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#17-7133 (Digitech EMS Billing, Inc. dba Digitech Computer, Inc.)
MEMORANDUM Date: July 19, 2017 To: Barbara Lance for Viviana Giarimoustas Procurement Services From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Contract #17-7133 "EMS Billing & Debit Collection Services" Contractor: Digitech EMS Billing, Inc. dba Digitech Computer, Inc. Attached for your records is one (1) original of the referenced contract above, (Item #16E6) adopted by the Board of County Commissioners on Tuesday, July 11, 2017. The Board's Minutes & Records Department has kept an original as part of the Board's Official Records. If you have any questions, please feel free to contact me at 252-7240. Thank you. Attachment AGREEMENT 17-7133 for EMS Billing & Debt Collection Services THIS AGREEMENT, made and entered into on this i l'"` day of J CL� 2017, by and between Digitech EMS Billing, Inc. d/b/a Digitech Computer, Inq) authorized to do business in the State of Florida, whose business address is 480 Bedford Road, Building 600- 2nd Floor, Chappaqua, NY 10514, (the "Contractor" or "Business Associate") and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: 1. AGREEMENT TERM. The Agreement shall be for a three (3) year period, commencing on October 1, 2017. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all of the terms and conditions contained in this Agreement for two (2) additional one (1) year periods. The County shall give the Contractor written notice of the County's intention to renew the Agreement term prior to the end of the Agreement term then in effect. The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred and eighty (180) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term prior to the end of the Agreement term then in effect. 2. STATEMENT OF WORK. The Contractor shall provide billing services in accordance with the terms and conditions of Request for Proposal (RFP) #17-7133, Exhibit A — Scope of Services, Exhibit B — Fee Schedule and Exhibit B — Business Associate Agreement, and Exhibit D - Contractor's Proposal , wich are hereby made an integral part of this Agreement. This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Parties, in compliance with the County's Procurement Ordinance, as amended, and Procurement Procedures in effect at the time such services are authorized. 3. THE AGREEMENT SUM. The County shall pay the Contractor for the performance of this Agreement based on Exhibit B - Fee Schedule, attached hereto. 3.1 Reporting: For monthly reconciliation and payment of invoice by the County, the Contractor will provide the following: camt) Page 1 of 13 17-7133 EMS Billing&Debt Collection Services Digitech Computer, Inc. a. Medicare adjustments applied to individual accounts with a summary of adjustments. b. Payments and return items are to be posted same date as bank deposit posting date. All posting should be current and all items reconciled by end of business month. Any irreconcilable items are to be reported timely to the County for direction and resolution. All postings should be reconciled with the County on a weekly basis. c. Provide monthly reports specific to County requirements. d. Monthly reports are to be received by the County no later than the 5th business day of the following month. 3.2 Payment will be made upon receipt of a proper invoice and upon approval by the EMS Project Manager or his designee, and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act." 3.3 Payments will be made for services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of the Agreement. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this Agreement. 4. SALES TAX. Contractor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. Collier County, Florida as a political subdivision of the State of Florida, is exempt from the payment of Florida sales tax to its vendors under Chapter 212, Florida Statutes, Certificate of Exemption # 85-8015966531C-2. 5. NOTICES. All notices from the County to the Contractor shall be deemed duly served if mailed to the Contractor at the following Address: Digitech EMS Billing, Inc. d/b/a Digitech Computer, Inc. Attention: Mark Schiowitz 480 Bedford Road Building 600, 2nd floor Chappaqua, NY 10514 (914) 741-1919 mschiowitz(a,digitechcomputer.com All Notices from the Contractor to the County shall be deemed duly served if mailed to the County to: Board of County Commissioners for Collier County, Florida c/o Collier County Emergency Medical Services Attention: Artie Bay 8075 Lely Cultural Parkway, Suite #267 Naples, FL 34113 (239) 252-3756 Page 2 of 13 17-7133 EMS Billing&Debt Collection Services(c'"):tom Digitech Computer, Inc. The Contractor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 6. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. 7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Contractor. The County will not be obligated to pay for any permits obtained by Subcontractors/Subconsultants. Payment for all such permits issued by the County shall be processed internally by the County. All non-County permits necessary for the prosecution of the Work shall be procured and paid for by the Contractor. The Contractor shall also be solely responsible for payment of any and all taxes levied on the Contractor. In addition, the Contractor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Contractor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Contractor. 8. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the Agreement of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 9. TERMINATION. Should the Contractor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said Agreement for cause; further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be sole judge of non- performance. In the event that the County terminates this Agreement, Contractor's recovery against the County shall be limited to that portion of the Agreement Amount earned through the date of termination. The Contractor shall not be entitled to any other or further recovery against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. Page 3 of 13 17-7133 EMS Billing&Debt Collection'SIN'ii4ces Digitech Corrk,y f,1nc. 10. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 11. INSURANCE. The Contractor shall provide insurance as follows: A. Commercial General Liability: Coverage shall have minimum limits of $1,000,000 Per Occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. B. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $500,000 for each accident. C. Technology Errors & Omissions: Such insurance shall have limits of not less than $1,000,000 per occurrence. D. Cyber Insurance: Such insurance shall have limits of not less than $1,000,000 per occurrence. Special Requirements: Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR, Collier County Government shall be listed as the Certificate Holder and included as an "Additional Insured" on the Insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of, the Additional Insured and the Contractor's policy shall be endorsed accordingly. Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. The Contractor shall provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County thirty (30) days prior to any expiration date. Coverage afforded under the policies will not be canceled or allowed to expire until the greater of: thirty (30) days prior written notice, or in accordance with policy provisions. Contractor shall also notify County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Contractor from its insurer, and nothing contained herein shall relieve Contractor of this requirement to provide notice. Contractor shall ensure that all subcontractors comply with the same insurance requirements that the Contractor is required to meet. 12. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Contractor shall defend, indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, Page 4 of 13 17-7133 EMS Billing&Debt Collection Services ` Digitech Computer, Inc. 1,, y1; reasonable attorneys' fees and paralegals' fees, whether resulting from any claimed breach of this Agreement by Contractor, any statutory or regulatory violations, or from personal injury, property damage, direct or consequential damages, or economic loss, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Contractor or anyone employed or utilized by the Contractor in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 12.1 The duty to defend under this Article 12 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Contractor, County and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Contractor. Contractor's obligation to indemnify and defend under this Article 12 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the County or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. 13. AGREEMENT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Emergency Medical Services Division. 14. CONFLICT OF INTEREST. Contractor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Contractor further represents that no persons having any such interest shall be employed to perform those services. 15. COMPONENT PARTS OF THIS AGREEMENT. This Agreement consists of the following component parts, all of which are as fully a part of the Agreement as if herein set out verbatim: RFP #17-7133, with Addendum, Insurance Certificate(s), Exhibit A Scope of Services, Exhibit B — Fee Schedule, Exhibit C — Business Associate Agreement, and Exhibit D - Contractor's Proposal. 16. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between the parties herein that this Agreement is subject to appropriation by the Board of County Commissioners. 17. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, as amended, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the individual and/or firm from doing business with the County for a specified period of Page 5 of 13 17-7133 EMS Billing&Debt Collection Services Digitech Computer, Inc. time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any Agreement held by the individual and/or firm for cause. 18. COMPLIANCE WITH LAWS. By executing and entering into this Agreement, the Contractor is formally acknowledging without exception or stipulation that it agrees to comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements applicable to this Agreement, including but not limited to those dealing with the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended; taxation, workers' compensation, equal employment and safety (including, but not limited to, the Trench Safety Act, Chapter 553, Florida Statutes, and the Florida Public Records Law Chapter 119, including specifically those contractual requirements at F.S. § 119.0701(2)(a)-(b) as stated as follows: IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Communication and Customer Relations Division 3299 Tamiami Trail East, Suite 102 Naples, FL 34112-5746 Telephone: (239) 252-8383 The Contractor must specifically comply with the Florida Public Records Law to: 1. Keep and maintain public records required by the public agency to perform the service. 2. Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the Contractor does not transfer the records to the public agency. 4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the Contractor or keep and maintain public records required by the public agency to perform the service. If the Contractor transfers all public records to the public agency upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public Page 6 of 13 17-7133 EMS Billing&Debt Collection Services Digitech Computer, Inc. agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. If Contractor observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Contractor to comply with the laws referenced herein shall constitute a breach of this Agreement and the County shall have the discretion to unilaterally terminate this Agreement immediately. 19. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful proposer extending the pricing, terms and conditions of this solicitation or resultant Agreement to other governmental entities at the discretion of the successful proposer. 20. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall remain in effect. 21. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to this Agreement in compliance with the Procurement Ordinance, as amended, and Procurement Procedures. 22. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. The negotiation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached during negotiations to County for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached at mediation to County's board for approval. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. 23. VENUE. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters. 24. KEY PERSONNEL AGREEMENT STAFFING. The Contractor's personnel and management to be utilized for this Agreement shall be knowledgeable in their areas of expertise. The County reserves the right to perform investigations as may be deemed necessary to ensure that competent persons will be utilized in the performance of the Agreement. The Contractor shall assign as many people as necessary to complete the services on a timely basis, and each person assigned shall be available for an amount Page 7of13 ( ;i: k 17-7133 EMS Billing&Debt Collection Servicess, Digitech Computer, Inc. of time adequate to meet the required service dates or dates set forth in the Project Schedule. The Contractor shall not change Key Personnel unless the following conditions are met: (1) Proposed replacements have substantially the same or better qualifications and/or experience. (2) that the County is notified in writing as far in advance as possible. The Contractor shall make commercially reasonable efforts to notify Collier County within seven (7) days of the change. The County retains final approval of proposed replacement personnel. 25. ORDER OF PRECEDENCE. In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the RFP, the Contractor's Proposal, and/or the County's Board approved Executive Summary, the Contract Documents shall take precedence. 26. ASSIGNMENT. Contractor shall not assign this Agreement or any part thereof, without the prior consent in writing of the County. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the County's consent, shall be void. If Contractor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Contractor all of the obligations and responsibilities that Contractor has assumed toward the County. 27. SECURITY. The Contractor is required to comply with County Ordinance 2004-52, as amended. Background checks are valid for five (5) years and the Contractor shall be responsible for all associated costs. If required, Contractor shall be responsible for the costs of providing background checks by the Collier County Facilities Management Division for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence and employment verifications and other related records. Contractor shall be required to maintain records on each employee and make them available to the County for at least four (4) years. All of Contractor's employees and subcontractors must wear Collier County Government Identification badges at all times while performing services on County facilities and properties. Contractor ID badges are valid for one (1) year from the date of issuance and can be renewed each year at no cost to the Contractor during the time period in which their background check is valid, as discussed below. All technicians shall have on their shirts the name of the contractor's business. The Contractor shall immediately notify the Collier County Facilities Management Division via e-mail (DL-FMOPScolliergov.net) whenever an employee assigned to Collier County separates from their employment. This notification is critical to ensure the continued security of Collier County facilities and systems. Failure to notify within four (4) hours of separation may result in a deduction of$500 per incident. * * * * • Page 8 of 13 17-7133 EMS Billing&Debt Collection Services Digitech Computer, Inc. IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person or agent, have executed this Agreement on the date and year first written above. BOARD OF COUNTY COMMISSIONERS ATTEST: COLLIER 1000 Y, FLORIDA Dwight E, Brock;Clerk of Courts A Spar , k By: ie....Pg. % - 3111Wil By: / Ob 0 11H Mon Me Penny Tayl Chairma Dated Olt/ 1 Ill i V/ Attest as to Chairman's sl9nature only. Digitech EMS Billing, Inc. dlbla Digitech Computer, Inc. Contractor By: , Z-----------r__-----------x------u----,__--L.,i 7r, / First Witness Signature (),A.eft- z \- (, ,kc- &AA c-k,,07._ P xt-&,,,v,4,.A- -4 c-cc TType/print witness namels TType/print signature and titleT _.. 4._• ,, ( -cond f itness 1,0-eilli(1011. TType/print witness nameT Approvs to For and Legality: ca iksste4 County Attornw CE9143— C-jt- --re-A-1-C Print Name Page 9 of 13 17-7133 EMS Biltrng&Debt Collection Services Digitech Computer, Inc. Exhibit A - Scope of Services (following this page) Page 10 of 13 17-7133 EMS Billing&Debt Collection Services Digitech Computer, Inc. 4 EXHIBIT A The following services to be performed by Business Associate require Business Associate to access, create and use PHI on behalf of Covered Entity in accordance with Agreement #17-7133 "EMS Billing Debt Collection Services: a. Provide billing and collection services for Emergency Medical Services (EMS) transports, as required on a case by case basis, using a billing system that conforms to generally accepted accounting principles(GAAP). b. Insure a segregation of duties, whereby the same individual must not be able to enter billing, adjust billing, post payments, nor deposit funds; and maintain the necessary levels of security in their automated billing system to protect the County from loss. c. Propose a fee for their services that will include all expenses of billing and collection including, but not limited to, e-mail communication, mail/payments, stationary, fax forms, envelopes, mailing, postage and communications costs. In accordance with Florida Statutes, provide a flat rate fee for each account paid by Medicaid. d. Ensure that all required documentation and agreements with payers (e.g. Medicare, Medicaid, Tri-Care, etc) are filed and maintained, and that the County is kept up to date of important changes to industry regulations. e. Provide periodic training (minimum annually)to County Emergency Medical Services personnel regarding the gathering of necessary information and proper completion of Patient Care Reports (PCRs). f. Download PCRs from the County's EMS data collection system (ImageTrend), or any EMS data collection system used by the County.Firm must accept electronic data from Collier County via a secure network supplied by the firm. The secure data transfer will be electronic in XML, ascii or any other acceptable electronic data transfer format. The contractor agrees to bear any cost associated with incompatibility due to future upgrades or changes in the County's ePCR vendor. Must be able to import all data elements from PCR system. g. Download payment information from the County electronically. h. Accept credit card/ACH payments (must be PCI Compliant), include any fees and where they will apply. i. Mail patient invoice and Notice of Privacy in the first mailing (including return envelope) to the patient within seven(7)business days of receipt of transport information from CCEMS. Have the flexibility to change wording on invoices as needed. j. Provide prompt submission of Medicare, Medicaid and Insurance claims after receiving PCRs, which will be the contractor's notice to commence the billing/collection process, including keeping logs confirming all electronic submissions. Secondary insurance provider claims will be submitted after the primary insurance provider has paid. The County will monitor for probate and bankruptcy cases for CCEMS patients and on receiving Bankruptcy and Probate notice, will Page 1 of 4 O submit information with appropriate detail to contractor for filing. The contractor will respond to County requests and post payments/adjustments related to probate and bankruptcy proceedings. k. Comply with all applicable Federal, State and local laws as they apply to the services being provided, such as, but not limited to, the Federal Debt Collection Practices Law. This also includes all requirements to maintain confidentiality for all medical and patient information as related to insurance and local laws or rules and regulations, such as, but not limited to,the Health Insurance Portability and Accountability Act(HIPAA),Hi Tech Rule and Red Flag Rule. 1. Guarantee claim follow up and re-bill and work with the insurance companies when applicable. Re-bill indicates that all charges applicable to the service be retrievable in billing type format and/or detailed statement. m. Provide a reconciliation of the number of transports (PCRs) collected with those transmitted to the contractor,and contact the County to report any discrepancies. n. Provide web access to the County for access to ad hoc reports on billing performance o. Establish a skip-tracing process to validate patient information ( correct spelling of name, social security #'s, Date of Birth, and mailing address to also include unit/condo #'s), and keep current with returned mail/bad addresses. If an account comes back with a bad address and the billing company is unable to locate a credible address for a patient, the account is to be immediately turned over to the County's contracted collection agency. p. Provide a designated, responsive and professional liaison for patient/payer concerns. Accept responsibility for all EMS consumer complaints and compliments by providing this information to the EMS administration via e-mail no later than the following business day. Provide the County and patients a means to provide billing information,preferably through a secure web site. q. Provide a local phone number or e-mail to respond to inquiries concerning patient account information. r. Provide proper security of confidential information and proper shredding of all disposed materials containing confidential information. Retain appropriate records in accordance with Florida records retention requirements. s. Establish professional relationships with CCEMS serviced hospitals to obtain/verify patient insurance and contact information. Must have the capability to receive hospital reports electronically. t. Respond within (1) one business day to the County, patients, and patient representatives on request for information, either written or verbal; and record all contact information in system for tracking purposes and the creation of an audit trail. u. Participate in face-to-face meeting between County personnel and your appropriate personnel on a semi-annual basis (at minimum) to discuss current legislation, trends, hot topics and better business practices. Page 2 of 4 D��`s v. Maintain appropriate accounting procedures and provide for reconciling all payments, bank deposits,receivables,billings,patient accounts, adjustments and refunds between the contractor's billing system and County records. w. Provide the County with copies of supporting documentation for refunds to be made by the County the month following the payment posting date. x. Provide timely comprehensive reports facilitating all required aspects of monitoring, evaluating, auditing and managing the services monthly. Reports are to include detailed revenue analysis and forecasts on an as needed basis. y. Provide pre-collection activities on accounts to significantly reduce accounts being turned to an outside collection agency. At minimum, this activity should include: three (3) statements sent within nine (9) months with no returned mail; if returned mail —contact "destination facility," one(1)telephone contact or three(3)attempts for telephone contact. z. Process Medicare Revalidation and represent CCEMS in Medicare and Medicaid audits. Will be responsible for any fines incurred due to negative audit findings. aa. Provide the County or designated collection agency with all unpaid invoices along with the complete processing history once accounts are past due by 180 days unless County has specified that a particular account not be sent to collection. bb. Be responsible for the filing of any claim for those accounts sent to collections where it has been determined insurance was available and provide county access to those accounts. cc. Negotiate and arrange modified payment schedules for individuals unable to pay full amount when billed in accordance with County procedures. The contractor will not lower any billed amount without the prior approval of the County. dd. Provide the County with access to all County accounts, data and information maintained in the automated system of the contractor including any hardware, software or connection services required and provide initial and then as needed on-site training for EMS administrative staff on the software utilized. ee. Provide storage of records and the related security and disaster recovery plans; ff. Develop a plan for receiving mail, depositing payments, and providing the County with payment information for accounts prior to the Contract period. gg. Provide copies of all user manuals,system overviews,technical manuals,reports on controls such as internal/external audits or regulatory authority reports when requested to do so by the County. hh. Comply with all applicable federal, state and local regulations. The proposal should describe recent and planned efforts for compliance with privacy requirements and data transmission. Recent audits by Medicare, Medicaid, or other agencies may be used to document compliance. Possession of the SAS 70 (Statement on Auditing Standards 70), SSAE16 (Statement on Standards for Attestation Engagements 16),or SOC 1 certification is required. Page 3 of 4 O� ii. Perform billing services on new collection cases at the proposed rate or for all existing cases at a separately negotiated rate. jj. Provide monthly reconciliation and payment of invoice by the County,that include the following: a. Advise County of Medicare adjustments. b. Payments and return items are to be posted same date as bank deposit posting date. All posting should be current and all items reconciled by end of business month. Any irreconcilable items are to be reported timely to the County for direction and resolution. All postings should be reconciled with the County on a weekly basis. c. Provide monthly reports specific to County requirements. d. Monthly reports are to be received by the County no later than the 5th business day of the following month. kk. Assist County in preparation of Medicaid CPE reporting and indicate fee for that service. Page 4 of 4 Exhibit B — Fee Schedule (following this page) (MCA-0, Page 11 of 13 17-7133 EMS Billing&Debt Collection Services Digitech Computer, Inc. Exhibit B Fee Schedule The prices shown herein shall include all expenses of billing and collection including, but not limited to, e-mail communication, mail/payments, stationary, fax forms, envelopes, mailing, postage and corn munications costs. Description Fee Medical Claim per each transport account $7.50 processed. Standard Claim for non-Medicaid transport 3.95% accounts with net collections less refunds. Exhibit C — Business Associate Agreement (following this page) E',3) Page 12 of 13 17-7133 EMS Billing&Debt Collection Services Digitech Computer, Inc. BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ("Agreement") is entered into between COLLIER COUNTY("Covered Entity")and Digitech EMS Billing, Inc. d/b/a Digitech Computer, Inc.,authorized to do business in the State of Florida, whose business address is 480 Bedford Road, Building 600-2nd Floor, Chappaqua,NY 10514, ("Business Associate"), effective as of this f!' day of Ad j , 2017 (the"Effective Date"). WHEREAS, Covered Entity and Business Associate have entered into, or plan to enter into, an arrangement pursuant to which Business Associate may provide services for Covered Entity that require Business Associate to access, create and use Protected Health Information ("PHI") that is confidential under state and/or federal law; and WHEREAS, Covered Entity and Business Associate intend to protect the privacy and provide for the security of PHI disclosed by Covered Entity to Business Associate, or collected or created by Business Associate, in compliance with the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 ("HIPAA"), and the regulations promulgated there under, including, without limitation, the regulations codified at 45 CFR Parts 160 and 164 ("HIPAA Regulations"); the Health Information Technology for Economic and Clinical Health Act, as incorporated in the American Recovery and Reinvestment Act of 2009, and its implementing regulations and guidance issued by the Secretary of the Department of Health and Human Services (the "Secretary") (the "HITECH Act"); and other applicable state and federal laws, all as amended from time to time, including as amended by the Final Rule issued by the Secretary on January 17, 2013 titled "Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information Nondiscrimination Act; Other Modifications to the HIPAA Rules"; and WHEREAS, the HIPAA Regulations require Covered Entity to enter into an agreement with Business Associate meeting certain requirements with respect to the Use and Disclosure of PHI, which are met by this Agreement. NOW, THEREFORE, in consideration of the mutual promises contained herein and the exchange of information pursuant to this Agreement,the parties agree as follows: 1.Definitions. Capitalized terms used herein without definition shall have the meanings ascribed to them in the HIPAA Regulations or the HITECH Act, as applicable unless otherwise defined herein. 