Support Emergent
5,508.00A0429 - Basic Life Support Emergent
127A0433 - ALS LVL2
1A0434 - SPECIALTY CARE TSPT
08/12/2025
Q27 Question: Net Gain Marketing Questions
What were your transports per year for advanced life support emergency level 1 for last year or for the last 12 months?
Answer: 6,015.00A0427 - Advanced Life Support Emergent
5,508.00A0429 - Basic Life Support Emergent
127A0433 - ALS LVL2
1A0434 - SPECIALTY CARE TSPT
08/12/2025
Q28 Question: Net Gain Marketing Questions
What were your transports per year for advanced life support emergency level 2 for last year or for the last 12 months?
Answer: 6,015.00A0427 - Advanced Life Support Emergent
5,508.00A0429 - Basic Life Support Emergent
127A0433 - ALS LVL2
1A0434 - SPECIALTY CARE TSPT
08/12/2025
Q29 Question: Net Gain Marketing Questions
What were your transports per year for basic life support for last year or for the last 12 months?
Answer: 6,015.00A0427 - Advanced Life Support Emergent
5,508.00A0429 - Basic Life Support Emergent
127A0433 - ALS LVL2
1A0434 - SPECIALTY CARE TSPT
Q30 Question: Net Gain Marketing Questions
What were your transports per year for basic life support emergency for last year or for the last 12 months?
Answer: 6,015.00A0427 - Advanced Life Support Emergent
5,508.00A0429 - Basic Life Support Emergent
127A0433 - ALS LVL2
1A0434 - SPECIALTY CARE TSPT
08/12/2025
Q31 Question: Net Gain Marketing Questions
What were your transports per year for specialty care transport for last year or for the last 12 months?
Answer: 6,015.00A0427 - Advanced Life Support Emergent
5,508.00A0429 - Basic Life Support Emergent
127A0433 - ALS LVL2
1A0434 - SPECIALTY CARE TSPT
08/12/2025
Q32 Question: Net Gain Marketing Questions
What were your transports per year for treatment without transport for last year or for the last 12 months?
Answer: We currently do not charge for tx without transport.
08/12/2025
Q33 Question: Net Gain Marketing Questions
What is your payer remit mix expressed as percentages of 100% of what you typically receive?
Answer: See attachment provided
08/12/2025
Q34 Question: Net Gain Marketing Questions
What is your average loaded miles per trip?
Answer: 6-7 miles for 2024
08/12/2025
Q35 Question: Net Gain Marketing Questions
What is your average revenue per call?
Answer: 342.02 was the average revenue per call in 2024.
08/12/2025
Q36 Question: Net Gain Marketing Questions
Do you have a lockbox provider and, if so, which provider?
Answer: No.. we do not have a lockbox provider.
08/12/2025
Q37 Question: Net Gain Marketing Questions
If you have a lockbox provider, will that provider remain in place as a result of this procurement?
Answer: We do not currently use a lockbox
08/12/2025
Q38 Question: Net Gain Marketing Questions
Do you have an EPCR provider and, if so, which provider?
Answer: We use ImageTrend and will remain with them for our documentation
Q39 Question: Net Gain Marketing Questions
Do you have a collection agency provider and, if so, which provider?
Answer: Yes, Creditors Bureau Associates
112 Ward St
Macon, GA 31204
08/12/2025
Q40 Question: Net Gain Marketing Questions
Which local hospitals or care facilities typically receive most of your patients?
Answer: Wellstar Douglas Hospital - approx 60%
Wellstar Cobb Hospital - approx 20%
Tanner Villa Rica - approx 10%
Specialty receiving facilities - approx 10%
08/12/2025
Q41 Question: Net Gain Marketing Questions
Please reconfirm the due date for this procurement by providing it in response to answers to questions.
Answer: The proposal closing date is 09-10-2025 at 2pm.
08/12/2025
Q42 Question: Net Gain Marketing Questions
When is the anticipated contract start date?
Answer: January 1, 2026 is anticipated change over date.
08/12/2025
Q43 Question: Net Gain Marketing Questions
When is the anticipated award date?
