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Agenda 07/11/2017 Item #16E607/11/2017 EXECUTIVE SUMMARY Recommendation to award RFP #17-7133 EMS Billing and Debt Collection Services to Digitech EMS Billing, Inc. d/b/a Digitech Computer, Inc. OBJECTIVE: To provide billing services for Collier County Emergency Medical Services ambulance transports. CONSIDERATIONS: On May 22, 2007 the Board approved the outsourcing of billing for Emergency Medical Services and awarded a contract to Advanced Data Processing, Inc. On November 13, 2012 the Board approved the award of RFP #12-5874 and contract once again to Advanced Data Processing dba Intermedix (ADPI). This contract expires on November 12, 2017. Staff posted RFP #17-7133 on May 8, 2017, and sent e-mail notifications to 505 entities; 48 entities requested the specifications, and 5 entities submitted proposals by the June 7, 2017, due date. The committee convened on June 12, 2017, scored and ranked the five proposals in the following order: Proposers Final Ranking Digitech EMS Billing Inc DBA Digitech Computer, Inc. 1 Advanced Data Processing Inc DBA Intermedix 2 PST Services LLC 3 Credit Bureau Systems DBA Ambulance Medical Billing 4 Life Line Billing Systems LLC DBA LifeQuest Services 5 The selection committee chose Digitech Computer, Inc., by consensus, to be the most qualifi ed vendor to perform the required services. To achieve a smooth transition, staff is requesting the new contract be dated October 1, 2017, in keeping with the County’s fiscal year. Since the new billing contract will commence on October 1, 2017, all new s ervices will be processed by Digitech Computer, Inc. as of that date. ADPI will complete all billing and collection efforts on behalf of the County for those accounts remaining in their system and entered on or before September 30, 2017. FISCAL IMPACT: The expiring contract has a rate of 4.45% of net revenues. The contract to be awarded offers a rate of 3.95%. The average annual cost of this service over the past five years was approximately $519,000. LEGAL CONSIDERATIONS: This item is approved as to form and legality, and requires majority vote for Board approval. -SRT GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact resulting from this action. RECOMMENDATION: To award RFP #17-7133 EMS Billing and Debt Collection Services to Digitech Computer, Inc. and authorize the Chair to execute the attached contract for EMS billing services with an effective date of October 1, 2017. Prepared by: Artie R. Bay, Supervisor, And Emergency Medical Services Admin. 07/11/2017 ATTACHMENT(S) 1. [Linked] Agreement - Digitech EMS Billing approved by CAO (PDF) 2. [Linked] 17-7133 Digitech_Proposal (PDF) 3. 17-7133 EMS Billing_NORA (PDF) 4. 17-7133 EMS Billing Debt Collection Services Solicitation (PDF) 5. 17-7133 Addendum #1 (PDF) 07/11/2017 COLLIER COUNTY Board of County Commissioners Item Number: 16.E.6 Doc ID: 3438 Item Summary: Recommendation to award RFP #17-7133 for EMS Billing and Debt Collection Services to Digitech EMS Billing, Inc. d/b/a Digitech Computer, Inc. Meeting Date: 07/11/2017 Prepared by: Title: Supervisor - Accounting – Administrative Services Department Name: Artie Bay 06/27/2017 8:16 AM Submitted by: Title: Department Head - Administrative Svc – Administrative Services Department Name: Len Price 06/27/2017 8:16 AM Approved By: Review: Procurement Services Barbara Lance Level 1 Purchasing Gatekeeper Completed 06/29/2017 1:48 PM Procurement Services Ted Coyman Additional Reviewer Completed 06/29/2017 5:48 PM Emergency Medical Services Tabatha Butcher Additional Reviewer Completed 06/29/2017 11:07 PM Procurement Services Viviana Giarimoustas Additional Reviewer Completed 06/30/2017 8:23 AM Procurement Services Swainson Hall Additional Reviewer Completed 06/30/2017 8:58 AM Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 06/30/2017 12:14 PM Procurement Services Sandra Herrera Additional Reviewer Completed 06/30/2017 4:55 PM Administrative Services Department Len Price Level 2 Division Administrator Review Completed 07/03/2017 10:11 AM Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 07/03/2017 10:31 AM Office of Management and Budget Laura Wells Additional Reviewer Completed 07/03/2017 10:34 AM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 07/03/2017 11:22 AM County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 07/03/2017 4:25 PM Board of County Commissioners MaryJo Brock Meeting Pending 07/11/2017 9:00 AM   © 2017 Digitech Computer, Inc. Solicitation 17‐7133 EMS Billing & Debt Collection Services 1  Request for Proposals #17‐7133  EMS Billing & Debt Collection Services  Collier County, FL  Due Wednesday, June 7th, 2017 at 10:00AM    Digitech Computer, Inc.  480 North Bedford Road  Building 600, 2nd Floor   Chappaqua, New York 10514  914.741.1919  914.741.2818 fax  www.digitechcomputer.com                                  Proposal                            © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 2 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 3 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 ................................................................................................................................................. 25 ........................................................................................................................................ 25 ....................................................................................................................................... 26 ................................................................................................................................................... 26 .................................................................................................................................... 27 TABLE OF CONTENTS © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 4 ........................................................................................................................................... 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 5 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 6 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. 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. EXECUTIVE SUMMARY Supporting Your Mission © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 7 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. 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. Demographic search tool finds missing patient or insurance info Automated, unrelenting appeals processing Document Management Imaging System Customizable interface that gives users a real-time picture of operations 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. Partnership EMS Billing Through Innovative Technology © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 8 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. 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. 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 Nuñez, 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 Meet Your Team © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 9 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. 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. Commitment to Compliance © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 10 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: 480 Bedford Road Building 600, 2nd Floor Chappaqua, NY 10514 Phone: (914) 741-1919 Fax: (914) 741-2818 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 Digitech is a privately held Subchapter S corporation that COVER LETTER AND REFERENCES © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 11 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. 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, Mark Schiowitz President & CEO Digitech Computer, Inc. Digitech’s business model marries advanced IT solutions with a highly experienced and knowledgeable staff that manages every detail of each account. for us to devote ourselves to them.   © 2017 Digitech Computer, Inc. Solicitation 17‐7133 EMS Billing & Debt Collection Services 12  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.    Current Client Name Contact Information Scope of Contract First Date of  Service  Gwinnett Fire Rescue   408 Hurricane Shoals Road NE,  Lawrenceville, GA 30046  Donna Buhler  Business Manager  (678) 518‐4876  Donna.buhler@gwinnettcounty.com  Annual Transports: 36,000  EMS Billing Services  Imaging & Hosting  ESO Solutions ePCR integration   12/07/11  Anderson County EMS  314 Public Safety Lane,  Clinton, TN 37716  Nathan Sweet  EMS Director  (865) 457‐8609  nsweet@andersonems.com  Annual Transports: 16,000  EMS Billing Services  Imaging & Hosting  07/01/16  Washington County – Johnson  City  296 Wesley St,  Johnson City, TN 37601  Lori Kemp  Comptroller  (423) 975‐5502  lkemp@wcjcems.org  Annual Transports: 23,000  EMS Billing Services  Imaging & Hosting  ESO Solutions ePCR integration  11/01/16  Newport News  2400 Washington Ave,  Newport News, VA 23607  Sergio Nardi  EMS Educator  (804) 384‐6483  snardi@nnva.gov  Annual Transports: 19,500  EMS Billing Services  Imaging & Hosting  ImageTrend ePCR integration  04/01/16  Memphis Fire   2714 Union Ave Extended, Suite 350,  Memphis, TN 38112  Pamela Kiestler  Division Chief  (901) 826‐5377  pamela.kiestler@memphistn.gov  Annual Transports: 83,000  EMS Billing Services  Imaging & Hosting  ImageTrend ePCR integration   01/13/10          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 References  © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 13 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, Digitech’s Billing Process BUSINESS PLAN BUSINESS PLANBUSINESS PLAN © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 14 The PCR Lens data quality reporting interface aggregates pre-hospital data from each transportation as it is transmitted through the Patient Care Report application and then 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. PCR Lens helps administrators of ambulance 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. better patient care, and increased revenue. 14 better patient care, and increased revenue. 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 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 our clients in order to perform billing services on their behalf is minimal, and well within the scope of the normal provision of ambulance transport services: Data collection, enhanced by the documentation training we provide and the PCR Lens tools we offer to monitor the quality and quantity of field data collections. 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. During the implementation phase of the project, Collier County’s active participation will be required to provide crucial information for registrations. We will also need the County’s cooperation in authorizing Digitech to sign registration forms in order to meet the timeline. Our tested interface will pull the billing and dispatch information from the ImageTrend servers once it has been marked “ready for billing,” usually after a review by the County’s QA personnel. Data Collection Research and Coding © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 15 Digitech will provide training to your medics to support the creation of compliant PCRs with narratives that accurately document all treatments provided and support their medical 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. Digitech pulls the billing and dispatch information from the ePCR host servers, and the second stage of the process begins. Pre-hospital Patient Care Reports and all associated transport data are uploaded into Digitech’s system via Secure File Transfer Protocol (sFTP). 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. 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. Data Upload We reconcile all transport records to PCRs. You will never lose a claim. transport, will ensure that all billable transports dispatched have been transferred to the billing system. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 16 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 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. Using Public and Private Databases to Locate Missing Patient Information Digitech uses proprietary search tools that connect to large databases, including Experian1, which contains records on nearly 300 million names and 116 million households, and performs searches using any available data to find additional demographic information. 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 companies in search of a policy number associated with that Social Security number. Digitech uses Change Healthcare and other such databases2 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 Digitech’s proprietary search tools help increase our collections by making it possible to find more information than our competitors. Verification Verification © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 17 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 is the intensive process by which we review each claim manually and 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 scheduled for invoicing. Any accompanying paperwork is verified and attached to the claim using Digitech’s SecureDocs document imaging interface. Editing is typically completed for all claims within 24 business 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. Editing Editing © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 18 Digitech’s Quality Assurance (QA) 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 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 of claims involves Invoicing, Posting, and Short-Pay follow-up. There is a circular dynamic between these steps as remittance processing often results in claims returning to the Invoicing function for re-billing to secondary 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: Invoicing 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. Quality Assurance – The Human Element Our dedicated QA department manually reviews 100% of Medicare, Medicaid, and Railroad claims. medical necessity, mileage, and signatures. All Medicaid claims are similarly verified for medical necessity. medical necessity, mileage, and signatures. All Medicaid claims are similarly verified for medical necessity. Resolution © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 19 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 20 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 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. 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 21 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 inform ation, 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) 95% of claims will be processed in the first 4 days after receipt of transport data © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 22 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. All forms and patient communications are customized for each client, so that all invoices, statements, and letters represent your service as you wish to be seen. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 23 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. Audits Permeating every aspect of Digitech’s billing process is a series of Quality Assurance and A uditing 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 24 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, Digitech’s proprietary software, is composed of 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 their software vendors who may require weeks or months to make programming changes, Digitech builds and owns our claims processing software. We have eight full-time programmers on staff to work only on this application, so we can prudently automate any element of the process. This improves efficiency, which frees up resources that we can then reallocate to collecting on the more difficult claims. Improving collections on these claims is where we derive much of the incremental revenue realized by our clients. We know of no other billing company that has created their claims- processing software platform and refined it over the course of more than 30 years. In the end, this will benefit the County in the following ways: We can react quickly to mandated regulatory and submission changes. To maintain compliance, Digitech employs continual monitoring, analysis, and software/process changes. Because we own the software, we can do all of this on our schedule. There is no dependence on third party software vendors. We can customize software as necessary – whether for 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. Ambulance Commander Digitech’s proprietary system delivers to our clients what we believe is the most advanced technology for ambulance transport billing that exists today. It can be securely and easily accessed by authorized County personnel from any computer with an internet browser and a reasonably fast connection. Ambulance Commander delivers comprehensive reporting on your operations and finances whenever you want it, 24 hours a day. It is highly customizable, and supported by a team of programmers who are constantly delivering updates to improve collections and increase data security based on changes to regulations or in response to client feedback. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 25 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. 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 search tool is given basic demographic information including address, phone, name, birth date, or any combination thereof to identify the patient's Social Security number. Once identified, the Social Security number is fed into our insurance polling system which sequentially queries multiple insurance companies in search of the policy number associated with the Social 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 hospital are not able to provide it. 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 Sleuth uncovers insurance and demographic information Access to the System © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 26 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. SecureDocs® will bring document storage and management efficiencies to the County. SecureDocs allows EMS providers and Digitech to easily store, organize and retrieve documents relating to the transport. This includes letters, legal materials, or any other documentation that may be of value in the future. SecureDocs surpasses paper filing systems by providing one-click access to all documentation. Using Optical Character Recognition (OCR) and Barcode recognition technologies, SecureDocs provides full text search capability for all scanned images, simplifying the process of locating, viewing, printing, or emailing important documentation. 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. Patients can access their account information through a secure and convenient online access interface that we call Portal. Through Portal, patients can provide insurance information, update their demographic information, and review the status of their accounts. Credit card payments can also be made through a 128-bit SSL self-service payment interface. Digitech’s Secure Document Management System Portal allows patients to access their account information securely and easily. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 27 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. 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 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. 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 Digitech's Dashboard is just one of the many tools you will have at your disposal to track operations and finances. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 28 accurately analyze the data collected by medics and compare their efforts to their peers, other EMS shifts, stations, and even other EMS organizations. PCR Lens enables you to see, measure, compare, and improve field data collection. Digitech’s data quality analysis tool earned EMS World’s Product Innovations Award. Digitech’s data quality analysis tool earned EMS World’s Product Innovations Award. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 29 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. 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 Baltimore City Fire 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 Baltimore City Fire 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 Baltimore City Fire © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 30 We were very impressed with Digitech’s methodical and cooperative approach, and they have made good on their promise to do better in every aspect of billing and customer service than our former contractor. David Morando Former Assistant Chief Johnson County Med-Act, Olathe KS 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. 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 always on the job, Digitech’s support team is on call around the clock. During our normal business hours of 8am – 6pm EST, Monday through Friday, our support team is available to respond to any questions that the County may have. Outside of normal business hours, Digitech’s team can be reached by phone to handle any urgent technical needs. Senior Management provides direct contact information, including personal mobile 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. Support Available to Collier County Customer Service – Including Communicating with Speakers of Other Languages © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 31 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. 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. Escalation of Service Issues © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 32 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. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 33 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 Digitech’s Training Plan © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 34 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: 1. List of Users. 2. Citrix software installed on users’ workstations. 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 35 SECUREDOCS – ARCHIVE BATCH TOOL  New Batches  View  Edit  Filter CALLS  Claim Search  Find Call  Call Utilities  Patient 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  Accounting Roll Forward HELP  About  Request Remote Support © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 36 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. 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. Implementation Plan The three phases of implementation ─ Requirements Gathering, System Installation, and Testing ─ can be accomplished in 60 days. The three phases of implementation ─ Requirements Gathering, System Installation, and Testing ─ can be accomplished in 60 days. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 37 Solicitation 17-7133 EMS Billing & Debt Collection Services 37 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. Requirements Gathering Phase © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 38 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. System Installation and Tailoring Phase 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 39 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. 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. 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 System Testing, Training, and Acceptance Phase Field Testing Phase © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 40 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. 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 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. 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. other known costs associated with the implementation plan for which Collier County is responsible. Our implementation process is a smooth and efficient deployment that often results in an increase in cash flow No Cash Flow Interruption © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 41 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 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. Key Performance Indicators (KPIs) Integration with Hospital EHR Systems © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 42 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. 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. Accounting and Reporting 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 Digitech’s data quality analysis tool earned EMS World’s Product Innovations Award. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 43 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. Receivable, and every other aspect of the month’s billing activity. Several examples from our monthly re package are shown here. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 44 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 44 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 FINANCIAL SCORECARD ANALYTICAL SCORECARD © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 45 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. Clicking on the cell opens a list of all the claims that comprise that value. Listing of all claims that make up the $5,588.34 Double click to go to an individual claim Listing of all claims that make up the $5,588.34 Double click to go to an individual claim © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 46 Within the claim, you can drill into the audit record to see when records were changed, who changed them, and how they were changed. Summary of every edit Every field changed – shows before and after © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 47 Review notes, payment records, procedure codes, and collections activity associated with the claim. Verify mileage using multiple mapping options. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 48 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. 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 49 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. 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. 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. Standard Operating Procedures Recovery Process and Defaulted Clients Patient Payment Arrangements © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 50 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 51 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. 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 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. Our Compliance Department works closely with Page, Wolfberg & Wirth, 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 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 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. 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 Auditing Is a Key Aspect of Our Business Model Auditors Auditing Is a Key Aspect of Our Business Model © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 52 choosing. We are familiar with JR Henry, Fitch and Associates, and Werfel and Werfel, LLC and have worked with each firm in the past. 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. 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: o Appropriate paperwork is attached o Level of service is accurate o Diagnosis is correct o Claims are properly coded 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. Monthly Claims Audit Random Daily Claims Audit © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 53 Within two business days, the department manager responsible for the issue responds with an evaluation and corrective action plan. 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. 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. 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. Audit Trail in Our Billing Software System Audit Trail in Every Claim Record © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 54 The Statement on Standards for Attestation Engagements (SSAE) No. 16, was created by the American Institute of Certified Public Accountants to measure and report on the controls that service organizations employ to manage financial reporting. Digitech engages the services of WithumSmith+Brown, a premier financial auditing company, to deliver an in- depth audit of its internal controls and related processes and certify that Digitech meets the recognized standards for controls and safeguards as they relate to hosting or processing our clients’ data. 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. 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. Ambulance Commander’s audit trail function will give you access to real-time records of every action performed on your account. SOC 1 Type II Certification Record Retention and Destruction Ambulance Commander’s audit trail function will give you access to real-time records of every action performed on your account. trail data through read-only interfaces. Ambulance Commander’s audit trail function will give you access to real every action performed on your account. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 55 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. 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. Physical Security Features Biometric access 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 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 Digitech’s Primary Data Center Colocation Data Center Storage and Security Disaster Recovery and Redundancy © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 56 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. 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 Disaster Recovery Planning scale resource interruption. Disaster Recovery PlanningDisaster Recovery Planning © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 57 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 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 58 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: Home computer with a secure connection to Digitech’s network Reliable internet connection Printer Phone line that can be dedicated for work during business hours Processing Center Redundancy © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 59 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. 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 th e 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. Data Backup and Archive © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 60 $8.00 3.95% % 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 Net Collected Revenue3. We have prepared this proposal under several basic assumptions, 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. In accordance with Florida statutes, Digitech will charge a flat rate fee of $8.00 for each account paid by Medicaid. 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. Total Proposed Fee as a Percent of Revenues Collected Medicaid Claims Fee COST OF SERVICES TO THE COUNTY © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 61 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 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. 