2. Obligations and Activities of Business Associate. a. Permitted Uses and Disclosures. Business Associate shall only Use or Disclose PHI for the purposes of (i) performing Business Associate's obligations under Exhibit A of this Agreement("Exhibit A")and as permitted by this Agreement; or(ii)as permitted or Required By Law; or (iii) as otherwise permitted by this Agreement. Business Associate shall not Use or further Disclose PHI other than as permitted or required by this Agreement or as Required By Law. Further, Business Associate shall not Use or Disclose PHI in any manner that would constitute a violation of the HIPAA Regulations or the HITECH Act if so used by Covered Entity, except that Business Associate may Use PHI (i) for the proper management and administration of Business Associate; and (ii) Page 1 of 12 O�� to carry out the legal responsibilities of Business Associate. Business Associate may Disclose PHI for the proper management and administration of Business Associate, to carry out its legal responsibilities or for payment purposes as specified in 45 CFR§ 164.506(c)(1) and(3), including but not limited to Disclosure to a business associate on behalf of a covered entity or health care provider for payment purposes of such covered entity or health care provider, with the expectation that such parties will provide reciprocal assistance to Covered Entity,provided that with respect to any such Disclosure either: (i)the Disclosure is Required By Law; or (ii) for permitted Disclosures when Required By Law, Business Associate shall obtain a written agreement from the person to whom the PHI is to be Disclosed that such person will hold the PHI in confidence and will not use and further disclose such PHI except as Required By Law and for the purpose(s)for which it was Disclosed by Business Associate to such person, and that such person will notify Business Associate of any instances of which it is aware in which the confidentiality of the PHI has been breached. b. Appropriate Safeguards. Business Associate shall implement administrative, physical and technical safeguards that (i) reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI that it creates, receives, maintains or transmits on behalf of Covered Entity; and (ii) prevent the Use or Disclosure of PHI other than as contemplated by Exhibit A and this Agreement. c. Compliance with Security Provisions. Business Associate shall: (i) implement and maintain administrative safeguards as required by 45 CFR§ 164.308, physical safeguards as required by 45 CFR § 164.3 10 and technical safeguards as required by 45 CFR § 164.3 12; (ii) implement and document reasonable and appropriate policies and procedures as required by 45 CFR § 164.3 16; and(iii) be in compliance with all requirements of the HITECH Act related to security and applicable as if Business Associate were a"covered entity,"as such term is defined in HIPAA. d. Compliance with Privacy Provisions. Business Associate shall only Use and Disclose PHI in compliance with each applicable requirement of 45 CFR § 164.504(e). Business Associate shall comply with all requirements of the HITECH Act related to privacy and applicable as if Business Associate were a "covered entity," as such term is defined in HIPAA. To the extent Business Associate is to carry out one or more of Covered Entity's obligation(s) under Subpart E of 45 CFR Part 164, Business Associate shall comply with the requirements of Subpart E that apply to Covered Entity in the performance of such obligation(s). e. Duty to Mitigate. Business Associate agrees to mitigate, to the extent practicable and mandated by law, any harmful effect that is known to Business Associate of a Use or Disclosure of PHI by Business Associate in violation of the requirements of this Agreement. f. Encryption. To facilitate Business Associate's compliance with this Agreement and to assure adequate data security, Covered Entity agrees that all PHI provided or transmitted to Business Associate pursuant to Exhibit A shall he provided or transmitted in a manner which renders such PHI unusable, unreadable or indecipherable to unauthorized persons,through the use of a technology or methodology specified by the Secretary in the guidance issued under section 13402(h)(2) of the HITECH Act. Covered Entity acknowledges that failure to do so could contribute to or permit a Breach requiring patient notification under the HITECH Act and further agrees that Business Associate shall have no liability for any Breach caused by such failure. 3. Reporting. Page 2 of 12 06) S a. Security Incidents and/or Unauthorized Use or Disclosure. Business Associate shall report to Covered Entity a successful Security Incident or any Use and/or Disclosure of PHI other than as provided for by this Agreement or permitted by applicable law within a reasonable time of becoming aware of such Security Incident and/or unauthorized Use or Disclosure (but not later than five (5) days thereafter), in accordance with the notice provisions set forth herein. Business Associate shall take (i) prompt action to cure any such deficiencies as reasonably requested by Covered Entity,and(ii)any action pertaining to such Security Incident and/or unauthorized Use or Disclosure required by applicable federal and state laws and regulations. If such successful Security Incident or unauthorized Use or Disclosure results in a Breach as defined in the HITECH Act, then Covered Entity shall comply with the requirements of Section 3.b below. b. Breach of Unsecured PHI. The provisions of this Section 3.b are effective with respect to the Discovery of a Breach of Unsecured PHI occurring on or after September 23, 2009. With respect to any unauthorized acquisition, access, Use or Disclosure of Covered Entity's PHI by Business Associate, its agents or subcontractors, Business Associate shall(i)investigate such unauthorized acquisition, access, Use or Disclosure; (ii) determine whether such unauthorized acquisition, access, Use or Disclosure constitutes a reportable Breach under the HITECH Act; and (iii) document and retain its findings under clauses (i) and (ii). If Business Associate Discovers that a reportable Breach has occurred, Business Associate shall notify Covered Entity of such reportable Breach in writing within five(5)days of the date Business Associate Discovers such Breach. Business Associate shall be deemed to have discovered a Breach as of the first day that the Breach is either known to Business Associate or any of its employees, officers or agents, other than the person who committed the Breach, or by exercising reasonable diligence should have been known to Business Associate or any of its employees, officers or agents, other than the person who committed the Breach. To the extent the information is available to Business Associate, Business Associate's written notice shall include the information required by 45 CFR § 164.410(c). Business Associate shall promptly supplement the written report with additional information regarding the Breach as it obtains such information. Business Associate shall cooperate with Covered Entity in meeting Covered Entity's obligations under the HITECH Act with respect to such Breach. 4. Business Associate's Agents. To the extent that Business Associate uses one or more subcontractors or agents to provide services under Exhibit A, and such subcontractors or agents receive or have access to PHI, Business Associate shall sign an agreement with such subcontractors or agents containing substantially the same provisions as this Agreement. 5. Rights of Individuals. a. Access to PHI. Within ten (10) days of receipt of a request by Covered Entity, Business Associate shall make PHI maintained in a Designated Record Set available to Covered Entity or, as directed by Covered Entity,to an Individual to enable Covered Entity to fulfill its obligations under 45 CFR § 164.524. Subject to Section 5.b below, (i) in the event that any Individual requests access to PHI directly from Business Associate in connection with a routine billing inquiry, Business Associate shall directly respond to such request in compliance with 45 CFR § 164.524; and (ii) in the event such request appears to be for a purpose other than a routine billing inquiry, Business Associate shall forward a copy of such request to Covered Entity and shall fully cooperate with Covered Entity in responding to such request. In either case, a denial of access to requested PHI shall not be made without the prior written consent of Covered Entity. b. Access to Electronic Health Records. If Business Associate is deemed to use or maintain an Electronic Health Record on behalf of Covered Entity with respect to PHI,then, to the extent an Individual has the right to request a copy of the PHI maintained in such Electronic Health Record Page 3 of 12 pursuant to 45 CFR § 164.524 and makes such a request to Business Associate, Business Associate shall provide such individual with a copy of the information contained in such Electronic Health Record in an electronic format and, if the Individual so chooses, transmit such copy directly to an entity or person designated by the Individual. Business Associate may charge a fee to the individual for providing a copy of such information, but such fee may not exceed Business Associate's labor costs in responding to the request for the copy. The provisions of 45 CFR § 164.524, including the exceptions to the requirement to provide a copy of PHI, shall otherwise apply and Business Associate shall comply therewith as if Business Associate were the "covered entity," as such term is defined in HIPAA. At Covered Entity's request, Business Associate shall provide Covered Entity with a copy of an Individual's PHI maintained in an Electronic Health Record in an electronic format and in a time and manner designated by Covered Entity in order for Covered Entity to comply with 45 CFR § 164.524, as amended by the HITECH Act. c. Amendment of PHI. Business Associate agrees to make any amendment(s) to PHI in a Designated Record Set that Covered Entity directs or agrees to pursuant to 45 CFR § 164.526 at the request of Covered Entity or an Individual,and in the time and manner designated by Covered Entity. d. Accounting Rights. This Section 5.d is subject to Section 5.e below. Business Associate shall make available to Covered Entity, in response to a request from an Individual, information required for an accounting of disclosures of PHI with respect to the Individual, in accordance with 45 CFR § 164.528, incorporating exceptions to such accounting designated under such regulation. Such accounting is limited to disclosures that were made in the six (6) years prior to the request and shall not include any disclosures that were made prior to the compliance date of the HIPAA Regulations. Business Associate shall provide such information as is necessary to provide an accounting within ten(10) days of Covered Entity's request. Such accounting must he provided without cost to the Individual or to Covered Entity if it is the first accounting requested by an Individual within any six(6) month period; however, a reasonable, cost-based fee may be charged for subsequent accountings during that period if Business Associate informs Covered Entity and Covered Entity informs the Individual in advance of the fee, the Individual is afforded an opportunity to withdraw or modify the request and charging such fee is not otherwise contrary to law. Such accounting obligations shall survive termination of this Agreement and shall continue as long as Business Associate maintains PHI. e. Accounting of Disclosures of Electronic Health Records. The provisions of this Section 5.e shall be effective on the date specified in the HITECH Act. If Business Associate is deemed to use or maintain an Electronic Health Record on behalf of Covered Entity, then, in addition to complying with the requirements set forth in Section 5.d above, Business Associate shall maintain an accounting of any Disclosures made through such Electronic Health Record for Treatment, Payment and Health Care Operations, as applicable. Such accounting shall comply with the requirements of the HITECH Act. Upon request by Covered Entity, Business Associate shall provide such accounting to Covered Entity in the time and manner specified by Covered Entity and in compliance with the HITECH Act. Alternatively, if Covered Entity responds to an Individual's request for an accounting of Disclosures made through an Electronic Health Record by providing the requesting Individual with a list of all business associates acting on behalf of Covered Entity, then Business Associate shall provide such accounting directly to the requesting Individual in the time and manner specified by the HITECH. Act. f. Agreement to Restrict Disclosure. If Covered Entity is required to comply with a restriction on the Disclosure of PHI pursuant to Section 13405 of the HITECH Act, then Covered Entity shall,to the extent necessary to comply with such restriction,provide written notice to Business Associate of the name of the Individual requesting the restriction and the PHI affected thereby. Business Associate shall, upon receipt of such notification,not Disclose the identified PHI to any health plan for the purposes of carrying out Payment or Health Care Operations, except as otherwise required by law. Covered Entity Page 4 of 12 Old, ,nom shall also notify Business Associate of any other restriction to the Use or Disclosure of PHI that Covered Entity has agreed to in accordance with 45 CFR§ 164.522. 6. Remuneration and Marketing. a. Remuneration for PHI. This Section 6.a shall be effective with respect to exchanges of PHI occurring six (6) months after the date of the promulgation of final regulations implementing the provisions of Section 13405(d) of the HITECH Act. On and after such date, Business Associate agrees that it shall not, directly or indirectly, receive remuneration in exchange for any PHI of Covered Entity except as otherwise permitted by the HITECH Act. b. Limitations on Use of PHI for Marketing Purposes. Business Associate shall not Use or Disclose PHI for the purpose of making a communication about a product or service that encourages recipients of the communication to purchase or use the product or service, unless such communication: (I)complies with the requirements of subparagraph(i), (ii)or(iii)of paragraph(1) of the definition of marketing contained in 45 CFR § 164.501, and (2) complies with the requirements of subparagraphs (A), (B) or(C) of Section 13406(a)(2) of the HITECH Act, and implementing regulations or guidance that may be issued or amended from time to time. Covered Entity agrees to assist Business Associate in determining if the foregoing requirements are met with respect to any such marketing communication. 7. Governmental Access to Records. Business Associate shall make its internal practices, books and records relating to the Use and Disclosure of PHI available to the Secretary for purposes of determining Covered Entity's compliance with the HIPAA Regulations and the HITECH Act. Except to the extent prohibited by law, Business Associate agrees to notify Covered Entity of all requests served upon Business Associate for information or documentation by or on behalf of the Secretary. Business Associate shall provide to Covered Entity a copy of any PHI that Business Associate provides to the Secretary concurrently with providing such PHI to the Secretary. 8. Minimum Necessary. To the extent required by the HITECH Act, Business Associate shall limit its Use, Disclosure or request of PHI to the Limited Data Set or, if needed, to the minimum necessary to accomplish the intended Use, Disclosure or request, respectively. Effective on the date the Secretary issues guidance on what constitutes "minimum necessary" for purposes of the HIPAA Regulations, Business Associate shall limit its Use, Disclosure or request of PHI to only the minimum necessary as set forth in such guidance. 9. State Privacy Laws. Business Associate shall comply with state laws to extent that such state privacy laws are not preempted by HIPAA or the HITECH Act. 10. Termination. a. Breach by Business Associate. If Covered Entity knows of a pattern of activity or practice of Business Associate that constitutes a material breach or violation of Business Associate's obligations under this Agreement, then Covered Entity shall promptly notify Business Associate. With respect to such breach or violation, Business Associate shall take reasonable steps to cure such breach or end such violation, if possible. If such steps are either not possible or are unsuccessful, upon written notice to Business Associate, Covered Entity may terminate its relationship with Business Associate. b. Breach by Covered Entity. If Business Associate knows of a pattern of activity or practice of Covered Entity that constitutes a material breach or violation of Covered Entity's obligations under this Agreement, then Business Associate shall promptly notify Covered Entity. With respect to Page 5 of 12 Dv such breach or violation, Covered Entity shall take reasonable steps to cure such breach or end such violation, if possible. If such steps are either not possible or are unsuccessful, upon written notice to Covered Entity, Business Entity may terminate its relationship with Covered Entity. c. Automatic Termination. This Agreement will automatically terminate, without any further action by the parties hereto, at such time as there are no longer any Service Agreements by and between the parties hereto. d. Effect of Termination. Upon termination of this Agreement for any reason, Business Associate shall either return or destroy all PHI, as requested by Covered Entity, that Business Associate or its agents or subcontractors still maintain in any form, and shall retain no copies of such PHI. If Covered Entity requests that Business Associate return PHI, such PHI shall be returned in a mutually agreed upon format and timeframe. If Business Associate reasonably determines that return or destruction is not feasible, Business Associate shall continue to extend the protections of this Agreement to such PHI, and limit further uses and disclosures of such PHI to those purposes that make the return or destruction of such PHI not feasible. If Business Associate is asked to destroy the PHI, Business Associate shall destroy PHI in a manner that renders the PHI unusable, unreadable or indecipherable to unauthorized persons as specified in the HITECH Act. 11. Amendment. The parties acknowledge that state and federal laws relating to data security and privacy are rapidly evolving and that amendment of this Agreement may be required to ensure compliance with such developments. The parties specifically agree to take such action as is necessary to implement any new or modified standards or requirements of HIPAA, the HIPAA Regulations, the HITECH Act and other applicable laws relating to the security or confidentiality of PHI.Upon the request of Covered Entity, Business Associate agrees to promptly enter into negotiation concerning the terms of an amendment to this Agreement incorporating any such changes. 12. No Third Party Beneficiaries. Nothing express or implied in this Agreement is intended to confer, nor shall anything herein confer, upon any person other than Covered Entity, Business Associate and their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever. 13. Effect on Underlying Arrangement. In the event of any conflict between this Agreement and any underlying arrangement between Covered Entity and Business Associate, the terms of this Agreement shall control. 14. Survival. The provisions of this Agreement shall survive the termination or expiration of any underlying arrangement between Covered Entity and Business Associate. 15. Interpretation. This Agreement shall he interpreted as broadly as necessary to implement and comply with HIPAA, the HIPAA Regulations and the HITECH Act. The parties agree that any ambiguity in this Agreement shall be resolved in favor of a meaning that complies and is consistent with such laws. 16. Governing Law. This Agreement shall be construed in accordance with the laws of the State of Florida. 17. Notices. All notices required or permitted under this Agreement shall be in writing and sent to the other party as directed below or as otherwise directed by either party, from time to time, by written notice to the other. All such notices shall be deemed validly given upon receipt of such notice by Page 6 of 12 certified mail, postage prepaid, facsimile transmission,e-mail or personal or courier delivery: If to Covered Entity: Collier County Government Center 3311 Tamiami Trail E. Naples, FL 34112 Attn: Risk Management Director Telephone No: 239-252-8461 Facsimile No: 239-252-8048 If to Business Associate: Digitech EMS Billing, Inc. d/b/a Digitech Computer,Inc. Attention:Mark Schiowitz 480 Bedford Road Building 600,2nd floor Chappaqua,NY 10514 Telephone No.: (914)741-1919 msch iowitz adigitechcomputer.cam 18. Indemnification. The Business Associate shall defend, indemnify and hold harmless Covered Entity and any of Covered Entity's affiliates, directors, officers, employees and agents from and against any claim, cause of action, liability, damage, cost or expense (including reasonable attorney's fees)arising out of or directly relating to any non-permitted disclosure of Protected Health Information or other breach of this Agreement by Business Associate or any affiliate, director, officer, employee, agent or subcontractor of Business Associate. 19. Miscellaneous. a. Severability. In the event that any provision of this Agreement is adjudged by any court of competent jurisdiction to be void or unenforceable, all remaining provisions hereof shall continue to be binding on the parties hereto with the same force and effect as though such void or unenforceable provision had been deleted. b. Waiver. No failure or delay in exercising any right, power or remedy hereunder shall operate as a waiver thereof; nor shall any single or partial exercise of any right, power or remedy hereunder preclude any other further exercise thereof or the exercise of any other right, power or remedy. The rights provided hereunder are cumulative and not exclusive of any rights provided by law. c. Entire Agreement. This Agreement constitutes the entire agreement between the parties hereto relating to the subject matter hereof, and supercedes any prior or contemporaneous verbal or written agreements, communications and representations relating to the subject matter hereof. d. Counterparts, Facsimile. This agreement may be signed in two or more counterparts, each of which shall be deemed an original and all of which taken together shall constitute one and the same instrument. A copy of this Agreement bearing a facsimile signature shall be deemed to be an original. Page 7 of 12 ON's IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be signed as of the date first set forth above. COVERED ENTITY: BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA By: 2rzt,..,,4,A__ Walker, Director of Risk Management First Witness: BUSINESS ASSOCIATE: Signature Digitech EMS Billing, Inc. d/b/a Digitech Computer,Inc. Print Name: By: Second Witness: Print Name: kr." vic- Sc in(c),) Uz gnature •- QO'r\R--• ,i3.6-v‘n(A-i, Title: e &1/4.Ae.,A-k" Print Name: As to Form and Legality: L._ scov . Teac Deputy County Attorney Page 8 of 12 Lvil/1 EXHIBIT A The following services to be performed by Business Associate require Business Associate to access, create and use PHI on behalf of Covered Entity in accordance with Agreement#17-7133 "EMS Billing Debt Collection Services: a. Provide billing and collection services for Emergency Medical Services (EMS) transports, as required on a case by case basis, using a billing system that conforms to generally accepted accounting principles(GAAP). b. Insure a segregation of duties, whereby the same individual must not be able to enter billing, adjust billing, post payments, nor deposit funds; and maintain the necessary levels of security in their automated billing system to protect the County from loss. c. Propose a fee for their services that will include all expenses of billing and collection including, but not limited to, pick-up and delivery of patient care reports and mail/payments, stationary, fax forms, envelopes, mailing, postage and communications costs. In accordance with Florida Statutes,provide a flat rate fee for each account paid by Medicaid. d. Ensure that all required documentation and agreements with payers (e.g. Medicare, Medicaid, Tri-Care, etc) are filed and maintained, and that the County is kept up to date of important changes to industry regulations. e. Provide periodic training (minimum annually)to County Emergency Medical Services personnel regarding the gathering of necessary information and proper completion of Patient Care Reports (PCRs). f. Download PCRs from the County's EMS data collection system (ImageTrend), or any EMS data collection system used by the County.Firm must accept electronic data from Collier County via a secure network supplied by the firm. The secure data transfer will be electronic in XML, ascii or any other acceptable electronic data transfer format. The contractor agrees to bear any cost associated with incompatibility due to future upgrades or changes in the County's ePCR vendor. Must be able to import all data elements from PCR system. g. Download payment information from the County electronically. h. Accept credit card/ACH payments (must be PCI Compliant), include any fees and where they will apply. i. Mail patient invoice and Notice of Privacy in the first mailing (including return envelope) to the patient within seven(7)business days of receipt of transport information from CCEMS. Have the flexibility to change wording on invoices as needed. j. Provide prompt submission of Medicare, Medicaid and Insurance claims after receiving PCRs, which will be the contractor's notice to commence the billing/collection process, including keeping logs confirming all electronic submissions. Secondary insurance provider claims will be submitted after the primary insurance provider has paid. The County will monitor for probate and bankruptcy cases for CCEMS patients and on receiving Bankruptcy and Probate notice, will submit information with appropriate detail to contractor for filing. The contractor will respond to County requests and post payments/adjustments related to probate and bankruptcy proceedings. Page 9 of 12 k. Comply with all applicable Federal, State and local laws as they apply to the services being provided, such as, but not limited to, the Federal Debt Collection Practices Law. This also includes all requirements to maintain confidentiality for all medical and patient information as related to insurance and local laws or rules and regulations, such as,but not limited to,the Health Insurance Portability and Accountability Act(HIPAA),Hi Tech Rule and Red Flag Rule. 1. Guarantee claim follow up and re-bill and work with the insurance companies when applicable. Re-bill indicates that all charges applicable to the service be retrievable in billing type format and/or detailed statement. m. Provide a reconciliation of the number of transports (PCRs) collected with those transmitted to the contractor,and contact the County to report any discrepancies. n. Provide web access to the County for access to ad hoc reports on billing performance o. Establish a skip-tracing process to validate patient information ( correct spelling of name, social security #'s, Date of Birth, and mailing address to also include unit/condo #'s), and keep current with returned mail/bad addresses. If an account comes back with a bad address and the billing company is unable to locate a credible address for a patient, the account is to be immediately turned over to the County's contracted collection agency. p. Provide a designated, responsive and professional liaison for patient/payer concerns. Accept responsibility for all EMS consumer complaints and compliments by providing this information to the EMS administration via e-mail no later than the following business day. Provide the County and patients a means to provide billing information,preferably through a secure web site. q. Provide a local phone number or e-mail to respond to inquiries concerning patient account information. r. Provide proper security of confidential information and proper shredding of all disposed materials containing confidential information. Retain appropriate records in accordance with Florida records retention requirements. s. Establish professional relationships with CCEMS serviced hospitals to obtain/verify patient insurance and contact information. Must have the capability to receive hospital reports electronically. t. Respond within (1) one business day to the County, patients, and patient representatives on request for information, either written or verbal; and record all contact information in system for tracking purposes and the creation of an audit trail. u. Participate in face-to-face meeting between County personnel and your appropriate personnel on a semi-annual basis (at minimum) to discuss current legislation, trends, hot topics and better business practices. v. Maintain appropriate accounting procedures and provide for reconciling all payments, bank deposits, receivables,billings, patient accounts, adjustments and refunds between the contractor's billing system and County records. Page 10 of 12 w. Provide the County with copies of supporting documentation for refunds to be made by the County the month following the payment posting date. x. Provide timely comprehensive reports facilitating all required aspects of monitoring, evaluating, auditing and managing the services monthly. Reports are to include detailed revenue analysis and forecasts on an as needed basis. y. Provide pre-collection activities on accounts to significantly reduce accounts being turned to an outside collection agency. At minimum, this activity should include: three (3) statements sent within nine (9) months with no returned mail; if returned mail —contact "destination facility," one(1)telephone contact or three(3)attempts for telephone contact. z. Process Medicare Revalidation and represent CCEMS in Medicare and Medicaid audits. Will be responsible for any fines incurred due to negative audit findings. aa. Provide the County or designated collection agency with all unpaid invoices along with the complete processing history once accounts are past due by 180 days unless County has specified that a particular account not be sent to collection. bb. Be responsible for the filing of any claim for those accounts sent to collections where it has been determined insurance was available and provide inquiry access to those accounts to the collection agency. cc. Negotiate and arrange modified payment schedules for individuals unable to pay full amount when billed in accordance with County procedures. The contractor will not lower any billed amount without the prior approval of the County. dd. Provide the County with access to all County accounts, data and information maintained in the automated system of the contractor including any hardware, software or connection services required and provide initial and then as needed on-site training for EMS administrative staff on the software utilized. ee. Provide storage of records and the related security and disaster recovery plans; ff. Develop a plan for receiving mail, depositing payments, and providing the County with payment information for accounts prior to the Contract period. gg. Provide copies of all user manuals, system overviews,technical manuals,reports on controls such as internal/external audits or regulatory authority reports when requested to do so by the County. hh. Comply with all applicable federal, state and local regulations. The proposal should describe recent and planned efforts for compliance with privacy requirements and data transmission. Recent audits by Medicare, Medicaid, or other agencies may be used to document compliance. Possession of the SAS 70 (Statement on Auditing Standards 70) or SSAE16 (Statement on Standards for Attestation Engagements 16)certification is required. ii. Perform billing services on new collection cases at the proposed rate or for all existing cases at a separately negotiated rate. jj. Provide monthly reconciliation and payment of invoice by the County,that include the following: Page 11 of 12 cep a. Advise County of Medicare adjustments. b. Payments and return items are to be posted same date as bank deposit posting date. All posting should be current and all items reconciled by end of business month. Any irreconcilable items are to be reported timely to the County for direction and resolution. All postings should be reconciled with the County on a weekly basis. c. Provide monthly reports specific to County requirements. d. Monthly reports are to be received by the County no later than the 5th business day of the following month. kk. Assist County in preparation of Medicaid CPE reporting and indicate fee for that service. Page 12 of 12 19 Exhibit D - Contractor's Proposal (following this page) r":••0 Page 13 of 13 17-7133 EMS Billing&Debt Collection Services Digitech Computer, Inc. k t :1Vdg 7q , f f .;..'t k, ',,,",,,,,, ,T ,.t z f : a �' �,p#4t h r,� 'W £ y�4 ixttss f ` f ' .