City of Mesquite
RFP- #FD-2020-01
[Publisher’s note: Formatting changes are a result of publication requirements and do not reflect any changes in the requirements of this RFP issued by the City of Mesquite. For questions please contact Jayson Andrus, Fire Chief, Mesquite Fire & Rescue]
Your participation is invited with regard to the above-referenced proposal. In order for your submission to be considered responsive this original document as well as one (1) original and three (3) copies of your proposal must be delivered prior to the time and at the place indicated herein. The City of Mesquite assumes no liability for proposals mistakenly opened due to improperly labeled envelopes and will return the same to the proposer without notice. It is strongly suggested that documents sent via carriers other than first-class mail should be placed in properly labeled and sealed envelopes prior to being placed in the carrier packaging in order to avoid premature opening.
DESCRIPTION OF PROCUREMENT PROCESS
Request for Proposal, the City of Mesquite is requesting proposals from qualified Firms to provide ambulance billing, collection (from ambulance transport clients and/or their insurance carriers), financial reporting, and analytical services. This includes complete management of the billing process from patient transport to account closure. It is the intent of Mesquite City to enter into a multiyear 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 firms interested in providing such services. Firms shall carefully examine the entire RFP and any addenda thereto, and all related materials and data referenced in performing the service. Firms are advised to read all sections of this RFP before submitting a proposal
Timetable
Application Period: | July 1 – July 31, 2020 |
RFP Due Date: | July 31, 2020 at 5:00 PM |
Anticipated Award Date: | August 25, 2020 |
Anticipated Service Start Date: | October 1, 2020 |
Interpretations and Clarifications
Requests for information or clarification of this RFP must be made in writing and addressed to Sonja Robinson at the address, phone, or e-mail address listed below, with e-mail being the preferred method of communication. Please reference the RFP page and topic.
City of Mesquite
ATTN: Sonja Robinson
10 E Mesquite Blvd
Mesquite, NV 89027
Phone: 702-346-2690 ext 5000
E-Mail: srobinson@mesquitenv.gov
The answers to questions submitted will be available to all vendors, upon the vendor’s request, via e-mail.
- Submission of Proposal: One (1) original and three (3) copies of the Proposal
(see Proposal Requirements beginning on page 11) must be submitted by July 31, 2020, at 5:00 p.m. to:
City of Mesquite
Attn: Sonja Robinson 10 E Mesquite Blvd
Mesquite, NV 89027
Proposals should be clearly marked “AMBULANCE BILLING SERVICE FOR MESQUITE FIRE RESCUE RFP No. FD-2020-01 ”.
When received, all proposals and supporting materials, as well as correspondence relating to the RFP, shall become the property of the City of Mesquite. In submitting a proposal, it is understood by the vendor that the City of Mesquite reserves the right to accept any proposal, to reject any and all proposals as non-responsive and to waive any irregularities or informalities in proposals when to do so is in the best interest of the City. Any proposal may be withdrawn or modified by a written request of the vendor, provided such request is received by the City at the designated address prior to the date and time set for receipt of proposals. If a proposal includes any proprietary data or information, such data or information must be specifically identified as such on every page on which it is found. The City will endeavor to keep data or information so identified confidential and will be used by City personnel solely for the purposes of evaluating proposals and conducting contract negotiations. The cost of preparing a response to the RFP will not be reimbursed by Mesquite City. After the RFP issue date, all communications between the Issuing Department and prospective Proposers shall be in writing or email, questions will be accepted. Any inquiries, requests for information, technical questions, clarifications, or additional information shall be directed to Sonja Robinson at the address or email on page two of this RFP. All questions concerning this RFP shall reference the RFP number, section number, and paragraph (emailed questions shall also reference RFP number, section number, and paragraph in the subject line). Questions and responses affecting the scope of the proposal will be provided to all prospective Proposers by the issuance of an Addendum.
CITY OF MESQUITE —FIRE RESCUE DEPARTMENT
II. INTRODUCTION AND BACKGROUND
The City of Mesquite operates an EMS ambulance service that utilizes six (6) Advanced Life Support (ALS) transport units and one (1) IFT transport vehicle for the sole purpose of providing interfacility transports from the local hospital to medical facilities located in the surrounding areas.The City documents patient care through the use of E-PCR software by HealthEMS. Patient care reports are submitted electronically to the EMS department. After daily review of each submitted patient care report (PCR), the EMS department marks each chart with bill or do not bill. The charts marked bill are electronically sent to the contracted billing agency.
