Ambulance Billing Servicesj:\worddoc\rfp\2018 rfp\ambulance billing services.doc
VILLAGE OF OAK BROOK Purchasing Division 1200 Oak Brook Road Oak Brook, IL 60523 (630) 368-5164
REQUEST FOR PROPOSAL
Ambulance Billing Services
September 2018
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TABLE OF CONTENTS
SECTION 1. REQUEST FOR PROPOSALS ............................................................................................... 1
A. NOTICE – POSTED ON THE VILLAGE WEBSITE SEPTEMBER PUBLISHED SEPTEMBER 24, 2018 .................... 1
B. GENERAL INFORMATION ......................................................................................................................... 1
SECTION 2. SCOPE OF SERVICES .......................................................................................................... 3
SECTION 3. PROPOSAL ............................................................................................................................. 5
Required Items ..................................................................................................................................... 5
SECTION 4. REVIEW PROCESS ............................................................................................................... 6
A. BASIS OF AWARD ............................................................................................................................... 6
C. TERMS AND CONDITIONS .................................................................................................................... 8
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Section 1. Request for Proposals
A. Notice – Posted on the Village website September Published September 24, 2018
Village of Oak Brook Request for Proposals Ambulance Billing Services
September 2018
The Village of Oak Brook is soliciting proposals from firms with demonstrated experience in the
provision of ambulance or similar billing services.
Proposals should be addressed to:
Rania Serences
Senior Purchasing Assistant
Village of Oak Brook
1200 Oak Brook Road
Oak Brook, IL 60523
The closing date and time for receipt of proposals is Wednesday, October 17, 2018 at 1:00
P.M. prevailing time. Proposals received after the submittal time will be rejected and returned
unopened to the sender.
A complete proposal package, of which this legal notice is a part, is on file for inspection and
may be downloaded from the Village’s website at www.oak-brook.org/purchasing or picked up
at the Butler Government Center, 1200 Oak Brook Road, Oak Brook, Illinois 60523, between
the hours of 8:00 a.m. and 4:30 p.m., Monday through Friday. There is no charge for the
package.
The Village reserves the right to reject any or all proposals, waive or not to waive any
irregularities therein, and to accept the proposal(s) considered to be in the best interest of the
Village.
B. General Information
The Village of Oak Brook is seeking a qualified firm to provide ambulance billing collection,
financial reporting and analytical services for ambulance services rendered by the Oak Brook
Fire Department for Advanced Life Support ("ALS") and Basic Life Support ("BLS") calls. This
includes complete management of the billing process from patient transport to account closure.
The Village of Oak Brook intends to evaluate the experience, the proposed solutions and
associated costs presented by the responding firms. The Village intends to select a firm that
provides the most advantageous solution, per the evaluation criteria specified in the RFP.
Terms, conditions, services and costs are subject to negotiation as specified in the RFP.
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The Village of Oak Brook maintains two fire stations which serve over 8,000 residents within its
8.5 square mile corporate boundaries. Each year Village emergency personnel respond to just
under 1,500 incidents transporting just under 1,000 patients.
Currently, the Village charges for residents are $1,600-ALS Level I, $1,600-ALS Level II,
$1,600-BLS, and $19.00 per mile per trip for each transport.
Charges for non-residents are $1,800-ALS Level I, $1,800-ALS Level II, $1,800-BLS, and
$19.00 per mile per trip for each transport.
In addition to the currently established fees, the Village may determine periodically to modify
existing fee schedules or implement other operational support fees.
Payment for these services is paid primarily by Medicare, Medicaid, private insurance and self-
payment. Revenue for the reporting period of January 1, 2017 through December 31, 2017
was $723,231 billed and $418,210 actual receipts or approximately 58% collection rate.
Revenue for the reporting period of January 1, 2016 through December 31, 2016 was
$562,007 billed and $381,026 actual receipts or approximately 67.8% collection rate.
Percentage of incidents experienced show an average of 36% Medicare, 9% Medicaid,
40% private insurance and 21% patient pay. Previous records indicate the department
receives similar revenue numbers annually.
The Oak Brook Fire Department routinely transports patients to Elmhurst Hospital in
Elmhurst, Good Samaritan Hospital in Downers Grove and Hinsdale Hospital in Elmhurst.
All three locations are approximately 4.5 miles from the center of the Village.
The Village does not bill for non-transports.
The Village of Oak Brook has completed a Medicare Revalidation within the last two years.
Delinquent accounts are currently handled by the Village’s billing contractor as follows: The
delinquent account is sent up to three notices requesting payment of the balance. If
payment is not received, the account is turned over to a collection agency.
The successful vendor will not be required to assume responsibility for any existing unbilled
and/or previously billed accounts.
Oak Brook electronic EMS patient care reports (Image Trend) are provided to the vendor.
Insurance information is not currently collected within the patient care report, and is left to
the discretion and ability of the billing contractor to obtain.
The department owns and uses Apple IPads for electronic patient care reporting.
The Village of Oak Brooks fiscal year begins January 1.