� ..1.. !it +uw . : w f g t k i,joill:i iii i . :1_, -:('s ' ' ''''' . '; ' '''' ' s:".; - \ ...'.' ,wkiHi.';'-'r.r°t.),4-it'''1. .. ''''.- '.--"'14" '.._,,,.'::-:::71:‘"---.. - I .: i ,„,-.;;;;-,,,..:•;„..,2Z.;„::',..,;,:•:',- wii„Y Proposal Request for Proposals #17-7133 EMS Billing & Debt Collection Services Collier County, FL Due Wednesday, June 7th, 2017 at 10:00AM Cao -ger Corsnty Digitech Computer, Inc. 480 North Bedford Road Building 600,2°d Floor Chappaqua,New York 10514 914.741.1919 R 914.741.2818 fax 11111 Dig Digitechi www.digitechcomputer.com SII► Digitech ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 2 Digitech x�= TABLE OF CONTENTS EXECUTIVE SUMMARY 6 SUPPORTING YOUR MISSION 6 PARTNERSHIP 7 EMS BILLING THROUGH INNOVATIVE TECHNOLOGY 7 MEET YOUR TEAM 8 COMMITMENT TO COMPLIANCE 9 COVER LETTER AND REFERENCES 10 REFERENCES 12 BUSINESS PLAN 13 DIGITECH'S BILLING PROCESS 13 DATA UPLOAD 15 EDITING 17 QUALITY ASSURANCE -THE HUMAN ELEMENT 18 RESOLUTION 18 INVOICING 18 INVOICING COMMERCIAL CARRIERS 19 INVOICING MEDICARE OR MEDICAID 19 REMITTANCE PROCESSING 20 WE APPEAL ALL SHORT-PAY CLAIMS 20 PATIENT INVOICING 22 FINAL CLAIM RESOLUTION PROCESS 23 COLLECTIONS AGENCIES 23 AUDITS 23 AMBULANCE COMMANDER 24 ACCESS TO THE SYSTEM 25 SieuthP 25 Appeal-IT' P 25 SecureDocs26 Portal 0 26 Dashboard 41 27 ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 3 ® ' )1111 Digitech PCR Lens 27 CUSTOMER SERVICE - INCLUDING COMMUNICATING WITH SPEAKERS OF OTHER LANGUAGES 30 ESCALATION OF SERVICE ISSUES 31 DIGITECH'S TRAINING PLAN 33 IMPLEMENTATION PLAN 36 REQUIREMENTS GATHERING PHASE 37 SYSTEM INSTALLATION AND TAILORING PHASE 38 SYSTEM TESTING, TRAINING, AND ACCEPTANCE PHASE 39 FIELD TESTING PHASE 39 NO CASH FLOW INTERRUPTION 40 INTEGRATION WITH HOSPITAL EHR SYSTEMS 41 KEY PERFORMANCE INDICATORS (KPIS) 41 ACCOUNTING AND REPORTING 42 MONTHLY FINANCIAL PACKAGE 43 MONTHLY REPORT SAMPLES 43 REAL-TIME REPORTING &TRANSPARENCY 44 RECOVERY PROCESS AND DEFAULTED CLIENTS 49 PATIENT PAYMENT ARRANGEMENTS 49 AUDITING IS A KEY ASPECT OF OUR BUSINESS MODEL 51 AUDITORS 51 RANDOM DAILY CLAIMS AUDIT 52 MONTHLY CLAIMS AUDIT 52 AUDIT TRAIL IN OUR BILLING SOFTWARE SYSTEM 53 SOC 1 TYPE II CERTIFICATION 54 RECORD RETENTION AND DESTRUCTION 54 DATA CENTER STORAGE AND SECURITY 55 PHYSICAL SECURITY FEATURES 55 LOGICAL SECURITY FEATURES 55 DISASTER RECOVERY AND REDUNDANCY 55 SECONDARY DATA CENTER 57 PROCESSING CENTER REDUNDANCY 58 PHONE SYSTEM REDUNDANCY 59 DATA BACKUP AND ARCHIVE 59 ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 4 I I I I I M M)H Digitech COST OF SERVICES TO THE COUNTY 60 TOTAL PROPOSED FEE AS A PERCENT OF REVENUES COLLECTED 60 MEDICAID CLAIMS FEE 60 SUMMARY OF FEATURES INCLUDED IN DIGITECH'S PRICE 60 MEDICARE AND MEDICAID EXPERIENCE 61 ECONOMIC BENEFIT TO COLLIER COUNTY 63 EXPERIENCE AND CAPACITY OF FIRM 64 QUALIFICATIONS TO PRODUCE THE REQUIRED DELIVERABLES 66 INTEGRATION EXPERTISE WITH IMAGETREND 67 NAAC CERTIFICATION 67 AVERAGE AMOUNT OF DAYS TO SEND INITIAL BILL AND RECEIVE A RESPONSE 67 CUSTOMERS OF SIMILAR SIZE AND SCOPE TO COLLIER COUNTY 68 SPECIALIZED EXPERTISE OF TEAM MEMBERS 69 ADDITIONAL RESOURCES 70 ACCEPTANCE OF CONDITIONS 72 REQUIRED FORM SUBMITTALS 73 EVALUATION MATRIX 87 Appendices Appendix A Digitech Report Samples Appendix B Certifications Appendix C Résumés of Key Personnel Attachments Attachment 1 Insurance Certificate Attachment 2 Foreign Profit Corporation Annual Report Attachment 3 Florida Department of State Detail by Document Number Addenda Q&A 1 Published 05/11/2017 Q&A 2 Published 05/12/2017 Q&A 3 Published 05/15/2017 Q&A 4 Published 05/30/2017 Q&A 5 Published 05/30/2017 Addendum 1 Published 06/05/2017 ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 5 )))D Digitech EXECUTIVE SUMMARY Digitech's team has thoroughly examined the scope of work for RFP #17-7133 and we are fully prepared to meet Collier County's needs for billing and collection services for Emergency Medical Services transports. Digitech is 100% dedicated to providing ambulance billing services of the highest quality. It's what we dedicate ourselves to every day. We state with confidence that we can fulfill and exceed the County's requirements by implementing our fully HIPAA-compliant, high-performance billing solution for the County. Supporting Your Mission We understand Collier County Emergency Medical Services' commitment to making the County a safer and healthier pace to live and visit by providing compassionate and timely life-saving emergency medical care. EMS providers take risks every day; it is our mission to support these public servants by ensuring that their revenue stream keeps flowing. It is our responsibility to the County to utilize all of our resources to collect every dollar possible in order to maximize collections. We are confident that we will be able to increase collections for Collier County. Our billing system has been developed to ensure that all of our clients receive maximum revenue, and has allowed us to increase collections over the previous solution every time we have been contracted. (See page 13 for more information about our billing process) This includes several major municipal services such as Dallas Fire-Rescue, Memphis Fire-Rescue, Grady EMS Atlanta, and Gwinnett County Fire. These are just a few of our current clients who previously used Intermedix as their EMS billing solution, and in every instance Digitech was able to significantly improve collections in the first year, as illustrated in the chart below. Collection Improvements vs.IMX NO year of service $26,000,000/50% .:• 1.,-.522S,61 8 Digitech %increase 519,500,00/37.5% S19,03$420 St c, 513,000,000/25% .. .. ._.. _.... .- . . .. ,- 444.971.682... §��.evaragm tmprovomant " y<� t 515,810,003 a,wU .0513.793,085_. ",�'` `;..._ .. $6,800,000 t 12.5% - 611.338.330 &5,271.004 RIW 52,680.051 53,956,258 52053,124 $2,616195 65 i 61.733 411 dollars!44 increase Corsicana,TX Rowland,TX Johnson County,KS Gwinnett County.GA Danes,TX Memphis,TN Grady EMS,Atlanta 5,140 Transports 5,150 Transports 20,000 Transports 31,500 Transports 98,009 Ttansporte 75,500 Transports 81,000 Transports ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 6 11111 Digitech 1.,,,- Partnership -Partnership Digitech takes a consultative approach to ambulance billing projects because experience dictates that every client is different, every client needs a unique combination of services, and some degree of solution customization is always beneficial. As part of this consultative style, we consider it our responsibility to keep the County up-to-date on important changes to regulations in the EMS industry in the state of Florida and across the country.The County can be assured that by staying on top of regulatory changes and observing industry best £ " practices, we are able to maintain the resources we need to integrate compliance within all of our business activities and serve as informed advisors for County officials. By partnering with Digitech, Collier County will receive the highest quality EMS billing service centered on innovative technology, responsive customer support, real-time reporting, and integration expertise. We have been providing Billing Services for EMS Transports for over 30 years, and we currently serve municipal and private ambulance entities in 20 states and process over $1 billion in claims. See page 12 for our list of references. Collier County will be provided with a deep pool of resources and experience to be called upon as you deem necessary. These resources include our innovative technology and dedicated staff of EMS billing experts. Our technology and our people have been successfully merged to create a uniquely powerful system that puts a premium on compliance and customer service. This approach will allow Digitech to increase billing efficiency and maximize collections for Collier County. EMS Billing Through Innovative Technology Ambulance Commander is Digitech's proprietary software package that is specifically designed for the medical transportation industry and that has been refined for 30 years. It is composed of a series of discrete modules designed and developed to manage all aspects of EMS billing and related data management and reporting, some of which are listed below. ..' Sleuth Demographic search tool finds missing patient or insurance info '. Appeal-lT' Automated, unrelenting appeals processing `; SecureDocs al Document Management Imaging System Dashboard Olk Customizable interface that gives users a real-time picture of operations Portal 0 Secure online access for patients to update information or pay their bills Digitech has the ability to download PCRs from any EMS data collection system used by the County.Ambulance Commander is already fully integrated with the ImageTrend ePCR system. While Digitech has experience integrating with many of the top-tier ePCR systems, our most extensive experience is with ImageTrend. We have built,tested, certified, and deployed what is now our standard ImageTrend interface many times over and have complete confidence in our ability to seamlessly integrate with them again for this project. Digitech's Account Management team will train Collier County personnel on how to review all aspects of Ambulance Commander, including the audit system. All authorized County personnel will have 24/7 access to the Ambulance Commander billing system. This includes financial reports, reports on all key performance indicators, dispatch reporting, claim details, and the ability to print an invoice, receipt, or statement. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 7 immMO Digitech In addition, several real-time reporting features will enable the County's EMS administrators to keep an up-to- date picture of financial and operational statistics at their fingertips. These interactive tools will allow the County to see summarized totals and drill down to the individual patient, claim, or transaction audit level whenever desired. Three examples of these powerful reports are the Ambulance Commander Analytical Scorecard,the Ambulance Commander Financial Scorecard,and the Dashboard. Meet Your Team As a part of your partnership with Digitech, Collier County will have access to our entire team of EMS billing experts. Our staff is one of the greatest resources we can offer the County. Our staff of over 135 people focuses exclusively on EMS billing. Digitech employs a flexible staffing model through which each payer group is handled by a team of Digitech staffers specializing in that area. For instance, Medicare claims from multiple clients are managed and processed by our team of Medicare specialists. Under this model, experienced staff works alongside newer staff members, so that all clients have the benefit of our most experienced coders and billers working their claims. This approach ensures claims processing will proceed without interruption due to vacations, unforeseen absences, or temporary reassignment due to a spike in volume. The chart below shows the main staff members that will be overseeing the various aspects of implementation and billing for the County. tt Walt Pickett,II Ben Lambert SVP Implementation • Joyce Kerulo and Support SVP Billing VP`technology • LA , , .... ...:,, '4.i., , , , fillH. -., f • .. t All iii.µ= ,441. ,, r.; .x: _. Mary del Franco Jacqueline Nunez Fran Cusco Cathy Tenzyk Jason Castened. Maxine rtAgostino Mxx Gerrie Mach Molder Suporvlsar Account Manager Patient Collection Quality ASSurarrct Insurance Caii°.'aion Medicare Manager Gala Analytic., Coo,nt liarSJll Account Management %tan i er Manager Manager The implementation of services for the County will be overseen over Walt Pickett, Digitech's Senior VP of Implementation and Support. He will also be the primary point of contact for the County during this project. Mary del Franco, Digitech's Account Management Supervisor, will be in charge of training and coaching end- users on system functionality. The County will be able to contact Mary and her team 24/7 with any questions related to the business aspects of implementation. Jacqui Nunez, one of our Account Managers, will handle enrollments for medical claims billing while ensuring the County maintains proper provider credentials. Joyce Kerulo, Digitech's Senior VP of Billing, will oversee the setup of Digitech's billing process for Collier County, and will be the senior-level point of contact for the County during the term of the contract. Joyce's team will handle all aspects of billing for Collier County. Fran Cuzzo, Digitech's Patient Care Manager, will oversee all aspects of patient collections, process electronic and paper billing, and provide high level support to the IT department testing new processes in Digitech's systems. Cathy Tenzyk, Digitech's Quality Assurance ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 8 �� M�II► Digitech Manager,will attend to regular random audits of Collier County claims to guarantee compliance with all federal and state regulations.Jason Castaneda will supervise the team handling insurance collections, Medicare HMOs, Medicaid HMOs, and facility and attorney invoices for the County. Maxine d'Agostino will ensure that Collier County's implementations for Medicare and Medicaid are handled in compliance with Florida and US regulations. Ben Lambert, Digitech's VP of Technology, will manage the technical aspects of implementation. He will supervise a team of programmers and analysts that will work to ensure all of the County's technological needs are met. One of the members of Collier County's technological team will be Max Dekle, Digitech's Data Analytics Specialist. He will create any custom reporting requirements for Collier County, and enroll the County in Digitech's award-winning PCR Lends reporting application. Finally, Mitch Holder will be a day-to-day resource for the County's financial and operational managers. He will guide and assist the County in maximizing the business insights available through the Ambulance Commander Dashboard and Analytical Scorecard. Commitment to Compliance Digitech's active compliance program, managed by our dedicated Compliance Officer and Attorney, incorporates many regulatory safeguards including random daily claims audits, monthly claims audits, and independent third party audits — including an annual SOC 1 Type II audit. Our flawless compliance record attests to our commitment. We maintain this record in the following ways: We support continuing education for our employees and encourage them to obtain industry certifications. We have a Certified Ambulance Compliance Officer on staff. We have a dedicated QA team of eight people that continuously conducts random claims audits. • We regularly submit ourselves to voluntary external audits by industry experts. For more information about our commitment to compliance,see page 50. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 9 M 11 Digitech COVER LETTER AND REFERENCES , Digitech Computer, Inc. is pleased to submit this proposal in response to Collier County's Request for Proposals for EMS Billing and Debt Collection Services. After carefully reviewing the requirements of the RFP, you can be confident that we understand the Scope of Work and will exceed the County's expectations should we be awarded this contract. Digitech is a New York company, incorporated in 1984. Our contact information follows: ,t 480 Bedford Road Building 600,2nd Floor Chappaqua, NY 10514 Digitech Phone:(914)741-1919111c,+nnlslaw, Fax:(914)741-2818 r Federal Tax ID#: 11-2693136 Digitech is a privately held Subchapter S corporation that specializes in ambulance billing. We process over$1 billion in ambulance claims annually for private, municipal, and hospital-based ambulance service providers in 20 states. Ambulance billing is our only focus, and as our references will confirm, we will provide you with service of the highest quality and exceptional compliance while maximizing revenue. We provide our partners with an unbeatable balance of advanced technology and experienced staff. This combination allows Digitech's performance to surpass that of our competitors. We believe we are the only ambulance billing firm who can say all of the following: Increased collections over the previous solution every time we have been contracted The design and development of a proprietary system refined over 20 years specifically for ambulance billing,which is arguably the most sophisticated system of its kind as evidenced by a Product Innovations Award by EMS World • A proactive compliance program that incorporates multiple regulatory safeguards, including an annual SOC 1 Type II audit, independent external audits and a flawless compliance record attesting to our dedication Powerful and comprehensive reporting that provides flexibility, ease of use, real-time graphical data,transparency, and the ability to customize to meet any reporting need No work offshored outside the United States, and no intention of ever doing so A comprehensive transition plan that ensures that new clients benefit from no disruption in cash flow and, in many cases, increases cash flow during the critical transition months Regular review of account performance, agency rates,and industry trends and best practices Annual revenue projections Breadth of experience with clients of all sizes including municipalities ranging in size from 1,000- 150,000 transports Collier County can be confident that we will make prudent long-term decisions on your behalf without the concern of a board looking for speedy return on investment. Because we do not have outside pressure to meet growth projections, we are able to balance our resources by focusing on our existing clients and are never in a ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 10 ■ u . MO Digitech . position where our survival depends on getting another client. While we are one of the largest ambulance billing services in the country,we have achieved this status with fewer than 100 clients,which makes it possible for us to devote ourselves to them. Digitech's business model marries advanced IT solutions with a highly experienced and knowledgeable staff that manages every detail of each account. lik As our client references will attest, there is a quantifiable difference between Digitech's technology, service, and results and that of our competitors. We have grown by referral rather than acquisition, which allows us to add clients in an orderly fashion, standardize training and procedures, and deliver continuity of service. Our financial stability positions us to be able to focus our energy on building a lasting relationship with every client we add.This is one reason we have a 98%client retention rate and still work with clients who contracted with us in 1987. Digitech is headquartered in Chappaqua, NY, a suburb 30 miles north of New York City. Excepting the five who work from home, all of our employees work from this office.While some organizations set up satellite locations in various states to show they have a local presence, we believe that a centralized approach yields better results without diminishing the benefits of local access. We look forward to discussing this in more detail should we be selected for shortlist. As a Digitech client, you will benefit from the expertise of our 10-person IT team whose only function is to develop, upgrade, and maintain Ambulance Commander®, our proprietary ambulance billing system. You will have full access to Ambulance Commander and its modules such as Dashboard, which makes demographics, operational statistics,and financial data easily accessible for your analysis.This is the same system we use to do our billing. It's important to us that our clients have complete transparency into what we do. The undersigned further represents and warrants that this bid is a firm and irrevocable offer for a period of 120 days and that he has full and complete authority to submit this proposal to Collier County on behalf of the bidder and enter into Contract if this proposal is accepted.The signature represented is authorized to bind the offeror to contract with the County. Respectfully submitted, J 7/ J , Mark Schiowitz President&CEO Digitech Computer, Inc. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 11 �■ 11lI► Digitech � . References Digitech regards our clients as our primary resource. We listen to them and learn from them, and their feedback is a continuous wellspring that drives our development as a billing service, brings new products and processes to market, and provides us with new opportunities to expand and improve our service. Our list of references follows. First Date of Current Client Name Contact Information Scope of Contract Service Donna Buhler Annual Transports:36,000 Gwinnett Fire Rescue Business Manager EMS Billing Services 408 Hurricane Shoals Road NE, 12/07/11 Lawrenceville,GA 30046 (678)518-4876 Imaging&Hosting Donna.buhler@gwinnettcounty.com ESO Solutions ePCR integration Nathan Sweet Annual Transports:16,000 Anderson County EMS EMS Director 314 Public Safety Lane, EMS Billing Services 07/01/16 Clinton,TN 37716 (865)457-8609 Imaging&Hosting nsweet@andersonems.com Washington County—Johnson Lori Kemp Annual Transports:23,000 City Comptroller EMS Billing Services 11/01/16 296 Wesley St, (423)975-5502 Imaging&Hosting Johnson City,TN 37601 Ikemp@wcjcems.org ESO Solutions ePCR integration Sergio Nardi Annual Transports:19,500 Newport News EMS Educator EMS Billing Services 2400 Washington Ave, 04/01/16 Newport News,VA 23607 (804)384-6483 Imaging&Hosting snardi@nnva.gov ImageTrend ePCR integration Pamela Kiestler Annual Transports:83,000 Memphis Fire Division Chief EMS Billing Services 2714 Union Ave Extended,Suite 350, 01/13/10 Memphis,TN 38112 (901)826-5377 Imaging&Hosting pamela.kiestler@memphistn.gov ImageTrend ePCR integration 44 I cannot begin to tell you what a joy it has been to work with all of you. I learned so much during the roll-out of the new EMS Billing and ePCR product. I will forever be grateful for the professionalism and excellence that you and everyone in your organization have shown throughout our association. Pam Kiestler Division Chief City of Memphis Fire Services ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 12 mimomm110 Di . itech allomall - BUSINESS PLAN '` g► Compliance, &Quality ' G l`A COLLECTION RESEARCH & CODING ESOT , •import PCRs Denials Data Upload ' r Dispatch ��� •reconciliation Crossovers \ Info ... .* find demographic info Clinical QA Verification find insurance Payment check eligibility Invoicing +•• Review •verify mileagePosting review medical necessityr< ( Patient Editing define level of service \Care Report apply procedure de • verify and attach documentation .X A Quality ..review all government claims Folloyr-up • Assurance tram= Pdv*t*P*y .. N100044 Atustmenta r . ..................................................... 00,401 CLIENT liil Digitech ., Digitech's Billing Process Digitech achieves exceptional results for every client, every time. This is true whether the service is large or small, converting from billing in-house, or using a billing service. According to our clients, they also see improvements in level of service,technology, and reporting capabilities.This is not by accident—it's by design. Our business model marries advanced IT solutions with a highly experienced and knowledgeable team that manages every detail of each account. Our compliance plans and collections policies adhere fully to all Local, State, and Federal laws and regulations regarding collections, financial transactions, privacy and "standards of reasonable care" for information handling, management, and destruction. This includes full compliance with FDCPA (Fair Debt Collection Practices Act), FACTA (Fair and Accurate Credit Transactions Act), FCRA (Fair Credit Reporting Act), GLB (Gramm-Leach-Bliley Act), FERPA (Family Educational Rights and Privacy Acts) and COPPA (Children's On-Line Privacy Protection Act). Digitech places importance on the aspects of our business that enable our firm to stay ahead of regulatory requirements and changes, as well as the resources we need to integrate compliance within all of our billing and collection activities,training, and quality management programs. A structured implementation plan is the foundation for an efficient transition and ultimately a successful partnership. Communication avenues will be established between Collier County and Digitech project leaders at the outset of the project and include regular meetings (initially weekly) via conference calls, detailed and documented implementation plan updates, email exchanges, and phone calls. All policies, procedures, ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 13 ammummmr- 0I► Digitech ... statements, and processes will be developed in consultation with Collier County and in accordance with your protocols. Digitech's process for creating and billing ambulance transport claims can be broken down into three stages: • Data Collection • Research and Coding • Resolution Data Collection DATA CO IION .,. �,L.Y.,�, �� ;"� The first stage occurs primarily on the client side, from dispatch of the transport to the creation of the patient care record in the Collier County ePCR application. The assistance that Digitech requires from / Dispatch our clients in order to perform billing services on their behalf is L Info minimal, and well within the scope of the normal provision of ambulance transport services: Clinical QA Review Data collection, enhanced by the documentation training we provide and the PCR Lens tools we offer to monitor patient the quality and quantity of field data collections. '.. Care • Report Timely provision of reasonably accurate patient care , reports with narrative descriptions of treatments provided and drugs administered. • Review by Collier County's Quality Assurance team to ensure that run records are complete and clinically accurate before marking them as "Ready to Bill" and preparing them for transfer to Digitech.While this step is not required, it is highly recommended. PCP Lens ` During the implementation phase of the project, Collier The PCR Lens data quality reporting interface County's active participation will be required to provide aggregates pre-hospital data from each crucial information for registrations. We will also need transportation as it is transmitted through the the County's cooperation in authorizing Digitech to sign Patient Care Report application and then serves it registration forms in order to meet the timeline. up in an interactive user interface.Ambulance Commander can then display the data in a variety of Research and Coding user-defined views,making it easy for EMS leaders to pinpoint problems,push training and re- education to where it's needed,and identify high Our tested interface will pull the billing and dispatch performance individuals. information from the ImageTrend servers once it has been marked "ready for billing," usually after a review PCR Lens helps administrators of ambulance by the County's QA personnel. transport agencies make sense of the mountains of field data collected by their medics and push that knowledge back into improvements in efficiency, better patient care,and increased revenue. EMSW#RRLD NNOVATIO AWARDS r=" ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 14 91I► Digitech110111011•11mmuz RESEARCH & D NGG Digitech will provide training to your medics to support the creation of compliant PCRs with narratives that accurately Data Upload : •match trips to PCRs document all treatments provided and support their medical •verify all trips uploaded necessity. In addition, Digitech offers PCR Lens, a unique tool to help providers see, measure, and improve the quality of • demographic and insurance data collection in the field. •find demographic info Verification find insurance check eligibility Data Upload verify mileage medical necessity review Digitech pulls the billing and dispatch information from the Editing ::'.verify and attach documents ePCR host servers,and the second stage of the process begins. •define level of service apply procedure codes Pre-hospital Patient Care Reports and all associated transport data are uploaded into Digitech's system via Secure File Transfer Protocol (5FTP). This process is typically completed within two to three hours each morning via an import routine written by Digitech for specific ePCR systems. Digitech has import routines for every major ePCR system on the market. Our routines are unique in that we import all of the information from the PCR system, not just the information required for billing. This greatly increases our ability to provide reporting and analytics that directly relate finances to patient care. On a regular basis, Digitech will do a reconciliation to make sure that all ePCRs have been imported into the billing system. This process, along with Collier County's reconciliation process of matching an ePCR to each transport,will ensure that all billable transports dispatched have been transferred to the billing system. We reconcile all transport records to PCRs. You will never lose a claim. Once the PCR data has been reconciled, our billers can see all critical transport data, including the dispatch data, the crew data, the unit data, etc. They can also see the Patient Care Report which contains the details of the patient assessment, the treatment provided, and the narrative entered by the responding medic. With this information,they can begin the next step in the billing process—Verification. ,ax:.�1 „ _. mn ....a f. A 1 "-""" Ambulance Commander";!'` =.7 ` W.wu,., "' 3 �r y k#. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 15 immimmtzr, . SII Digitech Verification Verification is the process of finding missing billing and demographic information and confirming the data that is currently available. This process is completed within one Verification business day of receipt of Patient Care Report data. Our verifiers do the following: • Access multiple public and private databases to locate missing patient information. Contact the patient by phone to get insurance information when necessary. Contact admitting hospitals to get patient information that can be used to find insurance information using our demographic search tools.When possible,we build electronic bridges to hospitals to enable direct querying of patient databases or transfer of patient demographic and insurance data. • Locate and verify insurance coverage, eligibility, and effective dates of coverage. Digitech's proprietary search tools help increase our collections by making it possible to find more information than our competitors. Using Public and Private Databases to Locate Missing Patient Information Digitech uses proprietary search tools that connect to large databases, including Experianl, which contains records on nearly 300 •i• • million names and 116 million households, and performs searches ,•,,,��' Et xperian • • s using any available data to find additional demographic information. A world of insight The goal is to find the patient's social security number which can then be submitted to other databases to find insurance information. Using Clearinghouses to Find or Verify Insurance and Demographic Information Using the demographic information available, verifiers then seek insurance information using large databases provided by clearinghouses to find or verify available insurance information and determine eligibility. This also allows us to find secondary insurance that field personnel will almost never obtain, and that even the receiving hospitals may not be able to provide. We validate Medicare, Medicaid, and all insurances on a daily basis for all of the claims that we receive. In addition to verification of insurance information on file, we validate patient insurance status by feeding the verified Social Security number into our insurance polling system which queries multiple insurance H L H C A P, ,. companies in search of a policy number associated with that Social Security number. Digitech uses Change Healthcare and other such databases' for this process. Validation of patient insurance status is typically completed in a matter of hours on the same day the trip information was downloaded. 1 Experian is a global leader in consumer and business credit reporting,marketing,and data services 2 Change Healthcare is a leading electronic health information aggregator,performing more than 6.4 billion health information exchanges annually ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 16 . - IIID Digitech 1=111011•111m!" Other Means Used to Find Insurance Information Digitech utilizes a number of other techniques to complete the demographic and insurance components of the record including: Hospital interface technology and systems which automate the process of retrieving information from receiving hospitals. Special invoicing forms with an easy to complete insurance information section and a return envelope,which make it easy for patients to return demographic and insurance information to Digitech by mail. Calling programs to contact the patient and get insurance information or set up payment plans. • Integrated web portals for each client where patients can check the status of their accounts, make payments, update demographic profiles, and provide insurance information. Editing Editing is the intensive process by which we review each claim manually and Editing determine level of service, medical necessity compliance, signature compliance, and mileage. As part of the editing process, Digitech's certified coders review the content of the ePCR, evaluate the narrative, and decide how a claim should be billed. It's important to get it right. Once the editing process is complete, claims are procedure coded and TM scheduled for invoicing. Any accompanying paperwork is verified and 4 attached to the claim using Digitech's SecureDocs document imaging interface. Editing is typically completed for all claims within 24 business Certified Ambulance Coder hours of receipt of ePCR data. Resolving Missing Information and Discrepancies When required for Medicare and Medicaid claims, Digitech will contact patients to obtain their signatures or those of their representatives. If we have exhausted all possible avenues of recovering missing information, our editors will compile a list of claims that cannot be edited or coded and therefore cannot be submitted, such as claims that are missing clinical information, trip origin or destination, or other critical transport details. Typically,this list represents less than 1%of claims we receive. The County's team will usually be notified of these discrepancies within 48 business hours of receipt of ePCR data. We will ask County representatives to review these lists and supply us with the requested information if possible, and we will update each claim accordingly. Ambulance Commander provides an audit trail of every action undertaken, so each time a claim is touched in any way or any bit of information or documentation is added, deleted, or changed, the system creates a time-stamped record. This audit trail shows what was changed, the user who made the change, and the date and time of the change. Digitech will report all open issues for the month to Collier County. Most issues are resolved prior to closing the month's transactions. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 17 910 Digitech , :e .,r. Quality Assurance—The Human Element Digitech's Quality Assurance (OA) team, headed by a NAAC-certified coder, is made up of nine staff members, all of whom have backgrounds as EMTs, paramedics, nurses, or ambulance billing professionals. The QA staff manually reviews 100% of Medicare, Medicaid, and Railroad claims. All Medicare claims are checked for medical necessity, mileage, and signatures.All Medicaid claims are similarly verified for medical necessity. Our dedicated QA department manually reviews 100%of Medicare, Medicaid, and Railroad claims. Our QA department frequently works directly with clients to ensure that they are trained on filling out the proper paperwork with as much accuracy as possible. If QA finds that the paperwork conflicts with the level of service listed in the claim,or if the narrative is not sufficiently informative, QA reaches out for more information.This could involve contacting the care facility or the patient for clarification. In the end, our highly experienced people, sophisticated processes, and constant vigilance create an unbeatable combination that leads to predictable results every time: increased revenue from ambulance transport collections for every client. Resolution Resolution of claims involves Invoicing, Posting, Denials and Short-Pay follow-up. There is a circular Crossovers ++ Appeals +� dynamic between these steps as remittance processing often results in claims returning to the Invoicing function for re-billing to secondary �fiVC}IGllig Posting and tertiary payers, for denied claims to be corrected and resubmitted, for appeals processing, or for balances to be invoiced directly to patients. +, In more detail,the processing layer includes the • following: Follow-up Commercial Payers Invoicing Medicare •• Medicaid ]+ Approximately 95% of the compliant claims Patient Pay completed by our clients make it through the Adjustments Charity Data Upload, Verification, and Editing processes To Collections so that they are invoiced within 24 business hours of being received. Ninety-eight percent are invoiced within 48 business hours of being received. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 18 ` I1 Digitech Invoicing Commercial Carriers This includes the submission of electronic files to carriers that accept them or sending paper claims to those who do not. Where possible, Digitech files directly with the carrier, but alternatively will file claims using intermediaries and clearinghouses. We prefer direct billing as it speeds the process, and faster processing speed typically results in better collections. In instances where the commercial carrier does not pay in full, Digitech will appeal the claim. Appeals are sent to carriers within 24 hours of a short paid claim being posted. All commercial claims are followed up on a regular basis (typically every 20 days) until they are resolved. Invoicing Medicare or Medicaid Digitech is focused on compliance. Depending on specific laws and regulations that may apply, before sending claims to Medicare or Medicaid we will verify that the: Level of service is correct Correct modifiers have been applied Signatures have been obtained Supporting Physician Certification Statements for non-emergency transports are attached Medical necessity of the transport is correctly documented Mileage is correct Digitech will file directly and electronically with both Medicare and Medicaid. Private Pay(Patient) Invoicing(3 invoice cycle) Digitech uses mailers specially designed to make it easy for the patients to return valid insurance information. Our patient invoicing process is as follows: Once we have exhausted all efforts to locate and verify insurance coverage for a patient,an initial invoice is sent, usually within 48 hours of our receipt of the ePCR data. A statement of account is generated and mailed to the patient's responsible party 30 calendar days after the original invoice and followed up with a phone call to the patient or to the patient's responsible party. When a patient account is not paid after 60 days, Digitech sends a pre-collection notice in accordance with the County's policies and again follows up with a telephone call. Patient accounts that remain unpaid after 120 calendar days are sent to collections or adjusted in accordance with the County's policies. Digitech will be responsible for preparing and mailing all invoices and overdue notices.All notices, invoices, and letters will be delivered in a format approved by Collier County and in compliance with the provisions of the Fair Debt Collection Act and all other applicable laws and regulations. We employ a positive customer service approach in dealing with overdue accounts and do not engage in any form of debtor harassment, improper language, or unreasonable conduct at any point in the billing or collection process. Our calling campaigns will include provisions for patients to set up payment plans or carry out charity plans as defined by Collier County. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 19 ® #II► Digitech ,.¢n Remittance Processing In most cases a lockbox is used,which facilitates the payment process in the following ways: All payments will be immediately credited to Collier County's account. Digitech will never have control over the County's cash. The bank will image all documentation so that both parties can view payment details at any time. • The lockbox simplifies the process of reconciling deposits. Once a payment is received, often in the form of an Explanation of Benefits,funds will be immediately posted to the County's account. Cash is reconciled every day. We never have unapplied accounts. 44 The City of Houston was profoundly pleased to discover that Digitech does not carry an unapplied funds account. We rest easily knowing that every dollar is correctly allocated. LaToya Jasper Deputy Assistant Director Finance Department,City of Houston If the claim is partially paid, one of the following will occur: The claim will be crossed over to the next payer if the original payer paid all that was legally due. The balance will be transferred to the patient if no additional insurance is available. Sometimes the claim is denied. • Less than 1%of claims submitted by Digitech are denied because our software traps claims for correction before they are submitted,speeding the collection process. The small number of claims that are denied will be corrected and sent back to the Invoicing function. At times, the claim (or a portion of the claim) is not paid and we are reasonably sure will never be paid. This happens most often when invoices are sent to patients for whom we do not have and cannot find a valid address, but sometimes occurs when we reach a patient who is unable to pay. In those situations,claims will be sent to collections or written off according to Collier County's protocols. We Appeal All Short-Pay Claims Digitech does not leave your money on the table. Here again, we leverage the power of hyper-automation to initiate and follow up on denials, appeals, and short-pay claims. Appeal-IT, another of the distinguishing automated features of the Ambulance Commander platform, systematically appeals the short paid claim until we have successfully recovered the complete balance. Where a manual appeal process may become prohibitively expensive and tiresome, an automated process is both affordable and unrelenting. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 20 � � M 1► Digitech immimemr- Probate Claims If an invoice is referred to probate court, Digitech will collect any remittances received and post them to the patient account. If an account has already been closed and referred to collections when payment is received from an estate, we will open the account to enable the posting of funds. All requests for Satisfaction of Claims will be forwarded to Collier County for approval and signature. Receiving and Processing Patient Record Requests Digitech uses ChartSwap (http://www.chartswap.com) as a repository for attorneys to request invoices, medical records, etc. for the clients they represent.The attorney's request typically consists of a letter detailing the nature of their request and a HIPAA form signed by the patient. After Digitech reviews the request, the attorney will be charged a fee based on the number of pages to be included in the document. The fee is inclusive of searching, handling, copying, and mailing costs. Segregation of Duties Digitech is committed to maintaining security in our billing system.To ensure that the County is protected from loss, the same individual on Digitech's staff will not be able to enter billing information, adjust billings, post payments, or deposit funds. Speed of Processing Impacts Collections Experience has shown that getting invoices out within a day or two of receipt of PCR data positively affects the outcome of the collections process, not only by avoiding timely filing issues, but also by enabling the follow-up on denials, partial payments,short-pay claims, and appeals to begin that much sooner. Typically,within one business day of receipt of transport data, Digitech billing personnel initiate all automated batch claim processing tasks including: Electronic invoicing and filing Paper invoicing, printing, and mailing when appropriate Self-pay invoicing Facility invoicing(if applicable) of claims processed 95%of claims will be processed in the first 4 days after receipt of transport data 11""1"1""' YRINVAIWWW.MPOP. Day 1 Day Day Day4 DayS+ ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 21 x MI) Digitech .'a Patient Invoicing When we're dealing with your patients, we want to speak to them as you would. Digitech's Customer Service representatives, billing agents, and all other staff who interact with patients are comprehensively trained in best practices guided by the principles of HIPAA security, OIG Waste, Fraud, and Abuse rules, the HITECH Breach Notification rules, Red Flag Identity Theft rules, local, state, and federal laws and regulations, as well as compassionate care for patient privacy and patient rights. '4'4' fNDy CITY OF SAMPLE TO PAY ONLINE:BY CREDIT CARD OR PROVIDE i' BILLING ON BEAOSA. INSURANCE INFORMATION PLEASE VISIT FILLING ON BEHALF OF SAMPLE PRE DEPT CITYNAME.PAYAMBULANCE-COM rn 430 BEDFORD ROAD,BLDG 500.2nd eL �- Lm W' CHAPPADUA,NY 16514 STATEMENT DATE PAY THIS AMOUNT %NVOICEa otIIt se RETURN SERVICE REQUESTED 11118114 $1,090,00 DCITY00 SHOW AMOUNT PAID HERE$ CITY-43 000000001 ♦Payment Address V x11111911,11x,lrlll411141llII Ili°IIIIII"1111lIshdi JOHN TESTPATIENT CITY OF SAMPLE 1 NE MAIN ST PO BOX 12345 SAMPLE XY 12345-1111 SAMPLE,XY 12345-1111 —Please check box n address is Incorrect or insurance Inkmmabon nes changed and todtcale ehande(sl on the lever.ride: PLEASE RETURN THIS PORTION WITH YOUR PAYMENT TAX ID:70-0000000 INVOICE N#:1 CITY OF SAMPLE PATIENT NAME INVOICE# INCIDENT it INVOICE DATE JOHN TESTPATIENT DCITY00 14000000 11/18114 ORIGIN: DESTINATION: PATIENT RESIDENCE TEST HOSPITAL 1 NE MAIN ST 1 TEST ST , SAMPLE,XY 12345 SAMPLE,XY 12345 DATE DESCRIPTION OF SERVICES PERFORMED QTY RATE AMOUNT 10/26/14 A0427 ALS EMERGENCY 1.0 $1,075.00 $1,075.00 A0425 MILEAGE 1.0 515.00 $$15.00 All forms and patient communications are customized for each client,so that all invoices,statements,and letters. represent your ser trice as you wish to be seen. CREDITS: $0.00 BALANCE DUE UPON RECEIPT OF THIS INVOICE: $1,090.00 PLEASE FORWARD YOUR INSURANCE INFORMATION OR REMIT PAYMENT IN FULL UPON RECEIPT OF THIS INVOICE. FOR INQUIRIES CALL 888-000-0000 MON-FRI(8AM-6PM EST)OR EMAIL XXXX@DIGITECHCOMPUTER COM 810 CDDIG125 DCITY ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 22 SEI► Digitech .. Final Claim Resolution Process During the implementation of the contract, Digitech will sit down with Collier County to understand and document the parameters so that we can then customize our processes to carry out those protocols as agreed. Generally, claims that go through the process and remain unpaid either go to collections or are written off according to the contract requirements.These amounts include: adjustments charity programs discounts claims sent to collections or written off in accordance with Collier County's policy Refunds and Overpayments Digitech has three established methods of processing refunds: We set up a client-funded account from which refund checks are issued. We submit a refund request to the client,who then writes the refund check and notifies Digitech so that we can make the financial adjustment to the account. We write the refund check and submit the amount on our monthly invoice to the client. Should Digitech be selected as the billing company for Collier County, we will work with you to determine your most advantageous refund processing option. Collections Agencies Digitech will write off claims according to Collier County's policies when we have not been able to make any contact or retrieve any kind of insurance information for a patient. We will prepare and transmit a file containing the claim data to your designated collection agency in a format and on a schedule determined jointly between Digitech, the collections agency, and Collier County. Digitech has experience with collection agencies across the nation and while we prefer to keep our relationships with collection services at arm's length to avoid any appearance of conflict of interest, we would be happy to recommend services that we have found to be reputable. R gIplian>ce, & Quali Audits Permeating every aspect of Digitech's billing process is a series of Quality Assurance and Auditing functions that ensure all other processes, either manual or automated, deliver proper and accurate results. In addition to automated functions that examine every link in the chain to verify that claims or data are not falling through the cracks, getting misdirected, or remaining unprocessed for any reason, we employ a team of QA personnel whose sole job is to check batches of claims manually every day to verify that both systems and people are processing all data with the high level of accuracy that we demand. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 23 mim■wr:-= WO Digitech 1111001110111wr Further oversight and analysis of our automated processes includes continuous random claim auditing by our QA department; a monthly Financial Reporting Review done by our dedicated client account managers before monthly reports are sent out; biennial audits conducted by one of the premier firms serving the EMS marketplace; and annual SOC 1 audits conducted by Withum, Smith, & Brown, one of the nation's most respected accounting firms. Our final accuracy check is our cash posting process, which enables our specially trained cash posters to pick up anything missed by the other safety measures. The Explanations of Benefits tell the whole story. Ambulance Commander Ambulance Commander, Digitech's proprietary software, is composed of Ambulance Commander a series of discrete modules that automate many of the most difficult tasks in the billing process. While other companies are at the mercy of Digitech's proprietary system their software vendors who may require weeks or months to make delivers to our clients what we programming changes, Digitech builds and owns our claims processing believe is the most advanced software. We have eight full-time programmers on staff to work only on technology for ambulance transport this application, so we can prudently automate any element of the billing that exists today. It can be process. This improves efficiency, which frees up resources that we can securely and easily accessed by then reallocate to collecting on the more difficult claims. Improving authorized County personnel from collections on these claims is where we derive much of the incremental any computer with an internet revenue realized by our clients. browser and a reasonably fast connection.Ambulance Commander We know of no other billing company that has created their claims delivers comprehensive reporting on processing software platform and refined it over the course of more than your operations and finances 30 years. In the end,this will benefit the County in the following ways: whenever you want it, 24 hours a day. It is highly customizable, and We can react quickly to mandated regulatory and submission supported by a team of changes.To maintain compliance, Digitech employs programmers who are constantly continual monitoring, analysis, and software/process delivering updates to improve changes. Because we own the software, we can do all of this collections and increase data on our schedule. security based on changes to There is no dependence on third party software vendors. regulations or in response to client • We can customize software as necessary—whether for feedback. custom reports or error-trapping utilities to simplify what could be a time consuming process. We can easily address the technological needs of the County. Dashboard,/al► Ambulance'# SecureDc►cs iii Commander Appeal-11'4P, PCR tense e Portal0Sleuth.° Pedestal ._.�_"_".`.�.._ Sentinel* ;3 ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 24 - 9I1) Digitech Access to the System Digitech's Account Management team will train Collier County personnel on how to review all aspects of Ambulance Commander, including the audit system. All authorized County personnel will have 24/7 access to the Ambulance Commander billing system. This includes financial reports, reports on all key performance indicators, dispatch reporting, claim details, and the ability to print an invoice, receipt,or statement. In addition, several real-time reporting features will enable the County's EMS administrators to keep an up-to- date picture of financial and operational statistics at their fingertips. These interactive tools will allow the County to see summarized totals and drill down to the individual patient, claim, or transaction audit level whenever desired. Three examples of these powerful reports are the Ambulance Commander Analytical Scorecard,the Ambulance Commander Financial Scorecard, and the Dashboard. SleuthP Sleuth is the name of the unique, proprietary,web-based, demographic search tool we use to obtain missing or incomplete patient or insurance information when it is unavailable to your medics in the field. € `` When the Social Security number is not available, the , r ' i, search tool is given basic demographic information # ' including address, phone, name, birth date, or any tia"s , ,A , 4 combination thereof to identify the patient's Social I / v_: ' { the Social Security 3)# ,, , ,,,,R;,� Security number. Once identified, �' a number is fed into our insurance polling system which ` sequentially queries multiple insurance companies in ""R..,'_ ,1•. , , -, ": search of the policy number associated with the Social t" : ' : �� , , , Security number. The policy number is then used to bill the , claim to the proper carrier. These two systems allow us to __ , ' find missing or incomplete patient and insurance information when field personnel and even the receiving Sleuth uncovers insurance and demographic information hospital are not able to provide it. Appeal-1T S'`------- We Appeal All Short-Pay Claims - An aspect of our collection process that distinguishes Digitech from other vendors is our vigorous pursuit of every dollar of insurance claims. Insurance companies will routinely short pay claims, even when they are required to pay the full amount. Many billing entities will accept less than the billed amount and write off the balance. Digitech's proprietary system automatically appeals the short-paid claim. Where a manual appeal process may become prohibitively expensive and tiresome,an automated process is both affordable and unrelenting. We turn what has traditionally been banter between insurance company computers and billing company personnel into a spirited discussion between our computers and theirs—a discussion where we pride ourselves on getting in the last word. Appeal-IT is just one of the many technological innovations made possible by the ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 25 MO Digitech ,,,,,,,,.,<- fact that Digitech owns, develops and maintains its own billing software, and one of the many ways by which we've managed significant collection increases for all of our clients. Appeal-IT, combined with our SecureDocs imaging System, uniquely positions Digitech to maximize the County's revenue by enabling us to appeal claims as often as necessary to collect the amount rightfully due the County. Our system tracks all appeals and other efforts to recover incremental revenue, allowing both our personnel and the County to review and monitor every step of the process. Secure Docs ii SecureDocs® will bring document storage and management efficiencies to the County. SecureDocsa„�,�..rR��., .-- -,•�.•.. allows EMS providers and Digitech to easily store, ,, organize and retrieve documents relating to the 4 µ transport. This includes letters, legal materials, or any i. other documentation that may be of value in the future. SecureDocs surpasses paper filing systems by in, — providing one-click access to all documentation. Using ,in, Optical Character Recognition (OCR) and Barcode �: SecureDocs a E ", recognition technologies, SecureDocs provides full text search capability for all scanned images, simplifying the process of locating, viewing, printing, or emailing important documentation. Digitech's Secure Document Management System While paper-based filing can lead to misplaced documents, SecureDocs ensures accuracy by providing a complete audit trail of every document and transport. SecureDocs was created with a focus on security, and meets all HIPAA compliance standards. With 128-bit Secure Socket Level (SSL) encoding and barcode technologies, all communication is secure. All images are stored and backed up on servers maintained by Digitech. Authorized users can store, manage, access, and share documents 24/7 through Digitech's hosted application server. P Portal E1 1S ONLINE BILL PAYPatients can access their account information through a secure and rlMy tlY IMWMY YR Pew. {MrYelrM. r, --.. convenient online access interface that �t.i lF::t iOGiN .............::. ;:;., 4• i:::,,.;,..ir•.n:::: i I1 1 IV:. we call Portal. Through Portal, patients . . . -- •-- can provide insurance information, i> -__a update their demographic information, ,` 721' _ I and review the status of their accounts. '9111111111r i _- ..0 - w, -- � Credit card payments can also be made iI through a 128-bit SSL self-service }74 ..'> , ' payment interface. .gym Portal allows patients to access their account information securely and easily. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 26 ., WI/ Digitech . Dashboard 4' Digitech's Dashboard will bring County operational and financial data into an easy-to-use interface that will enable your managers, administrators, and business analysts to get a real-time picture of any aspect of your operations.The intuitive user interface provides a set of sophisticated reporting and analysis tools that will help any ambulance transport organization stay on top of the game and ahead of the curve.The basic setup contains several views of critical operational metrics, including a set of Key Performance Indicators validated by Page, Wolfberg & Wirth, the premiere EMS law firm. Dashboard's front end is also highly customizable, allowing the County to configure and save a personal view of your operations that tells you exactly what you need to know when you need to know it. i wax a MA.S 1 0=1 Ill , rl 4.. x �• 1 ul Trn.,port j'Md ........ iA.v ono n tu�Tot/CaJ�fR.led.f1,961.11179 ..... .. i 1 (—• •AL3 E6ERGEM Y:16.0% 60660 f 'ALS 14002rVRli :20.0% I _ ii -AL31 EEElla./Y.0.0% I E. ;,Ji' »_ ALa21.1.2faCRaENCY:0.0% y�y�+� �y f}/�il ,....2:.,, uk BARIATRWC EMER 1160.0.0 1. ;./Cl si bVC77 \ ..- at BMNTRIC P Ef,,r3..1'10% l�S.o)0 q '-•.rr R9 EM`RGENCY:9.0`A 6l5 NON EMFRGENCN 53l% r f xd01,.4 cc-4,ox Y. ou iilata at 111,SO EhtERGENCI 0.0% ' f6m a.. .. �.._. .... ) A�N �vv`n.0 your fingertips.�+ ,SCT NON�EMERGElaC1'D.0% .. Dow.h:210 n0 ''' finger tips. ......... ',YENT(LO`JSi1CARE)30% _... ..... m •1 .... .. ... .. 1 I • .,M.-- G'".""0.i Co9.0I0041A 914960 J' 'i'is pane Prtant iwt i 1093t,j 3t ion 4. I ; • 6*01 .... E O6vgN<r ' _.... ....... ......... Overall Denial Ratio;20.46•d M ;Ini.WNe �♦i 1 ■N �FiR9.99rKY%27.0A LX:. 10', A IR ■rIMU+YOI. tt1 Qte9aW IMINAY ze.D% �' 0 M1% `N6TE1.1.04KY:15.0% 0.De%I i, IS.0:'-i a6T%? i r.6, ! 04 'j 1 GCl% ars% .III-._1/11... 000., ......T.-.- ....T_ ...... 1 Y.N:I .ch,SII hbJb 360 1xY.uY,N 3 II 166 h,0 i 1, .._Els- s Digitech`s Dashboard is just one of the many tools you will have at your disposal to track operations and finances. . PCR Lens The PCR Lens data quality reporting interface aggregates pre-hospital data from each _ run as it comes across through the Patient Care Report application and serves it up in an interactive user interface. Ambulance Commander can then display the data in aEMSWCRLD variety of user-defined views, making it easy for EMS leaders to pinpoint problems, #INNOVATION¢.. push training and re-education to where it's needed, and identify high performance AWARDS individuals and crews. PCR Lens includes a feature that provides EMS leaders and administrators an opportunity to compare the accuracy of pre-hospital data collection with the same data after it has been pushed through Digitech's error-trapping utilities, matched against national demographic databases, and reviewed and edited by Digitech's certified ambulance coders during the creation of the claim. Through PCR Lens, EMS Directors, Chiefs and administrators can quickly and ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 27 immiiiim--- MO Digitech Illommilli accurately analyze the data collected by medics and compare their efforts to their peers, other EMS shifts, stations, and even other EMS organizations. Data Collection Report Card Patient Demographics First Name:Worth 10 of 125 Possible Points Agency Identifier Percentage(Collected) Collected Grade Percentage(Accurate) Accuracy Grade 8 8 M1-126 75.33% C 47.45% M1-135 99,85% A 89.31% 8 M9.138 99.00% A 93.51% A j M1.141 70,00% C 69.25% 0 M2-119 82.84% a 91.53% A M2-137 100.00% A 94.91% A M3.126 100.00% A 86.67% 0 M3-129 93.04% h 93.37% A M3-136 99.74% A 93.10% A Last Mame:Worth 15 of 12.5 Passible Paints Agency Identifier Percentage(Collected) Collected Grade Percentage(Accurate) Accuracy Grade 0 0 M1=126 76.47% C 50.03% M9-135 99.86% A 90.07% A 841-138 99.73% A 94.67% A M1.191 82,86% 0 76.20% C I' M2-119 100.00% A 92.72% A M2-137 100.00% A 95.68% A M3-128 99.33% A 89.57% 0 M3-129 92.77% A 95.15% A M3-138 100.00% A 98.28% A PCR Lens -z- PCR Lens enables,au to see,macsu e. compere,and improve Meld data callection. .. .........