A. Terms
The City of Mesquite assumes no contractual obligation as a result of the issuance of this RFP, the preparation or submission of a proposal by a vendor, the evaluation of an accepted proposal, or the selection of a finalist. The City is not bound until both parties execute a written contract for the performance of the outlined work. The City intends to enter into an agreement for a period of a minimum of three (3) years, with annual renewals, if agreed upon by both parties. Either party shall have the option after one (1) year to terminate the agreement upon ninety (90) days written notification. All conditions associated with the services related to herein shall remain in effect
B. Proposal Costs
All costs incurred by the Firm in preparing the proposal or costs incurred in any other manner in responding to this proposal shall be solely the responsibility of the Firm. All materials and documents submitted by the Firm in response to this RFP shall become the property of The City of Mesquite and will not be returned.
III. SCOPE OF SERVICES
This section outlines the minimum contract requirements for ambulance billing, collection, financial reporting, and analytical services. The City desires to pursue a partnership to build an optimal revenue cycle. The minimal requirements are listed here, however, the City is open to alternatives to meet the requirements that may or may not be described below.
A. Billing
The Firm will commence billing the patient care reports with the start-up date established by the firm and the City. The Firm shall assign and identify a dedicated biller(s) to The City of Mesquite’s EMS account. The firm shall assign an account manager as the central point of contact for all agency billing issues/questions. The Firm and all billers dedicated to the City’s EMS account shall maintain certification through the National Academy of Ambulance Coders (NAAC).
The firm shall be able to prepare invoices according to:
- The rates established by the City of Mesquite.
- Guidelines and procedures established by the firm and the City.
- All applicable laws and regulation including those from Medicare and Medicaid Services (CMS)
- All applicable policies and procedures of major private insurers.
- All invoices must be able to be associated with all corresponding documentation, including but not limited to: physician certification statements, medical necessity documentation, signature forms, hospital face sheets, and any other pertinent documentation relating to billing and collections components.
The firm shall also bill all non-emergency transports according to all applicable laws established by Medicare, Medicaid and other applicable agencies.
All invoices shall also be billed in compliance with the Fair Debt Collection Practices Act.
Electronic filing is the required method of filing primary Medicare and Medicaid claims. Electronic filing is the preferred method of filing to all other guarantors, if applicable. Otherwise, paper invoices may be issued directly to appropriate patient guarantors.
The firm shall pre-screen all claims to confirm compliance with guarantors’ guidelines. (i.e. physician certification statements, assignment of benefit signature forms, medical necessity documentation)
The firm shall verify insurance eligibility utilizing available resources and commercial databases to include hospital face sheets, prior to the submission of any patient claim for reimbursement.
The firm shall make a good-faith attempt to call each patient when verification of insurance eligibility cannot be obtained by any other manner to ensure accurate guarantor responsibility information.
The expectation of the City is that the initial invoices will be processed within three (3) days of the electronic posting of the billing file on the Firm’s secure server, according to the agreed-upon process for various claim types.
HealthEMS is the current ePCR software utilized by the City. The billing software of the firm must be compatible with Health EMS. The interface between HealthEMS and the billing firm is the sole responsibility of the firm.
B. Collections
The Firm shall process all claims according to timelines agreed upon between the City and the
Firm. The claims shall be divided into multiple revenue categories: Medicare, Medicaid, Medicare HMO, Blue Cross and Blue Shield, Attorney Payments, Auto Insurance, Commercial Insurance, Worker Compensation, Nursing Homes, Veteran Administration, and private pay.
Claims shall be appropriately re-categorized after receiving payment from the primary guarantor.
All denials shall be processed according to the timeline defined by the Firm and the City.
Customer service shall be provided from 8:00 a.m. until 5:00 p.m. PST using a firm supplied phone number. A toll-free number for out-of-area or out-of-state customers shall be provided. The telephone systems utilized by the Firm must be able to accept voicemail messages and route incoming calls to the appropriate persons. The Firm must make a good faith effort to make return contact to all customers within 16 business hours after initial contact from any customer has been received. The Firm will treat all debtors fairly with professionalism, honesty, courtesy and integrity while obtaining the maximum results. The City will be the final arbitrator of disputes between the successful firm and customers. The City’s decision shall be final.
