Town of Wiscasset-Ambulance Service Billing-Emergency and Non-Emergency

Start Date: February 03, 2025
End Date: February 20, 2025
Type: Requests for Proposals (RFP)
Phone: 207-882-8200
Email: [email protected]

1. INTRODUCTION 

The Town of Wiscasset (hereinafter referred to as “the Town”) is requesting proposals from qualified firms to provide ambulance service billing for emergency and non-emergency medical transportation and service. The selected firm will be responsible for accurate, efficient, and compliant billing and revenue collection for the ambulance service owned by the Town. The Town operates one ambulance 24/7, with a second ambulance available should call volumes demand it. We respond to approximately 1,000 service calls per year and serve the towns of Alna, Dresden, and Westport. We provide mutual aid to surrounding towns.  

2. SCOPE OF WORK 

The selected contractor will be required to provide the following services: 

A. BILLING SERVICES

1. Claims Processing: 

- Accurately bill Medicare, Medicaid, private insurance, and self-pay patients in compliance with all applicable laws and regulations. 

            - Submit claims electronically when possible. 

2. Payment Posting & Reconciliation: 

- Accurately post payments from all sources. 

 - Provide reconciliation of deposits with billing records. 

3. Denial Management & Appeals: 

              - Identify and correct denied claims. 

              - Resubmit corrected claims and follow up on appeals as necessary. 

4. Patient Invoicing & Collections: 

  - Generate patient invoices and provide multiple payment options.

- Implement a process for follow-up on unpaid accounts that do not harass or intimidate those unable to pay 

5. Compliance & Regulatory Adherence: 

- Ensure compliance with all federal, state, and local laws, including HIPAA, Medicare, Medicaid, and the Affordable Care Act. 

  - Stay updated on changes in medical billing and ambulance reimbursement policies. 

B. Reporting & Transparency 

1. Provide monthly financial reports, including: 

              - Gross charges and payments received. 

              - Detailed aging of accounts receivable. 

              - Claim denial and appeal success rate. 

2. Provide quarterly and annual summaries of revenue and trends. 

3. Maintain audit-ready records and support external audits or financial reviews. 

C. Customer Service 

1. Offer a dedicated customer service line for billing inquiries. 

2. Provide support for patients needing help with insurance claims or financial assistance. 

3. Maintain a secure online payment portal. 

3. MINIMUM QUALIFICATIONS 

Interested firms must demonstrate the following: 

- Experience in ambulance billing for municipal or emergency service agencies. 

- Compliance with all state and federal billing regulations. 

- Capability to integrate with existing EMS reporting systems. 

- Secure and HIPAA-compliant data handling. 

- Proven track record of maximizing reimbursement while maintaining fair and ethical collection practices.        

4. PROPOSAL REQUIREMENTS 

Interested firms must submit a proposal including: 

1. Company Overview 

            - Legal name, address, and contact information. 

             - Brief history of the company and relevant experience. 

2. Technical Approach & Work Plan 

            - Description of billing workflow. 

              - Compliance policies and procedures. 

             - Technology/software used. 

3. Personnel & Qualifications 

             - Key team members, their roles, and experience. 

4. References 

   - At least three references from municipalities or EMS providers with similar service needs. 

5. Fee Proposal 

             - Pricing structure (percentage of revenue, per-claim fee, or other models). 

             - Any additional costs for software, setup, or support. 

5. EVALUATION CRITERIA 

Proposals will be evaluated based on: 

- Experience & Qualifications (30%) 

- Technical Approach & Compliance (30%) 

- Fee Proposal (20%) 

- Customer Service & Transparency (20%) 

 6. SUBMISSION DETAILS 

- Proposal Submission Deadline: 4:00 PM February 20th, 2025

- Submission Method: via courier or USPS Town Manager 51 Bath Road, Wiscasset, ME 04578 please mark the envelope “ambulance billing”

- Contact for Questions: Dennis Simmons, town manager [email protected] 207-882-8200. During the RFP process, questions or requests for information must be conducted through the town manager. Direct contact with other town employees is a cause for disqualification.

 7. TERMS & CONDITIONS 

- The Town reserves the right to reject any or all proposals. 

- The selected firm will enter into a formal contract for an initial term of 1 year, with renewal options. 

- The contractor shall maintain professional liability insurance.