The Village currently uses Andres Medical Billing, Ltd./Fire Recovery EMS of Arlington
Heights, IL.
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Section 2. Scope of Services
1. Provide all personnel, materials, and services necessary to perform and accomplish all
requirements for this proposal.
2. Provide a full time program manager for the duration of the contract.
3. Please provide the span of control the individual assigned would have within the
company, identifying the number of clients the individual would manage.
4. Ensure all required documentation and agreements with payers are properly filed and
maintained on behalf of the Village.
5. Obtain pre-approval from the Village of ail forms used in the execution of this
contract.
6. Provide samples of all paperwork to be used including, but not limited to forms,
invoices and correspondences utilized in the billing process.
7. Upon receipt of the ambulance report data, review, prepare and mail invoices
according to the rates established by the Village of Oak Brook to the patient within 3
business days. This mailing shall include all necessary forms for payment
processing, along with a return envelope.
8. Upon receipt of patient claim information, if required, electronically submit Medicare,
Medicaid, and insurance claims within 3 business days. Manual submission of
claims is acceptable only if electronic submission is not available.
9. Utilize current diagnostic coding to ensure compliance with federal, state and local
regulations.
10. Ensure proper security and confidentiality of patient information and records,
including, but not limited to executing a business associate agreement as required
by the Health Insurance Portability & Accountability Act of 1996 (HJPAA), as
amended.
11. Resubmit or resolve denied or disallowed claims.
12. Accept responsibility for patient billing inquires and complaints during regular
business hours.
13. Provide the tracking of submitted claims to ensure timely payments.
14. Provide monthly statements to allow patients to be aware of outstanding balances.
15. Maintain generally accepted accounting procedures and practices for the reconciling
of all financial transactions.
16. Facilitate the daily posting of revenues and provide daily document retrieval through
a lock-box arrangement with the Village's banking institute. Deposit all funds
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collected directly into the Village's account on a daily basis, followed by invoicing the
Village for the amount applicant claims it is owed by the Village for the fixed fee for
its services.
17. Provide prompt, accurate monthly reporting which shall include, but not limited to:
• Gross charges billed for the month minus contractual allowances, write-offs (abatement,
dismissals, bankruptcies and settlements), refunds, payments and indigence cost of care
rolling up to the net ending accounts receivable balance due. Include on this report the
number of trips per month, number of patients per month, gross charges per trip, cash
collected per trip and net collection percentage per trip. This report to be submitted by
the 10th day of each subsequent month.
• Charge and Credit report showing Contractual Allowances
• Aging reports
• Trips by Incident Number
• Payment Report of Accounts
• Prepare a financial summary showing "period to date" and "year to date" totals for
charges, receipts, adjustments, net accounts receivable, total accounts, receivable and
collection percentage, and aging rep01ts.
• A detailed report showing each activity that has taken place during the day that includes
receipts, charges, adjustments and total accounts receivable.
• This report should note any exceptions to standard chargeable amounts.
18. Prepare a report showing all transactions that affect the General Ledger. This report
shall be available in either detail or summary form.
19. Pursue non-payment by all resident and non-resident ambulance users with Village
approved collection agency.
20. Forward monthly reports, including account status, to a collection agency.
21. Utilize billing and data systems compatible with, or which complements “Image Trend
Elite”, the Oak Brook Fire Department Patient Collection software.
22. Be capable of electronic integration by exporting electronic patient care report
(ePCR) data from "Image Trend" and "Firehouse" software platforms.
23. Ensure that all data collection, reporting, and billing methods comply with all current
State and Federal Regulations.
24. Provide pre-claim submission error trapping process to reduce denials.
25. The vendor shall make on-line bill paying and credit card payments available to clients.
Any fee associated with on-line bill payments shall be negotiated and approved prior to
the implementation of this contract. Any associated transaction fees of any particular
credit card company shall be the sole responsibility of the card user. The Village of
Oak Brook shall not be responsible for any fees associated with on-line payments or
credit card usage of any client.
26. Ability to research and obtain missing insurance information before generating
claims or invoices.
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27. Provide 24-hour remote and secure access to billing system.
28. Provide any additional custom or managerial reports requested by the Village.
29. Postage is to be included in the medical billing contractor’s fee.
Section 3. Proposal
Four (4) copies of the proposal, including all attachments, shall be submitted to the office of the
Senior Purchasing Assistant, Rania Serences, and clearly marked “Ambulance Billing Services”
on or before 1:00 P.M., Wednesday, October 17, 2018. Proposals received after the
submittal time will be rejected and returned unopened to the sender.
All questions regarding this RFP should be directed in writing to Barry Liss, Fire Chief,
bliss@oak-brook.org. Questions will be accepted until 12:00 p.m. Wednesday, October 3,
2018.
All questions and responses will be compiled and submitted to all vendors electronically in one
general response memorandum by Wednesday, October 10, 2018.