All funds collected by the firm must be deposited daily to a bank account designated by the City. A report of funds deposited shall be electronically submitted to the City on the date of posting to the designated bank account. The Firm shall ensure that all deposited funds have been posted to the correct collection account prior to deposit.
The Firm must remit to the City all funds collected. Fees charged by the firm for billing and collections services will be based upon net cash collections. Refunds shall be processed by the Firm and submitted to the City with supporting documentation for final authorization by the City. The City regards “net cash collections” as total funds collected less refunds issued as a result of overpayments or erroneous payments.
An active Quality Assurance and Internal Auditing Controls program for detecting, correcting and avoiding process errors shall be maintained. It shall be the Firm’s responsibility to ensure that all collection activity conforms with the requirements of the City and all applicable laws or regulations.
The selected firm must have the capability to continue to manage accounts that are sent to a third-party collection agency. Currently, accounts are billed for three (30 day) cycles by the billing vendor. Accounts that have had no activity are then sent to the collections agency for a period of nine months. Accounts that continue to have no activity are returned to the Firm and then sent to Premier Recovery to remain until paid in full. The billing firm is expected to manage these accounts throughout the entire process.
C. Accounting and Reporting
Accounting for all billing pursuant to Generally Accepted Accounting Principles shall be provided on a daily, monthly, quarterly and annual basis, or as requested by the City. This shall include monthly auditing by the Firm to ensure the accuracy of bills. Such reports and all supporting documentation shall be available via web or cloud-based reporting to the City within ten (10) business days after the end of the month. The City shall have access to web-based reporting and accounting review. Detailed below are reports required by the City to monitor the billing and collections process. The list is not all-inclusive. The reports noted below must be available via a web interface to the appointed City’s EMS billing and collections contact by the time period specified. Failure to provide the requested reports in a timely fashion shall be grounds for termination of the agreement. Reports should be available via a web interface or submitted via a secure email. Reports should be provided in MS Excel and/or as a PDF document as required or when requested.
Additional reports may be requested on an “as needed” basis. Any report may require modification periodically on specific issues or other needs that might arise. Any report modification shall be the responsibility of the Firm.
The Firm must provide assistance regarding monthly audits related to the City’s EMS billing or collections activity, including any reports, statements, or explanations, at no additional charge.
The Firm must provide assistance regarding the reports related to the Ground Emergency Medical Transportation (GEMT) program.
Other reports relating to the accounting and reporting of the billing and collections component of the City’s EMS Operations may be requested or required by the City.
Daily Reports shall include, at a minimum, the following:
- A revenue report showing all activity occurring on the City’s account for the day. At a minimum, the report shall detail:
- revenue received from all billing and collection activities.
- any adjustments to the account.
- any releases or refunds to be debited from the account.
Weekly Reports shall include, at minimum, the following:
- A revenue report showing all transports billed. At a minimum, the report shall include the date of transport or service, the incident number, the patient name, origin, destination, procedure code and gross charges.
- A report showing transports that cannot be billed including the reason the transport cannot be billed.
- A report showing the number and amount of claims filed to Medicare and Medicaid, including the confirmation information from Medicare or Medicaid acknowledging receipt of the claim.
- A reconciliation report showing the amount of cash receipts posted and how the amount ties to each bank deposit. The report shall include an explanation of any cash that is unable to be posted and shall include the reason.
Monthly Reports shall include, at minimum, the following:
- A revenue report showing all transports billed. At a minimum, the report shall include the date of service, incident number, patient name, origin, destination, procedure code and gross charges.
- An outstanding aged accounts receivable report sorted by payer including a total outstanding aged report. The report should show four (4) categories of outstanding accounts: 30, 60, 90 and more than 120 days outstanding. The report shall also show the last date of activity on the account. The report shall break down the categories into the current financial class of the account (where the next dollar payment is expected from).
- A monthly listing of all refund requests processed for the month.
- Reports of all accounts returned to the City deemed “uncollectable.” The Billing Agency shall maintain responsibility in pursuing “uncollectible” accounts utilizing Debt Set Off, Garnishment of Wages or the decision to place an account with a contracted Collections Agency.
- Report of all account denials sorted by payer and then by type of denial.
- Report of all claims denied by Medicare and Medicaid.
- Report of any and all disclosures or releases of data or information and the reason therefore.