__......._................ PCR Lens C'�data qualityanalysis tool earned EMS World's Product Innovations Digitech's Y t -, r Award. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 28 MO Digitech PCPCR >, c, ■ Lens First Name-Accurate FlrstName•Inaccurate 8 ', � ; FirstName-Empty [1.±.1.:1, Last Name-Accurate �,,1 Last Name-Inaccurate Me 1 I ' m{ Last Name•Empty - I 11 Zip-Accurate 60'u 99 - "l Zip•Inaccmte , 4 o` i..... Zip•Empty • SSN-Accurate I; .1 SSN-Inaccurate ,, � SSN-Empty ' .;x„ :- a Date of Birth-Accurate ' h �- i �± Date of Binh•Inaccurate t 10a. J, Date of Birth•Empty sm i - 11 Medicare-Accurate �. � ; � a * ,z 4,Medicare-Inaccurate ma i,,,,l Medicare-Empty aa,,. _ 1 I r i ! Medicaid-Accurate • 75% ' 4 :1 L 11 ' _I A Medicaid-Inaccurate g .I t -� , ;.� Medicaid-Empty 2 �. u _ MedicalRec-Accurate am. ,� 1 1 MediealRec-Inaccurate s,. _ '' I g v,. f MedicalRec•Empty tab ` Billing Sig nature-Accurate ; 4 i Billing Signature•Inaccurate e i BillingSignalure-Empty .oK , • .- MasterSignature•inaccurate::' I • MasterSignature-Accurate r A. E J .a -MasterSignature-Empty MAX X _.,...+ _ELLIE JAKE PCR Lens can help County QA/QI administrators make sense of the mountains of field data collected by their medics and push that knowledge back into improvements in efficiency, better patient care and outcomes, and increased revenue for the department. Where one medic (Max above,for instance) may capture Social Security numbers 92% of the time, a data validity check might show that only 83% were accurate. Conversely, a crew might show that they only capture insurance information on four out of five runs, but get it right every time. 44 With Digitech's help, we've brought our EMS billing into the 21st Century. It took some pushing, and change is never easy, but the results speak for themselves. Jim Fischer Chief of Fiscal Services _` ''M T e f._' Baltimore City Fire ,:�,.,.. .,; a�*,a: ,..,Y :t`�.=.;a ;r°,^,. ' ,..`z �.-..tea.: m, >. eva,�s< €r?-k• r�'r�.'".r..,v. .,., r ='w wc.-. ._.__,_._.__.�,.. _,....�_.. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 29 �■ m , 110 Digitech 1111.11.1111111117 Customer Service—Including Communicating with Speakers of Other Languages While performing collections services on behalf of Collier County, Digitech will commit to the highest level of professionalism with respect to patient interactions. Digitech will provide a toll-free telephone number for customer service and patient inquiries. We have bilingual (English & Spanish) staff on-site in customer service positions during normal business hours. After-hours calls are directed to our voicemail service that allows patients to leave information for follow-up by our Customer Service Representatives. Our user-friendly voicemail system is designed to accommodate after- hours patient inquiries easily,with calls returned to patients the next business day. On Saturdays, Sundays, and holidays, patient voicemail and email communications will be checked at least once per day. Digitech is committed to the highest ethical standards. Our Customer Service Representatives are experts at dealing with patient issues and are well trained and knowledgeable with respect to EMS billing practices and procedures. Our representatives will counsel your patients through every step of the payment process. Patients in need will be guided to alternative financial resources that may be available to them. We believe this personalized attention to help your patients identify other options differentiates us from other billing companies. Digitech personnel will ensure that all patient interactions are professional and friendly. In providing our services, sensitivity to the County's reputation is our foremost consideration. Support Available to Collier County We pride ourselves on our exceptional customer service. We invite the County to contact any of our clients to ask how they feel about the way their patients are handled. Because emergency service providers are 660 We were very impressed with always on the job, Digitech's support team is Digitech's methodical and cooperative on call around the clock. During our normal business hours of 8am — 6pm EST, Monday approach, and they have made good on through Friday, our support team is available their promise to do better in every aspect to respond to any questions that the County of billing and customer service than our may have. Outside of normal business hours, Digitech's team can be reached by phone to former contractor. handle any urgent technical needs. Senior David Morando Management provides direct contact Former Assistant Chief information, including personal mobile Johnson County Med-Act,Olathe KS numbers, to our clients to enable the escalation of any issue to the highest levels of attention that may be required. Requests for information from the County, patients, and patient representatives will receive a response within one business day. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 30 ��#I► Digitech NEININIlaw51-7 Escalation of Service Issues Digitech's Service Escalation Tracking System will log any service issue that requires escalation and enable County administrators to track these issues through to resolution. Digitech will make every attempt to immediately resolve client or patient questions and issues during the initial phone call or interaction with clients and patients. All questions received by telephone are logged to the patient record, which includes details of all conversations, issues, and proposed resolutions. Digitech's call center also has the capacity to record patient calls if the client wants to have access to audio records. All related documentation is indexed to the patient record. Digitech strives to resolve issues and verify resolutions in writing within one business day whenever possible, based on the nature of the problem, and will make all associated records available to the County. Line of RA,:,pof c e�f Second Line ® DEPARTMENT UPERVISPR 41, Yxiy Third Line DEPARTMENT vow MANAGER. Last Stop SENIOR VP - ■einemi City andP atient 4o • 4 n .. R i o, notified Concerns regarding the actions of Digitech staff are also logged to the employee's personnel file, addressed through training where possible, and through disciplinary action when necessary. The escalation path for service issues is from the collection or billing specialist through the Department Area Supervisor to the Senior Vice President of Billing Services. Issues and comments received by Digitech will be brought to the attention of senior executives at Collier County through Digitech's account manager for the County or through the SVP of Billing Services when they are of a degree of urgency that requires the involvement of senior management. All actions, notes, and contacts will be entered into the complaint tracking system. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 31 4111 Digitech County officials who deal with Digitech's staff and executives will understand that we strive to be at our clients' disposal at all times, up to and including making the personal mobile phone number of our CEO available to senior County staff. All complaints will be responded to within 48 hours and every effort will be made to resolve ambulance users' complaints about the billing and collection of fees within five days. The following charts illustrate some of Digitech's call center metrics. 100% r„ %of answered calls In a typical month,94%of calls are answered within 90 seconds. 75% Of the 6%of calls that are abandoned,nearly halt are dropped within 60 seconds. 50% %of abandoned calls 25% 0% 30 seconds 60 seconds 90 seconds 20 secs 30 secs 60 secs ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 32 Digitech Digitech's Training Plan To ensure that all employees who are involved in the billing process are confident in their knowledge of patient care documentation, Digitech will provide comprehensive and up-to-date training on both documentation and compliance. Training will be delivered onsite at the County's training facilities on a schedule that will coincide with employee work schedules and accommodate all shifts and all divisions. All training information and support materials will be updated and refreshed annually. The broad outlines of Digitech's Documentation Training are as follows: A. Purpose of Documentation 1. Patient Care Report for Medical History 2. Inventory and Asset Management 3. Creation of a Legal Document 4. Sole Documentation for Reimbursement Billing B. Purpose of this Training 1. Improve Clinical Documentation to support the revenue recovery efforts 2. Understand how those two elements work together 3. Ensure documentation is focused on accuracy- NOT on billing criteria 4. Educate to prevent potential fraud C. Billing Basics 1. How a claim goes through the billing process D. What Does"Documentation" Include? 1. Any field in the ePCR 2. "Drop-downs" or"Pick-lists" 3. Activity Section within the ePCR 4. Narrative 5. Other ePCR fields that may capture information about the patient's condition or care 6. Patient Signatures E. Who is Involved in Documentation? 1. Any crew member on the ambulance 2. Patient, patient's family,and anyone else present 3. First Responders 4. Hospital 5. ePCR Vendor F. Elements for Creating a Claim for Billing 1. Required data to make a claim billable 2. Common errors and omissions ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 33 Nommimmr MMH, Digitech Collier County will have the benefit of access to Digitech's PCR Lens data quality reporting interface. PCR Lens aggregates pre-hospital data from each run as it comes across through the ePCR application and serves it up in an interactive user interface. Ambulance Commander can then display the data in a variety of user-defined views, making it easy for EMS leaders to pinpoint problems, push training and re-education to where it's needed, and identify high performance individuals and crews. Digitech will also provide complete and ongoing training for Collier County administrators on the Ambulance Commander system. During the final phase of implementation, we conduct user training so that Collier County will have qualified testers to conduct the final Acceptance Test. We will develop a Test Plan jointly with the County to ensure all contract requirements are met, which we will use during Acceptance Testing to guide testing and to evaluate results. We will work closely with Collier County to manage any discrepancies uncovered in Acceptance Testing, correcting and retesting as needed. Digitech will provide the County with unlimited remote training to ensure efficient access and use of the Ambulance Commander software. Training will be provided in a Train the Trainer format allowing the County to train other staff on the system as needed. Once the training has been completed, the County may identify a systems administrator who will have access to set up new employees with the appropriate permissions and security or change any employee's level of security at any time. This level of system control will enhance the County's data security by providing the specific level of access needed to employees on the system. Training on the Ambulance Commander system will include learning how to access and create reports, how to research individual claims, and how to review and audit collections activity. While the monthly reporting package that we will provide will cover all aspects of revenue recovery and corresponding operational detail, it's critical to Digitech to make sure that our clients know that they can see everything that has happened on any claim at any time, and that they can track the status of collections at any point in the process. The following table outlines Digitech's Ambulance Commander Training Plan: SESSION I PREREQUISITES FOR SESSION I: QUILLON SECURITY ADMINISTRATION [QUILLON is Digitech's hosting platform] Quillon Login Citrix Client Install • Quillon Site Overview • Quillon Security for Users AMBULANCE COMMANDER SECURITY ADMINISTRATION • AC System Overview • Key highlights ® Goals for the training session AC Security Groups AC User Profiles AC Menu Security SESSION II ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 34 M�II� Digitech' SECUREDOCS-ARCHIVE BATCH TOOL • New Batches View ® Edit Filter CALLS Claim Search • Find Call • Call Utilities IIIPatient Swap ® Claim Reporter SESSION III REPORTS Management Reports ® Analytical Scorecard ® Financial Scorecard • Dispatch&Operational—Daily Call Volume Report Data Dump—Trip and Dollar Dump Report Writer ACCOUNTING REPORTS • Sales Report • Adjustment Report • Cash Receipts Report • Accounts Receivable Report f Accounting Roll Forward HELP ® About • Request Remote Support ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 35 IMEM■ridill► Digitech Implementation Plan Digitech's time-tested implementation plan will ensure a well-organized, speedy rollout of services with no interruption in cash flow to Collier County. Central to a successful implementation plan is process organization. Process organization ensures that everything that needs to be done before Go-Live is completed,which in turn ensures a smooth transition from your previous vendor to Digitech. Timeline of Implementation es a Goiter County ce. a o'° c,°�`� , as`°�' ,, ` tQis ~` ��� .c ep'� �tia'� ,`�o� e°� R`e a .. ,"` `zse a a,`oo \ems ewe do \ems yGo `e o',.Gr eea;'`�� '��`Q Q� ,ted 6',x.4 wad. a,<e` ' tti `e ooNe ra o a,.\e 4' t•oy` ,bt+ 0,02 }e? ae0 �Q�a -4 `,- et\ arab `is' e�,�a Le4ea ,0' °Lt ceco Fe `�`dz <e� LeCA �e way `�` S� Cs CO ice ye « ,fie A ta0 efi ,' S�' .ca J�� / +4 4 M 14 / August 2017 September 2017 October 2017 /, i t G t",,,1-rji , t 371',Ns ormr ai 3 z 'iu" >N,tor i S,tE a l,, Qtal.,,e ^ ,r............-mu:.....m.�.uwm�x w:,, .... mttw,.......vw,...m,w 'ffi�' w..Ongoing support is Continuous through the operations phase including the productional'annual revenue summaries and detailed AUR reports The three phases of implementation—Requirements Gathering,System installation,and Testing—can be accomplished in 60 days. Our implementation plan begins at Contract Execution,with the Requirements Gathering Phase, using our New Client Checklist. A clear understanding of Collier County requirements will permit a speedy System Installation and Tailoring Phase, at which time the key components will be set up and relationships established with stakeholders to ensure successful operation. During the System Testing and Acceptance Phase, users will be trained and all aspects of the system will be thoroughly tested to ensure they are working according to contract requirements and joint Collier County and Digitech process requirements. Upon system acceptance, the Go- Live milestone is reached and the Digitech solution will begin billing and collection activities on behalf of Collier County. From Go-Live forward, we will be in the final phase of the Implementation Plan, the Field Testing Phase,where we will continue to work closely with Collier County,the payers, and other stakeholders to ensure that all processes are performing as expected, making any adjustments necessary to ensure smooth operations. Details of each Implementation Phase are discussed below. Weekly calls and emails track the progress of all implementation tasks. Digitech will stay engaged with Collier County to ensure the timely completion of the project. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 36 ®w,k )1)i Digitech` Requirements Gathering Phase Digitech's Implementation process begins with the Requirements Gathering Phase, where we will work with Collier County to complete our New Client Checklist. The New Client Checklist is a complete list of all the information required by Digitech to enroll Collier County with processors, and identify and document business rules, rates, and special processes of your organization. Using this information, we can complete a detailed written implementation plan to cover all the activities of the later phases, begin to set up the billing system, and enable Digitech's billing department to review the information required to establish the proper procedures to begin billing for Collier County. An example of the New Client checklist follows. We work closely with you to complete this document quickly. Ams tit ANCI COMMANC 7 1111) Digitech h ABS•20120101i 1x101 C39NT C.•ieCA6i1?-1111.1i9 SEA;x:E!(NC Part II:Primary Contact 3.TIus 3.Name .).1;1,.1; AO Digitech aS5•r012os03i ' wG SZ''''''''-%"(t1C S.City,ttd.162•p ...... NL"-0:Ciior3 tMtcxus]-moi _._ i 7.[*sir add a 1 Part V:A(Wltional Contacts z,MI.Part III.finanaal I I.Nr+,4 n 1.Nems 3.Aare .... 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'71.trod 4d1fre54 .3.Are youcun*ily is[eiti op.444W.44144 eltgronist*,In 135 format) ';OYES 1 ONO ID.O.St Ii1644335wnitt4nl=ie n atdr1e[11yASd SI to0i9litchrlrntht pratesaor.Di911 sth«Ul need to' ram 1161.1 3(01/,40441114C4rt them'AA 114. 12.C;Fy,Siplt 1 2,F .. _ .4,tun Naa+k ,S.Tr6ept.lnr d • 33.Rosa ._.... o....... �. 14,trwl Mann. : .4.matt: 39.Cite State&Zip ...... 3 ...... . .. .... ._. . .. `40.tort Addrea* ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 37 mumisair � EH Digitech� System Installation and Tailoring Phase System Installation and Tailoring begins with the installation of Ambulance Commander and the modules identified as a result of the Client Checklist research. The process of tailoring, customizing, and refining our service is iterative and collaborative because we want to make sure that all elements will meet Collier County needs. For example, we will work directly with Collier County to ensure that information systems, reporting formats, and information exchange processes are fully aligned with the requirements of the contract. The design of the solution and specifications for integration of billing services, communications, and ePCR functions will be well documented prior to System Testing to support review and approval. During this phase we complete initial setup tasks with external stakeholders, including processor registrations, hospital interfaces, and County systems.We also prepare customized patient correspondence. The process is managed using our detailed implementation plan which lists every task, the task owner, the current status of the task, and the estimated completion date. Weekly conference calls based around the implementation plan ensure that every task required for Go-Live is completed. lk } rfi�'� {k-'4€t/l;'' . kt�; .,._'' „'7.:-!"-:'”.am ,, :'' `. Task Dependents Owners Stat Status ETA Completed E 1 Sign Contract DCI CLIENT • 2.Send Wekorre Package-New Client Checklist, `` Digitech Roster 1.1 DCI Open 3.Complete&Return New Client Checklisti CLIENT Open 4.Complete Internal Billing Service Checklist 13 DCI Otae+t 5.Update Pedestal Client Master with basic agency &contact information 1.3 DCI Open 6.Update Pedestalwith Client Vendors,Billing ID's &Processors 1.3 DCI Open 7.Send Initial Implementation Plan i 4 DCI Opal o 6.Update Version Control Board I 3 CACI open ' 9.Update SOCi 3.12 Business to Business Transmission Decurrent 1.4 DCI cepa t. r 1a HoepitalAcce IA DCI 1pen Sample page of Digitech's Client Implementation Plan.These worksheets drive the agenda of weekly conference calls. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 38 Digitech System Testing, Training,and Acceptance Phase When all of the system components have been installed,tailored, and configured, we begin System Testing and Acceptance. In this phase, we test all components and connections to ensure that they meet contract requirements and the data standards required by all stakeholders. During this time, we also conduct user training so that Collier County will have qualified testers to implement the final Acceptance Test. Digitech will develop a Test Plan jointly with the County to ensure all contract requirements are met. We will use that plan during Acceptance Testing to guide testing and to evaluate results. We will work closely with the County to manage any discrepancies uncovered in Acceptance Testing, correcting and retesting as needed. Upon successful completion of Acceptance Testing, we will achieve the Go-Live milestone, transitioning to live operations and full responsibility for Collier County transport billing and collection from that point. Digitech will provide the County with training as needed to ensure efficient access and use of the Ambulance Commander software.Training will be provided in a "Train-the-Trainer" format allowing the County to instruct other staff on the system as needed. Once the training has been completed,the County may identify a systems administrator who will have access to set up new employees with the appropriate permissions and security or change any employee's level of security at any time.This level of system control will enhance the County's data security by providing the specific level of access needed by employees who are utilizing the system. Because all systems will be tested by Digitech and certified by Collier County prior to the Go-Live date, the County can be confident you will enjoy error-free billing and collections from the beginning of the project. 66 The implementation was a methodical and well thought out process. Digitech made what could be a difficult transition a smooth one by handling all the payer enrollments, integrations, and system setup. Their implementation plan clearly laid out all the required tasks and who was responsible for each task with ETAs, and it was updated weekly so we could watch the progress. Tamara Nilmeier Director of EMS and Physician Revenue Cycle Grady Health System,Atlanta,GA Field Testing Phase Once Digitech has assumed responsibility for all aspects of the transport billing and collection process, we will begin the final implementation phase, the Field Testing Phase. While all systems will be fully tested and all processes thoroughly vetted prior to the Go-Live date, there can be unanticipated issues that crop up, or opportunities to improve business processes that could not be foreseen without some actual experience with the system.Therefore, we use the period following Go-Live until the first full month's reporting is completed to closely and jointly monitor the system with Collier County. Further system monitoring and process improvements will continue throughout the term of the contract. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 39 ■�■� syr" M))I) Digitech Our solution allows Digitech to file most claims within 24 hours of receipt of trip information, allowing clients to realize maximum cash flow early in the collection cycle. We will deliver professional customer service while we maintain, support, and continually improve the overall processing service in accordance with the County's objectives and obtain the maximum financial results on the County's behalf. Working jointly, we can identify any bottlenecks and work together to reduce or eliminate them, achieving the levels of service and collection sought. No Cash Flow Interruption Our goals during implementation are to provide minimal interruption of Collier County's normal processes, avoid disruption to cash flow, and minimize your resource outlays. Careful planning, clear communication, and rigorous attention to detail ensure we achieve these goals. Beyond normal operating expenses, there are no other known costs associated with the implementation plan for which Collier County is responsible. Our comprehensive implementation plan ensures no disruption in cash flow. Often, our new clients see an uptick in revenue during the critical early months of a contract. Our implementation process is a smooth and efficient deployment that often results in an increase in cash flow during the critical early months of service. The chart below illustrates the monthly revenue collected for Memphis Fire Rescue subsequent to our roll-out there. During the first months of this contract, cash flow actually increased because Digitech was processing claims in one to two days,while the prior vendor was taking up to 30 days to get claims out. Transitional Cash Flow $2,000,000 .,, . .,..< ,..,-. .... _. .,..._...,... 51.800.090 ,.,..,..._...>...,.......,.,..<..,...........................,... ... .. .. Digitech pre-Digitech s1,49D.D90 $1,200,990 _,.,. $1,ODD,D00 $800:000 Digitech Go-Live January $900,000 $400:000 $290,000 $0 May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug .Sep Oct Nov Dec Collections often jump at Go-Live as Digitech begins collections Digitech ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 40 marirmswi. Digitech Integration with Hospital EHR Systems Digitech has successfully built interfaces with many of the top ten Electronic Health Record (EHR)systems and several others,including: Meditech Epic Systems Cerner • Eclipsys(Allscripts) McKesson Healthcare Management Systems Siemens Healthcare NextGen Patcom Key Performance Indicators(KPIs) Digitech regularly reviews a comprehensive set of Key Performance Indicators to manage our internal processes. We will share with Collier County any KPIs that we find useful. Because Collier County will have 24/7 access to the entire billing system in real time, you will have access to the same KPIs and reports as Digitech. With minimal training, Collier County will be able to produce reports on any KPI any time you want them. Digitech's standard KPIs are based on a combination of metrics we have refined over our 30 years in EMS billing and the most advanced recommendations from groups like Page, Wolfberg & Wirth, the American Ambulance Association, and Fitch & Associates. Our standard set includes ALS/BLS ratio, Collections per Transport, Transport Volume, Service Level Mix, and others. The KPIs we develop for Collier County will combine industry standard measures, Digitech's own experience, and input from professionals at Collier County who are familiar with the department. All reports and dashboards will be available in real-time. The Dashboard feature of Ambulance Commander is designed to give EMS administrators a real-time view of any aspect of their operations, collections activity, and financial status. Dashboard is 100% customizable and provides the ability to get the 30,000-foot view and to drill down to the minutest detail of any transport claim. The intuitive user interface provides a set of sophisticated reporting and analysis tools that will help Collier County stay informed. In addition, Dashboard's front end is highly customizable and will allow Collier County to configure and save a personalized view of operations. Comprehensive monthly reports will be delivered to the County detailing all aspects of Collier County's financial and operational status.The report package will be customized to include both detailed and graphical representations of key performance indicators and any other facet of the County's financial or operational status that you need to see on a regular basis.All reports can also be produced by authorized Collier County stakeholders on demand. In addition, Digitech will meet to review our performance with County officials on a regular mutually agreed- upon schedule. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 41 k#�I► Digitech Accounting and Reporting Digitech's standard monthly reporting package includes both detailed and graphical representations of critical financial data including Sales, Cash Receipts, Adjustments, Accounts Receivable, Days Sales Outstanding, Collection Percentages, Collections per Transport, and more. The package will be provided by Digitech and delivered to the County's specifications on a mutually agreed upon schedule. These reports can also be produced by authorized client stakeholders on demand. Our Dashboard module will enable Collier County to set up a customized graphical dashboard on a variety of statistics.The Dashboard is real-time and enables users to query any patient record or drill down into any chart created and view specific details behind the charts displayed all the way down to the details of individual call records. 44 Their reporting system, combined with the Dashboard, provides access to all of our data on a real-time basis which enhances the decision-making process. Neil J. DePascal,Jr.,CPA Deputy Assistant Director,CFO City of Houston Fire Department Our report generators enable clients to produce reports based on the tens of thousands of possible combinations through defining field combinations and specific sorting and filtering criteria. This functionality gives our clients the ability to print virtually any report imaginable. Clients can store the parameters to a custom menu for reuse. Should the County have specialized reporting requirements that are not already provided or cannot be created through the report generators, Digitech will customize any report needed at no cost — often within 24 hours of a request. All reports can be printed or downloaded in a variety of formats including Excel, Word,XML, or PDF. Our award-winning PCR Lens is an example of one of our project-specific reporting modules. PCR Lens measures the quantity and quality of data collected by medics. The data gathered in the field impacts compliance, patient care, and collections. PCR Lens gives chiefs the tools they need to identify both the disciplinary and training opportunities necessary for improving data collection. Sample reports have been included as Appendix A. Digitech's PCR Lens data quality analysis tool earned EMS World's Product Innovations Award . EMSWGRLD _. NNOVATION i AWARDS/' ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 42 9 ' Digitech Immullm®m Monthly Financial Package In addition to the comprehensive, flexible, real-time reports that Collier County officials will access through Ambulance Commander, we also deliver a complete monthly financial package to our clients. Digitech's monthly accounting package is accrual based and adheres to Generally Accepted Accounting Principles (GAAP), and includes our cash receipts report, sales reports, adjustment reports, the Accounts Receivable report, and the Accounts Receivable Roll Forward report,which ensures that the closing balance of each month is matched to the penny to the next month's opening balance. At the end of each month, Digitech performs a hard close of all books and records, which ensures all accounting numbers related to sales, cash receipts, adjustments, and receivables for that month will never change. We then produce a month end graphical package that shows time series data of collection percentages, collection per transport, carrier mix, transport level mix, DSO, etc. This format makes it easy for anyone to review performance and identify specific topics to explore. Monthly Report Samples The County's monthly reporting package will include full detail on Sales, Cash Adjustments, Accounts Receivable, and every other aspect of the month's billing activity. Several examples from our monthly reporting package are shown here. &cooler gwnm --- ort o �__mist OouP gales OrigrnarF.eP � . ins leMPenYfirFInaneaGroup Sampt5Report -" _ S_,ummary 9sSrtac.ac.:rt..ri (',aay5ahenO. s&a Ofl F,ina n _ Dae oService ,n-m nnaablrWP'�hI,O. 