Specifications include, but are not limited to: 1. The Billing Services Provider will prepare and submit accurate and complete insurance claims electronically (preferred) or manually, to include but not limited to Medicare, Medicaid, and any other applicable carriers including both commercial and private insurances. Claims submitted with complete and accurate information will be filed with third party entities within two days of receipt from the City of Carlsbad. 2. Verification and Missing Information Follow-Up: The EMS Billing Services Provider will provide all labor, materials and equipment for verification of the downloaded transport information and patient information. The EMS Billing Services Provider will gather missing patient information by, but not limited to, gathering electronic patient information from the hospital, search the billing service provider's billing data base; contacting the medical facility, interfacing with insurance provider's data systems, or by direct patient, family member or responsible party contact. When contact is made with the appropriate party, the EMS Billing Services Provider will verify and correct all patient information. To the extent permitted under HIPAA and other laws, the billing services provider shall not unduly withhold information from EMS's designated representatives when such information is needed to complete the billing process. 3. Prepare and mail invoices to patients responsible for co-pays and/or deductibles, private pay, and uninsured patients.