- Report of all claims “written off” during the month. Any write-off shall be authorized by the City prior to removing any outstanding balance. The City may elect to set a monetary threshold of accounts that may be written off without advanced approval.
- Any report deemed required on an “as needed” basis, that would be useful to the City in monitoring and evaluating the City’s ambulance service and/or accounts receivable process.
The City or its representatives reserves the right to audit the records of the Firm related to the City’s billing and collection efforts. The Firm shall make and keep full and complete records and books of accounts or revenue and income, costs and expenses that specifically relate to performance under this contract. Records and books of accounts, together with any of all other memoranda pertaining thereto that may be kept, maintained or possessed by the Firm, shall be open to examination during regular business hours by the City or its representatives for the purpose of inspection, auditing, verifying, or copying the same or making extracts there from. The Firm shall make and keep said records and books of account in accordance with generally accepted accounting principles.
The Firm shall provide to the City manuals outlining the policies and procedures established to facilitate the processing of the billing and collection component, including reporting procedures, between the parties upon award and successful completion of a contract. Such manuals shall be considered part of the contract and failure to follow the policies and procedures contained therein shall be grounds for termination of the contract.
D. Analytical Services
The Firm 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 Firm shall provide other analytical services as requested or required by the City or its representatives.
The Firm shall schedule monthly meetings with the City to review performance. Also, at a minimum, a written report reviewing the performance of the accounts 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 City.
The Firm will provide a Quality of Care survey, at least annually, which meets or exceeds the City’s requirements. The Firm must also be able to provide revenue projections based on previous collections, as determined by the amount the Firm expects to collect per trip.
E. Technology Requirements
The Firm shall provide all necessary software associated with the billing and collections.
The Firm shall provide Web-based or Cloud-based reporting services and administrative access to the City’s account.
The Firm shall provide a system that will ensure a complete and uninterrupted flow of service via back-up systems and a data recovery project plan/system should a disaster occur. Upon awarding of the bid, the Firm shall provide a copy of a written plan for review by the City’s Information Technology Division.
Records shall be retained according to an agreed upon record retention plan.
The Firm will be expected to enter into the County’s standard “Business Associate” agreement under HIPAA and HITECH rules. In the event that the Firm experiences a violation of the Security or Privacy Rule (as described in 42 CFR 160 and 164, as amended), the Firm will be responsible for any required notifications or corrective measures.
F. Training of EMS Personnel
The Firm shall provide, at no additional cost, in-depth documentation compliance training of the complex Medicare and Medicaid regulations as they relate to the pre-hospital delivery of emergency medical care. Additionally, training shall be provided to EMS Personnel that are responsible for the delivery of non-emergency convalescent transports to include in-depth training on all supporting documentation to meet the strict medical necessity requirements of CMS. The training shall include all necessary visual training aids and handout materials that personnel may reference at the conclusion of any training session.
The Firm shall provide, at a minimum, an initial training of the City’s EMS personnel two (2)
Compliance and Documentation sessions. The first training session shall be at least two (2)
weeks prior to the firm commencing billing and collections on behalf of The City. The second, supplemental training session shall be provided within one month after the completion of the first quarter. A training session shall be provided to each of the three shifts of the City EMS Operations for a total of six (6) training sessions. Training sessions shall be provided at a time and place designated by the City.
Supplemental training shall be provided every two years to each of the three shifts of the City’s EMS Operations for a total of three (3) training sessions and shall include changes of CMS rules and regulations as they relate to the delivery of EMS. The Firm shall provide the City with an in-depth analysis identifying any deficiencies in documentation guidelines or CMS regulations. This supplemental training shall include a strategy to resolve any deficiencies. The EMS Billing Liaison will work with the billing firm to train new employees that are hired between training.
The Firm shall provide any additional training as requested by the City and may include training sessions for any group or individual, at no additional cost to the County.
IV. PROPOSAL REQUIREMENTS
All respondents are required to provide the information cited below, as well as any supplemental information that the respondent feels will provide a comprehensive view of the Firm, the proposed design team and your approach to this project. However, information should be presented in a clear and concise manner.
- Pages 1-22 of the Request for Proposal, completing all applicable pages.
- A one-page statement of interest and qualifications for this proposal including the firm names, address, and telephone number. The respondent shall include the name, title, address and telephone and fax numbers, and e-mail addresses of each contact person for the duration of the proposal evaluation.