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. Medicare and Medicaid Experience Associate member since 2012 Member of EMS Section since 2012 Member since 2009 Corporate member since 2012 Sponsor Member since 2015 Associate member since 2015 Associate member since 2012 Gold member since 2015 Member since 2012 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 62 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. 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 63 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. Economic Benefit to Collier County © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 64 Gwinnett Fire Rescue Annual Transport Volume 36,000 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. 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. Gwinnett Fire Annual Transport Volume EXPERIENCE AND CAPACITY OF FIRM © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 65 Johnson County Med-ACT Annual Transport Volume 20,000 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. 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. Memphis Fire Annual Transport Volume © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 66 Plano Fire Rescue Annual Transport Volume 11,000 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. 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. Plano Fire Rescue ire Qualifications to Produce the Required Deliverables © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 67 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. All of Digitech’s Billing Managers are NAAC certified. Their certificates have been included as Appendix B. 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. Integration Expertise with ImageTrend NAAC Certification Average Amount of Days to Send Initial Bill and Receive a Response 95% of available revenue will be collected within 90 days. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 68 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. Current Client Name Contact Information Scope of Contract First Date of Service Gwinnett Fire Rescue 408 Hurricane Shoals Road NE, Lawrenceville, GA 30046 Donna Buhler Business Manager (678) 518-4876 Donna.buhler@gwinnettcounty.com Annual Transports: 36,000 EMS Billing Services Imaging & Hosting ESO Solutions ePCR integration 12/07/11 Johnson County Med-ACT 11811 S. Sunset Dr, Suite 1100, Olathe, KS 66061 Ted McFarlane EMS Director (913) 715-1960 tmcfarlane@jocoems.org Annual Transports: 20,000 EMS Billing Services Imaging & Hosting ImageTrend ePCR integration 01/01/09 Washington County – Johnson City 296 Wesley St, Johnson City, TN 37601 Dan Wheeley Chief/Executive Director (423) 975-5500 dwheeley@wcjcems.org Annual Transports: 23,000 EMS Billing Services Imaging & Hosting ESO Solutions ePCR integration 11/01/16 Newport News 2400 Washington Ave, Newport News, VA 23607 Robert E. Lee EMS Chief (757) 926-8404 relee@nnva.gov Annual Transports: 19,500 EMS Billing Services Imaging & Hosting ImageTrend ePCR integration 04/01/16 St. Louis 2634 Hampton Ave, St. Louis, MO 63139 Cynthia Dixon Manager, Fiscal Services St. Louis Fire Department (314) 289-1950 dixonc@stlouis-mo.gov Annual Transports: 40,000 EMS Billing Services Imaging & Hosting ESO Solutions ePCR integration 04/01/16 Customers of Similar Size and Scope to Collier County © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 69 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 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 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 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. SPECIALIZED EXPERTISE OF TEAM MEMBERS © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 70 Brad Stuart, Vice President – Billing Software Brad joined Digitech in 2002. He holds a degree in Computer Science from Pace University and also graduated cum laude from the College of Westchester with a degree in Computer Programming. Brad and his team led the successful development 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. Catherine L. Tenzyk, Quality Assurance and Compliance Manager 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 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 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 currently leads a staff of over 25 employees, and will be the liaison for Collier County 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 at creating reports for budget analysis. He studied Business Management at the University of Tennessee Chattanooga, and he completed the local government finance officer program through the University of Georgia’s Carl Vinson Institute of 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. Additional Resources Additional ResourcesAdditional Resources © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 71 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 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 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 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 72 Digitech takes no exceptions to the terms and conditions outlined in the RFP. ACCEPTANCE OF CONDITIONS © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 73 REQUIRED FORM SUBMITTALS © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 74 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 75 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 76 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 77 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 78 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 79 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 80 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 81 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 82 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 83 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 84 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 85 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 86 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 87 RFP Section Page References Requirements Detailed Scope of Work 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). p. 13 p. 24 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. p. 21 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. p. 60 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. p. 61 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). p. 33 f. Have the ability to 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. p. 15 g. Have the ability to download payment information from the County electronically. p. 20 h. Have the ability to accept credit card/ACH payments (must be PCI Compliant), include any fees and where they will apply. p. 26 p. 60 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. p. 19 p. 22 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. p. 18 p. 21 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. p. 13 l. 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. p. 50 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. p. 15 n. Provide web access to the County for access to ad hoc reports on billing performance p. 27 p. 42 o. Establish a skip-tracing process to validate patient information ( correct spelling of name, social p. 16 EVALUATION MATRIX © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 88 RFP Section Page References 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. 25 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. p. 26 p. 70 q. Provide a local phone number or e-mail to respond to inquiries concerning patient account information. p. 30 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. p. 50 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. p. 16 p. 41 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. p. 30 p. 31 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. p. 13 p. 60 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. p. 42 w. Provide the County with copies of supporting documentation for refunds to be made by the County the month following the payment posting date. p. 23 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. p. 27 p. 42 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. p. 22 z. Process Medicare Revalidation and represent CCEMS in Medicare and Medicaid audits. Will be responsible for any fines incurred due to negative audit findings. p. 23 p. 51 p. 71 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. p. 23 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. p. 23 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. p. 19 p. 23 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. p. 25 p. 34 ee. The proposal must provide a summary of the methods that the contractor intends to use for the storage of records and the related security and disaster recovery plans; and how it plans to ensure continuity of operations to operate in the event of a disaster or similar event that results in the interruption of the normal operating conditions of the contractor’s primary place of business providing services to the County or any of the support or technical aspects of that office. Include p. 54 p. 55 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 89 RFP Section Page References details about how the plan is exercised to assure the plan produces the intended results. ff. Develop a plan for receiving mail, depositing payments, and providing the County with payment information for accounts prior to the Contract period. p. 37 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. p. 51 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. p. 50 p. 54 ii. The County will have the option to authorize the selected proposer to perform billing services on new collection cases at the proposed rate or for all existing cases at a separately negotiated rate. jj. For monthly reconciliation and payment of invoice by the County, provide 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. p. 20 p. 42 p. 43 p. 61 kk. Assist County in preparation of Medicaid CPE reporting and indicate fee for that service. p. 62 Response Format 1. Tab I, Cover Letter / References Provide a cover letter, signed by an authorized officer of the firm, indicating the underlying philosophy of the firm in providing the services stated herein. Include the name(s), telephone number(s) and email(s) of the authorized contact person(s) concerning proposal. Submission of a signed Proposal is Vendor's certification that the Vendor will accept any awards as a result of this RFP. Provide a list of subcontractors who will participate on the team, if applicable. Also include, five (5) references from customers that you have done business with in the last five (5) years, please refer to Reference Questionnaire (attachment 9). p. 10 2. Tab II, Business Plan In this tab, include: p. 13  Detailed explanation of how your firm will provide the required Billing Services for Emergency Medical Services Transport. Discussion should include specific abilities related to skills and technical expertise. EMS billing service procedures and policy for account management. p. 13  Describe your proposed automated system and operational software. p. 13 p. 24  Detail any training that will be provided by your firm. p. 33  Timeline needed for transition of billing services to a new vendor p. 36  Provide samples of any reports that your firm shall provide in response to the County’s requirements. p. 42  Detail the recovery process, finding defaulted clients, and how long will services be provided for a defaulted client. p. 49  Explain procedures established for patient payment arrangements p. 49  Provide standard operating procedures to demonstrate how your firm will manage the p. 49 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 90 RFP Section Page References County’s accounts. Include the following: o Verification and/or correction of address o Quality assurance o Accuracy o Dispute resolution o Processing and collection timelines o Recent and Planned compliance with privacy requirements and data transmission 3. Tab III, Cost of Services to the County: p. 60  Provide a total proposed fee as a percent of revenues collected related to the performance of these services, except for Medicaid. In accordance with Florida Statutes, provide a flat rate fee for each account paid by Medicaid. p. 60 Discuss your knowledge as it relates to regulations regarding claims, reviews, and hearings as applied in the Medicare and Medicaid programs in performing the required services. p. 61  Submit a narrative explaining the direct economic benefit to Collier County to be realized by selecting your firm. During the term of this engagement detail the employment, subcontracting, and support services contracting as economic stimulus that your entity may generate that would directly benefit Collier County. p. 63 4. Tab IV, Experience and Capacity of Firm The prospect shall provide past performance for a minimum of five (5) contracts, at least two (2) with government entities that demonstrates recent and relevant past performance of similar scope, size and complexity of services identified. Provide information that documents your firm’s and subcontractors’ qualifications to produce the required deliverables, including abilities, capacity, skill, and financial strength, and number of years of experience in providing the required services. Also describe experience with other clients utilizing ImageTrend. Provide information regarding certification through the National Academy of Ambulance Coders (NAAC). p. 64 p. 67  Describe what your average amount of days to send the initial bill and get a response from the client. p. 67  Describe how many customer(s) of similar size and scope to Collier County that you currently provide services to. p. 68 5. Tab V, Specialized Expertise of Team Members Identify each person(s) of your firm who will be professionally associated with the County in the day-to-day operations and oversight of this project. Describe their respective area of expertise. Include personalized resumes which identify the qualification, training and experience of each person(s). Describe how that individuals time will be spent to achieve the goals and billing for Collier County. p. 69 Appendix C 6. Tab VI, Acceptance of Conditions Indicate any exceptions to the general terms and conditions of the RFP, and to insurance requirements or any other requirements listed in this RFP. If no exceptions are indicated in this tabbed section, it will be understood that no exceptions to these documents will be considered after the award, or if applicable, during negotiations. Exceptions taken by a Vendor may result in evaluation point deduction(s) and/or exclusion of proposal for Selection Committee consideration, depending on the extent of the exception(s). Such determination shall be at the sole discretion of the County and Selection Committee. p. 72 7. Tab VII, Required Form Submittals: p. 73  Attachment 2: Vendor Check List p. 73  Attachment 3: Conflict of Interest Affidavit p. 74 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 91 RFP Section Page References  Attachment 4: Vendor Declaration Statement p. 75  Attachment 5: Affidavit for Claiming Status as a Local Business p. 77  Attachment 6: Immigration Affidavit Certification p. 78  Attachment 7: Vendor Substitute W-9 p. 79  Attachment 8: Insurance and Bonding Requirements p. 80  Attachment 9: Reference Questionnaire p. 82  Other: i.e. signed addenda, licenses or certifications, promotional materials, etc. Appendices Addenda REPORT SAMPLES Digitech Computer, Inc. 480 Bedford Road, Building 600 – 2nd Floor Chappaqua, New York 10514 914.741.1919 914.741.2818 fax www.digitechcomputer.com Table of Contents DIGITECH RESERVES THE RIGHT TO REMOVE, ADD, OR MODIFY REPORTS AT ANY TIME ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 2 TABLE OF CONTENTS MONTHLY PUSH REPORTS ....................................................................................................................... 3 SCORECARDS .................................................................................. 22 SCORECARDS ....................................................................................................................................................................... 22 SUMMARY OF SCORECARD FUNCTIONALITY ............................................................................................................. 23 THE ANALYTICAL SCORECARD ....................................................................................................................................... 23 THE FINANCIAL SCORECARD ........................................................................................................................................... 24 REPORTING SYSTEM ............................................................................................................................... 25 STANDARD ONLINE REPORTS AND FUNCTION OVERVIEW .................................................................................... 25 ACCOUNTING REPORTS .................................................................................................................................................... 26 SALES REPORT .................................................................................................................................................................... 27 SAMPLE SALES REPORTS ................................................................................................................................................. 28 BILLING AND BACK OFFICE REPORTS .......................................................................................................................... 29 NOTE REPORT ...................................................................................................................................................................... 29 SAMPLE NOTES REPORT .................................................................................................................................................. 30 DATA DUMP ........................................................................................................................................................................... 32 DISPATCH AND OPERATIONAL REPORTS .................................................................................................................... 33 CALL VOLUME - CONDITION BY SOURCE REPORT ................................................................................................... 34 SAMPLE CALL VOLUME - CONDITION BY SOURCE REPORT .................................................................................. 35 SAMPLE CONDITION BY SOURCE REPORT ................................................................................................................. 36 MANAGEMENT REPORTS .................................................................................................................................................. 37 ............................................................................................................................................................... 38 ....................................................................................................................................................................... 40 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 3 MONTHLY PUSH REPORTS Digitech sends each client the following monthly package of Transport and Accounting reports: ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 4 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 5 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 6 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 7 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 8 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 9 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 10 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 11 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 12 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 13 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 14 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 15 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 16 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 17 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 18 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 19 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 20 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 21 All reports can be saved to a variety of file formats including Microsoft Word, Excel, Access, Crystal Reports, and Adobe Portable Document Format. ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 22 SCORECARDS Primary oversight and reporting functions available through Digitech’s Ambulance Commander® servicing system include the following: Scorecards Ambulance Commander® Scorecards combine performance information into online realtime snapshots from which Client employees can drill down all the way to the individual patient, claim, or transaction level for all processing events and performance measures. They include the Ambulance Commander® Analytical Scorecard and the Ambulance Commander® Financial Scorecard. ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 23 Summary of Scorecard Functionality The following sections illustrate the functionality of the Scorecards available through Digitech. The Analytical Scorecard The Analytical Scorecard functionality analyzes claim costs and charges on a per-Carrier or Major Payer level. The filter dialog for the report, shown below, follows the same conventions as those of the Sales, Receivables, and Adjustments Reports. Users may choose one or more options for Trip Priority, Financial Groups, Service Level, Trip Class, and Company data to include in a report. (Note the option to calculate transports by Financial Group.) ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 24 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 24 The Financial Scorecard Our Financial Scorecard gives the user online access to instantly review all receivables and view a breakdown of data by governmental and third-party payers, as well as, private-pay patients. Users can view (and with proper authorizations, edit) the financial details of any claim in the system, down to the individual transaction level. ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 25 REPORTING SYSTEM Digitech’s servicing system provides hundreds of report variations to select from. The most common categories of reports accessed by Digitech clients are Sales Reports, Adjustment Reports, Receivable Reports, Billing Reports, and Cash Receipt Reports. Reports detailing metrics and processing events cover a myriad of functions, for example, call taking, patient data updates, claims denials, etc. Standard Online Reports and Function Overview The Ambulance Commander® system offers a large number of standard reports out of the box. For length reasons, this document does not show samples of all of them, but their names and descriptions appear in this section Standard accounting reports include the Accounting Roll Forward Report, Accounts Receivables Reports, Adjustment Reports, Cash Receipts Reports, the Closing Utility, and Sales Reports. The Reports menu contains five report categories: Accounting Billing and Back Office Data Dump Dispatch and Operational Management ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 26 Accounting Reports Accounting Reports enable financial analysis by category. The Accounting Reports include the following: Accounting Roll Forward Accounts Receivables Report Adjustment Report Cash Receipts Report Closing Utility Sales Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 27 Sales Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 28 Sample Sales Reports ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 29 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 Billing and Back Office Reports Billing and Back Office Reports include the following: Claim Summary Report Invoice Run History Report Note Report Refund Report Note Report Note Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 30 Sample Notes Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 31 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 32 Data Dump The Data Dump menu provides access to the Ambulance Commander® system's data export functionality. Authorized users can perform a Trip & Dollar Dump to offload trip details and select financial information to a Microsoft Excel spreadsheet or other reporting application, or perform a more targeted, user-defined data dump. ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 33 Dispatch and Operational Reports Dispatch and Operational Reports primarily deal with the variables logged in Call Taking forms, such as call volume, cancellation reasons, response times, trip counts, and so on. Specifically, Dispatch and Operational Reports include: Call Volume – Condition by Source Report Daily Call Volume Report Day of Week by Time of Day Report Denied / Submitted Report Fractile Response Time Report UHU Report Volume by Financial Group Report Volume by Origin Monthly Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 34 Call Volume - Condition by Source Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 35 Sample Call Volume - Condition by Source Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 36 Sample Condition by Source Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 37 Management Reports Management Reports consist of the Analytical Scorecard and Financial Scorecard. Full details of the Analytical Scorecard on page 22. Full details of the Financial Scorecard on page 23. ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 38 Dashboard brings EMS operational and financial data into an easy-to-use, intuitive interface that enables managers, administrators, and business analysts to get a real-time picture of any aspect of their operations. Using the right click function, you are able to go deeper and deeper into statistics, eventually leading to individual claims, as shown below. HELPING HAND MEDICAL CENTER JOHNSON HOSPITAL GOOD SAMARITAN HOSPITAL DOWNTOWN GENERAL INNER BAY MEDICAL OUR LADY OF THE BAY SAINT CECILIA HOSPITAL MEMORIAL HOSPITAL SISTERS OF MERCY HOSPITAL EASTERN MEDICAL CENTER UNIVERSITY HOSPITAL RIVERSIDE MEMORIAL HOSPITAL ST AUGUSTINE MED CENTER VETERANS HOSPITAL LOYOLA MEDICAL CENTER WEST BAY MEDICAL ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 39 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 40 ©2015 Digitech Computer, Inc PROPRIETARY INFORMATION last updated August 2014 40 PCR Lens measures how completely and accurately crews collect field data. Administrators are able to compare the efficiency of medics to others in the service, as well as to crews in other services. PCR Lens includes a feature that allows users 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. PCR Lens helps administrators to make sense of the mountains of field data collected by their medics, pinpoint problems, and identify high-performance individuals or teams. CERTIFICATIONS Digitech Computer, Inc. 480 Bedford Road, Building 600 – 2nd Floor Chappaqua, New York 10514 914.741.1919 914.741.2818 fax www.digitechcomputer.com 2 This page left blank intentionally. presents this Certificate of Completion to Marie Ellingham for successful completion of Certified Ambulance Coder (CAC) Jason J. Leet Program Coordinator 04/22/16 Date of Completion 1 RÉSUMÉS OF KEY PERSONNEL      PROFESSIONAL EXPERIENCE  1984 – Present President & CEO, DIGITECH COMPUTER, INC.   Founded business   Successfully directed the Firm’s rapid growth   Responsible for setting overall business and technology strategy  1982 – 1984 GERALD METALS INC., Stamford, CT    Began a trading desk that focused on new financial product offered at COMEX and MERC.  These included Options on Bond Futures and Options on Gold Futures   Reworked the Black and Scholes Options Volatility Pricing Models for new futures  markets. Traded these instruments  1981 – 1982 LOMBARD WALL, INC., Money Market Trading Firm, New York, NY    Worked in the research area developing computer trading systems that defined   the buy and sell points based on trending algorithms   Later moved to the trading desks to trade short‐term government securities for Firm’s  portfolio  1979– 1981 E.F. HUTTON, INC., New York, NY   Graduated from Management Training Program   Back Office Operations   Moved to Corporate Bond desk and became a junior fixed income trader  AFFILIATIONS    American Ambulance Association   Commission on Accreditation of Ambulance Services   Health Financial Management Association   International Association of Fire Chiefs   North Central EMS Cooperative    New York State Volunteer Ambulance & Rescue Association  EDUCATION  1979 Major: Economics  Bucknell University, Lewisburg, PA       MARK D. SCHIOWITZ – PRESIDENT & CEO   PROFESSIONAL EXPERIENCE  1994 – Present SVP of Billing Services, DIGITECH COMPUTER, INC.   Oversees all aspects of billing service   Reports directly to President   Responsible for department budget   Responsible for staff of 83  1986– 1993 Assistant Controller, EDWARD EHRBAR, INC., Pelham, NY    Oversaw all aspects of Accounting Department including AP, AR, Payroll   Financial Reporting   Responsible for staff of 15  1982 – 1986 Assistant Controller, MEDICAB INC. OF NEW YORK    Oversaw all aspects of Accounting Department including AP, AR, Payroll   Financial Reporting   Responsible for staff of 8   Provided direct support to billing staff  AFFILIATIONS    New Castle Parks & Recreation Commissioner   New Castle Girls Soccer Coach   Chair of the New Family Outreach Committee  CERTIFICATIONS  June 2013 CAC Certificate  EDUCATION  1982 Major: Accounting  Double Minor: Economics and Religious Studies  B.S. Manhattan College, Riverdale, NY     JOYCE KERULO – SENIOR VICE PRESIDENT OF BILLING SERVICES   PROFESSIONAL EXPERIENCE  1999 – Present SVP Deployment & Support, DIGITECH COMPUTER, INC.   Manages software trainers   Manages technical support staff   Manages software developers   Responsible for new client implementation  1994 – 1999 Customer Support Representative & Programmer, DIGITECH COMPUTER, INC.,   Briarcliff Manor, NY    Responsible for all customer support issues   Made required & custom program modifications   Setup and maintained hardware/networks for Digitech and clients  1994 Receivables Management Account Representative, CELLUAR ONE, Paramus, NJ    Received incoming calls from customers who had questions about their bill   Made outgoing calls to customers who were behind in payment  AFFILIATIONS    New York Ambulette Coalition  EDUCATION  1994 Major: Mathematics  Minor: Chemistry  Susquehanna University, Selinsgrove, PA       WALTER C. PICKETT II – SVP – DEPLOYMENT & SUPPORT   PROFESSIONAL EXPERIENCE  2012 ‐ present VP of Billing Software, DIGITECH COMPUTER, INC.   