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Ambulance Billing Request for ProposalsREQUEST FOR PROPOSALS (RFPs) FOR EMS BILLING SERVICES FOR THE KALISPELL FIRE DEPARTMENT CITY OF KALISPELL Kalispell, MT INFORMATION AND INSTRUCTIONS TO SUBMITTERS 1. GENERAL INFORMATION 1.1 Pursuant to the authority granted to it under MCA Title 7, Chapter 5, Part 43, the City of Kalispell is soliciting proposals for services and/or materials for ambulance and response billing, collection, financial reporting and analytical services. The service desired includes the complete management of billing from receipt of patient care/incident reports to account closure, meeting the minimum requirements stated in this document to provide such services and or materials for the City of Kalispell. 1.2 The Proposal must be received by the City Clerk at 201 First Avenue East, Kalispell, Montana, by 2 pm local time, August 25, 2025. 1.3 General questions pertaining to the project should be directed to Jay Hagen, Fire Chief, at (406)758- 7761 or jhagen@kalispell.com . 1.4 The City of Kalispell shall not be held responsible for any oral instructions. Any changes to this Request for Proposals (RFP) will be in the form of an addendum, which will be furnished to all registered RFP holders. 1.5 The City of Kalispell reserves the right to reject any or all Proposals, to waive any informality or irregularity in any Proposal received, and to be the sole judge of the merits of the respective Proposals received. 2. ANTICIPATED SCOPE OF WORK After being selected, the successful Vendor will execute an agreement with the City to provide services and/or materials to fulfill the following scope of work: The City of Kalispell is seeking proposals from a firm to undertake and provide ambulance and response billing, collection, financial reporting and analytical services. The service desired includes the complete management of billing from receipt of patient care/incident reports to account closure, meeting the minimum requirements stated in this document. The City intends to enter into a contract with the selected firm that will include billing services for EMS transport events. This RFP shall not commit the City to enter into an agreement, to pay any expenses incurred in preparation of any response to this request, or to procure or contract for any supplies, goods or services. The City reserves the right to accept or reject all responses received as a result of this RFP if it is in the City's best interest to do so. This procurement is governed by the laws of the State of Montana for all legal proceedings. By offering to perform services under this RFP, all Submitters agree to be bound by the laws of the State of Montana and of the City, including, but not limited to, applicable wage rates, payments, gross receipts taxes, building codes, equal opportunity employment practices, safety, non-discrimination, etc. I. PROJECT BACKGROUND AND DESCRIPTION 1. The City of Kalispell Fire Department operates transporting ambulances as the primary agency within the city limits of Kalispell and in Flathead county by mutual aid dispatch when the primary transporting services in the applicable fire district are unavailable. The City of Kalispell is looking for a third-party vendor to provide ambulance and response billing, collection, financial reporting and analytical services. Il. SCOPE OF SERVICES 1. Vendor will be directly representing the City of Kalispell (COK)/ Kalispell Fire Department (KFD) when interacting with individuals and/or organizations, via written correspondence/bills, phone, email, etc. At all times during these interactions, vendor shall remain respectful and mindful, and act in the utmost professional manner. 2. Vendor shall be responsive to the needs of the COK/ KFD, acting promptly and professionally to assist with any issues related to ambulance and incident billing. 3. Processing and billing of incident and patient care reports shall be completed in a timely manner, with initial review (leading to billing or requests for additional information from the COK/ KFD) completed in 5 business days or less. All subsequent processing (after receipt of information, etc.) shall be completed in 5 business days or less. AMBULANCE BILLING 1. Compliance with all HIPAA and other applicable laws and regulations governing privacy shall be strictly followed in all phases of the ambulance billing process. 2. Retrieve the electronic Patient Care Reports (ePCR) and related information from the KFD's Record Management System (First Due). 3. Promptly notify the designated KFD member regarding any issues that impact, or missing information required to complete, the billing process. Work with KFD staff to ensure all required information is obtained to ensure the billing process can be completed from initial ePCR submission to account being considered paid in full or uncollectable. 