- A brief (3-page maximum) proposal summary that describes the Firm’s understanding of the RFP and how it intends to meet the stated requirements. The respondent shall include any concerns regarding scheduling, concept or expectations.
- Discussion of your Firm’s specific abilities and expertise to provide the required professional services and qualifications related to the proposal requirements.
- A brief historical overview of the billing firm to include any recent upper management changes.
- Provide some detail of the billing system and billing processes utilized as well as theidentity of the software utilized and whether it is third-party or proprietary.
- Provide sample customer invoices and sample Daily, Weekly, and Monthly reports as described above. In addition, provide sample policies and procedures which may be established to facilitate the processing and billing component of this Request for Proposal.
- Provide a description of your Firm’s customer service operation and capability to perform the required professional services.
- Provide a description of your Firm’s active Quality Assurance and Internal Auditing
Controls which will allow your Firm to perform the required professional services
- Key personnel proposed as project team members, including the identities and qualifications of the billers dedicated to the City of Mesquite’s EMS account.
- References of at least three (3) clients for which your firm has provided similar professional services in the last three (3) years. Please include current contact information (name, address, telephone and e-mail address) for each reference.
- List of all current government clients and the collection rate per trip (amount collected divided by trips billed) for the fiscal year ending June 30, 2019. Also include the year in which the Firm began working for the client.
- Describe and discuss the firm’s compliance program and how the program meets or exceeds the requirements of CMS and HIPAA.
- Describe any services provided by the firm that is not covered by the RFP, but would assist the City of Mesquite in enhancing its cash collections.
- Provide a list detailing any and all variances to the scope of work detailed in this RFP.
- Provide a copy of a completed SAS 70 Type I or Type II audit completed within the last twelve (12) months. If your firm does not have a SAS Type I or Type II audit, state why.
- Provide a projection of the average dollar amount collected per trip billed, with an explanation of how this amount will be realized.
If the Firm proposes to address a requirement in a manner different from the RFP specifications, the Firm shall provide an explanation of how that requirement will be met and demonstrate that the alternative is equal to or preferable to the requirement in the RFP.
Before submitting a proposal, each Firm is required to make a careful study of these specifications, and fully assure itself of the quality of the service required. The consistent quality of the service provided is of profound importance to the City of Mesquite’s on-going commitment to achieve fiscal objectives and maintain superior levels of customer service and satisfaction.
The cost proposal shall be submitted using the Quote Form – Page 23 of this document.
The proposal shall be complete and require no further explanation.
No contract will be awarded except to responsible organizations capable of providing the services outlined and achieving the identified expected results. Before the award of the contract, the Firm may be required to demonstrate any and/or all aspects of the Scope of Services.
V. GENERAL CONTRACT REQUIREMENTS
This section will outline the minimum contract requirements for billing, collection, financial reporting, analytical services, and insurance coverage and liability. the City of Mesquite desires to pursue a partnership to build an optimum revenue stream.
A. Billing:
- The Firm will receive on a daily basis the electronic billing data and other related billing information by way of an encrypted FTP file or batch filing process. The Firm will be responsible for providing Stryker Health EMS software that must be compatible to interface with the Firm’s software system.
Does your bid comply with this requirement? Yes _____ No _____
- The Firm will prepare invoices according to the rates, guidelines, and procedures established by the City of Mesquite as well as meet all applicable laws and regulations including those for Medicare and Medicaid.
Does your bid comply with this requirement? Yes _____ No _____
- The Firm will be responsible for reviewing each Patient Contact Report (PCR) for content and accuracy for billing purposes. The Firm will be responsible for contacting the designated City of Mesquite EMS employee to correct any discrepancies.
Does your bid comply with this requirement? Yes _____ No _____
- The Firm will be responsible for the initial collection of payments, generation of multiple collections attempts defined by the City of Mesquite and generation of any and all insurance forms as well as filing and record maintenance.
Does your bid comply with this requirement? Yes _____ No _____
- The firm must be able to manage the billing process as set forward by the City of
Mesquite. This includes sending delinquent accounts to a third party collections agency.
Does your bid comply with this requirement? Yes _____ No _____
- Records and histories for services processed by the Firm shall be available and accessible by authorized the City of Mesquite Staff.
Does your bid comply with this requirement? Yes _____ No _____
- The Firm must have access to and will utilize all available resources and databases to obtain proper billing information on all serviced clients.
Does your bid comply with this requirement? Yes _____ No _____
- All client complaints concerning service rendered will be referred to the designated individual within the City of Mesquite.