Directs software development projects   Creats internal programs that help make the billing service more profitable   Develops Medicare, Medicaid, and Commercial HIPAA billing specifications for several  different states   Support of implementation of billing system to clients   Monitors and maintains systems network and infrastructure  2002 – 2012 Senior Program Developer and Software Support, DIGITECH COMPUTER, INC., Briarcliff Manor, NY   Developed and designed software for ambulance dispatching and medical billing   Developed Medicare, Medicaid, and Commercial HIPAA billing specifications for several  different states   Support of implementation of billing system to clients   Monitored and maintained systems network and infrastructure   Created application that receives electronic remittance in which increases user’s  production by 75%   Responsible for constant cash flow for multimillion dollar hospital system  1998 – 2002 Network Administrator/Web Developer, FRONTLINE COMMUNICATIONS, Pearl River, NY    Designed, developed, and monitored e‐commerce websites   Maintained and developed applications such as “web mail” for customers   Installed, configured, and maintained mail servers for thousands of customers   Managed customer and corporate websites of Frontline Communications’ live sites and  company clients’ websites   Oversaw and maintained MS SQL server databases  AREAS OF EXPERTISE  Languages  Microsoft Visual C# and .Net   SQL   C++   ASP   Coldfusion   Javascript   HTML   Database development and implementation  Servers  Microsoft SQL Server   Windows Servers  IIS   Active directory  Applications  Microsoft Visual Studio   Microsoft Office Suite   Adobe Photoshop   Citrix   EDUCATION  September 2000 Associate Degree in Computer Programming, Graduated CUM LAUDE, QPA 3.8, Dean’s List,   College of Westchester, White Plains, NY  September 1994‐ May 1997  Major: Computer Science, Minor: General Business  Pace University, Pleasantville, NY    BRAD STUART – VP OF BILLING SOFTWARE          BENJAMIN LAMBERT – VP TECHNOLOGY PROFESSIONAL EXPERIENCE  2012–present Vice President of Technology, DIGITECH COMPUTER, INC.   Application and infrastructure architecture   Billing process mapping and efficiency identification   Resource allocation for IT and development   IT and development team staffing   Advise on Digitech strategies and direction  2002–2012 Senior Software Engineer, DIGITECH COMPUTER, INC., Briarcliff Manor, NY  Key Projects   Ambulance Commander®.NET – Team leader for the redesign of Ambulance Commander®,  using a Microsoft .NET/SQL Server framework   Centralized processing – Introduced aggregated processing and reporting across all agency  databases, driving Digitech to heightened levels of transparency and efficiency   Sentinel® ‐ Conceptualized and oversaw development of an automated alert system to seek  out issues and inefficiencies by comparing historical and real‐time data   SecureDocs® – Lead developer and project manager for proprietary system which provides  Web‐based access to millions of EMS documents    Ambulance Commander®   o Designed and implemented an import engine to integrate with third‐party ePCR  vendors using XML over ASP.NET web services  o Introduced real‐time insurance eligibility  o Revolutionized claim editing and coding process  2001–2002 ColdFusion Programmer, ACCESS TECHNOLOGIES GROUP, Plymouth Meeting, PA  2001–2002 Visual Basic Development Consultant, MEIXLER TECHNOLOGIES, Drexel, PA  EDUCATION  June 2007– July  2009  Executive MBA  Pace University  Valedictorian  March 2005 –  June 2007  BSIT  University of Phoenix  September 1998  – January 2001  Music Theory Studies  Temple University    PROFESSIONAL EXPERIENCE  2014 – Present Chief Compliance Officer, DIGITECH COMPUTER, INC.   Ensures compliance with all Federal, State, & Local statutes and regulations   Provides training to all Digitech employees with reference to compliance issues  2010‐2014 Associate, STEVEN JON LEVINE, ESQ., White Plains, NY    Provision of Civil Legal Services   Trained Mediator  2003‐2005 Director of Constituent Services, NYS ASSEMBLY, North White Plains, NY    Provided assistance to constituents to access NYS agencies and authorities  1990‐1995 Senior Social Worker, PAYNE WHITNEY CLINIC – NEW YORK HOSPITAL CENTER, NY     1988‐1990 Research Social Worker, NYS PSYCHIATRIC INSTITUTE, New York, NY     1985‐1988 Clinical Social Worker, BELLEVUE HOSPITAL CENTER, New York, NY     AFFILIATIONS   Westchester Women’s Bar Association – Co‐Chair of Mediation Committee  Westchester County Bar Association  New York State Bar Association  EDUCATION  2009    Juris Doctor   Pace Law School, White Plains, NY  1985 Master of Science  Columbia University School of Social Work, New York, NY  1982 Bachelor of Science, Psychology  University of Michigan, Ann Arbor, MI       JANE SILVERMAN – CHIEF COMPIANCE OFFICER   PROFESSIONAL EXPERIENCE  2000 – Present Patient Collection Manager, DIGITECH COMPUTER, INC.   Maintains a staff of 25 plus employees   Liaison for various Ambulance clients located around the country   Strong understanding for billing requirements with Medicare, Medicaid and third‐party  billing   Oversees all aspects of editing   Processes electronic and paper billing   Responsible for end of month reporting  1999 – 2000 Managed Care/Medicare/Commercial Billing Manager, TRANSWORLD, Jacksonville, FL    Trained new employees in different responsibilities within our department   Reviewed productivity and effectiveness of the collections staff   Set up new insurances in system with coding and pricing   Reconciled cash batches for vendor companies  1997 – 1998 Travel Expense Manager, CARLSON WAGONLIT TRAVEL, Phoenix, AZ    Maintained a staff of about 25 employees   Trained new employees in all aspects of data entry and quality control   High‐level accuracy processing traveler’s expense reports  1988 – 1997 Accounts Receivable Supervisor, TRANSCARE NY (AA AMBULANCE CO.), LIC, NY    Trained staff to ensure compliance with frequent regulatory updates   Improved staff productivity by developing procedures, form letters and follow up  processes to standardize interactions with clients and insurance carriers  1988 – 1997 Dispatcher/Accounts Receivable Clerk, EMPRESS AMBULANCE, Yonkers, NY    Performed Medicare, Medicaid manual billing, IC9 coding, remittance posting and denial  follow‐up.  Served as dispatcher and ambulance driver  CERTIFICATES  June 2013 CAC Certificate  December 2006 Front Office Medicare (Updated November 2005)  December 2006 Diagnosis Coding: Using the ICD‐9‐CM (Updated February 2003)          FRANCES CUZZO – PATIENT COLLECTION MANAGER   PROFESSIONAL EXPERIENCE  2012 – Present Manager of QA and Compliance, DIGITECH COMPUTER, INC.   Works closely with QA personnel, Medicare department, Digitech claim editors, clients, and  outside auditors.    Ensures that Digitech billing and collection practices comply with all federal and state  regulations.  2002 – 2012 Medicare Collection Manager, DIGITECH COMPUTER, INC., Briarcliff Manor, NY   Began as a billing and collection representative training on Ambulance Commander®  software in the Medicare Billing Department   Promoted after one year to Manager of two‐person Medicare Department   Responsible for the management, supervision and training of five‐person department in  Medicare ambulance billing and collections   Kept up‐to‐date on current Medicare regulations and guidelines in an effort to keep clients  advised on any changes in regulations and policies   Knowledgeable in the use of OMNI PRO and other Medicare on‐line systems and web‐based  on‐line insurance sites for the purpose of checking eligibility, claim status and doing actual  on‐line claim adjustments   Participated and oversaw the day‐to‐day responsibilities of billing and collecting Medicare  claims  1999 – 2002 Medical Secretary, JOHN A. GALENO, M.D., White Plains, NY    Medical Manager‐insurance billing (No Fault, Compensation and Private)   Corresponded with attorneys and disability insurance requesting medical records   Composed and typed letters for patients   Medical prescriptions‐medication, PT, tests and surgical supplies   Pre‐certification for tests‐calling in clinical information   Prepare charts and retrieve test results for office hours  1986 – 1999 Billing and Collections Clerk, ABBEY RICHMOND AMBULANCE SERVICE, White Plains, NY    Responsible for patient collections   Performed Medicare billing and appeals   Booked and dispatched ambulance calls  CERTIFICATES  2013 CAC Certificate  2007 CMS Certified in ICD‐9 Coding and Medical Necessity  EDUCATION  1980 Valhalla High School, Valhalla, NY      CATHERINE L. TENZYK – MANAGER OF QUALITY ASSURANCE DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE 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). CONTACTPRODUCERNAME: FAXPHONE(A/C, No):(A/C, No, Ext):E-MAILADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : 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. ADDL SUBRINSR POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITSPOLICY NUMBERLTR (MM/DD/YYYY) (MM/DD/YYYY)INSD WVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT $OTHER: COMBINED SINGLE LIMITAUTOMOBILE LIABILITY $(Ea accident) BODILY INJURY (Per person) $ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS AUTOSNON-OWNED PROPERTY DAMAGE $HIRED AUTOS (Per accident)AUTOS $ UMBRELLA LIAB EACH OCCURRENCE $OCCUR EXCESS LIAB CLAIMS-MADE AGGREGATE $ $DED RETENTION $ PER OTH-WORKERS COMPENSATION STATUTE ERAND EMPLOYERS' LIABILITY Y / NANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $N / AOFFICER/MEMBER EXCLUDED?(Mandatory in NH)E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2014/01) DIGICOM-01 BLEONVARGAS 6/1/2017 License # BR-868164 Lawley Westchester Grp LLC4 Manhattanville RdSuite 107Purchase, NY 10577 1 (914) 345-7000 1 (866) 211-4683 Sentinel Insurance Company 11000 Digitech Computer Inc 480 Bedford Road Bldg 600, 2nd Floor Chappaqua, NY 10514 Hartford Fire Insurance Co 19682 Travelers Casualty & Surety of America 31194 Ace American Insurance Co 22667 AX 1,000,000 X X 01SBAAW4097 01/11/2017 01/11/2018 1,000,000 10,000 1,000,000 2,000,000 X 2,000,000 1,000,000 A 01SBAAW4097 01/11/2017 01/11/2018 XX XX 5,000,000 A 01SBAAW4097 01/11/2017 01/11/2018 5,000,000 10,000X X B 01WECDW1840 01/11/2017 01/11/2018 1,000,000 1,000,000 1,000,000 C Prof Liability 01062972 07/01/2016 07/01/2017 Limit/Aggregate 3,000,000 D Cyber Liability EONG25549168001 08/18/2016 08/18/2017 Limit 1,000,000 Collier County is included as additional insured as per policy terms, conditions, exclusions and as required by written contract. Collier County 3295 Tamiami Trail East Naples, FL 34112 555 PLEASANTVILLE RD BRIARCLIFF MANOR, NY 10510 Current Principal Place of Business: Current Mailing Address: 555 PLEASANTVILLE RD BRIARCLIFF MANOR, NY 10510 US Entity Name: DIGITECH EMS BILLING, INC DOCUMENT# F12000002178 FEI Number: 11-2693136 Certificate of Status Desired: Name and Address of Current Registered Agent: BUSINESS FILINGS INCORPORATED 515 E. PARK AVENUE TALLAHASSEE, FL 32301 US The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Date Officer/Director Detail : I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: Electronic Signature of Signing Officer/Director Detail Date MARK WILLIAMS FILED Jan 31, 2014 Secretary of State CC5098599482 MARK SCHIOWITZ PRESIDENT & CEO 01/31/2014 2014 FOREIGN PROFIT CORPORATION ANNUAL REPORT Yes 01/31/2014 Title DIRECTOR Name SCHIOWITZ, MARK Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 Title PRESIDENT Name SCHIOWITZ, MARK Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 Title SECRETARY Name SCHIOWITZ, JOYCE Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 Title DIRECTOR Name SCHIOWITZ, JOYCE Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 Title VICE-PRESIDENT Name PICKETT II, WALTER C. Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 Title TREASURER Name SCHIOWITZ, JOYCE Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 (5/25/2017 11:49:23 AM Eastern) Question: Can you please provide a breakdown of number of transports by service level for the most recent fiscal year? ALS Emergency (A0427) ALS Non-Emergency (A0426) BLS Emergency (A0429) BLS Non-Emergency (A0428) ALS 2 (A0433) SCT (A0434) Treatment No Transport (A0998) Air Ambulance service, rotary wing (A0431) (5/26/2017 8:10:59 AM Eastern) Answer: This was answered in the Q&A already please read answers. (5/25/2017 11:45:35 AM Eastern) Question: What is your average loaded mileage per ground transport? Air Transport? (5/26/2017 8:17:54 AM Eastern) Answer: The mileage was also already provided. (5/17/2017 3:10:45 PM Eastern) Question: Due to the proprietary nature of the information requested, will Collier County accept a representative sample of our standard operating procedures in lieu of the full list asked? If chosen, SOP’s can be provided. (5/18/2017 12:08:57 PM Eastern) Answer: Please send what is requested in the RFP. If there is proprietary information provide that on a separate page as such and that can be protected from distribution. Committee members will have access to that information in order to make a decision. If you decide to send a proposal clearly mark and provide in a separate file if possible. (5/17/2017 3:10:14 PM Eastern) Question: How satisfied are you with your current EMS billing vendor? What is the reason for your RFP? (5/18/2017 8:04:59 AM Eastern) Answer: We are completely satisfied with our current vendor. This contract is about to expire and that is why it is coming up for solicitation again. (5/10/2017 3:29:28 PM Eastern) Question: Would it be acceptable to submit a redacted copy of our proposal (confidential information already blacked out) for Open Records requests? (5/12/2017 12:12:53 PM Eastern) Answer: Trade secrets can be protected from distribution. If you decide to send a proposal clearly mark and provide in a separate file if possible. We have the final discretion to determine if it falls under the Statute. (5/10/2017 3:29:15 PM Eastern) Question: On page 7, item ii, the RFP states: The County will have the option to authorize the selected proposer to perform billing services on new collection cases at the proposed rate or for all existing cases at a separately negotiated rate. Could you please clarify this statement? Is this in regard to delinquent accounts? Is this referring to cases that have been billed by the previous vendor, are not settled in full and not yet delinquent? (5/12/2017 10:57:42 AM Eastern) Answer: Possibly both scenarios (5/10/2017 3:29:05 PM Eastern) Question: Do you itemize or bundle your disposables? (5/12/2017 10:57:15 AM Eastern) Answer: Do not charge for disposables (5/10/2017 3:28:18 PM Eastern) Question: What is your rate for Treat-No-Transport? (5/12/2017 10:56:59 AM Eastern) Answer: 175.00 (5/10/2017 3:28:03 PM Eastern) Question: What is your current rate for Air Transports? (5/12/2017 10:53:09 AM Eastern) Answer: 5900.00 (5/10/2017 3:27:35 PM Eastern) Question: What were your 2016 total charges, mandatory adjustments, and total write-offs? (5/12/2017 10:54:53 AM Eastern) Answer: Total charges- $19,750,646.95 mandatory adjustments - $4,871,793.17 We have not yet done write offs for FY16. (5/10/2017 3:27:20 PM Eastern) Question: Who is your delinquent account collection agency? What is the current cost of those collections in dollars and percent? If you do not utilize a delinquent account collection agency, are you interested in considering bidders who provide collection services? (5/12/2017 10:53:32 AM Eastern) Answer: Mintex is County contracted collection agency. Commission is 14% (5/10/2017 11:06:43 AM Eastern) Question: What is your average revenue per call? Do you have a lockbox provider and, if so, which provider? If you have a lockbox provider, will that provider remain in (5/10/2017 11:06:43 AM Eastern) Question: What is your average revenue per call? Do you have a lockbox provider and, if so, which provider? If you have a lockbox provider, will that provider remain in place as a result of this procurement? Do you have an EPCR provider and, if so, which provider? Do you have a collection agency provider and, if so, which provider? Which local hospitals or care facilities typically receive most of your patients? (5/11/2017 8:50:01 AM Eastern) Answer: Average revenue per transport (ground only) - 383.50. Lockbox provider is First Florida Integrity Bank(this will continue). EPCR provider is ImageTrend. Collection Agency provider is Mintex. Local Hospitals - Naples Community Hospital Downtown, North Naples, Northeast, Physicians Regional in Pine Ridge and Collier Blvd, Lee Memorial and Lehigh Regional. (5/10/2017 11:06:37 AM Eastern) Question: What were your transports per year for advanced life support emergency level 1 for last year or for the last 12 months? What were your transports per year for advanced life support emergency level 2 for last year or for the last 12 months? What were your transports per year for basic life support for last year or for the last 12 months? What were your transports per year for basic life support emergency for last year or for the last 12 months? What were your transports per year for specialty care transport for last year or for the last 12 months? What were your transports per year for treatment without transport for last year or for the last 12 months? What is your payer mix expressed as percentages of 100% billed? What is your payer remit mix expressed as percentages of 100% of what you typically receive? How many total transport vehicles do you now operate? What is your average loaded miles per trip? (5/11/2017 11:56:43 AM Eastern) Answer: ALS1 - 20,884,452.20 ALS2 - 305,371.00 BLS - 3,000,924.50 Helicopter - 3151589.5 SCT- NA Treated with no transport - 43,575 Payer Mix 60% Medicare,10%Medicaid,20% Commercial, 10% Self Pay (5/10/2017 11:06:29 AM Eastern) Question: What were your annual billable transports last year or for the last 12 months? What are your per-mile ground transport charges? What is your average per-trip charge? When were the last changes to your transport rates, and are you considering raising any of the rates currently charged? Are there any other charges you assess not otherwise covered by our questions? What percentage of your patients are residents versus non-residents, and do you charge the two groups differently? Do you operate any shared services agreements with any other municipal or county governments in the region and, if so, with whom? What were your transports per year for life support for last year or for the last 12 months? (5/11/2017 11:59:29 AM Eastern) Answer: Last year transports 28,621. Mileage Charge 12.25 Average trip charge(ground only) - 805.42 Last Change of Rates 2008 We do not keep data for residents vs non residents and do not have shared service agreements. 28,621 transports per year of life support. (5/10/2017 11:05:42 AM Eastern) Question: Please confirm the due date for this procurement is 6/7/2017. What is the date by which you will answer these questions? Why is the contract out to bid at this time? Is there a deadline for questions? What estimated or actual dollars were paid last year, last month, or last quarter to any incumbent(s)? Please describe your level of satisfaction with your current vendor(s), if applicable. What were your annual total adjustments for last year or for the last 12 months? What were your annual contractual allowance write offs for last year or for the last 12 months? What were your annual gross collections last year or for the last 12 months? (5/11/2017 12:05:18 PM Eastern) Answer: Due date is provided on solicitation page 3 as 6/7/17, question and answer date is provided on page 8, 5/26/17. Actual dollars paid to consultant in the past 12 months- 520,845. Total adjustments for fiscal year 2016- 7932261.54 Contractual Adjustments 7932261.54 Gross Collections for fiscal year 2016 - 11930799.23 place as a result of this procurement? Do you have an EPCR provider and, if so, which provider? Do you have a collection agency provider and, if so, which provider? Which local hospitals or care facilities typically receive most of your patients? (5/11/2017 8:50:01 AM Eastern) Answer: Average revenue per transport (ground only) - 383.50. Lockbox provider is First Florida Integrity Bank(this will continue). EPCR provider is ImageTrend. Collection Agency provider is Mintex. Local Hospitals - Naples Community Hospital Downtown, North Naples, Northeast, Physicians Regional in Pine Ridge and Collier Blvd, Lee Memorial and Lehigh Regional. (5/10/2017 11:06:37 AM Eastern) Question: What were your transports per year for advanced life support emergency level 1 for last year or for the last 12 months? What were your transports per year for advanced life support emergency level 2 for last year or for the last 12 months? What were your transports per year for basic life support for last year or for the last 12 months? What were your transports per year for basic life support emergency for last year or for the last 12 months? What were your transports per year for specialty care transport for last year or for the last 12 months? What were your transports per year for treatment without transport for last year or for the last 12 months? What is your payer mix expressed as percentages of 100% billed? What is your payer remit mix expressed as percentages of 100% of what you typically receive? How many total transport vehicles do you now operate? What is your average loaded miles per trip? (5/11/2017 11:56:43 AM Eastern) Answer: ALS1 - 20,884,452.20 ALS2 - 305,371.00 BLS - 3,000,924.50 Helicopter - 3151589.5 SCT- NA Treated with no transport - 43,575 Payer Mix 60% Medicare,10%Medicaid,20% Commercial, 10% Self Pay (5/10/2017 11:06:29 AM Eastern) Question: What were your annual billable transports last year or for the last 12 months? What are your per-mile ground transport charges? What is your average per-trip charge? When were the last changes to your transport rates, and are you considering raising any of the rates currently charged? Are there any other charges you assess not otherwise covered by our questions? What percentage of your patients are residents versus non-residents, and do you charge the two groups differently? Do you operate any shared services agreements with any other municipal or county governments in the region and, if so, with whom? What were your transports per year for life support for last year or for the last 12 months? (5/11/2017 11:59:29 AM Eastern) Answer: Last year transports 28,621. Mileage Charge 12.25 Average trip charge(ground only) - 805.42 Last Change of Rates 2008 We do not keep data for residents vs non residents and do not have shared service agreements. 28,621 transports per year of life support. (5/10/2017 11:05:42 AM Eastern) Question: Please confirm the due date for this procurement is 6/7/2017. What is the date by which you will answer these questions? Why is the contract out to bid at this time? Is there a deadline for questions? What estimated or actual dollars were paid last year, last month, or last quarter to any incumbent(s)? Please describe your level of satisfaction with your current vendor(s), if applicable. What were your annual total adjustments for last year or for the last 12 months? What were your annual contractual allowance write offs for last year or for the last 12 months? What were your annual gross collections last year or for the last 12 months? (5/11/2017 12:05:18 PM Eastern) Answer: Due date is provided on solicitation page 3 as 6/7/17, question and answer date is provided on page 8, 5/26/17. Actual dollars paid to consultant in the past 12 months- 520,845. Total adjustments for fiscal year 2016- 7932261.54 Contractual Adjustments 7932261.54 Gross Collections for fiscal year 2016 - 11930799.23 (5/9/2017 1:55:51 PM Eastern) Question: what are your current billing charges for ALS, BLS and Mileage. (5/10/2017 8:09:59 AM Eastern) Answer: $700 BLS & ALS1, $750 ALS2 Mileage $12.25 (5/9/2017 1:55:19 PM Eastern) Question: what is your payer mix, divided by Medicare, Medicaid, Private Insurance and self pay. (5/10/2017 8:10:32 AM Eastern) Answer: Medicare 60% Medicaid 10% Private 20% Self Pay 10% (5/10/2017 3:29:28 PM Eastern) Question: Would it be acceptable to submit a redacted copy of our proposal (confidential information already blacked out) for Open Records requests? (5/12/2017 12:12:53 PM Eastern) Answer: Trade secrets can be protected from distribution. If you decide to send a proposal clearly mark and provide in a separate file if possible. We have the final discretion to determine if it falls under the Statute. (5/10/2017 3:29:15 PM Eastern) Question: On page 7, item ii, the RFP states: The County will have the option to authorize the selected proposer to perform billing services on new collection cases at the proposed rate or for all existing cases at a separately negotiated rate. Could you please clarify this statement? Is this in regard to delinquent accounts? Is this referring to cases that have been billed by the previous vendor, are not settled in full and not yet delinquent? (5/12/2017 10:57:42 AM Eastern) Answer: Possibly both scenarios (5/10/2017 3:29:05 PM Eastern) Question: Do you itemize or bundle your disposables? (5/12/2017 10:57:15 AM Eastern) Answer: Do not charge for disposables (5/10/2017 3:28:18 PM Eastern) Question: What is your rate for Treat-No-Transport? (5/12/2017 10:56:59 AM Eastern) Answer: 175.00 (5/10/2017 3:28:03 PM Eastern) Question: What is your current rate for Air Transports? (5/12/2017 10:53:09 AM Eastern) Answer: 5900.00 (5/10/2017 3:27:35 PM Eastern) Question: What were your 2016 total charges, mandatory adjustments, and total write-offs? (5/12/2017 10:54:53 AM Eastern) Answer: Total charges- $19,750,646.95 mandatory adjustments -$4,871,793.17 We have not yet done write offs for FY16. (5/10/2017 3:27:20 PM Eastern) Question: Who is your delinquent account collection agency? What is the current cost of those collections in dollars and percent? If you do not utilize a delinquent account collection agency, are you interested in considering bidders who provide collection services? (5/12/2017 10:53:32 AM Eastern) Answer: Mintex is County contracted collection agency. Commission is 14% (5/25/2017 11:49:23 AM Eastern) Question: Can you please provide a breakdown of number of transports by service level for the most recent fiscal year? ALS Emergency (A0427) ALS Non-Emergency (A0426) BLS Emergency (A0429) BLS Non-Emergency (A0428) ALS 2 (A0433) SCT (A0434) Treatment No Transport (A0998) Air Ambulance service, rotary wing (A0431) (5/26/2017 8:10:59 AM Eastern) Answer: This was answered in the Q&A already please read answers. (5/25/2017 11:45:35 AM Eastern) Question: What is your average loaded mileage per ground transport? Air Transport? (5/26/2017 8:17:54 AM Eastern) Answer: The mileage was also already provided. 1 ADDENDUM #1 Memorandum Date: June 5, 2017 From: Viviana Giarimoustas, Procurement Strategist To: Interested Parties Subject: RFP 17-7133 EMS Billing & Debt Collection Services The following questions were asked 5/25/17 by Samantha Travis, vendor has stated they do not see the answer provided in Q&A. Can you please provide a breakdown of number of transports by service level for the most recent fiscal year? ALS Emergency (A0427) ALS Non-Emergency (A0426) BLS Emergency (A0429) BLS Non-Emergency (A0428) ALS 2 (A0433) SCT (A0434) Treatment No Transport (A0998) Air Ambulance service, rotary wing (A0431) What is your average loaded mileage per ground transport? Air Transport? Please see the following page for additional response. If you require additional information please call Viviana Giarimoustas, Purchasing Department at 239- 252-8375 or by e-mail at VivianaGiarimoustas@colliergov.net . Thank you. Email: VivianaGiarimoustas@colliergov.net Telephone: (239) 252-8375 Charge Summary Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount Mileage Charges ALS Emergency Mileage A0425 ALS1 125317 1171781.2$14,354,319.70 A0425 ALS2 1825 17960$220,010.00 A0425 BLS 1005 7$85.75 A0425 SCT 21 120$1,470.00 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount ALS Non-Emergency Mileage A0425 ALS1 386 3386$41,478.50 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount BLS Emergency Mileage A0425 ALS1 2300 3$36.75 A0425 BLS 22435 172161$2,108,972.25 A0425 SCT 25 227$2,780.75 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount BLS Non-Emergency Mileage A0425 BLS 331 3239$39,677.75 A0425 SCT 3 28$343.00 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount Rotary Wing Air Mileage A0436 Rotary Wing 1438 49571$5,452,810.00 Mileage Charges 155086$22,221,984.45 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount Non Transport Charges Treatment / No-Transport A0998 TNT 1023 0$179,025.00     © 2017 Digitech Computer, Inc. Solicitation 17‐7133 EMS Billing & Debt Collection Services 1  Request for Proposals #17‐7133  EMS Billing & Debt Collection Services  Collier County, FL  Due Wednesday, June 7th, 2017 at 10:00AM    Digitech Computer, Inc.  480 North Bedford Road  Building 600, 2nd Floor   Chappaqua, New York 10514  914.741.1919  914.741.2818 fax  www.digitechcomputer.com                                  Proposal                            © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 2 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 3 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 ................................................................................................................................................. 25 ........................................................................................................................................ 25 ....................................................................................................................................... 26 ................................................................................................................................................... 26 .................................................................................................................................... 27 TABLE OF CONTENTS © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 4 ........................................................................................................................................... 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 5 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 6 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. 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. EXECUTIVE SUMMARY Supporting Your Mission © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 7 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. 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. Demographic search tool finds missing patient or insurance info Automated, unrelenting appeals processing Document Management Imaging System Customizable interface that gives users a real-time picture of operations 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. Partnership EMS Billing Through Innovative Technology © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 8 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. 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. 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 Nuñez, 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 Meet Your Team © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 9 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. 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. Commitment to Compliance © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 10 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: 480 Bedford Road Building 600, 2nd Floor Chappaqua, NY 10514 Phone: (914) 741-1919 Fax: (914) 741-2818 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 COVER LETTER AND REFERENCES © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 11 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. 