4. Prepare and submit accurate and complete insurance claims, using rates established and provided by KFD, guidelines and procedures established by vendor and KFD, and all applicable laws and regulations including those for Medicare and Medicaid, as well as any other applicable carriers including both commercial and private insurance. 5. File any claim reviews and represent the COK/ KFD in Medicare/Medicaid appeals. 6. Provide and staff a toll-free phone number for any billing and/or collections questions. Number must be staffed during normal business hours (8:00 a.m. to 4:00 p.m. MST) Monday through Friday, excluding holidays. Any voicemail messages (if used) shall be replied to within one business day. Post this number on all correspondence and bills. 7. Prepare and mail invoices to patients/parties responsible for co-pay and/or deductibles, private pay, and uninsured patients, or as directed by the KFD Fire Chief. 8. Post all payments to the appropriate accounts and provide reports to the KFD Fire Chief as described below. Ensure that all payments are deposited into a COK specified bank account, and the vendor shall send an electronic confirmation of the transaction to the KFD Fire Chief that includes a scanned copy of the deposit slip, and all checks deposited. 9. Deposit timing - specify the expected timing of deposits (e.g. daily, weekly within 48 hours or receipt). 10. Deposit Reconciliation Report – In addition to scanned deposit slips, the billing vendor needs to provide a reconciliation report that clearly ties the deposit amounts to the individual payments and accounts posted, for audit trail and transparency and upon request reports to the finance staff, to support reconciliation and audit process. 11. Assist with, and manage if appropriate, the establishment of the ability to accept credit/debit cards for payments. 12. Provide the following reports, at a minimum, via email to the KFD Fire Chief on a monthly basis (due date to be established by vendor and K FD Fire Chief after award): a. Monthly Invoice Listing b. Monthly Call Summary c. Change Detail d. Change Summary e. Credit Detail f. Credit Summary g. Aging Detail h. Aging Summary i. Accounts Receivable Balance j. Audit Support – The vendor should be able to provide timely support and documentation for annual financial audits and any other audit or review conducted by the City or external agencies. This includes access to historical billing, payment, and adjustment records, and any reconciliation reports. 13. Afford the ability to provide guidance on and generation of additional customized reports designed to strengthen the KFD's billing process and analytics. 14. Provide KFD with additional reports regarding uncollectable accounts and payment plan status as required by and in the format required by the Fire Chief. 15. Provide guidance, advice, and consulting to the COK/ KFD on all aspects of ambulance billing, including, but not limited to, procedures for setting billing rates, optimizing collections, tuning accounting procedures, etc. 16. Provide training annually, highlighting common issues seen with KFD personnel and other client documentation and ways to optimize billing success. 17. Provide training, if necessary, to the COK administrative staff and Fire Chief on best practices for optimizing the efficiency in the internal workflows of ambulance billing, reconciliation, etc. 18. Act as consultant to the COK and Fire Chief regarding selection of collection service. Consultation will include a presentation/discussion on types of collections (pre- collections/soft collections, full collections, etc.), advantages/disadvantages of each, and advice on selection. Final selection will be approved by the COK. 19. Provide annual review of KFD Notices of Privacy and other patient confidentiality handling for compliance with current requirements and best practices. 20. As necessary for extreme hardship cases, contact the party responsible, collect financial information, and present the Fire Chief requests for adjustment or relief of charges incurred. 21. Utilize only National Academy of Ambulance Coders (NAAC) certified ambulance coders in processing bills and agree to maintaining a Certified Ambulance Compliance Officer on staff. All certified coders and compliance officers shall remain current on billing practices and attend relevant routine training. 22. Conduct daily back -ups of all data with protection of individuals' personal health information that is created, received, used, or maintained in compliance with HIPAA Security Rule, 45 CFR Part 160 and Subparts A and C 23. Bill outstanding accounts/patients once a month for 3 months. If not paid within 120 days of first bill, notify patient of the delinquent amount. Report these "uncollectable" accounts to the Fire Chief and provide advice on subsequent actions. INCIDENT BILLING 1. The COK/ KFD intends to bill for treat/ no transport events when applicable. 2. Incident reports are generated in First Due, but Kalispell Fire will work with the vendor to develop a submission system that works for both entities if needed. 