Does your bid comply with this requirement? Yes _____ No _____
- All funds will be posted to the correct client account before the funds are deposited with the City of Mesquite.
Does your bid comply with this requirement? Yes _____ No _____ B. Collections:
- Process all claims according to timelines defined by the City of Mesquite and the Firm.
Does your bid comply with this requirement? Yes _____ No _____
- Re-categorize claims appropriately after receiving payment from the primary payer, and initiate any required secondary claims submission.
Does your bid comply with this requirement? Yes _____ No _____
- Act as the advocate for the client with Medicare, Medicaid and private insurance in an endeavor to optimize payment on behalf of the client.
Does your bid comply with this requirement? Yes _____ No _____
- Provide customer service at a minimum of 8:00 a.m. until 5:00 p.m. Monday thru Friday using a local telephone number as well as toll-free telephone number.
Does your bid comply with this requirement? Yes _____ No _____
- Record or credit all payments received by the Firms to the patient account within 24 business hours after the receipt of funds.
Does your bid comply with this requirement? Yes _____ No _____
- Maintain current and concise documentation that outlines the internal controls that are in place and practiced to ensure that all policies and procedures for proper handling of receipts of funds are being followed by the Firm.
Does your bid comply with this requirement? Yes _____ No _____
- Process all refunds and overpayments within timelines defined by the City of Mesquite and the Firm.
Does your bid comply with this requirement? Yes _____ No _____
- All funds received and collected by the Firm must be deposited by ACH transaction on a schedule that has been established by the City of Mesquite and the Firm. Corresponding reports must be provided with each deposit.
Does your bid comply with this requirement? Yes _____ No _____ C. Reporting Requirements:
the City of Mesquite reserves the right to request additional reports as needed.
- Daily Reports
- Provide Daily Reports as outlined in Section 2.3 “Accounting and Reporting” items “1” through “3”.
Does your bid comply with this requirement? Yes _____ No _____
- Weekly Information
- Provide Daily Reports as outlined in Section 2.3 “Accounting and Reporting” items “1” through “3”.
Does your bid comply with this requirement? Yes _____ No _____
- Deposit Summary and Explanation of Benefits. (EOB)
Does your bid comply with this requirement? Yes _____ No _____
- Medicare/Medicaid Electronic Funds Transfer (EFT) and Explanation of Benefits.(EOB)
Does your bid comply with this requirement?
e. Refund Requests. |
Yes _____ No _____ |
Does your bid comply with this requirement? | Yes _____ No _____ |
- Monthly Information
- Date of Service performance monitoring and account reconciliation.
Does your bid comply with this requirement? Yes _____ No _____
- Account Analysis by Month of all client accounts.
Does your bid comply with this requirement? Yes _____ No _____
- Account Analysis by Month, by Payer.
Does your bid comply with this requirement? Yes _____ No ____
- Aging Report by Current Payer and Aging Category. (Accounting Period Based)
Does your bid comply with this requirement? Yes _____ No _____
- Accounts Receivables Reconciliation Report (Accounting Period Based)
Does your bid comply with this requirement? Yes _____ No _____
- Yearly Information
- Annual NV EMS Medicaid Settlement Cost Report or equivalent.
Does your bid comply with this requirement?
b. Year-End Accounts Receivable Report. |
Yes _____ No _____ |
Does your bid comply with this requirement? | Yes _____ No _____ |
D. Analytical Services
- The City of Mesquite will expect the Firm to provide analysis and expertise in all issues related to ambulance billing. This includes analysis of trends and other pertinent issues that may develop.
Does your bid comply with this requirement? Yes _____ No _____
- At the beginning of the contract, the Firm will be expected to meet with the City of Mesquite on a monthly basis to review billing consistency, receivables performance, and other issues that have been encountered. Upon agreement of both entities these meetings may become less frequent but will be held not less than once a year. Also, the Firm must prepare and deliver a written report reviewing the performance of the accounts receivables, identifying outstanding issues, and list any strengths, weaknesses, and opportunities for improved performance. Additionally, this written report must identify key issues that might arise in the future, accompanied by strategies, procedures, and timelines to address these issues. This report shall be due six (6) months after the original contract date. The report will then be due on a yearly basis unless the City of Mesquite or the Firm request or determine the report is needed on a more frequent basis.