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, Mark Schiowitz President & CEO Digitech Computer, Inc. Digitech’s business model marries advanced IT solutions with a highly experienced and knowledgeable staff that manages every detail of each account.   © 2017 Digitech Computer, Inc. Solicitation 17‐7133 EMS Billing & Debt Collection Services 12  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.    Current Client Name Contact Information Scope of Contract First Date of  Service  Gwinnett Fire Rescue   408 Hurricane Shoals Road NE,  Lawrenceville, GA 30046  Donna Buhler  Business Manager  (678) 518‐4876  Donna.buhler@gwinnettcounty.com  Annual Transports: 36,000  EMS Billing Services  Imaging & Hosting  ESO Solutions ePCR integration   12/07/11  Anderson County EMS  314 Public Safety Lane,  Clinton, TN 37716  Nathan Sweet  EMS Director  (865) 457‐8609  nsweet@andersonems.com  Annual Transports: 16,000  EMS Billing Services  Imaging & Hosting  07/01/16  Washington County – Johnson  City  296 Wesley St,  Johnson City, TN 37601  Lori Kemp  Comptroller  (423) 975‐5502  lkemp@wcjcems.org  Annual Transports: 23,000  EMS Billing Services  Imaging & Hosting  ESO Solutions ePCR integration  11/01/16  Newport News  2400 Washington Ave,  Newport News, VA 23607  Sergio Nardi  EMS Educator  (804) 384‐6483  snardi@nnva.gov  Annual Transports: 19,500  EMS Billing Services  Imaging & Hosting  ImageTrend ePCR integration  04/01/16  Memphis Fire   2714 Union Ave Extended, Suite 350,  Memphis, TN 38112  Pamela Kiestler  Division Chief  (901) 826‐5377  pamela.kiestler@memphistn.gov  Annual Transports: 83,000  EMS Billing Services  Imaging & Hosting  ImageTrend ePCR integration   01/13/10          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 References  © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 13 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, Digitech’s Billing Process BUSINESS PLAN BUSINESS PLAN © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 14 The PCR Lens data quality reporting interface aggregates pre-hospital data from each transportation as it is transmitted through the Patient Care Report application and then 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. PCR Lens helps administrators of ambulance 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. 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 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 our clients in order to perform billing services on their behalf is minimal, and well within the scope of the normal provision of ambulance transport services: Data collection, enhanced by the documentation training we provide and the PCR Lens tools we offer to monitor the quality and quantity of field data collections. 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. During the implementation phase of the project, Collier County’s active participation will be required to provide crucial information for registrations. We will also need the County’s cooperation in authorizing Digitech to sign registration forms in order to meet the timeline. Our tested interface will pull the billing and dispatch information from the ImageTrend servers once it has been marked “ready for billing,” usually after a review by the County’s QA personnel. Data Collection Research and Coding © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 15 Digitech will provide training to your medics to support the creation of compliant PCRs with narratives that accurately document all treatments provided and support their medical 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. Digitech pulls the billing and dispatch information from the ePCR host servers, and the second stage of the process begins. Pre-hospital Patient Care Reports and all associated transport data are uploaded into Digitech’s system via Secure File Transfer Protocol (sFTP). 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. 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. Data Upload We reconcile all transport records to PCRs. You will never lose a claim. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 16 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 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. Using Public and Private Databases to Locate Missing Patient Information Digitech uses proprietary search tools that connect to large databases, including Experian1, which contains records on nearly 300 million names and 116 million households, and performs searches using any available data to find additional demographic information. 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 companies in search of a policy number associated with that Social Security number. Digitech uses Change Healthcare and other such databases2 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 Digitech’s proprietary search tools help increase our collections by making it possible to find more information than our competitors. Verification Verification © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 17 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 is the intensive process by which we review each claim manually and 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 scheduled for invoicing. Any accompanying paperwork is verified and attached to the claim using Digitech’s SecureDocs document imaging interface. Editing is typically completed for all claims within 24 business 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. Editing Editing © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 18 Digitech’s Quality Assurance (QA) 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 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 of claims involves Invoicing, Posting, and Short-Pay follow-up. There is a circular dynamic between these steps as remittance processing often results in claims returning to the Invoicing function for re-billing to secondary 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: Invoicing 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. Quality Assurance – The Human Element Our dedicated QA department manually reviews 100% of Medicare, Medicaid, and Railroad claims. Resolution © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 19 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 20 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 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. 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 21 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 inform ation, 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) 95% of claims will be processed in the first 4 days after receipt of transport data © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 22 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. All forms and patient communications are customized for each client, so that all invoices, statements, and letters represent your service as you wish to be seen. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 23 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. Audits Permeating every aspect of Digitech’s billing process is a series of Quality Assurance and A uditing 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 24 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, Digitech’s proprietary software, is composed of 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 their software vendors who may require weeks or months to make programming changes, Digitech builds and owns our claims processing software. We have eight full-time programmers on staff to work only on this application, so we can prudently automate any element of the process. This improves efficiency, which frees up resources that we can then reallocate to collecting on the more difficult claims. Improving collections on these claims is where we derive much of the incremental revenue realized by our clients. We know of no other billing company that has created their claims- processing software platform and refined it over the course of more than 30 years. In the end, this will benefit the County in the following ways: We can react quickly to mandated regulatory and submission changes. To maintain compliance, Digitech employs continual monitoring, analysis, and software/process changes. Because we own the software, we can do all of this on our schedule. There is no dependence on third party software vendors. We can customize software as necessary – whether for 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. Ambulance Commander Digitech’s proprietary system delivers to our clients what we believe is the most advanced technology for ambulance transport billing that exists today. It can be securely and easily accessed by authorized County personnel from any computer with an internet browser and a reasonably fast connection. Ambulance Commander delivers comprehensive reporting on your operations and finances whenever you want it, 24 hours a day. It is highly customizable, and supported by a team of programmers who are constantly delivering updates to improve collections and increase data security based on changes to regulations or in response to client feedback. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 25 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. 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 search tool is given basic demographic information including address, phone, name, birth date, or any combination thereof to identify the patient's Social Security number. Once identified, the Social Security number is fed into our insurance polling system which sequentially queries multiple insurance companies in search of the policy number associated with the Social 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 hospital are not able to provide it. 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 Sleuth uncovers insurance and demographic information Access to the System © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 26 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. SecureDocs® will bring document storage and management efficiencies to the County. SecureDocs allows EMS providers and Digitech to easily store, organize and retrieve documents relating to the transport. This includes letters, legal materials, or any other documentation that may be of value in the future. SecureDocs surpasses paper filing systems by providing one-click access to all documentation. Using Optical Character Recognition (OCR) and Barcode recognition technologies, SecureDocs provides full text search capability for all scanned images, simplifying the process of locating, viewing, printing, or emailing important documentation. 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. Patients can access their account information through a secure and convenient online access interface that we call Portal. Through Portal, patients can provide insurance information, update their demographic information, and review the status of their accounts. Credit card payments can also be made through a 128-bit SSL self-service payment interface. Digitech’s Secure Document Management System Portal allows patients to access their account information securely and easily. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 27 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. 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 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. 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 Digitech's Dashboard is just one of the many tools you will have at your disposal to track operations and finances. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 28 accurately analyze the data collected by medics and compare their efforts to their peers, other EMS shifts, stations, and even other EMS organizations. PCR Lens enables you to see, measure, compare, and improve field data collection. Digitech’s data quality analysis tool earned EMS World’s Product Innovations Award. Digitech’s data quality analysis tool earned EMS World’s Product Innovations Award. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 29 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. 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 Baltimore City Fire 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 Baltimore City Fire © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 30 We were very impressed with Digitech’s methodical and cooperative approach, and they have made good on their promise to do better in every aspect of billing and customer service than our former contractor. David Morando Former Assistant Chief Johnson County Med-Act, Olathe KS 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. 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 always on the job, Digitech’s support team is on call around the clock. During our normal business hours of 8am – 6pm EST, Monday through Friday, our support team is available to respond to any questions that the County may have. Outside of normal business hours, Digitech’s team can be reached by phone to handle any urgent technical needs. Senior Management provides direct contact information, including personal mobile 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. Support Available to Collier County Customer Service – Including Communicating with Speakers of Other Languages © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 31 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. 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. Escalation of Service Issues © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 32 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. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 33 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 Digitech’s Training Plan © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 34 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: 1. List of Users. 2. Citrix software installed on users’ workstations. 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 35 SECUREDOCS – ARCHIVE BATCH TOOL  New Batches  View  Edit  Filter CALLS  Claim Search  Find Call  Call Utilities  Patient 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  Accounting Roll Forward HELP  About  Request Remote Support © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 36 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. 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. Implementation Plan The three phases of implementation ─ Requirements Gathering, System Installation, and Testing ─ can be accomplished in 60 days. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 37 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. Requirements Gathering Phase © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 38 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. System Installation and Tailoring Phase 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 39 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. 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. 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 System Testing, Training, and Acceptance Phase Field Testing Phase © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 40 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. 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 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. 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. No Cash Flow Interruption © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 41 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 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. Key Performance Indicators (KPIs) Integration with Hospital EHR Systems © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 42 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. 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. Accounting and Reporting 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 Digitech’s data quality analysis tool earned EMS World’s Product Innovations Award. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 43 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. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 44 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 FINANCIAL SCORECARD ANALYTICAL SCORECARD © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 45 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. Clicking on the cell opens a list of all the claims that comprise that value. Listing of all claims that make up the $5,588.34 Double click to go to an individual claim Listing of all claims that make up the $5,588.34 Double click to go to an individual claim © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 46 Within the claim, you can drill into the audit record to see when records were changed, who changed them, and how they were changed. Summary of every edit Every field changed – shows before and after © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 47 Review notes, payment records, procedure codes, and collections activity associated with the claim. Verify mileage using multiple mapping options. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 48 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. 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 49 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. 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. 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. Standard Operating Procedures Recovery Process and Defaulted Clients Patient Payment Arrangements © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 50 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 51 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. 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 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. Our Compliance Department works closely with Page, Wolfberg & Wirth, 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 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 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. 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 Auditing Is a Key Aspect of Our Business Model Auditors Auditing Is a Key Aspect of Our Business Model © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 52 choosing. We are familiar with JR Henry, Fitch and Associates, and Werfel and Werfel, LLC and have worked with each firm in the past. 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. 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: o Appropriate paperwork is attached o Level of service is accurate o Diagnosis is correct o Claims are properly coded 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. Monthly Claims Audit Random Daily Claims Audit © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 53 Within two business days, the department manager responsible for the issue responds with an evaluation and corrective action plan. 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. 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. 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. Audit Trail in Our Billing Software System Audit Trail in Every Claim Record © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 54 The Statement on Standards for Attestation Engagements (SSAE) No. 16, was created by the American Institute of Certified Public Accountants to measure and report on the controls that service organizations employ to manage financial reporting. Digitech engages the services of WithumSmith+Brown, a premier financial auditing company, to deliver an in- depth audit of its internal controls and related processes and certify that Digitech meets the recognized standards for controls and safeguards as they relate to hosting or processing our clients’ data. 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. 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. Ambulance Commander’s audit trail function will give you access to real-time records of every action performed on your account. SOC 1 Type II Certification Record Retention and Destruction Ambulance Commander’s audit trail function will give you access to real-time records of every action performed on your account. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 55 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. 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. Physical Security Features Biometric access 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 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 Digitech’s Primary Data Center Colocation Data Center Storage and Security Disaster Recovery and Redundancy © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 56 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. 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 Disaster Recovery Planning Disaster Recovery Planning © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 57 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 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 58 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: Home computer with a secure connection to Digitech’s network Reliable internet connection Printer Phone line that can be dedicated for work during business hours Processing Center Redundancy © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 59 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. 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 th e 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. Data Backup and Archive © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 60 $8.00 3.95% % 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 Net Collected Revenue3. We have prepared this proposal under several basic assumptions, 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. In accordance with Florida statutes, Digitech will charge a flat rate fee of $8.00 for each account paid by Medicaid. 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. Total Proposed Fee as a Percent of Revenues Collected Medicaid Claims Fee COST OF SERVICES TO THE COUNTY © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 61 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 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. 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. Medicare and Medicaid Experience Associate member since 2012 Member of EMS Section since 2012 Member since 2009 Corporate member since 2012 Sponsor Member since 2015 Associate member since 2015 Associate member since 2012 Gold member since 2015 Member since 2012 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 62 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. 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 63 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. Economic Benefit to Collier County © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 64 Gwinnett Fire Rescue Annual Transport Volume 36,000 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. 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. EXPERIENCE AND CAPACITY OF FIRM © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 65 Johnson County Med-ACT Annual Transport Volume 20,000 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. 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 66 Plano Fire Rescue Annual Transport Volume 11,000 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. 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. Qualifications to Produce the Required Deliverables © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 67 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. All of Digitech’s Billing Managers are NAAC certified. Their certificates have been included as Appendix B. 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. Integration Expertise with ImageTrend NAAC Certification Average Amount of Days to Send Initial Bill and Receive a Response 95% of available revenue will be collected within 90 days. © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 68 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. Current Client Name Contact Information Scope of Contract First Date of Service Gwinnett Fire Rescue 408 Hurricane Shoals Road NE, Lawrenceville, GA 30046 Donna Buhler Business Manager (678) 518-4876 Donna.buhler@gwinnettcounty.com Annual Transports: 36,000 EMS Billing Services Imaging & Hosting ESO Solutions ePCR integration 12/07/11 Johnson County Med-ACT 11811 S. Sunset Dr, Suite 1100, Olathe, KS 66061 Ted McFarlane EMS Director (913) 715-1960 tmcfarlane@jocoems.org Annual Transports: 20,000 EMS Billing Services Imaging & Hosting ImageTrend ePCR integration 01/01/09 Washington County – Johnson City 296 Wesley St, Johnson City, TN 37601 Dan Wheeley Chief/Executive Director (423) 975-5500 dwheeley@wcjcems.org Annual Transports: 23,000 EMS Billing Services Imaging & Hosting ESO Solutions ePCR integration 11/01/16 Newport News 2400 Washington Ave, Newport News, VA 23607 Robert E. Lee EMS Chief (757) 926-8404 relee@nnva.gov Annual Transports: 19,500 EMS Billing Services Imaging & Hosting ImageTrend ePCR integration 04/01/16 St. Louis 2634 Hampton Ave, St. Louis, MO 63139 Cynthia Dixon Manager, Fiscal Services St. Louis Fire Department (314) 289-1950 dixonc@stlouis-mo.gov Annual Transports: 40,000 EMS Billing Services Imaging & Hosting ESO Solutions ePCR integration 04/01/16 Customers of Similar Size and Scope to Collier County © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 69 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 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 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 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. SPECIALIZED EXPERTISE OF TEAM MEMBERS © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 70 Brad Stuart, Vice President – Billing Software Brad joined Digitech in 2002. He holds a degree in Computer Science from Pace University and also graduated cum laude from the College of Westchester with a degree in Computer Programming. Brad and his team led the successful development 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. Catherine L. Tenzyk, Quality Assurance and Compliance Manager 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 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 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 currently leads a staff of over 25 employees, and will be the liaison for Collier County 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 at creating reports for budget analysis. He studied Business Management at the University of Tennessee Chattanooga, and he completed the local government finance officer program through the University of Georgia’s Carl Vinson Institute of 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. Additional Resources Additional Resources © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 71 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 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 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 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 72 Digitech takes no exceptions to the terms and conditions outlined in the RFP. ACCEPTANCE OF CONDITIONS © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 73 REQUIRED FORM SUBMITTALS © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 74 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 75 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 76 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 77 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 78 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 79 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 80 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 81 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 82 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 83 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 84 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 85 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 86 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 87 RFP Section Page References Requirements Detailed Scope of Work 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). p. 13 p. 24 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. p. 21 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. p. 60 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. p. 61 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). p. 33 f. Have the ability to 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. p. 15 g. Have the ability to download payment information from the County electronically. p. 20 h. Have the ability to accept credit card/ACH payments (must be PCI Compliant), include any fees and where they will apply. p. 26 p. 60 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. p. 19 p. 22 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. p. 18 p. 21 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. p. 13 l. 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. p. 50 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. p. 15 n. Provide web access to the County for access to ad hoc reports on billing performance p. 27 p. 42 o. Establish a skip-tracing process to validate patient information ( correct spelling of name, social p. 16 EVALUATION MATRIX © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 88 RFP Section Page References 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. 