3. PROPOSAL SELECTION CRITERIA 3.1 The Proposal will be selected through the following selection process. Firms interested in providing the services described above are requested to submit the following information. Responses to each item should appear in the same order as in this RFP and should identify the item to which the responses apply. a) Executive Summary • Please include general information about the firm, such as description of services offered, total years in business, number of staff, office location(s), basic qualifications of firm, and name, phone number, and email for authorized contact concerning the proposal . b) Firm/Individual Profile • List of individuals who will work on this project, relevant experience and the role they will play. c) Scope of Project • Provide a description of your services offered and an outline detailing your approach and concept for providing these services. • Include timelines for rollout of services and address any time commitments you see City personnel needing to provide. • Explain how you plan to deliver the services outlined in Section 3 Scope of Services. d) General and Technical Requirements • Please confirm your ability to integrate with First Due reporting records management software or outline the necessary steps to retrieve the required information if direct integration is not available. e) Related Experience with Projects Similar to the Scope of Services • Provide a list of a minimum of three (3) similar and relevant projects. f) References • Provide client references, including names, titles, addresses, telephone and e-mail addresses for at least three (3) clients for which you performed similar services. g) Training • Please outline any training that will be provided by you during this process. • Please outline any training that will be required by the fire department outside of your process. h) Price Proposal • Please outline your pricing structure for providing the services outlined in this proposal. 4. SUBMITTAL REQUIREMENTS 4.1 The Proposal shall include a one‐page cover letter plus a maximum of fifteen (15) pages to address the RFP criteria specified in Section 3 (excluding resumes). Table of Contents and section divider pages do not count towards the total page count. 4.2 Five copies of the Proposal must be submitted to the City Clerk at 201 First Avenue East, Kalispell, Montana, 59901 (Mail to: City Clerk, PO Box 1997, Kalispell, MT, 59903) by 2 pm local time, August 25, 2025. 4.3 Failure to comply with the following criteria may be grounds for disqualification: Receipt of submittal by the specific cut‐off date and time. The number of originals and/or copies of the submittal specified. Adherence to maximum page requirements. 4.4 Adherence to the maximum page criteria is critical; each page side (maximum 8 1/2” x 11”) with criteria information will be counted. Pages that have photos, charts and graphs will be counted towards the maximum number of pages. 5. SELECTION PROCESS AND SCHEDULE 5.1 A 5‐member Project Evaluation Committee will evaluate each Proposal according to the above criteria and may select up to three finalists that will be Short Listed for the contract. If interviews are determined to be desirable, the Short List firms will meet wi th the Project Evaluation Committee for interviews. The purpose of the interview will be to expand on the information provided in the Proposal, not to repeat information already provided. Those firms selected for the Short List will be provided additional instruction by the City. Those firms not selected for further consideration will be notified. 5.2 The following tentative schedule has been prepared for this project. Firms interested in this project must be available on the interview meeting date. Proposals due: 2 pm, August 25, 2025 Evaluation of Proposals: Week of August 25th, 2025 Interviews: (if necessary) Week of September 2nd, 2025 Recommendation Decision and Notifications: Noon, September 10, 2025 City Council Award: September 15, 2025 5.3 Following the interviews, the Project Evaluation Committee will rank each Short List firm of this RFP. Consideration will be given to both the written Proposals and any oral presentations or interviews. No other factors or criteria will be used in the qualification ranking. 5.4 The highest ranked firm will be recommended to the City Manager and City Council for contract award. 5.5 Requests for debriefings or selection decisions shall be made in writing to the City. All information submitted by firms and related Project Evaluation Committee evaluations and rankings shall be considered confidential until after contract execution and award by the City Council. 5.6 The City will enter a contract upon selection of the firm for the project to be submitted to the City Council for approval. A template of the proposed contract with the City will be provided to the Proposers upon request. If the selected firm determines not to enter into a contract with the City, the City may then contact the second or third highest ranked team until a contract is executed or may decide to terminate the selection process. Publication: August 10, and August 17, 2025