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Fpm uowr . gni r E-t t yp«x 8.,\61 .;.i� V'''''''')__.._..__. pneaG1a10r error WSU""C'' UMJ.NI.CNY2 " .,�r� f � 1 1i1�1 1M OE,ICPA F 1811+p dN�I � li '° Fr,r3� I,TIFNIF>)1� CR,� YFOrt�f4F1�' If1i�Hs'/S:1 rt 04<W NEolf%PIl] 1T{{d r� -£NSA 1 lel_ r �.,p NAW M�._n�'1 trP'Gu 0Ep1,l3rE -"-'`iW4 iN 4 t ::i l r......'' OG 3'+ ------ p.e 40,4 V a+i rf 1 µ0,1r-fir 47,{04 0.• -""'" , _.--- �----;gym ^' �P�E ua.�H.vN: l'''''' 1.3' fEor,:: PATO' 1r� .ae'w } jots,IV PPPENt ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 43 MO Digitech Real-time Reporting&Transparency All Ambulance Commander reports are real-time. Several of these reporting features will make it easy for Collier County administrators to keep an up-to-date picture of financial and operational statistics. These interactive tools allow the County to see summarized totals and to drill down to the individual patient, claim, or transaction audit level whenever desired. Two examples of these powerful reports are the Ambulance Commander Analytical Scorecard and the Ambulance Commander Financial Scorecard. Analytical Scorecard -Overall Summary By Financial Group AmbulanceCommander# Sample County.Fire& EMS � , , a ANALYTICAL SCORECARD Dates of Service: From:081111/2521 To:07/31/2022 '"AJWewW 4Mahvls smmE al est mos of new." - - Transp Gross Chrg Contractual Adj Net Chrg Bad Debt Adj Pald Due Transp Coll% Coll% Gross Net Chrg Paid 1 Mix Groes Net Chrg Transp Transp; Transp BCBS 255 175.13210 36774,86 138,357.24 0.00 65,429,72 72,927,52 19% 37% 47% 686.79 542.58 256.59 FACILITY 3 1,318.56 0.00 1,319,56 0.00 0.00 1,318,56 0% 0% 0% 439,52 439.52 0.00 INSURANCE 278 265,157.68 41,372.68 223,785.00 0.00 130,600.67 92,984,33 20% 49% 59% 953.80 804.98 470.51 MEDICAID 17 27,69270 10.674,85 17,017.85 0.00 1,140.00 15,877.85 1% 4% 7% 1,628.98 1,001.05 67,06 MEDICARE 711 199,596.96 -2.59 199,599.55 777.68 151,421.63 47,400,26 52% 76% 76% 280.73 280,73 212.97 PATIENT 101 131,813.95 249.29 131,564.66 0.00 13,141.92 118,422.74 7% 10% 10% 1,305.09 1,302.62 130.12 Grand Total 1365 800,711.95 89,069.09 711,642 86 77756 361.933.94 348,931.26 100% 45% 51% 586.60. 521.35 265.15 Filter Celina) „ Date of Service From: 0801/2021 _ Date of Service To: 07/31/2022 Financial Group; BCBS.FACILITY,INSURANCE,MEDICAID,MEDICARE,PATIENT Source to primary: False FIanr6a Group: BCBSa FACILITY, MEDICAID, PATIENT _zm. ,.,$a. , ," .Pr;; a .. , , ', ', ''' Financial BCBS,FACILITINSURANCE,MEDICMEDICARE,PATIENT`' Source to primary: False 4:25210,-.5,naknl i4c,ece d -' Fare+°FTE OF SERMCE F110M.01.51.3014 CATE OFSER9-,"E TO 0131:7718 STA113060 01,234.56. ACd r t ......._ ,.Q.-9,s.. Rdarel By Wiwi Air Ram Sarww<Apo From Red Invoice,Pee Rem tae Macias]Carden Bl:.T.4Jr........_ Fry,,„4,,;.„;, Avoca.OwlFINANCIAL SCORECARE) I Caner Gaee Net 01.. Sala B. Can Cn-In PaM Rs g 1 5. 2 H 4 5 D.Y 6 7-N.. Cdlac 7rs Aw ar Ava Paid ' .-. ;;.-re;u+Er�:rTcaH r }!s.s9c,s r 4�+.x rsu�.-.11 a x aec ... 93 0605 !632500 SOS 18,305,70 0,170 .. O CDS 77 0.50 12416125 7510. 1047 ' :BSH'4R'>;E4!ix-0651 1 NI T7 5H'7: 53.03 002. C30; CLa; 180 13 i 5944: 00 0502 Sri 62 903 00 CSK! ... 00 3515. 003 01 E7v.K?.JP7Ct 7E.4+KF 725,00 iEa� 0M • 070: 0+' � 6710'.. 36 00. 047 C T'....x} ow. COC ow ,rL 1. ...7E501_d ... 409 .. ....1, .....'1 ......... ...., .;. 0 ........ 1., -........ -._. ...:6,,:85..0.90,44) 7`13= 1'+]5 0?:-: Gv 0Y,`3. 0.£ til 5-: 4vC: Cil G,i4 Gam; 0001 005 Ox 0P 100 031;1 C DOC I 0.352 9,89117:60651431 I. 0.03 20: 8011`•: 0 02.i 0 20:1 020 £5 V.cc 003 000 00e. 0001 2.00 0O 0.00 004! 0'. 004 0.23 9715 OrrX87063' .351.510.,2 391912,4E 05,7.35514': OWL 744:5459030 270207958 II 3,77'_I0701 5703710 8.13486 0004.0T,I4 038 '905.43 ',14- 20, ?3118 1283 9285 OF 1084250 :112_5 E60.77 05550 00 325132. 65'-'1 159245 11731: 000 151071 0783 000 17.,3 5M 32.49 5548 8 402611 3551 ,. 160135 OF 1010AF=R,, 5.G,I 4. ,5,04'.4, 1047331 000. 000; 25452 1142'90, 32135' 58 121155 13158 000 422.17006 07043 E54 1 4 1533 I00606 II a s. ...F T .... ....._ ;.. .... 045 ,.... 180850E TX FE°68 -:.'?E if B9 see C 3 017: 2-76`7 2457:22 0211 fib t 311156 00 &2827 100 03 Llkt 00 8544' 37 "671x' ..6 29 I8LUECR455 BLUE 14 21948 21E 48 1E5951 00 000 7189 21948 0001 000 000 COS 0001 020 0133 0N1 1 00 0 ...000 tee I.._ _.,. 000 0. 00 1220''s 0. 1 1 90904 HD OO fiWHtKA M?1J�9OON ......8513 RI S£E GC OY C CLO, GOE 86000 043 £I}5 078 600� 0.00......._ _..._ _. ... . TBPA:tO kE4LT14 IBR-:..v .....17.43 ane 85:75: 0?? 011 CCO e.eni 7002. 900 OW OOD:. 006 ow ow C ow4i C DOI C• k. r • 72,,,92: COO ....Oiii .452 OW' 003 0134 110 1 413 1; 5231 1505; • jE.A ASFIRE BRPnu 5211.0) .26 Of 05 O7k CM' 007 16919 ... ... .... ..._. 5,...... _..._1, .. ,......03,........ ..,,. .... 51700E PAR Lm._. nes X30 000 OM: 0.5`1 0 d 9:39 8:.38 CM 1363!... ]v .13.44 OW 0.00! � OCC 91 0 7t^ 89: ?UAE iMFRDi'E1.5111„ 489591 2.353.35 280102 0.001225151i 5M M. 130'339 1;20'0 0SR. -1'58271 ^179: owl 0:1i3 063 O.tt' 591 5, 33z23 1 ,,57,23 1609E N0AF,EIN09P2, 3,4'_509 123534 0,00 000!.221395; 000.00. 1235535 008:. 000.' 0.00 0011 0801 0110 061 0 031 10000 74.1 247£1, 24751 !CENTRAL 5774E01RO. ! 71.30 7138 0.071 11.2'ii 070; 0.Gt 71 000,1 005 COG 0.700001 OW 0.04 0007 100.0C 11 0 004 0110 , ICEIYTRAI UH,TE23117 1 315 U: 71,8: 000; 007' 0001 000 3132. u 02: 203 000 0 00: pool 203 500 003 Iwor,i a 0:L' 000' iCRaMF`AGFUMPYA a}L 51 4291 0'Y! 007. 640 G& IS7141 05471 COO 000 05 07. nw! £113 003 ... 1300 1001'6 .0.:..:: OCL i.. 13001 • 1 +0n_>55E0250.e4321. ; 1101134 1153.94 CXi 9031 032..,,._ 146' 11,5304 0081 500. 400 003; 300 111.02 022 010 153091 0 0001 01110 I 4': Far f E+uc4 i ..... hot I: Ead 1. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 44 III) ®igitech ,-,. The Financial Scorecard answers the question "where is the money?" by breaking down claims into buckets (Denied Claims, for instance), and will allow Collier County to drill down and see everything ever done, who did it, and when it occurred on every claim. _ .........___^ r ;�•DEtA0-AnantJa16Car4<ard1 Rea 021601536410E FR014:O 786/2014 €ATE OF SERVICE TO:0&71,2014 STATUSES:0.1.2.3.4.5.6,7 Carien h Satin Rd4rrral 97 Sew I Ape Fiver Sa'in`Ave From First Placing T 2P Fees lad Make Caries Bl Task: CoDriers C almage;..>s Rranaal°ass ... . _. - ..... ±Mamie!Grow Goss Ch.._ Net Cha... Sale 24 Bad 24 Con 24 Co-ns... Pad Oce 0-Ready i-WADI 2-144d Pen.. 5 Deny 6 Ras 7-Ne9.. Collect i ATTORNEY 1 4121100 40.21050 4065€ 35 08E1 5611 2605 631 560500 000 456'' - 0.4 u0C 000 005' ,54 . .._ ... 3 C 050 9C.. _. OOr ...172 (FJ6N f 1330397 136.413, 6412.9 00 72424 608 1'556 ! 11.321 6 5,479,65 _ I II$J6 115 1$)9.30).39 106933:53 2&8605 3 000 !3?".157 213.65469 33 nra 255.35234 553055 -. 5135480 006 •1296657 757 ( h _ ._._._ ,14.:7: O00i •23351 67.03'4 NE€CAJO 11239460 0,406.13 2.21115 _. 0 51.8254 004• 352 42 1993855 1840791'4., 12 ( �--- - 1_. .00 ' '. 235.00; 90:1.....4203.31 .._65911• 165€02)0 HNO 224)9340 I€1,L^r.22i 23615511 090 123.12fi 16; 2050x. 66-2)03; ?450717 5251 1 _ s r �77��3` 137313 a-te 41+01 95 Teti M3xCiWF: YAH6,9331Ct* 62375 : 956'U2311 DCG $12.3;713 20345422 6KSl9T3' 6"65:2+37 S2fSi.3s t; J�c3Y3�,.W . i64E€1C4AE 1-160 366.9.492'. 19726.61] 51.351.541 a 2437.525311 66.400791 1101329E 4921355 12641 129725 OCG! .924E3 6312; 1618.19': 113.524.43 11151582. 35.412.531 340 6.98 511 50.53 606.56] 243513E....4.2251.17 �{•1{,, ).M01101 005 59921. RtrENT 2334411.97.:x-4905.;;1.:'92594 ;2'5.21335 2.531.371 65661 20510711;1525.55713... 3159562 2909 i 3.591 12E7215] 4473E9] 1022. GRAND TOTAL 545552008 423049347117722950;289.81336 1 225 026 61 1 464.11547 1,333231 84 2050.393271 '85 ,'" ` '`. Clicking on the cell opens a list of all the claims that comprise that value. ti DEMO-Finan 13l Scorecard Cell Detre' Scorecard - STATUS 2 FOR FINANCIAL GROUP MEDICARE .. ..._) P4acs»ah same 550894 as Omar/ ay DATE OF SERVICE FROM 0110112014 .P cu»ih dffe c t can a than gvnary DATE OF SERVICE TO 03 31 2014 '' STATUSES'0.1.2,3.4,5.6.7 •Pre•;a on canceld claims • % 1 Data <. Cry Cord' Procedue Gmss 015x99 Net Ch'' 033 000; i'N• 5 20 6211 14 144TH CHI 1?8.8$ MthlCaRE Med. TEx,.S HEALTH 8425 16700 I 056 am, a C 1363... :6%21:2014 'INATH.CHI 13413,9!MEDICARE Mat.. 8E040 HE-1.TI 40427 745.00 .1.054 w° 05' 4296557... 7576 "-112014 1-.Sr0 CEClL1.; 102610.MEDICARE Medi.. METtiODISTlfi ,A.C425 0,001214Y 00:1 73951 87.03 3 '22014J.SSD.CECIL€, 1$5610;MEDICARE Med...;METHvDIST IR 20227 'aS t4 0300a• 8.0a s 4.123•61 659 17;14.2014 OMALLEY,KARLIE 153500 MEDICARE Med... MEDICAL CENT ,0425 94 501 1 734 45o. 36333 50195 1 7x1472014 .,GMALLEY.KARUE 133508:MEDCARREMed... MEDICAL CENT AC429 62x0€`0 141125 OO41 9.133. 691 97/21,2014.52914 ADAMS,JEWELL 10»71 M 54" REMed_ TEXAS HEALTH A0.27 44500 00 0'L . M. 9 ' 1 7:2&.2014 'ADAMS,JEWELL 1E1,3713 1_D!':=RE Medi. I TEXAS HEALTH. 1AD425 lOee.50 C6. 1c4239 .7.352 lo 23 ' '.'3,2014 FAYNF SHAW,' •RE Med .ITEXASHEALTH 25425 600010 44512511 1267233 X64049, 4459. 8/3.2014 F.YNE.OHr•I•Ii• RE Med., TEXAS HEALTH 24425 7500 '53201 6VORLEY.'L,IvL 'RE Mad.. TEXAS HEALTH 21629 119000 I 2%2014 I WOR,EY.VIOL RE Med.. TEXAS HEALTH x0425 24 D0 1.0.5.2014 02560151.02 RE Med...1 TEXAS HEALTH25,427 745 C4 '.._. 101512014 1GABBERT.C=, ;E Med 1 TEXAS HEALTH ..042557 00 15:8.•2014 USSERY,Et2164. RE Med. 1MEDICAL CENT 20420 80.50 81.2014 USSERY.EMMA I97733,MEDICARE Med... MEDICAL CEN T .255427 145.50' • 0/1612014..,,. APP€.aA'T ELLER „,1$5494!MEDICARE Medi.. ',MEDICAL E'EN i 20425 900. t' r L Nit 11. ESA Displaying 29 Froc.1 F,664ere Est s. x..__ _x - A 1 Erase r 14:4 ll 4 m• Dlsplatdng 28 proc!s) - - � Win..,•.��*,, ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 45 mil Digitech Within the claim,you can drill into the audit record to see when records were changed,who changed them, and how they were changed. ..., ., ,.....-. ._ , wig (:'U 1. ...„ : ....... ,. Oil 4-4• - 11114... - klil ,-. ififii I • 1 ePCP Add Document Appeal View335 Viewistx,Depo.F...Eits ,Barcode Pont Calculate Milts Bing i:silafte.E0 .A 1:pty Save Can cel i t. ... . ... Patient , ,..._c......,•Paten Dee.::Osiers Noj;;I.......,, .._ .. .... IC 100 .5172 4 Audit . X6'1. ii'lF1 i , Co ny 1006:01,03.0123 IFRIAARY 010110:1100AS4;.01.5$ • 'I INA At*FIRE DEPT I.;';'. 1170RK: • I Top 11 31 ,FAEDr-4FR 1 hides A 140501 i P real •IPA111:11T PRIVATE PAY P.4TENT I sPCP,a 14147460 I 1.14,I.A MEDICAL CENP.TEOF PI.AiQ 1,.....,1: i j I ,CR11 M135012241 7 :1 lap I Lemmata paid rI 7 sem...).,744.e.1.r..','cbg.dip.,,,I. . ................_ 14FI 4 • I , . Even +Add Leg X Remove Leg 0 Miles -,4i-mzp It Orin ddre as ...., i Cal lakIngiii-aiii ses—s-c It gi-taisg i [1! ]I ; 1-9 Loc EV PiItlEhT RESIDEI4 - lk ...,:. Scheduling . ,.•4 i i , Response Ecwip ......................................................................................................................................... -,e Sir PARIAV000 KM) riA: po.rii:i:laiiiiii;H;;i161 '4 ''.:."'''''"°." ',7i; ,i 02 --!--"-- t 2 CoCY ID Sl 11 3p MS3-- Lt reereresed eta Sb1:E p.. L.)___....... .=.. p.„pd,,,,I -' : -i Dmor. ,1„.'..PAP.„„ 1 t PC----- . 1 11:. eStrati It'7.1: • (i. Drct WI Eo1 . .... Wet ,k) ,• Call Nature - I L ---- 1 1 • --- .............,,,, : , I ii.20:32 i.,•1 i Destine Address .- Caaion ictd•,,,..)i,.:i 1•.'+" i i 44444! `NO!MEDICAL CEMTER OF PLPA, NI--------------- .— -_____ ______ __ , _____J PFr44 i• I i i I,-, D apatch Notes I Sheet ii) I5TH sr 'mil 4,, ,edimi.<0 I co 0'114 fx zp'isiis3LL 1—:-.0' 1.ao R44,31 71144(535)0054SM 1 i i;:i. 11'-ii: ..-,. I xsveet failT k,• I IS ...,.. 1!2125 Dee.i .•• • Cot Rake On Sthedute Dispatdr Stalin Complete 005 1.23.2.n1-1 Cal Received 1 2327 Cal Taking Tsme:On No pending dlanges , - .. _,.. ,...j 0 1.:1 ,,k , ';:- , 14, t4.1 ri- M 1.• .6..,.... ....i .,.C,.....--L-1.113..........--...16-, , "...4.7 onr--Lf...-11..........4.--.. ...41,...4....-1-67.4.......L.A.-1J" -,--, 4.-' .....4- ' '''' ' ' ancel i 1 ' - ,..4044 i4:17431-37•MIN: on 13 .45172 , T.-...b.,fftory i Fnancaial Nadia held Henn L.,. 11..!•, ; vt„. ,....,) ,... , 1.;, Sammy held i7. 0010 ri]To -I 196000 111 0. KE40004 .01a21.-124-....1:S. .070/47E&urn* hodereleeriser i 0 I sen 5031 WARM i tarali I 0719 CREATE Tranerall Pal,eni i HANS BROU:114,1001Y 0 .•• 1 :Ifl' ' I.:CARR.% .7750.14,0511EDIT anoirt 01.,sech Ia./per:0 ., 15 r . c : 1 '' Provide 11:0a. {117.1i114 i 11-411 $1111 TIIRIKC4 Pmadie I TEXAS HEAL Di PLASIO IA ALIICIINV)Klat3 : :'..,21V 14 UEDIT.I.owi.rt c,"„. I I PLANO FIRE DEF'T 41 ........................, . :. ' :Transport,i. . nlirOiTAXIM.1F/104 0010 L.lif.!!: 1:',..eF19407:?4Y?!c" 4,14,44743 'Palle fi'sse oLrrOl00082I93 7:731,14 7432 COOkIE p, .01413.0011820 .:,Events•4:Ad • AvroiriyoloNG 07,11i 14:0010 ADJUST:ADJUSTMENT 1,Vac..h . . / Origin Addre •• , ;2 0731/11IWO80. 1AJUS WENhatriCarVOCIN3 11TwA 04I CIENZYK 107.11/14 I 1411 •EDI agerairi ' 110011 1'265 P 1 atrICONVOK:114-3 ;07131i 14 552 14)00 REASON 0(43734007 ! I I 1 !:2 Coi'PU,14) i All10041AMING :07.11114 i 2012 HOLD REASON:4047.SE1414ED ! : • l4FERRI•W? i 04;01.'1.177343 Ere iddr•Fr 09d Midi* I d x!fte HAFERWO S1/143500101 :Eorr Pciachn , . 1 7131211 I OEM Rid 11 715 CIREATE Cate i • I 1 i ] ,',' l• 1 Declination I ,. . . I I! . , ILeolm ia.7 1 i I I 1 ay kit:0 I e N - i : Rem . ,. . .,.• , . . - ' 'Sued ICC,17 1 Dee: •. - • .' I : ,1I i CA Status On Sched :SIr,.1,,,,,,, r 31 Dis was•Iwo*grieved lanedenu, . : 14;PAHL aeciad . No pending changes I, 71-4141C4 : !Nuance . . it.PM, ... Penert i' CAD Eier,:t i br,I F',,,ot .., (nun • ----'77-.7r ' : y: T': .:'' . :,,-....,, ,,I?!.',',-.'''':'':' :•''''''',.'':'':!',':''::'''::'-' -- _ ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 46 au • Dig IteCh Review notes,notes, payment records, procedure codes, and collections activity associated with the claim. .. DEMO/ 1.1./::•:).1.373 boa od, .... 0 7,..L: '' Audit occt , Add Document Appal Vr...IS View Deposits Sarcode !1.411Per.t ' Calc9fate ALlet E•nntsts,;rue,4, App ty Save Cancel Date or SerolPatient Poilo'll De1.0 i PMeint Naga: AC ID a 451071 -. LXINTRAPY MAPY :'''• ",'..''.../.- AGE.Thrli yam% ii0 I Sti;t1-3V OAKS Dii c..ir r: 1E2717 SEX,FemaSe FRISCO,XX 7SOM0 5435 Company 0011.106110nr/S4 PAMAPY PsOnt($...450,654156 0 Atil P1,0119 FIRF n.E.F.*.I ,- LVID RIC * Trp ce 5 MEDICARE, XXXXXXXXXX lAocIal 0 14,5476 Provider TRICAPE FOR LIFE: XXXXXXXXXXX r PCF4 0 14/13070-0 fT6P.1.6i(AQI.TIMi8.1.16.01.1h.ELAND i,:\ ACR S ICIE20S45•7* MR P • Ramped,liana Insuratice Paid —Sates,—Alerts i'"ralleetiee,! , LEVINE,EMILY 1'SrA5114 10/31102 AM wAIIINO FOR PAYMENT FROM ArrORREY TO PROCESS REELING ...____--,....— ..... ......_ — — ---- SIMON.S:10,7./2013 3,00.01 PM 055/535•5555 dialed on 111,02,2013 01,67:07 -Anowering Mectiine SIMON,S:10/2.72013 3,0507 PM 5S5-655-SSA5 dialed on OS:1112013 05:1,1:52 .Arniwerinty Meehlne HEARST,ALEXANDRA:.Et21/2013 1108:52 AM EPIC HOSP SYST HAS PTS 1ST NOOSE Sr MERRY:PROP NOS INFO 0.STATES PT HAS MOLINA STAR PLUS .......—— ...— — — 1 lig , L._.....: , Call Status On SON/lute I:Swatch Status Complete DOS 7,2817:014 Can Received 10:40 Call Taking Time Os. Illen/lino chan.irt Verify mileage using multiple mapping options. ...., 4.- .... ;41 ,,,,, 0 ' ' ' 1 . .. 4,111 44, Q . _. , ...: IA" , .1 ..,. . . „ . . . . . tot iii Audit Docs ePCR Add Document Appeal View835 View Deposits Barcode Print Calculate Miles l'•$'''')(Sht"test, 1, pply Save Cancel Fastest P I,b• Bing Vef 55 li1A(/1 S. VI'',DS MAPS 5455 leDne Dangle i.,bing ; P! ROIEI " l'i:' :,• - f.1; 1 '..:1'.' 'I' ......' l ''' C.-•''s''A,, k : * e- Directions x i 0,A‘vi..I•;4.`...,.1'..-ti.,W 4•7).C's(,c..,•P,,,, '0'0 17-t. \ ' ,2),• V.."'..1,1•1)(,16.inv., -4iN I • . . , Elk Fs -6 , , - A.:2800 W 10TH ST,PLANO,TX 70570(3 . < ip.,, g OPt,l SI ,ii7, i. „ 5 --1 T ' g 6200 WEST PARKER ROAD,PLANO,T 1 Asi; i add demiriaton slum aptKlm ...; , CIN.if II 1 ' f .. . Hetnon ' \*. 13k .- 7.1 ml,20 min driving ....;v,t>81.1: 4PteSident George Bush Tpke ' i- ... • view 554553 based an traffic 3'.! C A 2800W 15TH ST,PLANO,TX % 7 , ., President Ge< 75075(33.018387000,- ..)., ?.... ,, 9N Bon % 6.748337000) ()SOin hAi.kkes=411,4 ,,.. I `I 425 P* eisoli Csrovenon P 2P.P.I Ns,* -...-- .. ,....--*- ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 47 ® MH' Digitech . The Financial Scorecard is just one example of the depth and transparency of Digitech's reporting tools. Another unique feature of Digitech's reporting is our Accounts Receivable Roll Forward Report. This view summarizes all other accounting reports and, because it will balance to the penny the County's receipts, will provide proof that all claims are accounted for. Monthly Accounting Report- Roll Forward SAMPLE COUNTY FIRE&EMS - .- Mo End D. Q Reno JO_.. . 3 (+) f*) (-) (•) (-) f- Ending AR Mo End Beginning AR OMSslea PaYer Sale Adjusts Bad Debt Adpusts Contractual Cash Recet Reclasses Adjusts .,- 00 $370,000.00 5370,000.00 $60,007.00 5140,000.00 0309. y 52.089.800.00 Jon 2023 52.869.800.00 -- �� 0 9280,000.00 5280,000.00 t190.0Q700-..--48e8 3911------V236,p.1- S2, 59.800.00 Feb 2023 52,?89.80SJ.60 - ------------."070 -" - --- �- �,..�-- e-__>-3s5st50o.0a 539340000 16o,otw.on_____3434000.00•----_ - - -----------"------ 52.909,800.04 Mor 2023 -', ._ r-- ctsoa�"---S3t0 00400 $170,010.00 $105,0000___w. X30 Apr 2023 52,909,800.90, ;tib __. 3401)001)8 __'_ 30 9a .__ 4165,000.00 9128,000.09 5230,400.00 62,8 ,801.04 J lay 2021 $2,8Fvrr,840 1. .100.00 5278,00000 9279.900 0 5260,00200 800.90900 9310.000.03 x2,822,804.00 Jul _„ $2,0021 - -570.000.00 5340.000 00 9340,000.00 3210,000.00 5103.000.00 5300,000.00 92,779,800.00 Aup 2023 9570.000.00 5380,000.00 5370.000.00 5200.000.00 9109,000.90 53310,000000 52,740.800.00 Sep 2023 92.740.800.00 5900,000.00 9300,000.00 5330.000.00 5195.009.00 0108,000.00 5300,000.103 32,707,800.00 Oct2023 52.707,800 00 5790,000.00 9320,00000 9320.800.00 $199,505.00 5180.000.00 9390,030.00 52.838.300.00 Filer Mode :............... __._ :._... ._.. Mo End Date Range Jan 2023 Oct 2023 44 The implementation was impressively quick and effective, and Digitech's reports are providing new insights into our finances and operations. The basics are great, but the detail is amazing. Dorothy Pope Accounts Receivable Manager City of Norfolk-Department of Finance ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 48 assowr Digitech 10.1111111111111M77- Recovery Process and Defaulted Clients Digitech's recovery process is detailed below in the Standard Operating Procedures section on the next page. If by "defaulted clients" the County is referring to patients for whom a payment plan has been established who have subsequently defaulted on the agreed upon payment arrangement, it should be noted that our Ambulance Commander billing software system automatically tracks defaulted clients. Once a patient has deviated from an agreed upon payment plan our system automatically notifies our billing personnel that a payment has been missed. We then contact the patient to determine the cause for the missed payment. We will then reestablish a new plan with payment parameters that can be agreed upon and adhered to by the patient. We will provide services for a defaulted client for as long as the County requires us to pursue payment. Thereafter, all uncollectible accounts will be handled per the County's guidelines. Patient Payment Arrangements All payment policies will be defined by Collier County. Digitech will document and enforce all polices that the County currently has or wishes to put in place regarding payment plans, fees, and alternative payment arrangements. Our calling campaigns will include provisions for patients to set up payment plans or carry out charity plans as defined by Collier County. Standard Operating Procedures Verification Digitech imports the call records from the ImageTrend server.Typically,this happens first thing every day. Once the ePCRs are imported into Ambulance Commander and reconciled, a series of activities begin, including verification of demographic and insurance information, determination of eligibility, and research to gather missing information. Once the claims have been verified, Digitech's editors take over to review level of service, medical necessity compliance, signature compliance, narrative, and mileage. Verification and editing of claims is usually completed within 24 hours of receipt of ePCR data. Quality Assurance Surrounding and overseeing all claims processing and collection activities is Digitech's active compliance program, consisting of regular internal and external audits and daily oversight by our dedicated Quality Assurance team. Our QA team is headed by a NAAC-certified coder and is made up of nine staff members, all of whom have backgrounds as EMTs, paramedics, nurses, or ambulance billing professionals. They manually review 100% of Medicare, Medicaid, and Railroad claims. All Medicare claims are checked for medical necessity, mileage,and signatures.All Medicaid claims are similarly verified for medical necessity. Accuracy Less than 1% of claims submitted by Digitech are denied because our software traps claims for correction before they are submitted,speeding the collection process. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 49 M II► Digitech Dispute Resolution Digitech does not leave your money on the table. We leverage the power of hyper-automation to initiate and follow up on denials, appeals, and short-pay claims. Appeal-IT, another of the distinguishing automated features of the Ambulance Commander platform, systematically appeals the short paid claim until we have successfully recovered the complete balance. Where a manual appeal process may become prohibitively expensive and tiresome, an automated process is both affordable and unrelenting. Processing and Collection Timelines Approximately 95% of the compliant claims completed by our clients make it through the Data Upload, Verification, and Editing processes so that they are invoiced within 24 business hours of being received. Ninety- eight percent are invoiced within 48 business hours of being received. Experience has shown that getting invoices out within a day or two of receipt of PCR data positively affects the outcome of the collections process, not only by avoiding timely filing issues, but also by enabling the follow-up on denials, partial payments, short-pay claims, and appeals to begin that much sooner. Typically,within one business day of receipt of transport data, Digitech billing personnel initiate all automated batch claim processing tasks including: Electronic invoicing and filing Paper invoicing, printing,and mailing when appropriate Self-pay invoicing Facility invoicing(if applicable) Compliance with Privacy Requirements and Data Transmission Digitech is responsible for ensuring the privacy and security of all patient information we receive or use under both the Privacy Regulations (Privacy Rule) and the Security Regulations (Security Rule) of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Digitech is committed to ensuring that our Privacy and Security Policies, Procedures, and Training are up to date and effective in safeguarding the confidentiality, integrity, and availability of PHI and e-PHI received, maintained, and transmitted by our company. We will adjust our policies and procedures accordingly based on periodic reviews and evaluations of our privacy protection systems. Digitech submits electronic claims directly to Medicare, Medicaid, and BCBS in the currently accepted 5010 format. In addition, Digitech submits commercial claims electronically whenever possible via Emdeon, our clearinghouse. We submit claims on paper CMS-1500 forms for payers not capable of accepting electronic claim filing. Digitech is fully compliant with all HIPAA requirements for the management and handling of protected health information (PHI) and privacy notification procedures. We have implemented a comprehensive HIPAA compliance program that incorporates the following ongoing measures: Membership in organizations that provide research and updates with respect to current Federal and State law and best practice guidelines. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 50 amMMPI► Digitech Incorporation of detailed compliance awareness and established procedures within all training systems and at all levels.Training covers the regulatory requirements as well as the procedures and processes developed by Digitech.These include electronic configurations, business rules, and communication rules to ensure compliance with all regulatory, privacy, and security requirements. Automated tracking and monitoring systems including automated fraud indicator flags, compliance tracking, and intrusion detection and prevention. Quality assurance programs that ensure a daily focus on compliance management and verification. Comprehensive personnel screening and monitoring. Comprehensive binding terms and conditions within contracts between Digitech and suppliers. Legal and compliance advisory services that include the services of the firm Page,Wolfberg& Wirth, LLC, a nationally recognized law firm specializing in billing and compliance issues for the medical transportation industry -> Outreach security and compliance assistance and training for both suppliers and customers. Auditing Is a Key Aspect of Our Business Model As part of our regular processes, Digitech provides multiple levels of regulatory safeguards by way of various audit procedures throughout the performance of our contract. Among the audits performed regularly are the Auditing Is a Key Aspect of Our Business Model following: Random Daily Claims Audit Monthly Claims Audit • Audit Trail in Our Billing Software System Independent Random Audit of Digitech Claims Annual SOC 1 Type II Certification (SSAE 16 Type II) Digitech will provide copies of all reports on controls such as internal and external audits or regulatory authority reports when requested to do so by Collier County. Auditors e p Our Compliance Department works closely with Page, Wolfberg & Wirth, t'"`3 i & LLC, a nationally recognized law firm specializing in billing and compliance � issues for the medical transportation industry. We retain the services of -``` : ' - ' PWW for independent random claims audits and other services. Our %.;,• fMo) • billing personnel attend periodic conferences hosted by PWW and others on such topics as Medicare and Medicaid Regulatory Compliance and Revenue Maximization for EMS. A benefit to our Fl T C H clients is that Digitech can quickly get answers to questions of a legal or regulatory nature and we are happy to use this valuable resource on your behalf. ` A•a 0`.A T r s While Digitech has worked closely with PWW for many years, the County should be aware that Digitech is not contractually obligated to work with PWW and may choose to work with any industry expert of the County's ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 51 ■� m . MI> Digitech choosing. We are familiar with JR Henry, Fitch and Associates, and Werfel and Werfel, LLC and have worked with each firm in the past. Random Daily Claims Audit Each day random claims are pulled from the production queue and evaluated for quality, completeness, and accuracy of information. Additionally, Digitech takes part in a number of Quality Control tests on a daily basis, ranging from claim checks to timing of filing. Monthly Claims Audit On a monthly basis, our Billing Managers perform internal audits with the following tests: 1. Pre-Billing Tests The auditor ensures that every transport in the system that has paperwork is billed. Items not billed are identified and tagged for review. The auditor looks at every transport in the system that is not billed or cancelled to ensure that its current status is correct. The auditor reviews a random sampling of current claims that have not yet been billed to ensure the following: =4a% o Appropriate paperwork is attached o Level of service is accurate .111, o Diagnosis is correct o Claims are properly coded 1111111111111 o Procedure codes have correct modifiers o Proper carrier is billed o Correct mileage amount is billed 2. Post-Billing Tests — Our internal auditor examines a representative sample of claims whose service dates are greater than 60 days old for the following: Timely follow-up—for claims unpaid 30 days after the service date,the auditor must determine why and document any issues. Appeals—auditor verifies that denied claims are being properly appealed. Payment posting—ensures payments were posted to the correct carrier. Short-pays—if a claim is short paid,the auditor ensures a short pay appeal is filed. Timeliness—auditor reviews timeliness of all processes. 3. Exception Handling Tests Any exceptions are documented and presented to the billing department managers. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 52 �� _ SII► Digitech _ Within two business days,the department manager responsible for the issue responds with an evaluation and corrective action plan. 3 A corrective action plan is submitted to the billing manager. A formal corrective action document is prepared and produced for the department manager specifying implementation timelines.The department manager then implements corrective actions according to the defined schedule. Claim samples are reviewed to ensure corrective actions were effective. Audit Trail in Our Billing Software System Auditing tools are an integral feature of the Ambulance Commander billing platform. The billing system incorporates one of the most sophisticated audit and tracking systems available in the medical transportation software industry. All data change details and system events are tracked by the system's audit trail including data entry, record modifications, and billing events. Integrity of the audit trail is vital to the application for support and research purposes. Application users can in no way manufacture or edit audit trail records from within Ambulance Commander and can only access audit trail data through read-only interfaces. Below is a screen shot from the Ambulance Commander billing system that shows the level of detail that allows users to drill down to the individual trip level for every claim. i d i1048:U3i-DEGti7 TransaC._n Hs O'/ Fnanciab Fa636yfwd Hatay ____ _ _........ .._......... __..,. Who I ) Date Tots I. Pawn . Summar/ Field ,.i P To �EC . i w{"F 4�TE 7:: IrcroertNwobs, - ZAW, IWW184 fi ._. _.._.. __. 4OARRA :07+'24/14 07:59 CREATE Tranaoort Paomn : H.-.NSBROIJGH.MARY O KC.ARRA. 0729.14 C8.00 EDIT Anon Crspat9Nntur 0 9 _.. _. LFOX 07/30,14 13:88 EDIT Transport Fronde/ TEXAS HEALTH PLANO A,JTO44 O1CING 07,31;14 08:30 EDIT.?opoirt Company :PLANO FIRE DEPT AIJTOINYO1 ING 07/21/14 0630 CREATE Proc:90429.