Required Items
Items, which need to be included with the proposal at a minimum, include the following:
1. Provide a sample implementation plan with projected activities and timelines, including
all scheduled milestones. Identify the most critical issues that must be satisfactorily
addressed to assure this contract will he successfully implemented,
2. A description of the firm and its relevant prior experience with ambulance billing.
3. A description of the relevant background and experience of the individuals assigned to
service the Village’s account.
4. Names, addresses, and telephone numbers of persons who may be contacted for
references in the Chicagoland metropolitan area. These references should be relevant to
ambulance billing.
5. A description of the entire billing and collection process used by the billing service. Please
be sure to include a description as to the timing of sending late notices, whether telephone
call follow up is used, how Medicare accounts are administered, and whether the billing
service has the ability to submit claims with third-party insurance carriers.
6. Provide your agency's delinquent account collection process including what the Village
can financially anticipate as a result of your agency managing the collection aspect of
medical billing, The Village reserves the right to utilize its own collection agency to seek
funds from delinquent accounts.
7. A description as to the procedures and controls related to receiving payments on accounts.
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8. Sample invoices, late notices, and reports as required in the Scope of Services.
9. A description of the procedures relating to record retention and types of records maintained
as well as how FOIA requests are handled.
10. Provide any comments regarding medical billing services which have not been
addressed in these detailed specifications.
11. Provide an explanation of' the amount, which will be charged for the services requested
in these detailed specifications for your agency's medical billing services. The Village
prefers to pay a percentage of fees collected for this service. If this method of
compensation is utilized, identify what percentage of fees collected The Village prefers
to pay a percentage of fees collected for this service. If this method of compensation is
utilized, identify what percentage of fees collected will be assessed prior to the
disbursement of revenue to the Village. Your pricing should include detailed
descriptions of the services provided and the itemized costs for these services. Please
submit pricing with annual financial amounts.
Your pricing should breakout all anticipated start-up and on-going costs including, but
not limited to the following:
License fees for all required software
Implementation
Data conversions
Data updates
Report production
System maintenance costs, annual schedule
Support
Training Costs
Annual Fees
Please sign and date cost proposal, and provide and estimated time of completion for the
project.
The Village will require performance guarantees to be discussed prior to the final selection.
Section 4. Review Process
A. Basis of Award
Village staff will perform an evaluation of the proposals received. Appropriate finalist(s) will be
interviewed by the Village, after which a selection will be made.
The Village of Oak Brook reserves the right to reject any or all proposals and to waive any
informality or technical error and to accept any proposal deemed most favorable to the interests
of the Village of Oak Brook. The Village will review proposals based on the following criteria:
1. Prior experience with ambulance billing.
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2. The number and complexity of forms required by the billing service.
3. Qualifications of the individuals servicing the Village’s account.
4. The ability of the billing service to meet the time schedule outlined in the RFP.
5. The amount of the proposed fee.
B. Selection Process
An evaluation of the proposals will be made by Village staff. Appropriate finalists will be
interviewed by the Village after which a selection will be made. In addition to the criteria listed in
the section titled “Basis of Award”, selection of the billing firm will also be based on:
1. Understanding of the Village current and future needs.
2. Overall quality and completeness of the proposal.
3. Oral interview.
4. References.
Additional criteria to be used include:
1. The ability, capacity and skill of the firm to perform the contract to provide the service
required.
2. Whether the firm can perform the contract or provide the service promptly, or within the time
specified without delay or interference.
3. The character, integrity, reputation, judgment, experience and efficiency of the firm.
4. The quality of the performance on previous contracts for services.
5. The previous and existing compliance by the firm with laws and ordinances relating to the
firm’s services.
6. The sufficiency of the financial resources and ability of the firm to perform the contract or
provide the services.
7. The quality, availability and adaptability of the supplies or contractual services to the
particular use required.
8. The ability of the firm to provide future maintenance and service for the use of the subject of
the contract.
9. The number and scope of conditions attached to the proposal.
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C. Terms and Conditions
1. Any contract or agreement resulting from the acceptance of this proposal by the Village shall
be on forms either supplied by or approved by the Village's Attorney, and shall contain, as a
minimum, applicable provisions of this Request for Proposal. The Village reserves the right
to reject any agreement that does not conform to the Request for Proposal and any Village
requirements for agreements and contracts.
2. If, through any cause, the firm fails to fulfill any of the obligations agreed to in a timely and
proper manner, the Village shall have the right to terminate the contract by notifying the firm
in writing of such termination at least 30 calendar days in advance of such termination.
3. The Village reserves the right to request clarification of information submitted and request
additional information as needed.
4. The term of the agreement will be for five years beginning January 2019, with three (3)
option years to renew at the Village’s sole discretion. These costs will be fixed during the
first five years of the contract. The Village and the firm may mutually agree to price
adjustments for an optional sixth, seventh, and eighth year. If the firm elects to fix prices for
the entire eight-year term, it should be so stated. The firm may pass along costs which
increase due to federally mandated regulations upon submitting written notice of such
increase to the Finance Director two months prior to such proposed increase taking effect,
and upon demonstration of such mandate.