25 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. p. 26 p. 70 q. Provide a local phone number or e-mail to respond to inquiries concerning patient account information. p. 30 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. p. 50 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. p. 16 p. 41 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. p. 30 p. 31 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. p. 13 p. 60 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. p. 42 w. Provide the County with copies of supporting documentation for refunds to be made by the County the month following the payment posting date. p. 23 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. p. 27 p. 42 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. p. 22 z. Process Medicare Revalidation and represent CCEMS in Medicare and Medicaid audits. Will be responsible for any fines incurred due to negative audit findings. p. 23 p. 51 p. 71 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. p. 23 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. p. 23 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. p. 19 p. 23 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. p. 25 p. 34 ee. The proposal must provide a summary of the methods that the contractor intends to use for the storage of records and the related security and disaster recovery plans; and how it plans to ensure continuity of operations to operate in the event of a disaster or similar event that results in the interruption of the normal operating conditions of the contractor’s primary place of business providing services to the County or any of the support or technical aspects of that office. Include p. 54 p. 55 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 89 RFP Section Page References details about how the plan is exercised to assure the plan produces the intended results. ff. Develop a plan for receiving mail, depositing payments, and providing the County with payment information for accounts prior to the Contract period. p. 37 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. p. 51 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. p. 50 p. 54 ii. The County will have the option to authorize the selected proposer to perform billing services on new collection cases at the proposed rate or for all existing cases at a separately negotiated rate. jj. For monthly reconciliation and payment of invoice by the County, provide 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. p. 20 p. 42 p. 43 p. 61 kk. Assist County in preparation of Medicaid CPE reporting and indicate fee for that service. p. 62 Response Format 1. Tab I, Cover Letter / References Provide a cover letter, signed by an authorized officer of the firm, indicating the underlying philosophy of the firm in providing the services stated herein. Include the name(s), telephone number(s) and email(s) of the authorized contact person(s) concerning proposal. Submission of a signed Proposal is Vendor's certification that the Vendor will accept any awards as a result of this RFP. Provide a list of subcontractors who will participate on the team, if applicable. Also include, five (5) references from customers that you have done business with in the last five (5) years, please refer to Reference Questionnaire (attachment 9). p. 10 2. Tab II, Business Plan In this tab, include: p. 13  Detailed explanation of how your firm will provide the required Billing Services for Emergency Medical Services Transport. Discussion should include specific abilities related to skills and technical expertise. EMS billing service procedures and policy for account management. p. 13  Describe your proposed automated system and operational software. p. 13 p. 24  Detail any training that will be provided by your firm. p. 33  Timeline needed for transition of billing services to a new vendor p. 36  Provide samples of any reports that your firm shall provide in response to the County’s requirements. p. 42  Detail the recovery process, finding defaulted clients, and how long will services be provided for a defaulted client. p. 49  Explain procedures established for patient payment arrangements p. 49  Provide standard operating procedures to demonstrate how your firm will manage the p. 49 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 90 RFP Section Page References County’s accounts. Include the following: o Verification and/or correction of address o Quality assurance o Accuracy o Dispute resolution o Processing and collection timelines o Recent and Planned compliance with privacy requirements and data transmission 3. Tab III, Cost of Services to the County: p. 60  Provide a total proposed fee as a percent of revenues collected related to the performance of these services, except for Medicaid. In accordance with Florida Statutes, provide a flat rate fee for each account paid by Medicaid. p. 60  Discuss your knowledge as it relates to regulations regarding claims, reviews, and hearings as applied in the Medicare and Medicaid programs in performing the required services. p. 61  Submit a narrative explaining the direct economic benefit to Collier County to be realized by selecting your firm. During the term of this engagement detail the employment, subcontracting, and support services contracting as economic stimulus that your entity may generate that would directly benefit Collier County. p. 63 4. Tab IV, Experience and Capacity of Firm The prospect shall provide past performance for a minimum of five (5) contracts, at least two (2) with government entities that demonstrates recent and relevant past performance of similar scope, size and complexity of services identified. Provide information that documents your firm’s and subcontractors’ qualifications to produce the required deliverables, including abilities, capacity, skill, and financial strength, and number of years of experience in providing the required services. Also describe experience with other clients utilizing ImageTrend. Provide information regarding certification through the National Academy of Ambulance Coders (NAAC). p. 64 p. 67  Describe what your average amount of days to send the initial bill and get a response from the client. p. 67  Describe how many customer(s) of similar size and scope to Collier County that you currently provide services to. p. 68 5. Tab V, Specialized Expertise of Team Members Identify each person(s) of your firm who will be professionally associated with the County in the day-to-day operations and oversight of this project. Describe their respective area of expertise. Include personalized resumes which identify the qualification, training and experience of each person(s). Describe how that individuals time will be spent to achieve the goals and billing for Collier County. p. 69 Appendix C 6. Tab VI, Acceptance of Conditions Indicate any exceptions to the general terms and conditions of the RFP, and to insurance requirements or any other requirements listed in this RFP. If no exceptions are indicated in this tabbed section, it will be understood that no exceptions to these documents will be considered after the award, or if applicable, during negotiations. Exceptions taken by a Vendor may result in evaluation point deduction(s) and/or exclusion of proposal for Selection Committee consideration, depending on the extent of the exception(s). Such determination shall be at the sole discretion of the County and Selection Committee. p. 72 7. Tab VII, Required Form Submittals: p. 73  Attachment 2: Vendor Check List p. 73  Attachment 3: Conflict of Interest Affidavit p. 74 © 2017 Digitech Computer, Inc. Solicitation 17-7133 EMS Billing & Debt Collection Services 91 RFP Section Page References  Attachment 4: Vendor Declaration Statement p. 75  Attachment 5: Affidavit for Claiming Status as a Local Business p. 77  Attachment 6: Immigration Affidavit Certification p. 78  Attachment 7: Vendor Substitute W-9 p. 79  Attachment 8: Insurance and Bonding Requirements p. 80  Attachment 9: Reference Questionnaire p. 82  Other: i.e. signed addenda, licenses or certifications, promotional materials, etc. Appendices Addenda REPORT SAMPLES Digitech Computer, Inc. 480 Bedford Road, Building 600 – 2nd Floor Chappaqua, New York 10514 914.741.1919 914.741.2818 fax www.digitechcomputer.com Table of Contents DIGITECH RESERVES THE RIGHT TO REMOVE, ADD, OR MODIFY REPORTS AT ANY TIME ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 2 TABLE OF CONTENTS MONTHLY PUSH REPORTS ....................................................................................................................... 3 SCORECARDS .................................................................................. 22 SCORECARDS ....................................................................................................................................................................... 22 SUMMARY OF SCORECARD FUNCTIONALITY ............................................................................................................. 23 THE ANALYTICAL SCORECARD ....................................................................................................................................... 23 THE FINANCIAL SCORECARD ........................................................................................................................................... 24 REPORTING SYSTEM ............................................................................................................................... 25 STANDARD ONLINE REPORTS AND FUNCTION OVERVIEW .................................................................................... 25 ACCOUNTING REPORTS .................................................................................................................................................... 26 SALES REPORT .................................................................................................................................................................... 27 SAMPLE SALES REPORTS ................................................................................................................................................. 28 BILLING AND BACK OFFICE REPORTS .......................................................................................................................... 29 NOTE REPORT ...................................................................................................................................................................... 29 SAMPLE NOTES REPORT .................................................................................................................................................. 30 DATA DUMP ........................................................................................................................................................................... 32 DISPATCH AND OPERATIONAL REPORTS .................................................................................................................... 33 CALL VOLUME - CONDITION BY SOURCE REPORT ................................................................................................... 34 SAMPLE CALL VOLUME - CONDITION BY SOURCE REPORT .................................................................................. 35 SAMPLE CONDITION BY SOURCE REPORT ................................................................................................................. 36 MANAGEMENT REPORTS .................................................................................................................................................. 37 ............................................................................................................................................................... 38 ....................................................................................................................................................................... 40 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 3 MONTHLY PUSH REPORTS Digitech sends each client the following monthly package of Transport and Accounting reports: ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 4 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 5 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 6 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 7 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 8 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 9 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 10 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 11 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 12 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 13 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 14 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 15 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 16 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 17 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 18 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 19 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 20 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 21 All reports can be saved to a variety of file formats including Microsoft Word, Excel, Access, Crystal Reports, and Adobe Portable Document Format. ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 22 SCORECARDS Primary oversight and reporting functions available through Digitech’s Ambulance Commander® servicing system include the following: Scorecards Ambulance Commander® Scorecards combine performance information into online realtime snapshots from which Client employees can drill down all the way to the individual patient, claim, or transaction level for all processing events and performance measures. They include the Ambulance Commander® Analytical Scorecard and the Ambulance Commander® Financial Scorecard. ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 23 Summary of Scorecard Functionality The following sections illustrate the functionality of the Scorecards available through Digitech. The Analytical Scorecard The Analytical Scorecard functionality analyzes claim costs and charges on a per-Carrier or Major Payer level. The filter dialog for the report, shown below, follows the same conventions as those of the Sales, Receivables, and Adjustments Reports. Users may choose one or more options for Trip Priority, Financial Groups, Service Level, Trip Class, and Company data to include in a report. (Note the option to calculate transports by Financial Group.) ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 24 The Financial Scorecard Our Financial Scorecard gives the user online access to instantly review all receivables and view a breakdown of data by governmental and third-party payers, as well as, private-pay patients. Users can view (and with proper authorizations, edit) the financial details of any claim in the system, down to the individual transaction level. ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 25 REPORTING SYSTEM Digitech’s servicing system provides hundreds of report variations to select from. The most common categories of reports accessed by Digitech clients are Sales Reports, Adjustment Reports, Receivable Reports, Billing Reports, and Cash Receipt Reports. Reports detailing metrics and processing events cover a myriad of functions, for example, call taking, patient data updates, claims denials, etc. Standard Online Reports and Function Overview The Ambulance Commander® system offers a large number of standard reports out of the box. For length reasons, this document does not show samples of all of them, but their names and descriptions appear in this section Standard accounting reports include the Accounting Roll Forward Report, Accounts Receivables Reports, Adjustment Reports, Cash Receipts Reports, the Closing Utility, and Sales Reports. The Reports menu contains five report categories: Accounting Billing and Back Office Data Dump Dispatch and Operational Management ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 26 Accounting Reports Accounting Reports enable financial analysis by category. The Accounting Reports include the following: Accounting Roll Forward Accounts Receivables Report Adjustment Report Cash Receipts Report Closing Utility Sales Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 27 Sales Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 28 Sample Sales Reports ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 29 Billing and Back Office Reports Billing and Back Office Reports include the following: Claim Summary Report Invoice Run History Report Note Report Refund Report Note Report Note Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 30 Sample Notes Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 31 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 32 Data Dump The Data Dump menu provides access to the Ambulance Commander® system's data export functionality. Authorized users can perform a Trip & Dollar Dump to offload trip details and select financial information to a Microsoft Excel spreadsheet or other reporting application, or perform a more targeted, user-defined data dump. ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 33 Dispatch and Operational Reports Dispatch and Operational Reports primarily deal with the variables logged in Call Taking forms, such as call volume, cancellation reasons, response times, trip counts, and so on. Specifically, Dispatch and Operational Reports include: Call Volume – Condition by Source Report Daily Call Volume Report Day of Week by Time of Day Report Denied / Submitted Report Fractile Response Time Report UHU Report Volume by Financial Group Report Volume by Origin Monthly Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 34 Call Volume - Condition by Source Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 35 Sample Call Volume - Condition by Source Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 36 Sample Condition by Source Report ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 37 Management Reports Management Reports consist of the Analytical Scorecard and Financial Scorecard. Full details of the Analytical Scorecard on page 22. Full details of the Financial Scorecard on page 23. ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 38 Dashboard brings EMS operational and financial data into an easy-to-use, intuitive interface that enables managers, administrators, and business analysts to get a real-time picture of any aspect of their operations. Using the right click function, you are able to go deeper and deeper into statistics, eventually leading to individual claims, as shown below. HELPING HAND MEDICAL CENTER JOHNSON HOSPITAL GOOD SAMARITAN HOSPITAL DOWNTOWN GENERAL INNER BAY MEDICAL OUR LADY OF THE BAY SAINT CECILIA HOSPITAL MEMORIAL HOSPITAL SISTERS OF MERCY HOSPITAL EASTERN MEDICAL CENTER UNIVERSITY HOSPITAL RIVERSIDE MEMORIAL HOSPITAL ST AUGUSTINE MED CENTER VETERANS HOSPITAL LOYOLA MEDICAL CENTER WEST BAY MEDICAL ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 39 ©2015 Digitech Computer, Inc. PROPRIETARY INFORMATION last updated August 2014 40 PCR Lens measures how completely and accurately crews collect field data. Administrators are able to compare the efficiency of medics to others in the service, as well as to crews in other services. PCR Lens includes a feature that allows users 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. PCR Lens helps administrators to make sense of the mountains of field data collected by their medics, pinpoint problems, and identify high-performance individuals or teams. CERTIFICATIONS Digitech Computer, Inc. 480 Bedford Road, Building 600 – 2nd Floor Chappaqua, New York 10514 914.741.1919 914.741.2818 fax www.digitechcomputer.com 2 This page left blank intentionally. presents this Certificate of Completion to Marie Ellingham for successful completion of Certified Ambulance Coder (CAC) Jason J. Leet Program Coordinator 04/22/16 Date of Completion 1 RÉSUMÉS OF KEY PERSONNEL      PROFESSIONAL EXPERIENCE  1984 – Present President & CEO, DIGITECH COMPUTER, INC.   Founded business   Successfully directed the Firm’s rapid growth   Responsible for setting overall business and technology strategy  1982 – 1984 GERALD METALS INC., Stamford, CT    Began a trading desk that focused on new financial product offered at COMEX and MERC.  These included Options on Bond Futures and Options on Gold Futures   Reworked the Black and Scholes Options Volatility Pricing Models for new futures  markets. Traded these instruments  1981 – 1982 LOMBARD WALL, INC., Money Market Trading Firm, New York, NY    Worked in the research area developing computer trading systems that defined   the buy and sell points based on trending algorithms   Later moved to the trading desks to trade short‐term government securities for Firm’s  portfolio  1979– 1981 E.F. HUTTON, INC., New York, NY   Graduated from Management Training Program   Back Office Operations   Moved to Corporate Bond desk and became a junior fixed income trader  AFFILIATIONS    American Ambulance Association   Commission on Accreditation of Ambulance Services   Health Financial Management Association   International Association of Fire Chiefs   North Central EMS Cooperative    New York State Volunteer Ambulance & Rescue Association  EDUCATION  1979 Major: Economics  Bucknell University, Lewisburg, PA       MARK D. SCHIOWITZ – PRESIDENT & CEO   PROFESSIONAL EXPERIENCE  1994 – Present SVP of Billing Services, DIGITECH COMPUTER, INC.   Oversees all aspects of billing service   Reports directly to President   Responsible for department budget   Responsible for staff of 83  1986– 1993 Assistant Controller, EDWARD EHRBAR, INC., Pelham, NY    Oversaw all aspects of Accounting Department including AP, AR, Payroll   Financial Reporting   Responsible for staff of 15  1982 – 1986 Assistant Controller, MEDICAB INC. OF NEW YORK    Oversaw all aspects of Accounting Department including AP, AR, Payroll   Financial Reporting   Responsible for staff of 8   Provided direct support to billing staff  AFFILIATIONS    New Castle Parks & Recreation Commissioner   New Castle Girls Soccer Coach   Chair of the New Family Outreach Committee  CERTIFICATIONS  June 2013 CAC Certificate  EDUCATION  1982 Major: Accounting  Double Minor: Economics and Religious Studies  B.S. Manhattan College, Riverdale, NY     JOYCE KERULO – SENIOR VICE PRESIDENT OF BILLING SERVICES   PROFESSIONAL EXPERIENCE  1999 – Present SVP Deployment & Support, DIGITECH COMPUTER, INC.   Manages software trainers   Manages technical support staff   Manages software developers   Responsible for new client implementation  1994 – 1999 Customer Support Representative & Programmer, DIGITECH COMPUTER, INC.,   Briarcliff Manor, NY    Responsible for all customer support issues   Made required & custom program modifications   Setup and maintained hardware/networks for Digitech and clients  1994 Receivables Management Account Representative, CELLUAR ONE, Paramus, NJ    Received incoming calls from customers who had questions about their bill   Made outgoing calls to customers who were behind in payment  AFFILIATIONS    New York Ambulette Coalition  EDUCATION  1994 Major: Mathematics  Minor: Chemistry  Susquehanna University, Selinsgrove, PA       WALTER C. PICKETT II – SVP – DEPLOYMENT & SUPPORT   PROFESSIONAL EXPERIENCE  2012 ‐ present VP of Billing Software, DIGITECH COMPUTER, INC.   Directs software development projects   Creats internal programs that help make the billing service more profitable   Develops Medicare, Medicaid, and Commercial HIPAA billing specifications for several  different states   Support of implementation of billing system to clients   Monitors and maintains systems network and infrastructure  2002 – 2012 Senior Program Developer and Software Support, DIGITECH COMPUTER, INC., Briarcliff Manor, NY   Developed and designed software for ambulance dispatching and medical billing   Developed Medicare, Medicaid, and Commercial HIPAA billing specifications for several  different states   Support of implementation of billing system to clients   Monitored and maintained systems network and infrastructure   Created application that receives electronic remittance in which increases user’s  production by 75%   Responsible for constant cash flow for multimillion dollar hospital system  1998 – 2002 Network Administrator/Web Developer, FRONTLINE COMMUNICATIONS, Pearl River, NY    Designed, developed, and monitored e‐commerce websites   Maintained and developed applications such as “web mail” for customers   Installed, configured, and maintained mail servers for thousands of customers   Managed customer and corporate websites of Frontline Communications’ live sites and  company clients’ websites   Oversaw and maintained MS SQL server databases  AREAS OF EXPERTISE  Languages  Microsoft Visual C# and .Net   SQL   C++   ASP   Coldfusion   Javascript   HTML   Database development and implementation  Servers  Microsoft SQL Server   Windows Servers  IIS   Active directory  Applications  Microsoft Visual Studio   Microsoft Office Suite   Adobe Photoshop   Citrix   EDUCATION  September 2000 Associate Degree in Computer Programming, Graduated CUM LAUDE, QPA 3.8, Dean’s List,   College of Westchester, White Plains, NY  September 1994‐ May 1997  Major: Computer Science, Minor: General Business  Pace University, Pleasantville, NY    BRAD STUART – VP OF BILLING SOFTWARE          BENJAMIN LAMBERT – VP TECHNOLOGY PROFESSIONAL EXPERIENCE  2012–present Vice President of Technology, DIGITECH COMPUTER, INC.   Application and infrastructure architecture   Billing process mapping and efficiency identification   Resource allocation for IT and development   IT and development team staffing   Advise on Digitech strategies and direction  2002–2012 Senior Software Engineer, DIGITECH COMPUTER, INC., Briarcliff Manor, NY  Key Projects   Ambulance Commander®.NET – Team leader for the redesign of Ambulance Commander®,  using a Microsoft .NET/SQL Server framework   Centralized processing – Introduced aggregated processing and reporting across all agency  databases, driving Digitech to heightened levels of transparency and efficiency   Sentinel® ‐ Conceptualized and oversaw development of an automated alert system to seek  out issues and inefficiencies by comparing historical and real‐time data   SecureDocs® – Lead developer and project manager for proprietary system which provides  Web‐based access to millions of EMS documents    Ambulance Commander®   o Designed and implemented an import engine to integrate with third‐party ePCR  vendors using XML over ASP.NET web services  o Introduced real‐time insurance eligibility  o Revolutionized claim editing and coding process  2001–2002 ColdFusion Programmer, ACCESS TECHNOLOGIES GROUP, Plymouth Meeting, PA  2001–2002 Visual Basic Development Consultant, MEIXLER TECHNOLOGIES, Drexel, PA  EDUCATION  June 2007– July  2009  Executive MBA  Pace University  Valedictorian  March 2005 –  June 2007  BSIT  University of Phoenix  September 1998  – January 2001  Music Theory Studies  Temple University    PROFESSIONAL EXPERIENCE  2014 – Present Chief Compliance Officer, DIGITECH COMPUTER, INC.   Ensures compliance with all Federal, State, & Local statutes and regulations   Provides training to all Digitech employees with reference to compliance issues  2010‐2014 Associate, STEVEN JON LEVINE, ESQ., White Plains, NY    Provision of Civil Legal Services   Trained Mediator  2003‐2005 Director of Constituent Services, NYS ASSEMBLY, North White Plains, NY    Provided assistance to constituents to access NYS agencies and authorities  1990‐1995 Senior Social Worker, PAYNE WHITNEY CLINIC – NEW YORK HOSPITAL CENTER, NY     1988‐1990 Research Social Worker, NYS PSYCHIATRIC INSTITUTE, New York, NY     1985‐1988 Clinical Social Worker, BELLEVUE HOSPITAL CENTER, New York, NY     AFFILIATIONS   Westchester Women’s Bar Association – Co‐Chair of Mediation Committee  Westchester County Bar Association  New York State Bar Association  EDUCATION  2009    Juris Doctor   Pace Law School, White Plains, NY  1985 Master of Science  Columbia University School of Social Work, New York, NY  1982 Bachelor of Science, Psychology  University of Michigan, Ann Arbor, MI       JANE SILVERMAN – CHIEF COMPIANCE OFFICER   PROFESSIONAL EXPERIENCE  2000 – Present Patient Collection Manager, DIGITECH COMPUTER, INC.   Maintains a staff of 25 plus employees   Liaison for various Ambulance clients located around the country   Strong understanding for billing requirements with Medicare, Medicaid and third‐party  billing   Oversees all aspects of editing   Processes electronic and paper billing   Responsible for end of month reporting  1999 – 2000 Managed Care/Medicare/Commercial Billing Manager, TRANSWORLD, Jacksonville, FL    Trained new employees in different responsibilities within our department   Reviewed productivity and effectiveness of the collections staff   Set up new insurances in system with coding and pricing   Reconciled cash batches for vendor companies  1997 – 1998 Travel Expense Manager, CARLSON WAGONLIT TRAVEL, Phoenix, AZ    Maintained a staff of about 25 employees   Trained new employees in all aspects of data entry and quality control   High‐level accuracy processing traveler’s expense reports  1988 – 1997 Accounts Receivable Supervisor, TRANSCARE NY (AA AMBULANCE CO.), LIC, NY    Trained staff to ensure compliance with frequent regulatory updates   Improved staff productivity by developing procedures, form letters and follow up  processes to standardize interactions with clients and insurance carriers  1988 – 1997 Dispatcher/Accounts Receivable Clerk, EMPRESS AMBULANCE, Yonkers, NY    Performed Medicare, Medicaid manual billing, IC9 coding, remittance posting and denial  follow‐up.  Served as dispatcher and ambulance driver  CERTIFICATES  June 2013 CAC Certificate  December 2006 Front Office Medicare (Updated November 2005)  December 2006 Diagnosis Coding: Using the ICD‐9‐CM (Updated February 2003)          FRANCES CUZZO – PATIENT COLLECTION MANAGER   PROFESSIONAL EXPERIENCE  2012 – Present Manager of QA and Compliance, DIGITECH COMPUTER, INC.   Works closely with QA personnel, Medicare department, Digitech claim editors, clients, and  outside auditors.    Ensures that Digitech billing and collection practices comply with all federal and state  regulations.  2002 – 2012 Medicare Collection Manager, DIGITECH COMPUTER, INC., Briarcliff Manor, NY   Began as a billing and collection representative training on Ambulance Commander®  software in the Medicare Billing Department   Promoted after one year to Manager of two‐person Medicare Department   Responsible for the management, supervision and training of five‐person department in  Medicare ambulance billing and collections   Kept up‐to‐date on current Medicare regulations and guidelines in an effort to keep clients  advised on any changes in regulations and policies   Knowledgeable in the use of OMNI PRO and other Medicare on‐line systems and web‐based  on‐line insurance sites for the purpose of checking eligibility, claim status and doing actual  on‐line claim adjustments   Participated and oversaw the day‐to‐day responsibilities of billing and collecting Medicare  claims  1999 – 2002 Medical Secretary, JOHN A. GALENO, M.D., White Plains, NY    Medical Manager‐insurance billing (No Fault, Compensation and Private)   Corresponded with attorneys and disability insurance requesting medical records   Composed and typed letters for patients   Medical prescriptions‐medication, PT, tests and surgical supplies   Pre‐certification for tests‐calling in clinical information   Prepare charts and retrieve test results for office hours  1986 – 1999 Billing and Collections Clerk, ABBEY RICHMOND AMBULANCE SERVICE, White Plains, NY    Responsible for patient collections   Performed Medicare billing and appeals   Booked and dispatched ambulance calls  CERTIFICATES  2013 CAC Certificate  2007 CMS Certified in ICD‐9 Coding and Medical Necessity  EDUCATION  1980 Valhalla High School, Valhalla, NY      CATHERINE L. TENZYK – MANAGER OF QUALITY ASSURANCE DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE 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). CONTACTPRODUCERNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : 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. ADDL SUBRINSR POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITSPOLICY NUMBERLTR (MM/DD/YYYY) (MM/DD/YYYY)INSD WVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT $OTHER: COMBINED SINGLE LIMITAUTOMOBILE LIABILITY $(Ea accident) BODILY INJURY (Per person) $ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS AUTOSNON-OWNED PROPERTY DAMAGE $HIRED AUTOS (Per accident)AUTOS $ UMBRELLA LIAB EACH OCCURRENCE $OCCUR EXCESS LIAB CLAIMS-MADE AGGREGATE $ $DED RETENTION $ PER OTH-WORKERS COMPENSATION STATUTE ERAND EMPLOYERS' LIABILITY Y / NANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $N / AOFFICER/MEMBER EXCLUDED? (Mandatory in NH)E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2014/01) DIGICOM-01 BLEONVARGAS 6/1/2017 License # BR-868164 Lawley Westchester Grp LLC4 Manhattanville RdSuite 107 Purchase, NY 10577 1 (914) 345-7000 1 (866) 211-4683 Sentinel Insurance Company 11000 Digitech Computer Inc 480 Bedford Road Bldg 600, 2nd Floor Chappaqua, NY 10514 Hartford Fire Insurance Co 19682 Travelers Casualty & Surety of America 31194 Ace American Insurance Co 22667 AX 1,000,000 X X 01SBAAW4097 01/11/2017 01/11/2018 1,000,000 10,000 1,000,000 2,000,000 X 2,000,000 1,000,000 A 01SBAAW4097 01/11/2017 01/11/2018 XX XX 5,000,000 A 01SBAAW4097 01/11/2017 01/11/2018 5,000,000 10,000X X B 01WECDW1840 01/11/2017 01/11/2018 1,000,000 1,000,000 1,000,000 C Prof Liability 01062972 07/01/2016 07/01/2017 Limit/Aggregate 3,000,000 D Cyber Liability EONG25549168001 08/18/2016 08/18/2017 Limit 1,000,000 Collier County is included as additional insured as per policy terms, conditions, exclusions and as required by written contract. Collier County 3295 Tamiami Trail East Naples, FL 34112 555 PLEASANTVILLE RD BRIARCLIFF MANOR, NY 10510 Current Principal Place of Business: Current Mailing Address: 555 PLEASANTVILLE RD BRIARCLIFF MANOR, NY 10510 US Entity Name: DIGITECH EMS BILLING, INC DOCUMENT# F12000002178 FEI Number: 11-2693136 Certificate of Status Desired: Name and Address of Current Registered Agent: BUSINESS FILINGS INCORPORATED 515 E. PARK AVENUE TALLAHASSEE, FL 32301 US The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Date Officer/Director Detail : I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: Electronic Signature of Signing Officer/Director Detail Date MARK WILLIAMS FILED Jan 31, 2014 Secretary of State CC5098599482 MARK SCHIOWITZ PRESIDENT & CEO 01/31/2014 2014 FOREIGN PROFIT CORPORATION ANNUAL REPORT Yes 01/31/2014 Title DIRECTOR Name SCHIOWITZ, MARK Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 Title PRESIDENT Name SCHIOWITZ, MARK Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 Title SECRETARY Name SCHIOWITZ, JOYCE Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 Title DIRECTOR Name SCHIOWITZ, JOYCE Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 Title VICE-PRESIDENT Name PICKETT II, WALTER C. Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 Title TREASURER Name SCHIOWITZ, JOYCE Address 555 PLEASANTVILLE RD 110 NORTH City-State-Zip:BRIARCLIFF MANOR NY 10510 (5/25/2017 11:49:23 AM Eastern) Question: Can you please provide a breakdown of number of transports by service level for the most recent fiscal year? ALS Emergency (A0427) ALS Non-Emergency (A0426) BLS Emergency (A0429) BLS Non-Emergency (A0428) ALS 2 (A0433) SCT (A0434) Treatment No Transport (A0998) Air Ambulance service, rotary wing (A0431) (5/26/2017 8:10:59 AM Eastern) Answer: This was answered in the Q&A already please read answers. (5/25/2017 11:45:35 AM Eastern) Question: What is your average loaded mileage per ground transport? Air Transport? (5/26/2017 8:17:54 AM Eastern) Answer: The mileage was also already provided. (5/17/2017 3:10:45 PM Eastern) Question: Due to the proprietary nature of the information requested, will Collier County accept a representative sample of our standard operating procedures in lieu of the full list asked? If chosen, SOP’s can be provided. (5/18/2017 12:08:57 PM Eastern) Answer: Please send what is requested in the RFP. If there is proprietary information provide that on a separate page as such and that can be protected from distribution. Committee members will have access to that information in order to make a decision. If you decide to send a proposal clearly mark and provide in a separate file if possible. (5/17/2017 3:10:14 PM Eastern) Question: How satisfied are you with your current EMS billing vendor? What is the reason for your RFP? (5/18/2017 8:04:59 AM Eastern) Answer: We are completely satisfied with our current vendor. This contract is about to expire and that is why it is coming up for solicitation again. (5/10/2017 3:29:28 PM Eastern) Question: Would it be acceptable to submit a redacted copy of our proposal (confidential information already blacked out) for Open Records requests? (5/12/2017 12:12:53 PM Eastern) Answer: Trade secrets can be protected from distribution. If you decide to send a proposal clearly mark and provide in a separate file if possible. We have the final discretion to determine if it falls under the Statute. (5/10/2017 3:29:15 PM Eastern) Question: On page 7, item ii, the RFP states: The County will have the option to authorize the selected proposer to perform billing services on new collection cases at the proposed rate or for all existing cases at a separately negotiated rate. Could you please clarify this statement? Is this in regard to delinquent accounts? Is this referring to cases that have been billed by the previous vendor, are not settled in full and not yet delinquent? (5/12/2017 10:57:42 AM Eastern) Answer: Possibly both scenarios (5/10/2017 3:29:05 PM Eastern) Question: Do you itemize or bundle your disposables? (5/12/2017 10:57:15 AM Eastern) Answer: Do not charge for disposables (5/10/2017 3:28:18 PM Eastern) Question: What is your rate for Treat-No-Transport? (5/12/2017 10:56:59 AM Eastern) Answer: 175.00 (5/10/2017 3:28:03 PM Eastern) Question: What is your current rate for Air Transports? (5/12/2017 10:53:09 AM Eastern) Answer: 5900.00 (5/10/2017 3:27:35 PM Eastern) Question: What were your 2016 total charges, mandatory adjustments, and total write-offs? (5/12/2017 10:54:53 AM Eastern) Answer: Total charges- $19,750,646.95 mandatory adjustments - $4,871,793.17 We have not yet done write offs for FY16. (5/10/2017 3:27:20 PM Eastern) Question: Who is your delinquent account collection agency? What is the current cost of those collections in dollars and percent? If you do not utilize a delinquent account collection agency, are you interested in considering bidders who provide collection services? (5/12/2017 10:53:32 AM Eastern) Answer: Mintex is County contracted collection agency. Commission is 14% (5/10/2017 11:06:43 AM Eastern) Question: What is your average revenue per call? Do you have a lockbox provider and, if so, which provider? If you have a lockbox provider, will that provider remain in (5/10/2017 11:06:43 AM Eastern) Question: What is your average revenue per call? Do you have a lockbox provider and, if so, which provider? If you have a lockbox provider, will that provider remain in place as a result of this procurement? Do you have an EPCR provider and, if so, which provider? Do you have a collection agency provider and, if so, which provider? Which local hospitals or care facilities typically receive most of your patients? (5/11/2017 8:50:01 AM Eastern) Answer: Average revenue per transport (ground only) - 383.50. Lockbox provider is First Florida Integrity Bank(this will continue). EPCR provider is ImageTrend. Collection Agency provider is Mintex. Local Hospitals - Naples Community Hospital Downtown, North Naples, Northeast, Physicians Regional in Pine Ridge and Collier Blvd, Lee Memorial and Lehigh Regional. (5/10/2017 11:06:37 AM Eastern) Question: What were your transports per year for advanced life support emergency level 1 for last year or for the last 12 months? What were your transports per year for advanced life support emergency level 2 for last year or for the last 12 months? What were your transports per year for basic life support for last year or for the last 12 months? What were your transports per year for basic life support emergency for last year or for the last 12 months? What were your transports per year for specialty care transport for last year or for the last 12 months? What were your transports per year for treatment without transport for last year or for the last 12 months? What is your payer mix expressed as percentages of 100% billed? What is your payer remit mix expressed as percentages of 100% of what you typically receive? How many total transport vehicles do you now operate? What is your average loaded miles per trip? (5/11/2017 11:56:43 AM Eastern) Answer: ALS1 - 20,884,452.20 ALS2 - 305,371.00 BLS - 3,000,924.50 Helicopter - 3151589.5 SCT- NA Treated with no transport - 43,575 Payer Mix 60% Medicare,10%Medicaid,20% Commercial, 10% Self Pay (5/10/2017 11:06:29 AM Eastern) Question: What were your annual billable transports last year or for the last 12 months? What are your per-mile ground transport charges? What is your average per-trip charge? When were the last changes to your transport rates, and are you considering raising any of the rates currently charged? Are there any other charges you assess not otherwise covered by our questions? What percentage of your patients are residents versus non-residents, and do you charge the two groups differently? Do you operate any shared services agreements with any other municipal or county governments in the region and, if so, with whom? What were your transports per year for life support for last year or for the last 12 months? (5/11/2017 11:59:29 AM Eastern) Answer: Last year transports 28,621. Mileage Charge 12.25 Average trip charge(ground only) - 805.42 Last Change of Rates 2008 We do not keep data for residents vs non residents and do not have shared service agreements. 28,621 transports per year of life support. (5/10/2017 11:05:42 AM Eastern) Question: Please confirm the due date for this procurement is 6/7/2017. What is the date by which you will answer these questions? Why is the contract out to bid at this time? Is there a deadline for questions? What estimated or actual dollars were paid last year, last month, or last quarter to any incumbent(s)? Please describe your level of satisfaction with your current vendor(s), if applicable. What were your annual total adjustments for last year or for the last 12 months? What were your annual contractual allowance write offs for last year or for the last 12 months? What were your annual gross collections last year or for the last 12 months? (5/11/2017 12:05:18 PM Eastern) Answer: Due date is provided on solicitation page 3 as 6/7/17, question and answer date is provided on page 8, 5/26/17. Actual dollars paid to consultant in the past 12 months- 520,845. Total adjustments for fiscal year 2016- 7932261.54 Contractual Adjustments 7932261.54 Gross Collections for fiscal year 2016 - 11930799.23 place as a result of this procurement? Do you have an EPCR provider and, if so, which provider? Do you have a collection agency provider and, if so, which provider? Which local hospitals or care facilities typically receive most of your patients? (5/11/2017 8:50:01 AM Eastern) Answer: Average revenue per transport (ground only) - 383.50. Lockbox provider is First Florida Integrity Bank(this will continue). EPCR provider is ImageTrend. Collection Agency provider is Mintex. Local Hospitals - Naples Community Hospital Downtown, North Naples, Northeast, Physicians Regional in Pine Ridge and Collier Blvd, Lee Memorial and Lehigh Regional. (5/10/2017 11:06:37 AM Eastern) Question: What were your transports per year for advanced life support emergency level 1 for last year or for the last 12 months? What were your transports per year for advanced life support emergency level 2 for last year or for the last 12 months? What were your transports per year for basic life support for last year or for the last 12 months? What were your transports per year for basic life support emergency for last year or for the last 12 months? What were your transports per year for specialty care transport for last year or for the last 12 months? What were your transports per year for treatment without transport for last year or for the last 12 months? What is your payer mix expressed as percentages of 100% billed? What is your payer remit mix expressed as percentages of 100% of what you typically receive? How many total transport vehicles do you now operate? What is your average loaded miles per trip? (5/11/2017 11:56:43 AM Eastern) Answer: ALS1 - 20,884,452.20 ALS2 - 305,371.00 BLS - 3,000,924.50 Helicopter - 3151589.5 SCT- NA Treated with no transport - 43,575 Payer Mix 60% Medicare,10%Medicaid,20% Commercial, 10% Self Pay (5/10/2017 11:06:29 AM Eastern) Question: What were your annual billable transports last year or for the last 12 months? What are your per-mile ground transport charges? What is your average per-trip charge? When were the last changes to your transport rates, and are you considering raising any of the rates currently charged? Are there any other charges you assess not otherwise covered by our questions? What percentage of your patients are residents versus non-residents, and do you charge the two groups differently? Do you operate any shared services agreements with any other municipal or county governments in the region and, if so, with whom? What were your transports per year for life support for last year or for the last 12 months? (5/11/2017 11:59:29 AM Eastern) Answer: Last year transports 28,621. Mileage Charge 12.25 Average trip charge(ground only) - 805.42 Last Change of Rates 2008 We do not keep data for residents vs non residents and do not have shared service agreements. 28,621 transports per year of life support. (5/10/2017 11:05:42 AM Eastern) Question: Please confirm the due date for this procurement is 6/7/2017. What is the date by which you will answer these questions? Why is the contract out to bid at this time? Is there a deadline for questions? What estimated or actual dollars were paid last year, last month, or last quarter to any incumbent(s)? Please describe your level of satisfaction with your current vendor(s), if applicable. What were your annual total adjustments for last year or for the last 12 months? What were your annual contractual allowance write offs for last year or for the last 12 months? What were your annual gross collections last year or for the last 12 months? (5/11/2017 12:05:18 PM Eastern) Answer: Due date is provided on solicitation page 3 as 6/7/17, question and answer date is provided on page 8, 5/26/17. Actual dollars paid to consultant in the past 12 months- 520,845. Total adjustments for fiscal year 2016- 7932261.54 Contractual Adjustments 7932261.54 Gross Collections for fiscal year 2016 - 11930799.23 (5/9/2017 1:55:51 PM Eastern) Question: what are your current billing charges for ALS, BLS and Mileage. (5/10/2017 8:09:59 AM Eastern) Answer: $700 BLS & ALS1, $750 ALS2 Mileage $12.25 (5/9/2017 1:55:19 PM Eastern) Question: what is your payer mix, divided by Medicare, Medicaid, Private Insurance and self pay. (5/10/2017 8:10:32 AM Eastern) Answer: Medicare 60% Medicaid 10% Private 20% Self Pay 10% (5/10/2017 3:29:28 PM Eastern) Question: Would it be acceptable to submit a redacted copy of our proposal (confidential information already blacked out) for Open Records requests? (5/12/2017 12:12:53 PM Eastern) Answer: Trade secrets can be protected from distribution. If you decide to send a proposal clearly mark and provide in a separate file if possible. We have the final discretion to determine if it falls under the Statute. (5/10/2017 3:29:15 PM Eastern) Question: On page 7, item ii, the RFP states: The County will have the option to authorize the selected proposer to perform billing services on new collection cases at the proposed rate or for all existing cases at a separately negotiated rate. Could you please clarify this statement? Is this in regard to delinquent accounts? Is this referring to cases that have been billed by the previous vendor, are not settled in full and not yet delinquent? (5/12/2017 10:57:42 AM Eastern) Answer: Possibly both scenarios (5/10/2017 3:29:05 PM Eastern) Question: Do you itemize or bundle your disposables? (5/12/2017 10:57:15 AM Eastern) Answer: Do not charge for disposables (5/10/2017 3:28:18 PM Eastern) Question: What is your rate for Treat-No-Transport? (5/12/2017 10:56:59 AM Eastern) Answer: 175.00 (5/10/2017 3:28:03 PM Eastern) Question: What is your current rate for Air Transports? (5/12/2017 10:53:09 AM Eastern) Answer: 5900.00 (5/10/2017 3:27:35 PM Eastern) Question: What were your 2016 total charges, mandatory adjustments, and total write-offs? (5/12/2017 10:54:53 AM Eastern) Answer: Total charges- $19,750,646.95 mandatory adjustments -$4,871,793.17 We have not yet done write offs for FY16. (5/10/2017 3:27:20 PM Eastern) Question: Who is your delinquent account collection agency? What is the current cost of those collections in dollars and percent? If you do not utilize a delinquent account collection agency, are you interested in considering bidders who provide collection services? (5/12/2017 10:53:32 AM Eastern) Answer: Mintex is County contracted collection agency. Commission is 14% (5/25/2017 11:49:23 AM Eastern) Question: Can you please provide a breakdown of number of transports by service level for the most recent fiscal year? ALS Emergency (A0427) ALS Non-Emergency (A0426) BLS Emergency (A0429) BLS Non-Emergency (A0428) ALS 2 (A0433) SCT (A0434) Treatment No Transport (A0998) Air Ambulance service, rotary wing (A0431) (5/26/2017 8:10:59 AM Eastern) Answer: This was answered in the Q&A already please read answers. (5/25/2017 11:45:35 AM Eastern) Question: What is your average loaded mileage per ground transport? Air Transport? (5/26/2017 8:17:54 AM Eastern) Answer: The mileage was also already provided. 1 ADDENDUM #1 Memorandum Date: June 5, 2017 From: Viviana Giarimoustas, Procurement Strategist To: Interested Parties Subject: RFP 17-7133 EMS Billing & Debt Collection Services The following questions were asked 5/25/17 by Samantha Travis, vendor has stated they do not see the answer provided in Q&A. Can you please provide a breakdown of number of transports by service level for the most recent fiscal year? ALS Emergency (A0427) ALS Non-Emergency (A0426) BLS Emergency (A0429) BLS Non-Emergency (A0428) ALS 2 (A0433) SCT (A0434) Treatment No Transport (A0998) Air Ambulance service, rotary wing (A0431) What is your average loaded mileage per ground transport? Air Transport? Please see the following page for additional response. If you require additional information please call Viviana Giarimoustas, Purchasing Department at 239- 252-8375 or by e-mail at VivianaGiarimoustas@colliergov.net . Thank you. Email: VivianaGiarimoustas@colliergov.net Telephone: (239) 252-8375 Charge Summary Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount Mileage Charges ALS Emergency Mileage A0425 ALS1 125317 1171781.2$14,354,319.70 A0425 ALS2 1825 17960$220,010.00 A0425 BLS 1005 7$85.75 A0425 SCT 21 120$1,470.00 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount ALS Non-Emergency Mileage A0425 ALS1 386 3386$41,478.50 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount BLS Emergency Mileage A0425 ALS1 2300 3$36.75 A0425 BLS 22435 172161$2,108,972.25 A0425 SCT 25 227$2,780.75 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount BLS Non-Emergency Mileage A0425 BLS 331 3239$39,677.75 A0425 SCT 3 28$343.00 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount Rotary Wing Air Mileage A0436 Rotary Wing 1438 49571$5,452,810.00 Mileage Charges 155086$22,221,984.45 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount Non Transport Charges Treatment / No-Transport A0998 TNT 1023 0$179,025.00   Digitech Computer, Inc. REQUEST FOR PROPOSAL COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS Solicitation 17-7133 EMS Billing & Debt Collection Services Viviana Giarimoustas Procurement Strategist 252-8375 (Telephone) VivianaGiarimoustas@colliergov.net (Email) This proposal solicitation document is prepared in a Microsoft Word format. Any alterations to this document made by the Vendor may be grounds for rejection of proposal, cancellation of any subsequent award, or any other legal remedies available to the Collier County Government. Our new address is 3295 Tamiami Trail East, Naples Florida 34112 Table of Contents LEGAL NOTICE .................................................................................................................................................................. 3 EXHIBIT I: SCOPE OF WORK, SPECIFICATIONS AND RESPONSE FORMAT ........................................................................... 4 EXHIBIT II: GENERAL RFP INSTRUCTIONS .........................................................................................................................11 EXHIBIT III: COLLIER COUNTY PURCHASE ORDER TERMS AND CONDITIONS ....................................................................14 EXHIBIT IV: ADDITIONAL TERMS AND CONDITIONS FOR RFP...........................................................................................17 ATTACHMENT 1: VENDOR’S NON-RESPONSE STATEMENT ...............................................................................................27 ATTACHMENT 2: VENDOR CHECK LIST .............................................................................................................................28 ATTACHMENT 3: CONFLICT OF INTEREST AFFIDAVIT ........................................................................................................29 ATTACHMENT 4: VENDOR DECLARATION STATEMENT ....................................................................................................30 ATTACHMENT 5: AFFIDAVIT FOR CLAIMING STATUS AS A LOCAL BUSINESS ....................................................................32 ATTACHMENT 6: IMMIGRATION AFFIDAVIT CERTIFICATION ...........................................................................................33 ATTACHMENT 7: VENDOR SUBSTITUTE W – 9 .................................................................................................................34 ATTACHMENT 8: INSURANCE AND BONDING REQUIREMENTS ........................................................................................35 ATTACHMENT 9: REFERENCE QUESTIONNAIRE ................................................................................................................37 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 2 Legal Notice Proposals to provide 17-7133 EMS Billing and Debt Collection will be received until 10 AM Naples local time, on June 7, 2017. Solicitation 17-7133 EMS Billing & Debt Collection Services Services to be provided may include, but not be limited to the following: provide billing and collection of ground and air ambulance transportation. All statements shall be made upon the official proposal form which may be obtained on the Collier County Procurement Services Division Online Bidding System website: www.colliergov.net/bid. Collier County does not discriminate based on age, race, color, sex, religion, national origin, disability or marital status. BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA, BY: /S/ Edward F. Coyman, Jr. Director, Procurement Services This Public Notice was posted on the Collier County Procurement Services Division website: www.colliergov.net/purchasing and in the Lobby of Procurement Services Division Building, Collier County Government Center on May 8, 2017. Our new address is 3295 Tamiami Trail East, Naples Florida 34112 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 3 Exhibit I: Scope of Work, Specifications and Response Format As requested by the Collier County EMS Division (hereinafter, the “Division or Department”), the Collier County Board of County Commissioners Procurement Services Division (hereinafter, “County”) has issued this Request for Proposal (hereinafter, “RFP”) with the intent of obtaining proposals from interested and qualified Consultants in accordance with the terms, conditions and specifications stated or attached. The Consultant, at a minimum, must achieve the requirements of the Specifications or Scope of Work stated. The results of this solicitation may be used by other County departments once awarded according to the Board of County Commissioners Procurement Ordinance, as amended. Brief Description of Purchase The Collier County Board of Commissioners is soliciting sealed proposals to provide for the billing and debt collection of ground and air ambulance transportation. Background Collier County Emergency Medical Services (CCEMS) provides emergency ambulance services exclusively in Collier County, Florida. A high volume of moderate dollar amounts characterizes the billing and collection operations. In 2016, the County billed for 28,610 transports and 249 were treated with no transports with total revenue collections of approximately $12 million. Our current provider rate is 4.45% of net revenue. Detailed Scope of Work Collier County is seeking professional service agencies, companies, corporations, partnerships, individuals organizations and/or other legal entities organized under the laws of the State of Florida to provide billing services for EMS transport. The prospect must have provided Billing Services for Emergency Medical Services Transport in the last five (5) years and be prepared to assume billing services for Collier County as early as October 1, 2017. 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). 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 4 f. Have the ability to 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. Have the ability to download payment information from the County electronically. h. Have the ability to 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. 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. l. 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. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 5 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. 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 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 6 required and provide initial and then as needed on-site training for EMS administrative staff on the software utilized. ee. The proposal must provide a summary of the methods that the contractor intends to use for the storage of records and the related security and disaster recovery plans; and how it plans to ensure continuity of operations to operate in the event of a disaster or similar event that results in the interruption of the normal operating conditions of the contractor’s primary place of business providing services to the County or any of the support or technical aspects of that office. Include details about how the plan is exercised to assure the plan produces the intended results. 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. The County will have the option to authorize the selected proposer to perform billing services on new collection cases at the proposed rate or for all existing cases at a separately negotiated rate. jj. For monthly reconciliation and payment of invoice by the County, provide 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. Term of Contract The contract term, if an award(s) is/are made is intended to be for three (3) years with two (2) one year renewal options. Prices shall remain firm for the initial term of this contract. Surcharges will not be accepted in conjunction with this contract, and such charges should be incorporated into the pricing structure. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 7 Projected Solicitation Timetable The following projected timetable should be used as a working guide for planning purposes only. The County reserves the right to adjust this timetable as required during the course of the RFP process. Event Date Issue Solicitation Notice 5/8/17 Last Date for Receipt of Written Questions 5/26/17, 10 AM, Naples Local Time Addendum Issued Resulting from Written Questions 5/27/17 Solicitation Deadline Date and Time 6/7/17, 10 AM, Naples Local Time Anticipated Evaluation of Submittals 6/8/17 to 6/12/17 Anticipated Completion of Contract Negotiations 6/12 to 6/16/17 Anticipated Board of County Commissioner’s Contract Approval Date 7/11/2017 Response Format The Vendor understands and agrees to abide by all of the RFP specifications, provisions, terms and conditions of same, and all ordinances and policies of Collier County. The Vendor further agrees that if it is awarded a contract, the work will be performed in accordance with the provisions, terms and conditions of the contract. To facilitate the fair evaluation and comparison of proposals, all proposals must conform to the guidelines set forth in this RFP. Any portions of the proposal that do not comply with these guidelines must be so noted and explained in the Acceptance of Conditions section of the proposal. However, any proposal that contains such variances may be considered non-responsive. The items listed below shall be submitted with each proposal and should be submitted in the order shown. Each section should be clearly labeled, with pages numbered and separated by tabs. Failure by a Vendor to include all listed items may result in the rejection of its proposal. 1. Tab I, Cover Letter / References (10 points) Provide a cover letter, signed by an authorized officer of the firm, indicating the underlying philosophy of the firm in providing the services stated herein. Include the name(s), telephone number(s) and email(s) of the authorized contact person(s) concerning proposal. Submission of a signed Proposal is Vendor's certification that the Vendor will accept any awards as a result of this RFP. Provide a list of subcontractors who will participate on the team, if applicable. Also include, five (5) references from customers that you have done business with in the last five (5) years, please refer to Reference Questionnaire (attachment 9). 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 8 2. Tab II, Business Plan (25 points) In this tab, include: • Detailed explanation of how your firm will provide the required Billing Services for Emergency Medical Services Transport. Discussion should include specific abilities related to skills and technical expertise. EMS billing service procedures and policy for account management. • Describe your proposed automated system and operational software. • Detail any training that will be provided by your firm. • Timeline needed for transition of billing services to a new vendor • Provide samples of any reports that your firm shall provide in response to the County’s requirements. • Detail the recovery process, finding defaulted clients, and how long will services be provided for a defaulted client. • Explain procedures established for patient payment arrangements • Provide standard operating procedures to demonstrate how your firm will manage the County’s accounts. Include the following:  Verification and/or correction of address  Quality assurance  Accuracy  Dispute resolution  Processing and collection timelines  Recent and Planned compliance with privacy requirements and data transmission 3. Tab III, Cost of Services to the County (15 points) • Provide a total proposed fee as a percent of revenues collected related to the performance of these services, except for Medicaid. In accordance with Florida Statutes, provide a flat rate fee for each account paid by Medicaid. • Discuss your knowledge as it relates to regulations regarding claims, reviews, and hearings as applied in the Medicare and Medicaid programs in performing the required services. • Submit a narrative explaining the direct economic benefit to Collier County to be realized by selecting your firm. During the term of this engagement detail the employment, subcontracting, and support services contracting as economic stimulus that your entity may generate that would directly benefit Collier County. 4. Tab IV, Experience and Capacity of Firm (20 points) The prospect shall provide past performance for a minimum of five (5) contracts, at least two (2) with government entities that demonstrates recent and relevant past performance of similar scope, size and complexity of services identified. Provide information that documents your firm’s and subcontractors’ qualifications to produce the required deliverables, including abilities, capacity, skill, and financial strength, and number of years of experience in providing the required services. Also describe experience with other clients utilizing ImageTrend. Provide information regarding certification through the National Academy of Ambulance Coders (NAAC). • Describe what your average amount of days to send the initial bill and get a response from the client. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 9 • Describe how many customer(s) of similar size and scope to Collier County that you currently provide services to. 5. Tab V, Specialized Expertise of Team Members (20 points) Identify each person(s) of your firm who will be professionally associated with the County in the day-to-day operations and oversight of this project. Describe their respective area of expertise. Include personalized resumes which identify the qualification, training and experience of each person(s). Describe how that individuals time will be spent to achieve the goals and billing for Collier County. 6. Tab VIl, Acceptance of Conditions Indicate any exceptions to the general terms and conditions of the RFP, and to insurance requirements or any other requirements listed in this RFP. If no exceptions are indicated in this tabbed section, it will be understood that no exceptions to these documents will be considered after the award, or if applicable, during negotiations. Exceptions taken by a Vendor may result in evaluation point deduction(s) and/or exclusion of proposal for Selection Committee consideration, depending on the extent of the exception(s). Such determination shall be at the sole discretion of the County and Selection Committee. 7. Tab VIIl, Required Form Submittals • Attachment 2: Vendor Check List • Attachment 3: Conflict of Interest Affidavit • Attachment 4: Vendor Declaration Statement • Attachment 5: Affidavit for Claiming Status as a Local Business • Attachment 6: Immigration Affidavit Certification • Attachment 7: Vendor Substitute W-9 • Attachment 8: Insurance and Bonding Requirements • Attachment 9: Reference Questionnaire • Other: i.e. signed addenda, licenses or certifications, promotional materials, etc. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 10 Exhibit II: General RFP Instructions 1. Questions Direct questions related to this RFP to the Collier County Procurement Services Division Online Bidding System website: www.colliergov.net/bid. Vendors must clearly understand that the only official answer or position of the County will be the one stated on the Collier County Procurement Services Division Online Bidding System website. For general questions, please call the referenced Procurement Strategist noted on the cover page. 2. Pre-Proposal Conference The purpose of the pre-proposal conference is to allow an open forum for discussion and questioning with County staff regarding this RFP with all prospective Vendors having an equal opportunity to hear and participate. Oral questions will receive oral responses, neither of which will be official, nor become part of the RFP. Only written responses to written questions will be considered official, and will be included as part of this RFP as an addendum. All prospective Vendors are strongly encouraged to attend, as, this will usually be the only pre- proposal conference for this solicitation. If this pre-proposal conference is denoted as “mandatory”, prospective Vendors must be present in order to submit a proposal response. 3. Compliance with the RFP Proposals must be in strict compliance with this RFP. Failure to comply with all provisions of the RFP may result in disqualification. 4. Ambiguity, Conflict, or Other Errors in the RFP It is the sole responsibility of the Vendor if the Vendor discovers any ambiguity, conflict, discrepancy, omission or other error in the RFP, to immediately notify the Procurement Strategist, noted herein, of such error in writing and request modification or clarification of the document prior to submitting the proposal. The Procurement Strategist will make modifications by issuing a written revision and will give written notice to all parties who have received this RFP from the Procurement Services Division. 5. Proposal, Presentation, and Protest Costs The County will not be liable in any way for any costs incurred by any Vendor in the preparation of its proposal in response to this RFP, nor for the presentation of its proposal and/or participation in any discussions, negotiations, or, if applicable, any protest procedures. 6. Delivery of Proposals All proposals are to be uploaded on the County’s on line bidding system (www.colliergov.net/bid) before 10 AM, Naples local time, on or before 6/7/17. 7. Validity of Proposals No proposal can be withdrawn after it is filed unless the Vendor makes their request in writing to the County prior to the time set for the closing of Proposals. All proposals shall be valid for a 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 11 period of one hundred eighty (180) days from the submission date to accommodate evaluation and selection process. 8. Evaluation of Proposals The County’s procedure for selecting is as follows: 1. The County Manager or designee shall appoint a selection committee to review all proposals submitted. 2. The Request for Proposal is issued. 3. Subsequent to the closing date for the proposals, the Procurement professional will conduct a preliminary review of the proposals received and review each proposal to determine if it’s responsive to the requirements of the published RFP. 4. Selection committee meetings will be open to the public and the Procurement professional will publicly post notice of such meeting(s) in the lobby of the Procurement Services Division Building, County calendar and on the County’s Procurement Services Internet site. Public meeting dates and times should be posted with at least three (3) days in advance on the County’s website calendar. 5. Selection committee members will independently review and score each proposal based on the evaluation criteria stated in the request for proposal using the Individual Selection Committee Score and Rank Form. Committee members will individually prepare comments for discussion at the next meeting. The Individual Selection Committee Score and Rank Form is merely a tool to assist the selection committee member in their review of the proposals. Although it is a tool, the signed form will become part of the final procurement record. 6. At the scheduled selection meeting, the members will present their independent conclusions and comments based on their reading and interpretation of the materials presented to each other, and they may ask questions of one another 7. The Selection Committee reserves the right to hold oral presentations and establish a rank order for presentations. In any of the selection committee meeting deliberations, by consensus, members may request to invite firms in to clarify their proposals, ask for additional information, present materials, interview, and ask questions, etc. The members may consider any and all information obtained through this method in formulating their individual ranking and subsequent selection committee overall ranking and final ranking. 8. Once the individual ranking has been completed, the Procurement professional will direct selection committee members to read their individual ranking publically. The Procurement professional will record individual rankings on the Final Ranking Sheet which will mathematically compile into an overall selection committee rank of proposers. Once final rank is completed by the Committee, the public will be permitted to provide comments (limited to three (3) minutes). 9. After final consensus of the ranking, staff will subsequently enter into negotiations. Recommendation of contract award is dependent upon the successful and full execution of a mutually agreed contract, pending the final approval by the Board of County Commissioners. The County reserves the right to withdraw this RFP at any time and for any reason, and to issue such clarifications, modifications, and/or amendments as it may deem appropriate. Receipt of a proposal by the County or a submission of a proposal to the County offers no rights upon the Vendor nor obligates the County in any manner. Acceptance of the proposal does not guarantee issuance of any other governmental approvals. Proposals which include provisions requiring the granting of zoning variances shall not be considered. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 12 9. References The County reserves the right to contact any and all references pertaining to this solicitation and related proposal. 10. Proposal Selection Committee and Evaluation Factors The County Manager shall appoint a Selection Committee to review all proposals submitted. The factors to be considered in the evaluation of proposal responses are listed below. Tab I, Cover Letter/References 10 Points Tab II, Business Plan 25 Points Tab III, Cost of Services to the County 15 Points Tab IV, Experience and Capacity of Firm 20 Points Tab V, Specialized Expertise of Team Members 20 Points Local Vendor Preference 10 Points TOTAL 100 Points Tie Breaker: In the event of a tie, both in individual scoring and in final ranking, the firm with the lowest paid dollars by Collier County to the vendor (as obtained from the County’s financial system) within the last five (5) years will receive the higher individual ranking. If there is a multiple firm tie in either individual scoring or final ranking, the firm with the lowest volume of work shall receive the higher ranking, the firm with the next lowest volume of work shall receive the next highest ranking and so on. 11. Acceptance or Rejection of Proposals The right is reserved by the County to waive any irregularities in any proposal, to reject any or all proposals, to re-solicit for proposals, if desired, and upon recommendation and justification by Collier County to accept the proposal which in the judgment of the County is deemed the most advantageous for the public and the County of Collier. Any proposal which is incomplete, conditional, obscure or which contains irregularities of any kind, may be cause for rejection. In the event of default of the successful Vendor, or their refusal to enter into the Collier County contract, the County reserves the right to accept the proposal of the second ranked firm or to re-advertise using the same or revised documentation, at its sole discretion. 12. Reserved Rights Collier County reserves its right in any solicitation to accept or reject any or all bids, proposals or offers; to waive minor irregularities and technicalities; or to request resubmission. Also Collier County reserves the right to accept all or any part of any bid, proposal, or offer, and to increase or decrease quantities to meet the additional or reduced requirements of Collier County. Collier County reserves its right to cancel, extend or modify any or all bids, proposals or offers; to award to one or more vendors; to award all or part of a solicitation; and to award by individual line items when it is deemed to be in the best interest of the County. Collier County reserves its right to reject any sole response. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 13 Exhibit III: Collier County Purchase Order Terms and Conditions 1. Offer This offer is subject to cancellation by the COUNTY without notice if not accepted by VENDOR within fourteen (14) days of issuance. 2. Acceptance and Confirmation This Purchase Order (including all documents attached to or referenced therein) constitutes the entire agreement between the parties, unless otherwise specifically noted by the COUNTY on the face of this Purchase Order. Each delivery of goods and/or services received by the COUNTY from VENDOR shall be deemed to be upon the terms and conditions contained in this Purchase Order. No additional terms may be added and Purchase Order may not be changed except by written instrument executed by the COUNTY. VENDOR is deemed to be on notice that the COUNTY objects to any additional or different terms and conditions contained in any acknowledgment, invoice or other communication from VENDOR, notwithstanding the COUNTY’S acceptance or payment for any delivery of goods and/or services, or any similar act by VENDOR. 3. Inspection All goods and/or services delivered hereunder shall be received subject to the COUNTY’S inspection and approval and payment therefore shall not constitute acceptance. All payments are subject to adjustment for shortage or rejection. All defective or nonconforming goods will be returned pursuant to VENDOR'S instruction at VENDOR’S expense. To the extent that a purchase order requires a series of performances by VENDOR, the COUNTY prospectively reserves the right to cancel the entire remainder of the Purchase Order if goods and/or services provided early in the term of the Purchase Order are non-conforming or otherwise rejected by the COUNTY. 4. Shipping and Invoices a) All goods are FOB destination and must be suitably packed and prepared to secure the lowest transportation rates and to comply with all carrier regulations. Risk of loss of any goods sold hereunder shall transfer to the COUNTY at the time and place of delivery; provided that risk of loss prior to actual receipt of the goods by the COUNTY nonetheless remain with VENDOR. b) No charges will be paid by the COUNTY for packing, crating or cartage unless otherwise specifically stated in this Purchase Order. Unless otherwise provided in Purchase Order, no invoices shall be issued nor payments made prior to delivery. Unless freight and other charges are itemized, any discount will be taken on the full amount of invoice. c) All shipments of goods scheduled on the same day via the same route must be consolidated. Each shipping container must be consecutively numbered and marked to show this Purchase Order number. The container and Purchase Order numbers must be indicated on bill of lading. Packing slips must show Purchase Order number and must be included on each package of less than container load (LCL) shipments and/or with each car load of equipment. The COUNTY reserves the right to refuse or return any shipment or equipment at VENDOR’S expense that is not marked with Purchase Order numbers. VENDOR agrees to declare to the carrier the value of any shipment made under this Purchase Order and the full invoice value of such shipment. d) All invoices must contain the Purchase Order number and any other specific information as identified on the Purchase Order. Discounts of prompt payment will be computed from the date of receipt of goods or from date of receipt of invoices, whichever is later. Payment will be made upon receipt of a proper invoice and in compliance with Chapter 218, Fla. Stats., otherwise known as the “Local Government Prompt Payment Act,” and, pursuant to the Board of County Commissioners Purchasing Policy. 5. Time Is Of the Essence Time for delivery of goods or performance of services under this Purchase Order is of the essence. Failure of VENDOR to meet delivery schedules or deliver within a reasonable time, as interpreted by the COUNTY in its sole judgment, shall entitle the COUNTY to seek all remedies available to it at law or in equity. VENDOR agrees to reimburse the COUNTY for any expenses incurred in enforcing its rights. VENDOR further agrees that undiscovered delivery of nonconforming goods and/or services is not a waiver of the COUNTY’S right to insist upon further compliance with all specifications. 6. Changes The COUNTY may at any time and by written notice make changes to drawings and specifications, shipping instructions, quantities and 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 14 delivery schedules within the general scope of this Purchase Order. Should any such change increase or decrease the cost of, or the time required for performance of the Purchase Order, an equitable adjustment in the price and/or delivery schedule will be negotiated by the COUNTY and VENDOR. Notwithstanding the foregoing, VENDOR has an affirmative obligation to give notice if the changes will decrease costs. Any claims for adjustment by VENDOR must be made within thirty (30) days from the date the change is ordered or within such additional period of time as may be agreed upon by the parties. 7. Warranties VENDOR expressly warrants that the goods and/or services covered by this Purchase Order will conform to the specifications, drawings, samples or other descriptions furnished or specified by the COUNTY, and will be of satisfactory material and quality production, free from defects and sufficient for the purpose intended. Goods shall be delivered free from any security interest or other lien, encumbrance or claim of any third party. These warranties shall survive inspection, acceptance, passage of title and payment by the COUNTY. 8. Statutory Conformity Goods and services provided pursuant to this Purchase Order, and their production and transportation shall conform to all applicable laws, including but not limited to the Occupational Health and Safety Act, the Federal Transportation Act and the Fair Labor Standards Act, as well as any law or regulation noted on the face of the Purchase Order. 9. Advertising No VENDOR providing goods and services to the COUNTY shall advertise the fact that it has contracted with the COUNTY for goods and/or services, or appropriate or make use of the COUNTY’S name or other identifying marks or property without the prior written consent of the COUNTY’S Purchasing Department. 10. Indemnification VENDOR shall indemnify and hold harmless the COUNTY from any and all claims, including claims of negligence, costs and expenses, including but not limited to attorneys' fees, arising from, caused by or related to the injury or death of any person (including but not limited to employees and agents of VENDOR in the performance of their duties or otherwise), or damage to property (including property of the COUNTY or other persons), which arise out of or are incident to the goods and/or services to be provided hereunder. 11. Warranty of Non-Infringement VENDOR represents and warrants that all goods sold or services performed under this Purchase Order are: a) in compliance with applicable laws; b) do not infringe any patent, trademark, copyright or trade secret; and c) do not constitute unfair competition. VENDOR shall indemnify and hold harmless the COUNTY from and against any and all claims, including claims of negligence, costs and expense, including but not limited to attorneys' fees, which arise from any claim, suit or proceeding alleging that the COUNTY’S use of the goods and/or services provided under this Purchase Order are inconsistent with VENDOR'S representations and warranties in section 11 (a). If any claim which arises from VENDOR'S breach of section 11 (a) has occurred, or is likely to occur, VENDOR may, at the COUNTY’S option, procure for the COUNTY the right to continue using the goods or services, or replace or modify the goods or services so that they become non-infringing, (without any material degradation in performance, quality, functionality or additional cost to the COUNTY). 12. Insurance Requirements The VENDOR, at its sole expense, shall provide commercial insurance of such type and with such terms and limits as may be reasonably associated with the Purchase Order. Providing and maintaining adequate insurance coverage is a material obligation of the VENDOR. All insurance policies shall be executed through insurers authorized or eligible to write policies in the State of Florida. 13. Compliance with Laws In fulfilling the terms of this Purchase Order, VENDOR agrees that it will comply with all federal, state, and local laws, rules, codes, and ordinances that are applicable to the conduct of its business. By way of non-exhaustive example, this shall include the American with Disabilities Act and all prohibitions against discrimination on the basis of race, religion, sex creed, national origin, handicap, marital status, or veterans’ status. Further, VENDOR acknowledges and without exception or 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 15 stipulation shall be fully responsible for complying with the provisions of 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. Failure by the awarded firm(s) to comply with the laws referenced herein shall constitute a breach of the award agreement and the County shall have the discretion to unilaterally terminate said agreement immediately. Any breach of this provision may be regarded by the COUNTY as a material and substantial breach of the contract arising from this Purchase Order. 14. Force Majeure Neither the COUNTY nor VENDOR shall be responsible for any delay or failure in performance resulting from any cause beyond their control, including, but without limitation to war, strikes, civil disturbances and acts of nature. When VENDOR has knowledge of any actual or potential force majeure or other conditions which will delay or threatens to delay timely performance of this Purchase Order, VENDOR shall immediately give notice thereof, including all relevant information with respects to what steps VENDOR is taking to complete delivery of the goods and/or services to the COUNTY. 15. Assignment VENDOR may not assign this Purchase Order, nor any money due or to become due without the prior written consent of the COUNTY. Any assignment made without such consent shall be deemed void. 16. Taxes Goods and services procured subject to this Purchase Order are exempt from Florida sales and use tax on real property, transient rental property rented, tangible personal purchased or rented, or services purchased (Florida Statutes, Chapter 212), and from federal excise tax. 17. Annual Appropriations The COUNTY’S performance and obligation to pay under this Purchase Order shall be contingent upon an annual appropriation of funds. 18. Termination This Purchase Order may be terminated at any time by the COUNTY upon 30 days prior written notice to the VENDOR. This Purchase Order may be terminated immediately by the COUNTY for breach by VENDOR of the terms and conditions of this Purchase Order, provided that COUNTY has provided VENDOR with notice of such breach and VENDOR has failed to cure within 10 days of receipt of such notice. 19. General a) This Purchase Order shall be governed by the laws of the State of Florida. The venue for any action brought to specifically enforce any of the terms and conditions of this Purchase Order shall be the Twentieth Judicial Circuit in and for Collier County, Florida b) Failure of the COUNTY to act immediately in response to a breach of this Purchase Order by VENDOR shall not constitute a waiver of breach. Waiver of the COUNTY by any default by VENDOR hereunder shall not be deemed a waiver of any subsequent default by VENDOR. c) All notices under this Purchase Order shall be sent to the respective addresses on the face page by certified mail, return receipt requested, by overnight courier service, or by personal delivery and will be deemed effective upon receipt. Postage, delivery and other charges shall be paid by the sender. A party may change its address for notice by written notice complying with the requirements of this section. d) The Vendor agrees to reimbursement of any travel expenses that may be associated with this Purchase Order in accordance with Florida Statute Chapter 112.061, Per Diem and Travel Expenses for Public Officers, employees and authorized persons. e) In the event of any conflict between or among the terms of any Contract Documents related to this Purchase Order, the terms of the Contract Documents shall take precedence over the terms of the Purchase Order. To the extent any terms and /or conditions of this Purchase Order duplicate or overlap the Terms and Conditions of the Contract Documents, the provisions of the Terms and/or Conditions that are most favorable to the County and/or provide the greatest protection to the County shall govern. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 16 Exhibit IV: Additional Terms and Conditions for RFP 1. Insurance Requirements The Vendor shall at its own expense, carry and maintain insurance coverage from responsible companies duly authorized to do business in the State of Florida as set forth in the Insurance and Bonding attachment of this solicitation. The Vendor shall procure and maintain property insurance upon the entire project, if required, to the full insurable value of the scope of work. The County and the Vendor waive against each other and the County’s separate Vendors, Contractors, Design Consultant, Subcontractors agents and employees of each and all of them, all damages covered by property insurance provided herein, except such rights as they may have to the proceeds of such insurance. The Vendor and County shall, where appropriate, require similar waivers of subrogation from the County’s separate Vendors, Design Consultants and Subcontractors and shall require each of them to include similar waivers in their contracts. Collier County shall be responsible for purchasing and maintaining, its own liability insurance. Certificates issued as a result of the award of this solicitation must identify “For any and all work performed on behalf of Collier County.” The General Liability Policy provided by Vendor to meet the requirements of this solicitation shall name Collier County, Florida, as an additional insured as to the operations of Vendor under this solicitation and shall contain a severability of interests’ provisions. Collier County Board of County Commissioners shall be named as the Certificate Holder. 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. The "Certificate Holder" should read as follows: Collier County Board of County Commissioners Naples, Florida The amounts and types of insurance coverage shall conform to the minimum requirements set forth in the Insurance and Bonding attachment, with the use of Insurance Services Office (ISO) forms and endorsements or their equivalents. If Vendor has any self-insured retentions or deductibles under any of the below listed minimum required coverage, Vendor must identify on the Certificate of Insurance the nature and amount of such self- insured retentions or deductibles and provide satisfactory evidence of financial responsibility for such obligations. All self-insured retentions or deductibles will be Vendor’s sole responsibility. Coverage(s) shall be maintained without interruption from the date of commencement of the Work until the date of completion and acceptance of the scope of work by the County or as specified in this solicitation, whichever is longer. The Vendor and/or its insurance carrier shall provide 30 days written notice to the County of policy cancellation or non-renewal on the part of the insurance carrier or the Vendor. The Vendor shall also notify the 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 Vendor from its insurer and nothing contained herein shall relieve Vendor of this requirement to provide notice. In the event of a reduction in the aggregate limit of any policy to be provided by Vendor 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 17 hereunder, Vendor shall immediately take steps to have the aggregate limit reinstated to the full extent permitted under such policy. Should at any time the Vendor not maintain the insurance coverage(s) required herein, the County may terminate the Agreement or at its sole discretion shall be authorized to purchase such coverage(s) and charge the Vendor for such coverage(s) purchased. If Vendor fails to reimburse the County for such costs within thirty (30) days after demand, the County has the right to offset these costs from any amount due Vendor under this Agreement or any other agreement between the County and Vendor. The County shall be under no obligation to purchase such insurance, nor shall it be responsible for the coverage(s) purchased or the insurance company or companies used. The decision of the County to purchase such insurance coverage(s) shall in no way be construed to be a waiver of any of its rights under the Contract Documents. If the initial or any subsequently issued Certificate of Insurance expires prior to the completion of the scope of work, the Vendor shall furnish to the County renewal or replacement Certificate(s) of Insurance not later than ten (10) calendar days after the expiration date on the certificate. Failure of the Vendor to provide the County with such renewal certificate(s) shall be considered justification for the County to terminate any and all contracts. 2. Offer Extended to Other Governmental Entities Collier County encourages and agrees to the successful vendor extending the pricing, terms and conditions of this solicitation or resultant contract to other governmental entities at the discretion of the successful vendor. 3. Additional Items and/or Services Additional items and / or services may be added to the resultant contract, or purchase order, in compliance with the Procurement Ordinance. 4. County’s Right to Inspect The County or its authorized Agent shall have the right to inspect the Vendor’s facilities/project site during and after each work assignment the Vendor is performing. 5. Vendor Performance Evaluation The County has implemented a Vendor Performance Evaluation System for all contracts awarded in excess of $25,000. To this end, vendors will be evaluated on their performance upon completion/termination of this Agreement. 6. Additional Terms and Conditions of Contract Collier County has developed standard contracts/agreements, approved by the Board of County Commissioners (BCC). The resultant contract(s) may include purchase or work orders issued under one, or any combination of price methodologies by the County’s project manager. The County reserves the right to include in any contract document such terms and conditions, as it deems necessary for the proper protection of the rights of Collier County. A sample copy of this contract is available upon request. The County will not be obligated to sign any contracts, maintenance and/or service agreements or other documents provided by the Vendor. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 18 The County’s project manager, shall coordinate with the Vendor / Contractor the return of any surplus assets, including materials, supplies, and equipment associated with the scope or work. 7. Payment Method Payments are made in accordance with the Local Government Prompt Payment Act, Chapter 218, Florida Statutes. Vendor’s invoices must include: • Purchase Order Number • Description and quantities of the goods or services provided per instructions on the County’s purchase order or contract. Invoices shall be sent to: Board of County Commissioners Clerk’s Finance Department ATTN: Accounts Payable 3299 Tamiami Trail E Ste 700 Naples FL 34112 Or emailed to: bccapclerk@collierclerk.com. Collier County, in its sole discretion, will determine the method of payment for goods and/or services as part of this agreement. Payment methods include: • Traditional – payment by check, wire transfer or other cash equivalent. • Standard – payment by purchasing card. Collier County’s Purchasing Card Program is supported by standard bank credit suppliers (i.e. VISA and MasterCard), and as such, is cognizant of the Rules for VISA Merchants and MasterCard Merchant Rules. The County may not accept any additional surcharges (credit card transaction fees) as a result of using the County’s credit card for transactions relating to this solicitation. The County will entertain bids clearly stating pricing for standard payment methods. An additional separate discounted price for traditional payments may be provided at the initial bid submittal if it is clearly marked as an “Additional Cash Discount.” Upon execution of the Contract and completion of each month’s work, payment requests may be submitted to the Project Manager on a monthly basis by the Contractor for services rendered for that prior month. Services beyond sixty (60) days from current monthly invoice will not be considered for payment without prior approval from the Project manager. All invoices should be submitted within the fiscal year the work was performed. (County's fiscal year is October 1 - September 30.) Invoices submitted after the close of the fiscal year will not be accepted (or processed for payment) unless specifically authorized by the Project Manager. Payments will be made for articles and/or 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 contract. 