Does your bid comply with this requirement? Yes _____ No _____
- The Firm will provide a Quality of Care survey, at least annually, which meets or exceeds the County’s requirements.
Does your bid comply with this requirement? Yes _____ No _____
- The Firm will provide initial projections of revenue expected to be collected on a per-trip basis and will provide updates to these projections on a regular basis.
Does your bid comply with this requirement? Yes _____ No _____ E. Technology Requirements:
- The Firm will provide all software associated with the billing and collection process.
Does your bid comply with this requirement? Yes _____ No _____
- The Firm will provide a system that will ensure the complete and uninterrupted flow of service via backup systems and a Data Recovery Project Plan/System should a disaster occur and will provide for the security and privacy of protected health information.
Does your bid comply with this requirement? Yes _____ No _____
- The Firm will retain records according to an agreed upon record retention plan.
Does your bid comply with this requirement? Yes _____ No _____
- The Firm shall provide sufficient HIPAA compliance training to all employees dealing with applicable information.
Does your bid comply with this requirement? Yes _____ No _____
- The Firm must provide HealthEMS Solutions, including Health Data Exchange for recording of prehospital call reports.
Does your bid comply with this requirement? Yes _____ No _____
- Insurance and Liability Requirements:
- The Firm shall maintain and provide the City of Mesquite with evidence of the following described insurance, all on mutually-agreed terms and consistent with the custom in the area for similar collection contracts:
- Fidelity bonding for Firm and its employees involved in the handling or accounting for the monies of the City of Mesquite in the amount of $100,000.00.
- General comprehensive liability insurance with aggregate of $1,000,000.00
- An Errors and Omissions insurance policy covering itself and the services of its employees or contractors in the amount of $1,000,000.00. Coverage under the Errors and Omissions policy shall survive termination of this collection contract for a minimum of two (2) years.
Does your bid comply with these requirements? Yes _____ No _____
- To the extent available without significant surcharge, the City of Mesquite will be named as an additional named insured on all insurance policies specified in paragraph F.1. In all events, the insurance company will be required to provide the City of Mesquite with prior written notice of cancellation, non-renewal or material amendment of each such policy.
Does your bid comply with this requirement? Yes _____ No _____
- The firm shall accept liability and hold the City of Mesquite harmless for the following:
- Any penalties or fees, including legal fees and costs, incurred by the City of Mesquite as a result of any audits, investigations or other legal actions conducted by the Health Care Financing Administration (“HCFA”) or any other federal or State government agency resulting from any act or omission of Firm. The firm shall not be responsible, however, where such penalties and fees are proximately caused by incorrect or inaccurate information provided to Firm by the City of
Mesquite; and
- Any payments received for services rendered by the City of Mesquite that are not delivered to the City of Mesquite due to any act or omission, including theft or any other illegal acts of Firm’s staff or agents.
Does your bid comply with these requirements? Yes _____ No _____
- Location of Operations:
All of the Firm’s operations; including but not limited to; billing, collections, reporting, technology, compliance, customer service; shall be performed within the continental United States of America. In no case shall any of the services provided to the City of Mesquite as part of this contract be performed outside of the continental United States.
Violation of this condition shall result in the immediate termination of the contract.
Does your bid comply with this requirement? Yes _____ No _____
VI. COST PROPOSAL FORMAT
The Cost Proposal submitted shall be a percentage based fee. This shall be a percentage (%) of the “net cash collections” realized.
The Firm shall also submit their expected collection rate, expressed on a per-trip basis.
AWARD OF THIS CONTRACT WILL BE TO THE MOST RESPONSIVE, RESPONSIBLE BIDDER WITH PRICE BEING ONLY ONE OF THE FACTORS CONSIDERED.
VII. SELECTION CRITERIA
1. Program Approach | 25 pts allowed |
2. Experience and Capacity of the Fire | 25 pts allowed |
3. Cost Proposal and Pricing Methodology | 25 pts allowed |
4. Familiarity with Local Area | 15 pts allowed |
a. Subtotal Points | 90 possible |
5. References | 10 Pts allowed |
a. Total Points | 100 Possible |
VIII. TERMS and CONDITIONS
- The City of Mesquite reserves the right to award and/or reject any and/or all proposals in whole or in part, and waive any technicalities or irregularities.
- It is the desire of the City of Mesquite to pay promptly. It is the vendor’s responsibility to submit invoices directly to the City of Mesquite, 10 E Mesquite Blvd, Mesquite NV 89027.
- It is the intent of the City of Mesquite to award the contract to the lowest responsive and responsible vendor. the City of Mesquite reserves the right to determine the lowest responsive and responsible vendor on the basis of an individual item, groups of items, or any way determined to be in the best interest of the City of Mesquite. Award shall be based on the following factors (where applicable): (a) adherence to all conditions and requirements of the specifications; (b) price, reporting, and analytical requirements; (c) qualifications of the vendor, including past performance, financial responsibility, general reputation, experience, service capabilities, and facilities; (d) delivery or completion date; (e) maintenance costs and warranty provisions.
- The contract shall be deemed binding only to the extent of appropriated funds for the purpose set forth in this contract.
- Addenda to these conditions and/or specifications shall be made in writing. Information provided verbally outside these specifications shall not be binding. Each vendor is responsible for determining that all addenda issued by the City of Mesquite have been received before submitting a quote.
- At least three recent business (non-client) references are required and shall be indicated on the QUOTE FORM. the City of Mesquite may request additional evidence of the vendor’s experience, qualifications, ability, products, service facilities, and financial standing for which the vendor shall be prepared to provide to the City of Mesquite if required.
- The City of Mesquite intends to contract with the successful vendor. The successful vendor shall be the prime contractor and shall be solely responsible for all contractual performance. the City of Mesquite shall be informed if any part of any proposal requires subcontracting any portion of the proposal. Any contract entered into with a successful bidder shall not be assignable.
- Each vendor shall perform his/her own evaluation and due diligence verification of all information and data provided by the City of Mesquite. the City of Mesquite makes no representation or warranties regarding any information or data provided by the City of Mesquite.
- Sales taxes should not be included in the total price quotation. Sales tax should be listed as a separate line item on the invoice.
IX. THE CITY OF MESQUITE BILLING AND COLLECTION INFORMATION
In FY 18/19, the City of Mesquite had transports broken down as follows:
- Medicare Only: waiting on updated numbers from IRIS Medicaid Only: waiting on updated numbers from IRIS
- Private Pay: waiting on updated numbers from IRIS
- Commercial: waiting on updated numbers from IRIS
Total:
IRIS Medical Services is the City of Mesquite’s current billing and collection provided and has served the City of Mesquite for approximately ten (10) years. IRIS charges the City of Mesquite a fee of 6.5 % of net collections. Following is the billing and collections information for the FY 18/19.
- Billed: $2,764,910.06
- Cash Collected: $1,030,752.99
- Contractual Adjustments: $1,489,037.45
- Refunds: $10,716.39
- *Medicaid Cost Report Adjustment (GEMT): $338,829.59
- Collections/Debt Setoff: $234,808.11
Payor Mix:
- Medicare 51%
- Medicaid 11%
- Commercial 21%
- Self Pay 17%
*The City of Mesquite does not consider these amounts subject to any collection fee.
Fee Schedule as approved by the City of Mesquite City Council
● | Emergency ALS | $1,173.25 |
● | Emergency BLS | $1,018.52 |
● | Critical Care Transport | $1,273.16 |
● | Loaded Mileage | $30.31 |
*Each year the City of Mesquite Rescue’s billing table increases on July 1 in accordance with the CPI.
Call volume by code for dates between July 1, 2018, and June 30, 2019
- BLS Emergency 759
- ALS Emergency 1335
- Critical Care 69
- Loaded Miles 33,465
QUOTE FORM
Instructions: Complete all FOUR parts of this quote form.
PART I: Summary Quote
Fee for Collections (% of amount collected) _____________________
Additional fees and charges (explain in detail): _____________________________________
____________________________________________________________________________
Compliance with Reporting requirement: Yes_______ No____________ Expected Collection (per trip): $___________
PART II: Addenda Acknowledgements (if applicable)
Firm Name | |
Address | |
Telephone | |
Representative
(Print Name) |
|
Signature of Representative | |
Date Submitted |
Each vendor is responsible for determining that all addenda issued by the City of Mesquite, have been received before submitting a quote.
Addenda | Date Issued | Date Vendor Received |
“A” | ||
“B” |
PART III: References
Provide at least three (3) business (non-client) references
Business Name | Contact Name | Phone Number |
PART IV: Submitted by (this quote includes all terms and conditions as set forth in pages 1-22 above except whereas noted)
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