Answer: 60-90 days after the evaluation is completed and Board of Commissioners has awarded a vendor
08/12/2025
Q44 Question: Net Gain Marketing Questions
Can you please provide greater details regarding your bid bond and/or performance bond requirements related to this contract? For example, what is required with the proposal, and what is required to comply during the term of the contract?
Answer: Bid bond is five percent (5%) from an approved surety and is due with the submission of the
RFP. Performance bond is only to be provided by the awarded contractor and should remain active for the duration of the contract.
08/12/2025
Q45 Question: Net Gain Marketing Questions
Are bidders permitted to deviate in any way from any manner of quoting fees you may be expecting?
For example, if there is a pricing page in the RFP, can bidders submit an alternate fee structure? If there is no pricing page in the RFP, do you have any preference for how bidders should quote fees or can bidders create their own pricing categories?
Answer: A cost worksheet is attached and provided with the submittal. However, alternates are accepted however, they must be labeled as "Alternate Cost."
Q46 Question: Net Gain Marketing Questions
Please describe your level of satisfaction with your current or recent vendor(s) for the same purchasing activity, if applicable.
Answer: We have been satisfied. However, with a new client representative earlier this year, we have noticed our collection rates decline as well as our percentages for BLS vs ALS coding compared to
2024. We need a solution that is engaged with their clients, proactive,and that can enhance the collection for fees from services provided.
08/12/2025
Q47 Question: Merchant Account
1.Does your agency currently have a merchant account established with a credit card processing solution?
a.If so, please provide the name of the solution.
b.Will your agency pay for associated credit card processing fees?
Answer: This is currently handled by the billing company.
08/18/2025
Q48 Question: Bank Lockbox
2.Does your agency utilize a bank lockbox for receipt and deposit of payments?
a.If so, will the billing vendor have online access?
b.Will the billing vendor be required to pay the lockbox fee, or will the cost be covered by the agency?
c.If you require the billing vendor to pay, can you provide the current cost of the lockbox?
Answer: We do not utilize a lockbox.
08/18/2025
Q49 Question: Notice of Privacy Practice
Will the billing vendor be required to mail Notice of Privacy Practices to transported patients?
Answer: Yes, we would prefer this to continue
08/18/2025
Q50 Question: Current Rates
4.Please provide your current rates for each of the following service levels:
a.Mileage b.ALS Emergency c.ALS Non-Emergency d.BLS Emergency e.BLS Non-Emergency f.ALS 2 g.Specialty Care Transport h.Paramedic Intercept i.Treatment No Transport j.Lift Assists k.Any other billable dispositions broken out by each disposition
Answer: A0429 - 767.00
A0427 - 929.00
A0433 - 1,152.00
A0425 - 13.20
This is our fee schedule. We are requesting to increase our fees by 30% starting 9/1/2025.
08/18/2025
Q51 Question: Loaded Mileage
What is your average loaded mileage?
Answer: 6-7 is our average loaded mile
08/18/2025
Q52 Question: Customization
On page 17, Section 2. Invoicing, (k). Can you please confirm our understanding that the vendor shall have the ability to customize the County’s profile settings as it relates to items such as the number of statements being sent to patients, statement language, timing with which accounts will be sent to collections, etc?
Answer: This will be a collective effort on both parties to discuss and agree upon.
08/18/2025
Q53 Question: Offshoring
The current RFP includes a requirement prohibiting the use of offshore resources. Many public sector and healthcare organizations nationwide successfully utilize international partners for certain administrative functions, provided they meet rigorous compliance standards (e.g., HIPAA, SOC II, HITRUST) and remain under direct oversight of U.S.-based staff.
Would the County consider allowing the use of offshore resources under a model that ensures:
- All compliance and security requirements are fully met;
- U.S.-based staff maintain oversight and accountability; and
- Offshore resources are limited to defined, repetitive tasks that support efficiency and timely processing?
This flexibility could help accelerate processing times and reduce the risk of delays, while maintaining the same level of compliance and service quality.
Answer: Please submit the RFP as instructed and feel free to offer an alternate solution. If an alternate is provided along with the original, make sure the alternate is properly labeled and follows the same instructions.
08/22/2025
Questions & Answers - 1
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