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. In instances where the successful contractor may owe debts (including, but not limited to taxes or other fees) to Collier County and the contractor has not satisfied nor made arrangement to satisfy 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 19 these debts, the County reserves the right to off-set the amount owed to the County by applying the amount owed to the vendor or contractor for services performed of for materials delivered in association with a contract. Invoices shall not reflect sales tax. After review and approval, the invoice will be transmitted to the Finance Division for payment. Payment will be made upon receipt of proper invoice and in compliance with Chapter 218 Florida Statutes, otherwise known as the “Local Government Prompt Payment Act.” Collier County reserves the right to withhold and/or reduce an appropriate amount of any payment for work not performed or for unsatisfactory performance of Contractual requirements. 8. Environmental Health and Safety All Vendors and Sub vendors performing service for Collier County are required and shall comply with all Occupational Safety and Health Administration (OSHA), State and County Safety and Occupational Health Standards and any other applicable rules and regulations. Vendors and Sub vendors shall be responsible for the safety of their employees and any unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site. All firewall penetrations must be protected in order to meet Fire Codes. Collier County Government has authorized OSHA representatives to enter any Collier County facility, property and/or right-of-way for the purpose of inspection of any Vendor’s work operations. This provision is non-negotiable by any department and/or Vendor. All new electrical installations shall incorporate NFPA 70E Short Circuit Protective Device Coordination and Arc Flash Studies where relevant as determined by the engineer. All electrical installations shall be labeled with appropriate NFPA 70E arch flash boundary and PPE Protective labels. 9. Licenses The Vendor is required to possess the correct Business Tax Receipt, professional license, and any other authorizations necessary to carry out and perform the work required by the project pursuant to all applicable Federal, State and Local Law, Statute, Ordinances, and rules and regulations of any kind. Additionally, copies of the required licenses must be submitted with the proposal response indicating that the entity proposing, as well as the team assigned to the County account, is properly licensed to perform the activities or work included in the contract documents. Failure on the part of any Vendor to submit the required documentation may be grounds to deem Vendor non-responsive. A Vendor, with an office within Collier County is also required to have an occupational license. All State Certified contractors who may need to pull Collier County permits or call in inspections must complete a Collier County Contractor License registration form and submit the required fee. After registering the license/registration will need to be renewed thereafter to remain “active” in Collier County. If you have questions regarding professional licenses contact the Contractor Licensing at (239) 252- 2431, 252-2432 or 252-2909. Questions regarding required occupational licenses, please contact the Tax Collector’s Office at (239) 252-2477. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 20 10. Principals/Collusion By submission of this Proposal the undersigned, as Vendor, does declare that the only person or persons interested in this Proposal as principal or principals is/are named therein and that no person other than therein mentioned has any interest in this Proposal or in the contract to be entered into; that this Proposal is made without connection with any person, company or parties making a Proposal, and that it is in all respects fair and in good faith without collusion or fraud. 11. Relation of County It is the intent of the parties hereto that the Vendor shall be legally considered an independent Vendor, and that neither the Vendor nor their employees shall, under any circumstances, be considered employees or agents of the County, and that the County shall be at no time legally responsible for any negligence on the part of said Vendor, their employees or agents, resulting in either bodily or personal injury or property damage to any individual, firm, or corporation. 12. Termination Should the Contractor be found to have failed to perform services in a manner satisfactory to the County, the County may terminate this Agreement immediately 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 award of this solicitation is made by the Procurement Services Director, the award and any resultant purchase orders may be terminated at any time by the County upon thirty (30) days written notice to the awarded vendor(s) pursuant to the Board’s Procurement Ordinance. 13. Lobbying All firms are hereby placed on NOTICE that the Board of County Commissioners does not wish to be lobbied, either individually or collectively about a project for which a firm has submitted a Proposal. Firms and their agents are not to contact members of the County Commission for such purposes as meeting or introduction, luncheons, dinners, etc. During the process, from Proposal closing to final Board approval, no firm or their agent shall contact any other employee of Collier County in reference to this Proposal, with the exception of the Procurement Director or his designee(s). Failure to abide by this provision may serve as grounds for disqualification for award of this contract to the firm. 14. Public Records Compliance Florida Public Records Law Chapter 119, including specifically those contractual requirements in 119.0701(2)(a)-(b) 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: 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 21 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 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. 15. Certificate of Authority to Conduct Business in the State of Florida (Florida Statute 607.1501) In order to be considered for award, firms must be registered with the Florida Department of State Divisions of Corporations in accordance with the requirements of Florida Statute 607.1501 and provide a certificate of authority (www.sunbiz.org/search.html) prior to execution of a contract. A copy of the document may be submitted with the solicitation response and the document number shall be identified. Firms who do not provide the certificate of authority at the time of response shall be required to provide same within five (5) days upon notification of selection for award. If the firm cannot provide the document within the referenced timeframe, the County reserves the right to award to another firm. 16. Single Proposal Each Vendor must submit, with their proposal, the required forms included in this RFP. Only one proposal from a legal entity as a primary will be considered. A legal entity that submits a proposal as a primary or as part of a partnership or joint venture submitting as primary may not then act as a sub- consultant to any other firm submitting under the same RFP. If a legal entity is not submitting as a primary or as part of a partnership or joint venture as a primary, that legal entity may act as a sub- consultant to any other firm or firms submitting under the same RFP. All submittals in violation of this requirement will be deemed non-responsive and rejected from further consideration. 17. Survivability Bids (ITBs/RFPs): The Consultant/Contractor/Vendor agrees that any Work Order/Purchase Order that extends beyond the expiration date of Solicitation 17-7133 EMS Billing & Debt Collection Services resultant of this solicitation will survive and remain subject to the terms and conditions of that Agreement until the completion or termination of any Work Order/Purchase Order. 18. Protest Procedures Any prospective vendor / proposer who desires to protest any aspect(s) or provision(s) of the solicitation (including the form of the solicitation documents or procedures) shall file their protest with 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 22 the Procurement Director prior to the time of the bid opening strictly in accordance with the County’s then current Procurement Ordinance and policies. The Board of County Commissioners will make award of contract in public session. Award recommendations will be posted outside the offices of the Procurement Services Division on Wednesdays and Thursdays. Any actual or prospective respondent who desires to formally protest the recommended contract award must file a notice of intent to protest with the Procurement Director within two (2) calendar days (excluding weekends and County holidays) of the date that the recommended award is posted. Upon filing of said notice, the protesting party will have five (5) days to file a formal protest and will be given instructions as to the form and content requirements of the formal protest. A copy of the "Protest Policy" is available at the office of the Procurement Director. 19. Public Entity Crime A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017 for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 20. Security and Background Checks 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-FMOPS@colliergov.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. CCSO requires separate fingerprinting prior to work being performed in any of their locations. This will be coordinated upon award of the contract. If there are additional fees for this process, the vendor is responsible for all costs. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 23 21. Conflict of Interest Vendor shall complete the Conflict of Interest Affidavit included as an attachment to this RFP document. Disclosure of any potential or actual conflict of interest is subject to County staff review and does not in and of itself disqualify a firm from consideration. These disclosures are intended to identify and or preclude conflict of interest situations during contract selection and execution. 22. 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, the current Collier County Ethics Ordinance 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 time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any contract held by the individual and/or firm for cause. 23. Immigration Affidavit Certification Statutes and executive orders require employers to abide by the immigration laws of the United States and to employ only individuals who are eligible to work in the United States. The Employment Eligibility Verification System (E-Verify) operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA), provides an Internet- based means of verifying employment eligibility of workers in the United States; it is not a substitute for any other employment eligibility verification requirements. The program will be used for Collier County formal Invitations to Bid (ITB) and Request for Proposals (RFP) including professional services and construction services. Exceptions to the program: • Commodity based procurement where no services are provided. • Where the requirement for the affidavit is waived by the Board of County Commissioners 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. Vendors are also required to provide the Collier County Procurement Services Division an executed affidavit certifying they shall comply with the E-Verify Program. The affidavit is attached to the solicitation documents. If the Bidder/Vendor does not comply with providing both the acceptable E-Verify evidence and the executed affidavit the bidder’s / vendor’s proposal may be deemed non-responsive. Additionally, vendors shall require all subcontracted vendors to use the E-Verify system for all purchases not covered under the “Exceptions to the program” clause above. For additional information regarding the Employment Eligibility Verification System (E-Verify) program visit the following website: http://www.dhs.gov/E-Verify. It shall be the vendor’s responsibility to familiarize themselves with all rules and regulations governing this program. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 24 Vendor acknowledges, and without exception or stipulation, any firm(s) receiving an award shall be fully responsible for complying with the provisions of 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 and with the provisions contained within this affidavit. Failure by the awarded firm(s) to comply with the laws referenced herein or the provisions of this affidavit shall constitute a breach of the award agreement and the County shall have the discretion to unilaterally terminate said agreement immediately. 24. Collier County Local Preference Policy Collier County provides an incentive to local business to enhance the opportunities of local businesses in the award of County contracts. In the evaluation of proposals, the County rewards Vendors for being a local business by granting a ten (10) points incentive in the evaluation criterion points. 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. Under this solicitation proposers desiring to receive local preference will be invited and required to affirmatively state and provide docum entation as set forth in the solicitation in support of their status as a local business. Any proposer who fails to submit sufficient docum entation with their proposal offer shall not be granted local preference consideration f or the purposes of that specific contract award. Except where f ederal or state law, or any other funding source, mandates to the contrar y, Collier County and its agencies and instrumentalities, wil l give preference to local businesses in the following manner. For all purchases of commodities and services procured through a competitive proposal process and not otherwise exem pt from this local preference section, the solicitation shall include a weighted criterion for local preference that equals 10 percent of the total points in the evaluation criteria published in the solicitation. Purchases of prof essional services as defined and identified under subsection 11B.2 (which are subject to Section 287.055, F.S.) and subsection 11B.3 (which are subject to Section 11.45, F.S.) shall not be subject to this local pref e rence section. The vendor must complete and submit with their proposal response the Affidavit for Claiming Status as a Local Business which is included as part of this solicitation. Failure on the part of a vendor to submit this Affidavit with their proposal response will preclude said Vendor from being considered for local preference under this solicitation. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 25 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. 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 26 Attachment 1: Vendor’s Non-Response Statement The sole intent of the Collier County Procurement Services Division is to issue solicitations that are clear, concise and openly competitive. Therefore, we are interested in ascertaining reasons for prospective Vendors not wishing to respond to this solicitation. If your firm is not responding to this RFP, please indicate the reason(s) by checking the item(s) listed below and return this form via email or fax, noted on the cover page, or mail to Collier County Government, Procurement Services Division, 3295 Tamiami Trail E, Naples, FL 34112. We are not responding to Solicitation 17-7133 EMS Billing & Debt Collection Services for the following reason(s): Services requested not available through our company. Our firm could not meet specifications/scope of work. Specifications/scope of work not clearly understood or applicable (too vague, rigid, etc.) Project is too small. Insufficient time allowed for preparation of response. Incorrect address used. Please correct mailing address: ___________________________________________________________________________ _____________________________________________________________________________ _______________________________________________________________________ Other reason(s):_____________________________________________________________ _____________________________________________________________________________ _________________________________________________________________________ ___________________________________________________________________________ Name of Firm: ________________________________________________________ Address: ________________________________________________________ City, State, Zip: ________________________________________________________ Telephone: ________________________________________________________ Email: ________________________________________________________ Representative Signature: ________________________________________________________ Representative Name: _______________________________________ Date ____________ 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 27 Attachment 2: Vendor Check List IMPORTANT: THIS SHEET MUST BE SIGNED. Please read carefully, sign in the spaces indicated and return with your Proposal. Vendor should check off each of the following items as the necessary action is completed: The Proposal has been signed. All applicable forms have been signed and included, along with licenses to complete the requirements of the project. Any addenda have been signed and included. Name of Firm: ________________________________________________________ Address: ________________________________________________________ City, State, Zip: ________________________________________________________ Telephone: ________________________________________________________ Email: ________________________________________________________ Representative Signature: ________________________________________________________ Representative Name: _____________________________________ Date ______________ 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 28 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 procurement’s 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: ____________________________________________________________________________________ Signature and Date:_________________________________________________________________________ Print Name: _______________________________________________________________________________ Title of Signatory: __________________________________________________________________________ State of_____________________________________ County of ____________________________________ SUBSCRIBED AND SWORN to before me this ____________ day of __________________, 20__________, by _______________________________________________, who is personally known to me to be the ________________________________________ for the Firm, OR who produced the following identification ________________________________________. __________________________________________________________ _____________________________ Notary Public Commission Expiration 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 29 Attachment 4: Vendor Declaration Statement BOARD OF COUNTY COMMISSIONERS Collier County Government 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 purpose of establishing a formal contractual relationship between the firm and Collier County, for the performance of all requirements to which the proposal pertains. 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) 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 30 PROPOSAL CONTINUED IN WITNESS WHEREOF, WE have hereunto subscribed our names on this _____ day of _____________, 20 in the County of _______________, in the State of _____________. Firm’s Legal Name: Address: City, State, Zip Code: Florida Certificate of Authority Document Number: Federal Tax Identification Number CCR # or CAGE Code Telephone: FAX: Signature by: (Typed and written) Title: 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_CCNATemplate_12092016 31 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 Collier County 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 Collier County or Lee County: ________ Number of Employees (Including Owner(s) or Corporate Officers):_________ Number of Employees Living in Collier County or Lee (Including Owner(s) or Corporate Officers):_________ 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: _________________________________________ Date: ________________________ Collier or Lee County Address: ___________________________________________________________ Signature: ____________________________________________ Title: ________________________ STATE OF FLORIDA COLLIER COUNTY LEE COUNTY Sworn to and Subscribed Before Me, a Notary Public, for the above State and County, on this __________ Day of ______________, 20_____. _____________________________________________ Notary Public My Commission Expires: ________________________ (AFFIX OFFICIAL SEAL) 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 32 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-Verify 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 ____________________________________________________________________ Print Name Title _______________________ Signature Date _______________________ State of ___________________ County of _________________ The foregoing instrument was signed and acknowledged before me this ______day of ________________, 20___, by _______________________________ who has produced _____________________________ as identification. (Print or Type Name) (Type of Identification and Number) _____________________________________ Notary Public Signature _____________________________________ Printed Name of Notary Public _____________________________________ Notary Commission Number/Expiration 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 RFP_Non_CCNATemplate_12092016 33 Attachment 7: 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 (includin g 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 yo ur business and return with your quote or proposal. 1. General Information (provide all information) Taxpayer Name ___________________________________________________________________________________ (as shown on income tax return) Business Name ___________________________________________________________________________________ (if different from taxpayer name) Address ____________________________________ City _______________________________________________ State ______________________________________ Zip ________________________________________________ Telephone __________________ FAX ______________________ Email __________________________________ Order Information Address ___________________________________ Remit / Payment Information Address ____________________________________________ City __________ State ________ Zip ___________ City _____________ State _________ Zip ______________ FAX ______________________________________ Email _____________________________________ FAX ______________________________________________ Email _____________________________________________ 2. Company Status (check only one) Individual / Sole Proprietor Corporation Partnership Tax Exempt (Federal income tax-exempt entity under Internal Revenue Service guidelines IRC 501 (c) 3) Limited Liability Company Enter the tax classification (D = Disregarded Entity, C = Corporation, P = Partnership) 3. Taxpayer Identification Number (for tax reporting purposes only) Federal Tax Identification Number (TIN) _______________________________________________________________ (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: Under penalties of perjury, I certify that the information shown on this form is correct to my knowledge. Signature ___________________________________________________________ Date _________________________________ Title _______________________________________________________________ Phone Number ________________________ 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 34 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. Employer’s Liability $500,000 single limit per occurrence 3. Commercial General Liability (Occurrence Form) patterned after the current ISO form Bodily Injury and Property Damage $1,000,000 single limit 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 4. Indemnification To the maximum extent permitted by Florida law, the Contractor/Vendor/Consultant 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 Contractor/Vendor/Consultant or anyone employed or utilized by the Contractor/Vendor/Consultant 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. Other insurance as noted: Watercraft $ __________ Per Occurrence 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 Technology Errors & Omissions $1,000,000 Per Occurrence 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 Valuable Papers Insurance $__________ Per Occurrence Employee Dishonesty / Crime $__________ Per Occurrence Including Employee Theft, Funds Transfer Fraud, Include a Joint Loss Payee endorsement naming Collier County. 6. 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. Performance and Payment Bonds For projects in excess of $200,000, bonds shall be submitted with the 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. 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. Collier County must be named as "ADDITIONAL INSURED" on the Insurance Certificate for Commercial General Liability where required. 10. 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. 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 _______________________________________ Date ____________________________ Vendor Signature _________________________________________________________________________ Print Name _________________________________________________________________________ Insurance Agency _________________________________________________________________________ Agent Name _______________________________________ Telephone Number _________________ 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 36 Attachment 9: Reference Questionnaire Solicitation: 17-7133 EMS Billing & Debt Collection Services Reference Questionnaire for: (Name of Company Requesting Reference Information) (Name of Individuals Requesting Reference Information) Name: (Evaluator completing reference questionnaire) Company: (Evaluator’s Company completing reference) Email: FAX: Telephone: Collier County is implementing a process that collects reference information on firms and their key personnel to be used in the selection of firms to perform this project. The Name of the Company listed in the Subject above has listed you as a client for which they have previously performed work. Please complete the survey. Please rate each criteria to the best of your knowledge on a scale of 1 to 10, with 10 representing that you were very satisifed (and would hire the firm/individual again) and 1 representing that you were very unsatisfied (and would never hire the firm/indivdiual again). If you do not have sufficient knowledge of past performance in a particular area, leave it blank and the item or form will be scored “0.” (Please note, references from Collier County staff will not be accepted.) Project Description: ___________________________ Completion Date: _____________________________ Project Budget: _______________________________ Project Number of Days: _______________________ Change Orders - Dollars Added : _________________ Change Orders - Days Added: __________________ Item Citeria Score 1 Ability to manage the project costs (minimize change orders to scope). 2 Ability to maintain project schedule (complete on-time or early). 3 Quality of work. 4 Quality of consultative advice provided on the project. 5 Professionalism and ability to manage personnel. 6 Project administration (completed documents, final invoice, final product turnover; invoices; manuals or going forward documentation, etc.) 7 Ability to verbally communicate and document information clearly and succinctly. 8 Abiltity to manage risks and unexpected project circumstances. 9 Ability to follow contract documents, policies, procedures, rules, regulations, etc. 10 Overall comfort level with hiring the company in the future (customer satisfaction). TOTAL SCORE OF ALL ITEMS 17-7133 EMS Billing & Debt Collection Services RFP_Non_CCNATemplate_12092016 37 1 ADDENDUM #1 Memorandum Date: June 5, 2017 From: Viviana Giarimoustas, Procurement Strategist To: Interested Parties Subject: RFP 17-7133 EMS Billing & Debt Collection Services The following questions were asked 5/25/17 by Samantha Travis, vendor has stated they do not see the answer provided in Q&A. Can you please provide a breakdown of number of transports by service level for the most recent fiscal year? ALS Emergency (A0427) ALS Non-Emergency (A0426) BLS Emergency (A0429) BLS Non-Emergency (A0428) ALS 2 (A0433) SCT (A0434) Treatment No Transport (A0998) Air Ambulance service, rotary wing (A0431) What is your average loaded mileage per ground transport? Air Transport? Please see the following page for additional response. If you require additional information please call Viviana Giarimoustas, Purchasing Department at 239- 252-8375 or by e-mail at VivianaGiarimoustas@colliergov.net . Thank you. Email: VivianaGiarimoustas@colliergov.net Telephone: (239) 252-8375 Charge Summary Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount Mileage Charges ALS Emergency Mileage A0425 ALS1 125317 1171781.2$14,354,319.70 A0425 ALS2 1825 17960$220,010.00 A0425 BLS 1005 7$85.75 A0425 SCT 21 120$1,470.00 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount ALS Non-Emergency Mileage A0425 ALS1 386 3386$41,478.50 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount BLS Emergency Mileage A0425 ALS1 2300 3$36.75 A0425 BLS 22435 172161$2,108,972.25 A0425 SCT 25 227$2,780.75 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount BLS Non-Emergency Mileage A0425 BLS 331 3239$39,677.75 A0425 SCT 3 28$343.00 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount Rotary Wing Air Mileage A0436 Rotary Wing 1438 49571$5,452,810.00 Mileage Charges 155086$22,221,984.45 Charge Category Charge Description Charge HcpcsLevel Of Service NumberMileage UnitCharge Amount Non Transport Charges Treatment / No-Transport A0998 TNT 1023 0$179,025.00