•14EDICA7 rnsryvrert Fake Tru/ A lTOH4L41,"1-I 7'31:11 06 36 CREATE Proc AC427•I DICK! • AUTOINLD'CING 07/31/14 06:30 ADJUST:ADJUSTMENT Pmc:P ALrfJINVO CING 0;"31,14 35:30 ADJUST:ADJUSTMENT Prot: f TENZYK 07/31,.14 14,31 EDIT Ppport AUTOINVO CIRO 07/11/14 20:92 :HOLD REASON'AC'427SH MED AUTOINVO1C1MG 07/31/14 20.52 ,.. HOLD REASON:A0425SH MED MFERPARO 03,3I/14 09:49 EDIT Address'_lest Andrus :. MFERRARO 09,01,14 0958 EDIT Ppport CTEAZYE 93'1614 17:10 CREATE Calor • Vlew History lY.is nos a mansoly antorod 6mestamp FJ j _� TansPort Insnance Audit Trail in Every Claim Record The left side of the screen shown above provides a line item summary of every time the claim was viewed and saved. Summary information includes the person that edited the claim, the date and time it was saved and a brief description of the activity that was done.The right side of the screen displays every field that was changed showing its original value and the new value. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 53 )11D Digitech ,, Soc 1 Type II Certification u.i.:Jj 5 _39The Statement on Standards for Attestation Engagements (SSAE) No. 16, was created by the o,9anoatioe �� G� W American Institute of Certified Public AICPA Accountants to measure and report on the controls that service organizations Q employ to manage financial reporting. Digitech engages the services of mazdfus4.1zA WithumSmith+Brown, a premier financial auditing company, to deliver an in- SCLC depth audit of its internal controls and related processes and certify that Digitech pQh�cpa.org/so�c o�y meets the recognized standards for controls and safeguards as they relate to YSAs1a sQ hosting or processing our clients' data. Record Retention and Destruction Records of all services performed, including data entry, record modifications, billing events, and all financial transactions are tracked by Ambulance Commander's audit trail function. These records are available to our clients in real-time, providing an unalterable record of every action ever taken on an account. Application users cannot manufacture or edit audit trail records from within Ambulance Commander and can only access audit trail data through read-only interfaces. Ambulance Commander's audit trail function will give you access to real-time records of Fla, every action performed on your account. J Digitech will retain records for a minimum of seven years. Paper records requiring destruction will be destroyed by a NAID certified document destruction firm. A certificate of destruction will be maintained by Digitech. Digitech will maintain all data and billing records in a form permitting transfer to a new billing vendor within 30 days of the end of our contract. We will continue processing all existing accounts in our possession until collection efforts have been exhausted, then turn over any uncollectible claims to the County's designated collection agency in accordance with contracted protocols. In the unlikely event of a breach or termination of contract, Digitech will immediately begin the process of transitioning all patient account information and billing back to Collier County. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 54 MII► Digitecti Data Center Storage and Security Digitech maintains a Tier III Primary Data Center in Tarrytown, NY in a facility originally designed as a mainframe bunker for a Fortune 500 corporation. At this facility and all other Digitech operations facilities we employ comprehensive security measures to monitor and safeguard our clients' data, including annual SOC 1 Type II audits. Security measures and controls employed by Digitech include network security, virus protection software, and monitoring systems, as well as comprehensive procedures for information chain of custody management. Our data center is an SSAE 16 Type II certified facility that consistently delivers 99.999%uptime. Digitech's Primary Data Center Coloration Biometric access O Man Traps Sign in process • Quarterly access reviews • Termination processes Logical Security Features Network Access security-Access rights granted in accordance with job-related needs All users are assigned both a unique network user ID and password ct Quarterly Access reviews are scheduled to ensure proper access for all employees and vendors; Termination processes ensure all accounts are disabled after the departure of staff • Password reset procedures prevent common "phishing"schemes • Annual network vulnerability scanning identifies security breaches or attempted breaches £:` Disaster Recovery and Redundancy Our Disaster Recovery Plan provides a means to operate in the event that we lose one, or any combination, of the core components listed above for a period of greater than five business days.The worst case scenario is a permanent loss of the Primary Processing Center. Processing interruptions such as power outages or inclement weather, which we reasonably believe will be repaired within five days, will not trigger implementation of the complete Disaster Recovery Plan. Such interruptions will not significantly affect our work schedule as our remote work capability and backup generators will make it possible for operations to continue in the event of a minor incident by using portions of the recovery plan. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 55 �� .. M I► Digitech We discuss in detail in the following sections the specific redundancy we have built into each of these critical areas: Redundant Data Centers—including power considerations, air conditioning,fire suppression, and security Redundant Processing Centers—facilities where billing personnel work Failsafe Application Servers and Storage Systems—computers for data processing and storage Data Backup Systems Duplicate Communications Servers—equipment necessary for outside users to access our clients' data Redundant Internet Connectivity Redundant Phone Systems The structural features listed above provide the redundancy that allows for both a flexible response to short- term or limited resource interruptions as well as a more robust response in the event of a long-term or large scale resource interruption. Disaster Recovery Planning preparedness Recovery Digitech's Disaster Recovery Plan is based on pre-staging the assets required to recover from catastrophes quickly enough so that the client experiences no data loss or cash flow interruption. To meet that goal, Digitech has implemented the following: A Tier III facility as our Primary Data Center which guarantees 99.999%environmental uptime A Secondary Data Center in the event the primary data center is destroyed Maintenance of both Primary and Secondary Processing Centers to ensure processing continuity in the event the Primary Processing Center is either destroyed or unreachable for extended periods of time Purchase of top quality hardware and software components from Dell, Cisco,Citrix etc. An IT department staffed with IT veterans with years of experience designing and maintaining complex infrastructure systems Established redundancy in our phone system ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 56 w NO Digitech illimimilmv Testing,Staffing,and Invoking the Disaster Recovery Plan With the assets in place,the plan then focuses on refining the procedures to invoke the plan and defining both the list of personnel that will implement the plan and their individual responsibilities. We then certify the plan by testing the redundancy built into the system and by identifying specific disaster scenarios and reviewing our strategy to recover from them. Primary Data Center Digitech's Primary Data Center is equipped with the redundancy necessary to provide 99.999% uptime. This includes four independent internet connections, back-up power generators, a redundant cooling system, advanced fire suppression systems, and much more. Secondary Data Center The Secondary Data Center is located adjacent to Digitech's offices in Chappaqua, New York.This data center is a secure room with dedicated air conditioning, power conditioning, and biometric access. Features of the secondary data center include: A battery backup/power filtering system to provide protection against power spikes and troughs and short-term power losses Firewalls used to protect against intrusion by non-authorized personnel,viruses and malware with quarterly change reviews of our firewall rules to ensure only legitimate traffic is allowed to enter our networks Redundant Internet Connectivity:The main internet connection is a T2 broadband through Lightpath and the secondary connection is through cable Disaster Plan Elements ill . t> . ,,° 4 .I.J., ,1 Flexibility Stability Redundancy ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 57 E(' Digitech Processing Center Redundancy Processing centers are the physical locations where the billing staff reports for work. To provide the redundancy necessary to meet our continuity goals, Digitech maintains two processing centers. The Primary Processing Center is the physical location where billers will process claims, make outgoing phone calls to insurance companies and other payers, post cash, and handle incoming calls from patients. The processing center features the following: It is equipped to house up to 150 employees It has offices for managers and the clients' account managers It has a conference/training room It has a diesel generator hook-up capable of accepting a mobile diesel generator in the event of a long-term power outage It has ample POTS (Plain Old Telephone Service) lines in case the fiber phone or VOIP system goes down • It has redundant internet connectivity:the main internet connection is a T2 broadband through Lightpath and the secondary connection is through cable In the event the Primary Processing Center is unusable or inaccessible, processing will resume using a combination of a small coordination and phone service group at a Secondary Processing Center and work from home for a large portion of the employees. To avoid the kinds of threats that are more commonly directed at public facilities,the Secondary Processing Center is located in a private residence that accommodates up to ten billers and managers.This group of employees will coordinate the at-home workers and patient collectors.The Secondary Processing Center is equipped with the following: A phone system that easily accommodates the transfer of phone lines from the Primary Processing Center High speed internet connectivity required to access either the primary or secondary data center Work stations available for ten users During a potential disaster which would leave the Primary Processing Center either unusable or inaccessible, workers who would not be required at the Secondary Processing Center would work from home. These employees will be pre-certified to work from home and their home office will have been certified by Digitech to have the required resources.These resources will include a: Processing Center Home computer with a secure connection to Digitech's network ■ ■ aestd."*SA4000000\‘ Reliable internet connection Printer ■ ® ■ ' Phone line that can be dedicated ■ ® ■ for work during business hours • a ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 58 mismemr #I!► Digitech Phone System Redundancy Digitech's phone systems are built on a VoIP structure, enabling complete portability of our communications capabilities. All phone system functions can easily be ported to a secondary location. Phone system redundancy requires that phone communications will be available in a number of different adverse circumstances.This may include periodic interruption of service as can sometimes be seen when repairers accidentally cut cables or permanent interruption of service which might result if a terrorist attack devastates the telecommunications infrastructure.To deal with these possibilities, Digitech has instituted the measures that follow. The Primary Processing Center is equipped with a T1 based VoIP phone system through one of the major carriers. The Primary Processing Center is equipped with at least ten POTS (Plain Old Telephone Service) lines which will be on the ATT network. The system is designed so that lines can easily be forwarded to a phone system in the Secondary Processing Center. All equipment necessary to accept call forwarded lines from the Primary Processing Center will be available at the Secondary Processing Center, and ample cellular telephones will be available at all times in the event that cellular is the only means of communications. Data Backup and Archive Digitech's backup system is a hard disk based solution designed to protect both applications and data. Our system provides for fast backups, easy data retrieval, and high availability assurance to meet our clients' expected Recovery Time Objectives. Our strategy ensures that at least two copies exist at any one time. The backup system runs continuously, taking snapshots and copying only changed blocks to backup servers. Compressed and de-duplicated data is stored as a point-in-time image that includes the operating system and system state along with applications and data. This makes the restore process much easier and allows our administrators to seamlessly restore single files or entire servers in minutes rather than hours as seen with legacy backup systems.All servers, applications, and data are continuously replicated between datacenters. To ensure the integrity of our backup system, our IT staff performs monthly data restore tests and monitors the health of daily snapshots. As a result, our clients can have the confidence that their applications and data are completely protected and easily recoverable in the event of data loss or disaster. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 59 immumwr 110 Digitech COST OF SERVICES TO THE COUNTY Total Proposed Fee as a Percent of Revenues Collected Digitech is confident that we will increase collections for Collier County as we have in every other instance where we have been contracted. We are offering a fee of 3.95% of 3•95 o Net Collected Revenue3. We have prepared this proposal under several basic assumptions, 0 including the following: All billing,collection, and transport data provided by the County in its RFP is accurate and it is understood by both parties that Digitech has relied on Collier County data for pricing purposes. Collier County will provide reasonably complete demographic information as part of your Patient Care Reports and it is understood that crews will make best efforts to provide insurance information, social security numbers, and other demographic information. Collier County will provide remittance information within 24 hours of receiving it. Medicaid Claims Fee In accordance with Florida statutes, Digitech will charge a flat rate fee of $8.00 for each account paid by Medicaid. $8.00 After the contract award, good faith negotiations will take place during which both Collier County and Digitech can discuss and negotiate specific requirements of the RFP. Summary of Features Included in Digitech's Price All hardware and software required by Digitech personnel to accurately and efficiently perform medical transport billing and collection • All mailing forms, billing forms, insurance forms, and envelopes necessary to perform all billing functions Any postage necessary to mail billing or other information to patients, insurance companies,third parties, and attorneys Availability of a national toll free 800 number for patients, Collier County personnel, insurance companies, attorneys, and third parties to call for information or discussion of account status All fees related to our national consumer database(Change Healthcare and Experian) searches for patient demographic information • All fees related to the electronic submission of claims All costs associated with mailing Notices of Privacy Policies All fees and expenses associated with processing credit card payments All fees and expenses associated with the hosting of our application An electronic interface to the ImageTrend ePCR system or to any future ePCR system chosen by the County during the term of the contract Ongoing review of ePCR documentation by qualified Digitech staff 3 Net Collected Revenue is defined as total collected revenue less refunds. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 60 imaso --- 110 Digitech r: Ongoing review and analysis of rates, policies, and procedures with County officials In-depth documentation compliance training for Collier County medics Regular meetings for review of performance on a mutually-agreed upon schedule Medicare and Medicaid Experience Active membership in industry trade organizations, participation in regional and national ambulance associations and conferences, and consultation with authorities on ambulance industry law allow Digitech to continuously monitor industry trends and track updates to federal, state, and local rules and regulations. By staying on top of regulatory changes and observing industry best practices, we are able to maintain the resources we need to integrate compliance within all of our business activities and serve as informed advisors for our clients. AMERICAN GA.EMSFC AMEuLANcE _ I A ASSOCIATION f %-ul--1 INTERNATIONAL ASSOCIATION OF FIRE CHIEFS ', Member of EMS Section since 2012 Member since 2009 Associate member since 2012 p CA�b `y North Carolina AssociationT •Pwud parts: of NAEMT Spa i ember since 2015 ii .,k ,r, .:- �� 4.,- Corporate member since 2012 •�suc ,q! Associate member since 2015 TAlk 0,., 4 - ..:, rilAiSA . OEMS ALLIANCE Gold member since 2015 Associate member since 2012 Member since 2012 At Digitech, all of our professional coders are required to be CMS (Center for Medicare and Medicaid Services) coding certified. To be certified, these employees complete comprehensive coursework and must pass the certification test, after which they are certified by CMS as coders. Our staff receives monthly updates from CMS (Center for Medicare/Medicaid Services) on all aspects of EMS billing and receives regular training at industry sponsored conferences and industry certification to remain current on all regulatory issues. In addition to continuing education, all of our staff attends seminars given by the law firm of Page, Wolfberg & Wirth, LLC, a nationally recognized law firm specializing in billing and compliance issues for the medical transportation industry. Digitech receives notification of regulatory changes from PW&W and passes these updates along to our clients to keep them apprised of these important changes. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 61 �- . SEI► Digitech Our personnel undergo rigorous Privacy, Regulatory Requirements and Security training. Regulatory training is comprised predominantly of regulatory procedures encompassed by FDCPA (Fair Debt Collection Practices Act), FCRA (Fair Credit Reporting Act) and FACTA. Within the framework of both of these topic areas, and with specific focus on Privacy and Security are specific courses delivered to Digitech personnel that comprehensively cover HIPAA(Health Insurance Portability and Accountability Act). Digitech's internal processes and our Ambulance Commander proprietary billing platform are fully compliant with all Medicare, Medicaid, and private and third-party billing policies. This compliance is a continual process of monitoring, analysis, and updates to our software and processes. We believe our ability to guide our clients through the complex issues of CMS compliance is one of our greatest attributes. We are constantly attentive to changing rules and regulations and to the most recent interpretations and implementations of the laws that regulate the medical transportation industry. We affirm our commitment to Collier County to monitor federal, state, and local regulations and to advise the County on best practices to maintain compliance. Digitech will assist the County in preparation of Medicaid CPE reporting.This is included in our fee for service. Invoicing Medicare and Medicaid Depending on specific laws and regulations that may apply, before sending claims to Medicare or Medicaid we will verify that the: Level of service is correct Correct modifiers have been applied Signatures have been obtained Supporting Physician Certification Statements for non-emergency transports are attached Medical necessity of the transport is correctly documented Mileage is correct Digitech will file directly and electronically with both Medicare and Medicaid. 404 Digitech staff has always gone above and beyond to assist us with increasing our billing numbers and fulfilling any data requests that we have had of them. They have a very 'can-do' attitude that has been greatly appreciated by all of us here at DFR who have needed their assistance. Norman Seals Assistant Chief Emergency Medical Service Bureau,Dallas Fire Rescue ; ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 62 Digitech Economic Benefit to Collier County Collier County will benefit from the maximization of revenue that will result from the efficiencies that Digitech will bring to your billing processes. To date, Digitech has increased collections over the previous solution every time we have been contracted. This includes several major municipal services such as the Cities of Houston, Dallas, Baltimore, Memphis,Atlanta (Grady Memorial EMS), Gwinnett County GA, and Johnson City KS. Our most prolific example is the increase we achieved for the City of Houston, which grew from $35.5 million to more than $68 million, including the $28 million in funds Digitech helped recover from the Texas Ambulance Supplemental Payment Program. The table below illustrates instances where we have increased collections over your incumbent. Collection Improvements vs.!MX first yew of MRlvice 56.804.361 50% %increase 54,414,488 40% 51,314,748 305,. ......._..... -..,._..,. ._.._...._ ..._.._.._.. 24.2'e everaga improvement 53,299,417 5319 71314 ,.,.... , � z 5163,869 5653.956 r Ts<» Orally ,Atlanta Pearotd,TX Conlin na,TX ilamptt&,TN .to8nson Co1mt KS Gailitrunt County,GA Wank TX 81.800 Tranap0rt& 5,150 Tfanspons 5,140 TraininaiN ?5,500 llanannriarnOO 1 Tfanspofta 31.500 TinnaixiklA 5000 Tretrts;wrls. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 63 - MI) Digitechmimilmillimmrrt. EXPERIENCE AND CAPACITY OF FIRM ay4iN NETT Gwinnett Fire ,,(),*'\-'12' 1"I Annual Transport Volume 36,000 Rescue y�.'.,_ - ,i, _Rt Services Provided Gwinnett County Fire Rescue became a Digitech client in January of 2012. At Gwinnett, our implementation plan encompassed EMS Billing, Imaging, and Hosting services, full integration with the ESO Solutions ePCR system, and the establishment of connectivity with County hospitals for the exchange of patient information. 40,0 F044 Norfolk Fire . Rescue ,:, '� Annual Transport Volume 29,000 Services Provided Norfolk needed a speedy implementation and decided to stop sending claims to their former vendor before the contract was awarded.The last claims Norfolk sent to the prior vendor were dated December 31st, 2014. To accommodate Norfolk, we began the implementation process after the award notification and before contract signing. We received notification of award on January 12th, 2015 and delivered our New Client Check list on January 15th. We completed all we could complete before contract signing. Items such as enrolling as Norfolk's billing service with payers could not be done until that time.The contract was signed on March 3rd and we completed the implementation and began invoicing on April 4th—less than one month from contract signing. While staying current,we began billing back claims with dates of service beginning January 1, 2015 and were able to bill all of these claims successfully with no adjustments for timely filing. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 64 191I1 Digitech MED—ACT AMM ON COUNTY Johnson County 40= : 2f0 { ' Annual Transport Volume 20,000 Med-ACT "LT^� , NUM L! ate 3 Services Provided Johnson County Med-ACT is the emergency medical services provider for 20 cities and several unincorporated areas in the Kansas City metro area. Med-ACT signed on with Digitech to provide billing services in 2008 because they desired leading-edge technology, advanced reporting capabilities, and a pay- for-performance fee structure. When Johnson County Med-ACT merged with Lenexa, a neighboring jurisdiction, in the middle of our first contract term,they required Digitech to create a set of reports enabling them to account for first responder handoffs. We delivered a complete set of custom reports to Med-ACT, including "The Chiefs Report," the Johnson County/Lenexa First Responder Fee Report, the First Responder Cash Report, the First Responder Uncollectable Report, and a Lenexa Billed Transports report. When Johnson County faced a cash crunch in 2011, Med-ACT asked us to prepare an analysis of rates to see if a rate increase might be a means of making up the shortfall they expected from the County budget. Digitech delivered a complete analysis of prevailing rates in the surrounding communities and in jurisdictions nationwide with demographics similar to those of the County, then presented the County Board of Commissioners several options for revenue projections based on the various scenarios we put forward. a ; Memphis Fire ,' Annual Transport Volume 83,000 Services Provided Digitech's implementation project at Memphis began in January of 2010 and included the deployment of EMS Billing, Imaging, and Hosting services, connection to the City's hospitals, full integration with the ImageTrend ePCR system, which was simultaneously deployed. The Memphis implementation also included the installation, configuration, and mounting of Panasonic Toughbooks and mobile hotspots in all of the Department's rescue vehicles, and training of all personnel. At Memphis we were faced with several obstacles. The client required turnkey project management from Digitech as they were transitioning from a paper PCR environment to a new ePCR system. Additionally we were faced with an abbreviated timeframe at the request of the client. Digitech was able to complete the implementation in record time including testing, certification and Go-Live of the integrated solution. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 65 MCMI► Digitech h ., 4t,AN0p Plano Fire F Rescue (tE '460 k Annual Transport Volume 11,000 —1 41*'xtiNnl Services Provided Prior to Digitech, Plano's previous vendor had been billing most claims as Advanced Life Support transports. Despite the fact that we billed far fewer claims at the ALS level of service, Digitech still managed to increase collections by 1.7% in the first year of our contract and have continued to increase collections in subsequent years. Further, as part of that contract, Plano required Digitech to undergo periodic external audits which sharpened our focus on compliance — a focus that we carry over to every client with whom we interact. Plano extended their contract with Digitech in 2016. Qualifications to Produce the Required Deliverables Medical Transportation Billing is our complete focus and our only business. To date, we have increased collections over the previous solution every time we have been contracted. We are a team of 135, including software engineers, former EMS directors, certified coders, nurses, EMTs, paramedics, and ambulance billing professionals. We have over 30 years of EMS billing experience, and we process over $1 billion of ambulance claims annually for municipal and hospital based ambulance service providers in 20 states. As our client references will attest, there is a quantifiable difference between Digitech's technology, service, and results and that of our competitors. We have grown by referral rather than acquisition, which allows us to add clients in an orderly fashion,standardize training and procedures, and deliver continuity of service. Digitech is financially stable, with over two years of available cash, no debt, and no hedge fund or Wall Street investors. Without a board looking for speedy return on investment, we have made prudent long term decisions. Without outside pressure to meet growth projections, we can carefully select which potential new clients we pursue while ensuring that our existing clients continue to thrive. Our financial stability positions us to be able to focus our energy on building a lasting relationship with every client we add. Digitech will conduct all activities required to process ambulance billing claims on behalf of Collier County with complete attention to, and in compliance with, all federal, state, and local rules and regulations governing the reimbursement of health care services. We will carry out our business in a transparent manner with respect and compassion for the citizens of Collier County. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 66 s �I Digitech' Integration Expertise with ImageTrend Digitech's Ambulance Commander is already fully integrated with the ImageTrend ePCR system. While Digitech has experience integrating with many of the top-tier ePCR systems, our most extensive experience is with ImageTrend. We have built, tested, certified, and deployed what is now our standard ImageTrend interface many times over and have complete confidence in our ability to seamlessly integrate with them again for this project. ImageTrend was our ePCR partner for the Burnsville, MN project and our partner for two of our largest municipal projects, Memphis Fire Department and Baltimore Fire Department. NAAC Certification All of Digitech's Billing Managers are NAAC certified.Their certificates have been included as Appendix B. Average Amount of Days to Send Initial Bill and Receive a Response Approximately 95% of the compliant claims completed by our clients make it through the Data Upload, Verification, and Editing processes so that they are invoiced within 24 business hours of being received. Ninety- eight percent are invoiced within 48 business hours of being received. Our experience has shown that 95%of available revenue will be collected within 90 days. 60% 95% of available revenue will be collected within 90 days. :ctattill"17,,A 40°f° jam, 20% . _ 0% First Month Second Month Third Month Fourth Month ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 67 amiNso110 Digitech ,r._ Customers of Similar Size and Scope to Collier County Digitech has provided five references that are similar in size and scope to Collier County. We will be happy to provide a complete client list should we be selected for shortlist. First Date of Current Client Name Contact Information Scope of Contract Service Donna Buhler Annual Transports:36,000 Gwinnett Fire Rescue Business Manager EMS Billing Services 408 Hurricane Shoals Road NE, 12/07/11 (678)518-4876 Imaging&Hosting Lawrenceville,GA 30046 Donna.buhler@gwinnettcounty.com ESO Solutions ePCR integration Johnson County Ted McFarlane Annual Transports:20,000 Med-ACT EMS Director EMS Billing Services 11811 S.Sunset Dr, 01/01/09 (913)715-1960 Imaging&Hosting Suite 1100, tmcfarlane@jocoems.org ImageTrend ePCR integration Olathe,KS 66061 Dan Wheeley Annual Transports:23,000 Washington County—Johnson City Chief/Executive Director EMS Billing Services 11/01/16 296 Wesley St, (423)975-5500 Imaging&Hosting Johnson City,TN 37601 dwheeley@wcjcems.org ESO Solutions ePCR integration Robert E.Lee Annual Transports:19,500 Newport News EMS Chief EMS Billing Services 2400 Washington Ave, 04/01/16 Newport News,VA 23607 (757)926-8404 Imaging&Hosting relee@nnva.gov ImageTrend ePCR integration Cynthia Dixon Annual Transports:40,000 St.Louis Manager,Fiscal Services EMS Billing Services 2634 Hampton Ave, St.Louis Fire Department 04/01/16 Imaging&Hosting St.Louis,MO 63139 (314)289-1950 ESO Solutions ePCR integration dixonc@stlouis-mo.gov ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 68 � SII► Digitech SPECIALIZED EXPERTISE OF TEAM IVMEt � Mark D.Schiowitz, President&CEO Mark wrote the first version of Ambulance Commander®, Digitech's billing software platform, which was released in 1985. By 1987, the company began to focus its programming resources on the ambulance industry. Since then, Digitech has grown to become the only ambulance billing company that has created and regularly updates its own award-winning technology for multiple Tier One clients. Mark has a degree in Economics from Bucknell University and did graduate study in Accounting } and Computer Science at Baruch College. Before forming Digitech, he worked for Lombard Wall, Inc. in New York City. Mark is actively involved in all aspects of Digitech's business and will oversee the execution of the contract should the County choose Digitech to process your claims. Joyce E. Kerulo,Senior Vice President—Billing Services CAC Prior to joining Digitech,Joyce was the Assistant Controller of MediCab, one of the _ largest providers of medical transportation in New York State. She holds a BS in f Accounting from Manhattan College in NY. Joyce joined Digitech in 1994 and is _ responsible for overseeing the processing of more than $1 billion in ambulance claims annually. Her staff includes eight managers and over 80 billing specialists. Joyce will be the County's point of contact for all customer service and accounts receivable activities. Walter C. Pickett,Senior Vice President—Deployment and Support Walt holds a degree in Mathematics and Chemistry from Susquehanna University. He joined Digitech in 1994 and has more than 22 years of experience in the la ambulance billing industry. Walt is responsible for deployment and support and will directly oversee all activities related to the implementation and ongoing technical support of this project. He will work closely with the County to ensure that any system customizations, including custom reporting requirements, are implemented before the Go-Live date. Ben Lambert,Vice President—Technology In addition to overseeing development and IT teams, Ben focuses on process analysis, automation, and innovation. Ben holds an Executive MBA from Pace University, where he graduated with top academic honors. He joined Digitech in 2003 as a software engineer. Since then, he has served as a leader and driving force in rewriting the Ambulance Commander software suite, the conception and design of advanced billing technologies, and the migration to a virtualized infrastructure, all of which will be available to Collier County. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 69 EID Digitech Brad Stuart,Vice President—Billing Software Additional Resources Brad joined Digitech in 2002. He holds a degree in Computer Science from Pace ii4 University and also graduated cum laude from the College of Westchester with a = . 44 :No degree in Computer Programming. Brad and his team led the successful development r # and maintenance of medical billing and remittance posting. Using today's leading edge technology, Brad will work closely with the Billing Management team to develop technological solutions to increase billing efficiency for Collier County. rf� Catherine L.Tenzyk,Quality Assurance and Compliance Manager CAC`+'" Cathy Tenzyk joined Digitech in 2002 as a Billing and Collection Representative in the Medicare Billing Department. She was promoted to Manager of the department after one year. Cathy's responsibilities included the management, supervision, and training of the Medicare Department's personnel, and staying up-to-date on Medicare regulations and guidelines to be able to properly advise clients on any changes in policies. Cathy oversaw Digitech's Medicare Department until 2012,when she became the leader of our Quality Assurance team. She continues to work closely with our QA personnel, Medicare Department, claim editors, clients, and outside auditors to ensure that Digitech's billing and collection practices comply with all federal and state regulations. Digitech's dedicated Quality Assurance team, headed by Cathy, will randomly audit the County's claims and make continuing recommendations regarding anything related to compliance and documentation. Frances Cuzzo,Patient Collection Manager CACI.J Fran joined Digitech in 2000 with a background in dispatch, accounts receivable, and management of Medicare and commercial billing. At Digitech, she has introduced a F '- number of process improvements which have boosted efficiency within her department. Fran oversees all aspects of our editing process and brings over 32 years of experience and a deep understanding of Medicare, Medicaid, and third- *". / party billing requirements to her role in training and mentoring her team. She k currently leads a staff of over 25 employees, and will be the liaison for Collier County 111111 regarding all Patient Collection matters. Mitchel Holder,Client Liaison Mitchel has over 30 years of experience in the field of Fire and EMS and expertise at4 -4414 creating reports for budget analysis. He studied Business Management at the ;4 University of Tennessee Chattanooga, and he completed the local government finance officer program through the University of Georgia's Carl Vinson Institute of F\" Government. Mitchel has dedicated his career to the advancement of Fire and EMS. He began as a Paramedic/Firefighter and worked his way through the ranks in the Fire Service. He served as Logistics Chief in the Business Services Division of Gwinnett County Fire and Emergency Services, one of the largest fire departments in Metro Atlanta, where he was instrumental in fostering numerous improvements. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 70 milemamtr- I1 Digitech .. Mitchel will be available to work with Collier County on your reports and address any other needs that may arise. Digitech takes a consultative approach to ambulance billing projects because experience dictates that every client is different, every client needs a unique combination of services, and some degree of solution customization is always beneficial. In addition to the company principals who will be directly involved in the implementation and delivery of billing services, Digitech will make available the following resource pool to be used by Collier County as you deem necessary: Reporting and Analytics Max Dekle has been a software developer with Digitech for seven years. A graduate of the Rochester Institute of Technology with a B.S. in computer science, Max has a background working in both healthcare billing at Excellus Blue Cross Blue Shield and in .• computer-aided dispatch at RailComm. At Digitech, Max was a lead developer on the PCR Lens and a co-developer of the .NET Computer aided dispatch module. He has �~ experience with all areas of the development process, including database management and maintenance, report and chart designing, and integration with third-party service h providers for both GPS and ePCR. Knowledgeable in a wide array of coding technologies, including Microsoft's T-SQL, C# .NET, and ASP.NET, as well as reporting and charting suites, Max is committed to ensuring Digitech's clients have all the tools necessary to effectively analyze and excel with their business. Compliance CA Jane Silverman, our Certified Ambulance Compliance Officer, is also an attorney who earned her JD from Pace Law School. She oversees compliance training for all Digitech employees and ensures that company practices are in compliance with all v federal, state, and local statutes and regulations. She also conducts compliance '* investigations and coordinates any necessary reporting. Jane will provide the County with any compliance training, compliance plan development support, and consultation on fee schedules that the County may find necessary. Account Management Mary DelFranco has been the leader of Digitech's Account Management team since 2010. She holds a degree in Computer Science from Stony Brook University. As a Senior Account Manager, Mary trains new additions to the team on setting up client systems and providing system support. Digitech's Account Managers maintain relationships with our clients over the duration of their contracts. This includes providing training, coordinating systems implementation, enrolling clients in all aspects of Medical Claims Billing, supervising the 855B Medicare Revalidation Certification and Medicaid Revalidation process, and ensuring clients maintain provider credentials. Mary and her team work with third party vendors as required for system integration with Digitech's software and provide remote access support for system issue resolution and user inquiries. Please refer to Appendix C for detailed résumés. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 71 )MH' Digitech ACCEPTANCE OF CONDITIONS Digitech takes no exceptions to the terms and conditions outlined in the RFP. ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 72 Digitech 110=101111w, REQUIRED FORM SUBMITTALS Attachment 2:Vendor Check List IMPORTANT: THIS SHEET MUST BE SIGNED. Please read carefully,sign in the spaces indicated and return with yourPropwsm|. Vendor should check off each of the following items as the necessary action is completed: The Proposal has been signed. 12:1 All applicable forms have been signed and included,along with licenses to complete the requirements of the project. d E Any addenda have been signed and in included. Name of Firm: Digitech Computer, Inc. Address: 480 Bedford Road,Building d Fl City, State,Zip: Chappaqua,NY 10514 Telephone: (914)7414919 Email: u�er��om '^~^ Representative Signature: ��»� /« ^"-- Rap,eaen1e#veNama: Mark Schiowitz,President&cEoDo$e 06/06/2017 ,r4/oEMS BON uDebt uvmKtwoServices RFPiw^n_cowAry `plate_,z99z ^o 28 ~ ^^°� �^^�^_ ,�= Nammi■or Digitech vUfl`:S'i'31±`it.:^.wr4'ft.[;5 D4111111.0-t Attachment 3:Conflict of Interest Affidavit The Consultant certifies that,to the best of its knowledge and belief,the past and current work on any Collier County project affiliated with:17-7133 EMS Billing&Debt Collection Services does not pose an organizational conflict as described by one of the three categories below: Biased ground rules The firm has not set the"ground rules"for affiliated past or current Collier County project identified above(e.g.,writing a procurements statement of work,specifications,or performing systems engineering and technical direction for the procurement)which appears to skew the competition in favor of my firm. Impaired objectivity—The firm has not performed work on an affiliated past or current Collier County project identified above to evaluate proposals/past performance of itself or a competitor, which calls into question the contractor's ability to render impartial advice to the government. Unequal access to information—The firm has not had access to nonpublic information as part of its performance of a Collier County project identified above which may have provided the contractor (or an affiliate)with an unfair competitive advantage in current or future solicitations and contracts. In addition to this signed affidavit,the contractor/consultant must provide the following: 1. All documents produced as a result of the work completed in the past or currently being worked on for the above mentioned project:and, 2. Indicate if the information produced was obtained as a matter of public record(in the"sunshine") or through non-public(not in the"sunshine")conversation(s),meeting(s),document(s)and/or other means. 3. Failure to disclose all material or having an organizational conflict in one or more of the three categories above be identified,may result in the disqualification for future solicitations affiliated with the above referenced project(s). By the signature below,the firm(employees,officers and/or agents)certifies,and hereby discloses,that, to the best of their knowledge and belief, all relevant facts concerning past, present,or currently planned interest or activity(financial,contractual,organizational,or otherwise)which relates to the project identified above has been fully disclosed and does not pose an organizational conflict, Firm: Digitech Comput r,Inc. . t2 7 /- Signature and Date: Print Name: Mark Schiowitz Title of Signatory: President&CEO State of New York _ _ ._ County of Westchester_ �._._....____._....___........ _._._... �. • SUBSCRIBED AND SWORN to before me this,,...._-„ 6th day of tune 20 17• by Mark Schiowitz. , who is personally known to me to be the _....Pte"silent,&..CE,D,..........._....._.........._..._....__._._....___...._......_._._._... for the Firm, OR who produced the following identification 08/20/2018 Notary Public Commission Ex.iration ANC w 1LV1.„.RM N 17-7133 EMS Billing&Deptcollection Services RFP,„Non,_CCNATemplate,_12092p 16 NOTARY PtiBt,10,STATE OF NEIN YORK 29 latoation No.G,514221032 Qualified fn Wesirl:osdcr County Commission•Expires Altgtsl 20,201e ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 74 N� Digitech � _--��-____- CO_tiler County Attachment 4:Vendor Declaration Statement BOARD OF UNTY COMMISSIONERS Collier County ent Complex Naples, Florida 34112 RE: Solicitation: 17-7133 EMS Billing&Debt Collection Services Dear Commissioners: The Undersigned,as Contractor declares that this proposal is made without connection or arrangement with any other person and this proposal is in every respect fair and made in good faith,without collusion or fraud The Contractor agrees,if this proposal is accepted.to execute a Collier County document for the of establishing a formal contractual relationship between the firm and Collier County,for the performance of all requirements to which the proposal pertain& The Consultant states that the proposal is based upon the proposal documents listed by the above referenced Solicitation 17-7133 EMS Billing & Debt Collection Services. (Proposal Continued on Next Page) /7-/`mrEMS Dint ouDee:Collection Sewicec PEP 7JnnCcNAT~"otatv_/2092016 0 2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 75 11•11•1111111111.r Digitech PROPOSAL CONTINUED IN WITNESS WHEREOF,WE have hereunto subscribed our names on this 6th day of June ,20 17 in the County of Westchester .in the State of New York Firm's Legal Name: Digitech Computer,Inc. Address: 480 Bedford Road,Building 600-2nd Floor City,State,Zip Code: New York,NY 10514 Florida Certificate of F12000002178 Authority Document Number: Federal Tax Identification 11-2693136 Number CCR#or CAGE Code Telephone: (914(7414919 FAX: (919,741-2818 Signature by: - Mark Schiowitz (Typed and written) Title: President&CEO Additional Contact Information Send payments to: (required if different from above) Company name used as payee Contact name: Title: Address. City,State,ZIP Telephone: FAX: Email: Office servicing Collier County to place orders (required if different from above) Contact name: Title: Address: City,State,ZIP Telephone: Email -17.7133 EMS Billing&Debt Collection Services RFP_Non_CCNATemplate12092016 31 C)2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 76 ■��■� � 1) Digitech ._ Centile-Comfy kimai ct atron Services(kir uir mrn 0.,14 D ;on Attachment 5: Affidavit for Claiming Status as a Local Business Solicitation:17-7133 EMS Billing&Debt Collection Services(Check Appropriate Boxes Below) State of Florida(Select County if Vendor Is described as a Local Business El Collier County N/A ❑Lee County Vendor affirms that it is a local business as defined by the Procurement Ordinance of the Collier County Board of County Commissioners and the Regulations Thereto. As defined in Section XI of the Collier County Procurement Ordinance: Local business means the vendor has a current Business Tax Receipt issued by the Collier County Tax Collector for at least one year prior to bid or proposal submission to do business within Collier County,and that identifies the business with a permanent physical business address located within the limits of Collier County from which the vendor's staff operates and performs business in an area zoned for the conduct of such business. A Post Office Box or a facility that receives mail,or a non-permanent structure such as a construction trailer,storage shed,or other non-permanent structure shall not be used for the purpose of establishing said physical address,In addition to the foregoing,a vendor shall not be considered a'local business"unless it contributes to the economic development and well-being of Collier County in a verifiable and measurable way.This may include,but not be limited to,the retention and expansion of employment opportunities:support and increase to the County's tax base, and residency of employees and principals of the business within Collier County.Vendors shall affirm in writing their compliance with the foregoing at the time of submitting their bid or proposal to be eligible for consideration as a"local business"under this section.A vendor who misrepresents the Local Preference status of its firm in a proposal or bid submitted to the County will lose the privilege to claim Local Preference status for a period of up to one year. Vendor must complete the following information: Year Business Established in DCollier County or❑Lee County: N/A Number of Employees(Including Owner(s)or Corporate Officers): N/A Number of Employees Living in 0 Collier County or El Lee(Including Owner(s)or Corporate Officers):., N/A If requested by the County,vendor will be required to provide documentation substantiating the information given in this affidavit.Failure to do so will result in vendor's submission being deemed not applicable. Vendor Name: Digitech Computer,Inc. Date: 06/06/2017 Collier or Lee County Address'_ !'N1 °/ Signature. 0 i<. c�{ _.._._.. ..............._._....._....._____Title: President&.CEO STATE OF FLORIDA ❑COLLIER COUNTY 0 LEE COUNTY N/A Sworn to and Subscribed Before Me,a Notary Public,for the above State and County,on this 6th Day of _........._lune_....... ,20.._7._.' _. Notary Public My Commission Expires: 08/20/2017 (AFFIX OFFICIAL SEAL) JANE SILVl Rft AN 17=7133 EMS Billing&Debt Collection Services NOTARY MUG.STATE OF N4o2 i RFp.,Nan,,,CCNA'Template_120�J2t716 Ragfstretien No.OXSt6P24092 Qualritod In weit'ttot,f sr Cuutrty 32 Conrrni.51nn EJ;pt;as August 20.NIS ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 77 Milli Digitech n Colter qty Atk skates SesrvviceS Deoartment t',{N'„,f:Vaf-pltt�N;,'::iya J•Ca!N? Attachment 6:Immigration Affidavit Certification Solicitation: 17-7133 EMS Billing&Debt Collection Services This Affidavit is required and should be signed,notarized by an authorized principal of the firm and submitted with formal Invitations to Bid(ITB's)and Request for Proposals(RFP)submittals. Further,Vendors/Bidders are required to enroll in the E-Verify program,and provide acceptable evidence of their enrollment,at the time of the submission of the vendor's/bidder's proposal. Acceptable evidence consists of a copy of the properly completed E-Verify Company Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company. Failure to include this Affidavit and acceptable evidence of enrollment in the E•Verifv program,may deem the Vendor/Bidder's proposal as non-responsive. Collier County will not intentionally award County contracts to any vendor who knowingly employs unauthorized alien workers,constituting a violation of the employment provision contained in 8 U.S.C.Section 1324 a(e)Section 274A(e)of the Immigration and Nationality Act("INA"). Collier County may consider the employment by any vendor of unauthorized aliens a violation of Section 274A(e) of the INA. Such Violation by the recipient of the Employment Provisions contained in Section 274A(e)of the INA shall be grounds for unilateral termination of the contract by Collier County. Vendor attests that they are fully compliant with all applicable immigration laws(specifically to the 1986 Immigration Act and subsequent Amendment(s))and agrees to comply with the provisions of the Memorandum of Understanding with E-Verify and to provide proof of enrollment in The Employment Eligibility Verification System (E-Verify).operated by the Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the Vendor's/Bidder's proposal. Company Name Digitech Computer,Inc. Print Name Marl� 1 witz ./ Title President&CEO � ,/ _� Sig nature ' Date 06/06/2017 State of New York t� County of Westchester The foregoing instrument was signed and acknowledged before me this 6th day of June 20 17,by Mark Schiowitz who has produced as identification, (Print or Tvoe Name) (Type of Identification and Number) ti JAMIE SILVl:itWRI4 Notary Public Signature Jane Silverman NOTARY PUBLIC,3rA1t OF Nr,W Y ORt Printed Name of NotaryPublicagistraiion Na..(281022928/20/2017 ouallficxl in U!�sit:luwler t�aiirity Notary Commission Number/Expiration Commission ErpLas Aur±at 20,tlllti The signee of this Affidavit guarantees,as evidenced by the sworn affidavit required herein,the truth and accuracy of this affidavit to interrogatories hereinafter made. 17-7133 EMS Billing&Debt Collection Services R F P_N on_CCNATen1plate_12092018 33 ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 78 )iii) Digitech ceL, county Mm+nalrat 4e Se vices©etnxtrrrrt Attachment 1.Vendor Substitute W–9 Request for Taxpayer Identification Number and Certification In accordance with the Internal Revenue Service regulations, Collier County is required to collect the following information for tax reporting purposes from individuals and companies who do business with the County(including social security numbers if used by the individual or company for tax reporting purposes). Florida Statute 119,071(5)require that the county notify you in writing of the reason for collecting this information,which will be used for no other purpose than herein stated. Please complete all information that applies to your business and return with your quote or proposal. 1. General Information(provide all information) Taxpayer Name Digitech Computer,Inc. (as shown on income tax return) Business Name (if different from taxpayer name) Address 480 Bedford Rd,Building 600-2nd Floor City Chappaqua State NY Zip 1051.4 Telephone (914)7414919 FAX (914)741-2818 Email mschiowitz@digitechcomputer.com Order Information Remit t Payment Information Address 480 Bedford Road,Building 600-2nd floor Address 480 Bedford Road,Building 600-2nd Floor City Chappaqua State NY Zip 10514 City Chappaqua State NY Zip 10514 FAX (914)741-2818 FAX (914)741-2818 Email mschiowitz(aldigitechcarnputer.com Email mschiowitz@digitechcomputer.com 2. Company Status(check only one) I — Individual/Sole Proprietor r X Corporation Partnership I _Tax Exempt(Federal income tax-exempt entity Limited Liability Company I under Internal Revenue Service guidelines IRC 501(c)3) C Enter the tax classification 1 _(p_=Disregarded Entity,C=Corporation.P=Partnership) 3. Taxpayer Identification Number(for tax reporting purposes only) Federal Tax Identification Number(TIN)._.11-26931136 (Vendors who do not have a TIN,will be required to provide a social security number prior to an award of the contract.) 4. Sign and Date Form Certification:Ujiier penalties art!perjury,1 certify that the information shown on this form is correct to my knowledge. Signature '/ {. Date 06/06/2017 Title President&CEO Phone Number (914)241-1919 -- 17.7133 EMS Billing&Debt Collection Services RFP Non_CCNATompiate-,1209201t3 34 ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 79 )SII► Digitech M., Colter County Arlen r.A a1,vs ;;;:v,r.a L)C(orli+0II Attachment 8:Insurance and Bonding Requirements Insurance/Bond Type Required Limits 1. Worker's Compensation Statutory Limits of Florida Statutes,Chapter 440 and all Federal Government Statutory Limits and Requirements 2. 3 Employer's Liability $500.000 single limit per occurrence 3. EJCommercial General Bodily Injury and Property Damage Liability{Occurrence Form) patterned after the current $1:000,000 single limit per occurrence,$2,000,000 aggregate for Bodily Injury ISO form Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability 4. 0 Indemnification To the maximum extent permitted by Florida law,the ContractorNendorlConsultant shall indemnify and hold harmless Collier County,its officers and employees from any and all liabilities,damages, losses and costs,including,but not limited to,reasonable attorneys'fees and paralegals'fees,to the extent caused by the negligence,recklessness,or intentionally wrongful conduct of the ContractorNendor/Consultant or anyone employed or utilized by the ContractorNendorlConsultant in the performance of this Agreement. This indemnification obligation shall not be construed to negate,abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 4. ❑Automobile Liability $ Each Occurrence;Bodily Injury&Property Damage, Owned/Non-owned/Hired;Automobile Included 5. 0 Other insurance as ❑Watercraft $ Per Occurrence noted; ❑Maritime Coverage(Jones Act)shall be maintained where applicable to the completion of the work. $ Per Occurrence ❑Aircraft Liability coverage shall be carried in limits of not less than $5,000,000 each occurrence if applicable to the completion of the Services under this Agreement. $ Per Occurrence ❑Pollution $ Per Occurrence 0 Technology Errors&Omissions $1,000,000 Per Occurrence 0 Cyber Insurance $1,000.000 Per Occurrence ❑Professional Liability $ Per Occurrence • $ 500,000 each claim and in the aggregate • $1,000,000 each claim and in the aggregate • $2,000,000 each claim and in the aggregate ❑Professional Liability $ per claim and in the aggregate • $1,000,000 per claim and in the aggregate • $2,000,000 per claim and in the aggregate ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 80 amisimmim Digitech ❑Valuable Papers Insurance $ Per Occurrence 0 Employee Dishonesty/Crime $ Per Occurrence Including Employee Theft. Funds Transfer Fraud, Include a Joint Loss Payee endorsement naming Collier County. 6. 0 Bid bond Shall be submitted with proposal response in the form of certified funds, cashiers'check or an irrevocable letter of credit,a cash bond posted with the County Clerk,or proposal bond in a sum equal to 5%of the cost proposal.All checks shall be made payable to the Collier County Board of County Commissioners on a bank or trust company located in the State of Florida and insured by the Federal Deposit Insurance Corporation. 7. 0 Performance and For projects in excess of$200,000,bonds shall be submitted with the Payment Bonds executed contract by Proposers receiving award,and written for 100%of the Contract award amount,the cost borne by the Proposer receiving an award. The Performance and Payment Bonds shall be underwritten by a surety authorized to do business in the State of Florida and otherwise acceptable to Owner:provided,however,the surety shall be rated as"A-"or better as to general policy holders rating and Class V or higher rating as to financial size category and the amount required shall not exceed 5%of the reported policy holders'surplus.all as reported in the most current Best Key Rating Guide, published by A.M.Best Company,Inc.of 75 Fulton Street,New York,New York 10038. 8. 0 Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is required to meet. The same Vendor shall provide County with certificates of insurance meeting the required insurance provisions. 9. 0 Collier County must be named as"ADDITIONAL INSURED"on the Insurance Certificate for Commercial General Liability where required. 10, 0 The Certificate Holder shall be named as Collier County Board of County Commissioners,OR,Board of County Commissioners in Collier County,OR Collier County Government,OR Collier County. The Certificates of Insurance must state the Contract Number,or Project Number,or specific Project description,or must read: For any and all work performed on behalf of Collier County. 11, 0 Thirty(30)Days Cancellation Notice required. RLC 5/5/2017 Vendor's insurance Statement We understand the insurance requirements of these specifications and that the evidence of insurability may be required within five(5)days of the award of this solicitation. Name of Firm Digit 9i C,qmpu.ter, �Itad Date 06/06/2017 Vendor Signature 6 rzt t"'--- Print Name Mark Schiowltz,President&CEO Insurance Agency Lawley Insurance Agent Name Belinda Leon-Vegas Telephone Number (914.)345-7008 17-7133 EMS Billing&Debt Collection Services RFP_Non CCNATemplete_12092016 36 ©2017 Digitech Computer,Inc. Solicitation 17-7133 EMS Billing&Debt Collection Services 81 AccoRD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: BR#868164 PHONE EXtt. 914-345-7000 rA/c.Nol 866-211-4683 LawleyWestchester Group,LLC ���� ADDRESS: 4 Manhattanville Road,Suite 107 INSURER(S)AFFORDING COVERAGE NAIC# Purchase,NY 10577 INSURERA:Sentinel Insurance Company 11000 INSURED INSURER B:Hartford Fire Ins Co 19682 Digitech Computer Inc. INSURERC: Travelers Indemnity Company 31194 480 Bedford Road, INSURER D' Federal Insurance Company/Chubb Insurance 12777 Bldg 6,2nd Floor INSURER E: Chappaqua,NY 10514 INSURER F' COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR P TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EX INSD WVD POLICY NUMBER (MMIDD/YYYYI (MMIDD/YYYY) LIMITS XX COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE XX OCCUR DAMAGE TO RENTED 1,000,000 PREMISFS(Fa occurrence) $ MED EXP(Any one person)_ $ 10,000 _ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE� LOC PRODUCTS-COMP/OP AGG $ 2,000,000 A OTHER: A 01SBAAW4097 1/11/2017 1/11/2018 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000 000 1Fa accident) > ANY AUTO BODILY INJURY(Per person) $ — ALL OWNED SCHEDULED��JJggBODILY INJURY(Per accident) $ AUTOS NON�OWNED PROPERTY DAMAGE XX HIRED AUTOS _AUTOS (Per accident) $ A 01SBAAW4097 1/11/2017 1/11/2018 $ XX UMBRELLA LIAB XX OCCUR EACH OCCURRENCE $ 5,000,000 ' EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 A DED XX RETENTION$ 10,000 01SBAAW4097 1/11/2017 1/11/2018 $ WORKERS COMPENSATIONPER U I H- AND EMPLOYERS'LIABILITY XX STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? n N/A E.L.EACH ACCIDENT $ 1>000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 B DyesESCRIPTION OF OPERATIONS below 01 WECDW 1840 1/112017 1/11/2018 E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Crime 106306571 7/24/2017 7/24/2018 Limit $2,000,000 D Cyber Liability 942341 7/11/2017 7/11/2018 Limit $1,000,000 D Technology and Professional Liability 942341 7/11/2017 7/11/2018 Each Occurrence/Aggregate$3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Collier County Board of County Commissioners,or Board of County Commissioners in Collier County Government are included as additional insureds as per policy terms,conditions,exclusions and as required by written contract on a primary&non contributory basis. CERTIFICATE HOLDER CANCELLATION Collier County Board of County Commissioners,or Board of County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners in Collier County,or,Collier County Government ACCORDANCE WITH THE POLICY PROVISIONS. 8075 Lely Cultural Parkway,Suite#267 Naples,FL 34113 AUTHORIZED REPRESENTATIVE DJ:Liz:_.9 @ 1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD