A. Billing 1. Retrieve the electronic billing file and other billing related information from the County via a web-based patient care reporting software or equal, or a process approved by Dallas County EMS. 2. Prepare and submit accurate and complete insurance claims according to the rates established by the County, guidelines and procedures established by the Vendor and the County, and all applicable laws and regulations including those for Medicare, Medicaid, and any other applicable carriers including both commercial and private insurances. Patient Care Reports submitted with complete and accurate information will be filed with third party entities within two (2) days of receipt from the County. The first contract shall include submittal of retro-active billing at a date to be determined. 3. Verification and Missing Information Follow-up: The Vendor will provide all labor, materials and equipment for verification of the downloaded transport information and patient information. The Vendor will promptly notify Dallas County EMS, regarding the missing information required to complete the billing process. The Vendor will file any claim reviews and represent Dallas County in Medicare/Medicaid appeals up to and including cases before and ALJ (Administrative Law Judge). The Vendor will also respond to any billing and collections questions. 4. The Vendor will supply, and update weekly, files compatible with Iowa Offset Program to the Service for the Service to upload weekly to the State’s Iowa Offset Program’s FTP site. These files will contain outstanding debtors to Dallas County EMS with the information required by the Iowa Offset Program. 5. The Vendor will respond to all requests for Patient Care Reports made to Dallas County EMS. When authorized by Dallas County EMS policy, the Vendor can charge, collect and keep any and all appropriate and reasonable fees from the requesting party. 6. The Vendor will upload data from Patient Care Reports to the National Emergency Medical Services Information System on a timely manner as required by the State. 7. The Vendor will work with the Service to find and assist with implementation of alternate methods of collecting funds that may arise from local, State or Federal programs that may be offered. a. Example: the Ground Emergent Medical Transportation Program. 8. Prepare and mail invoices to patients/parties responsible for co-pays and/or deductibles, private pay, and uninsured patients, or as directed by Dallas County. 9. Post payments to the appropriate accounts and provide payment posting and revenue reports to the County. Vendor will ensure that all checks are scanned by a bonded employee and sent electronically to the bank of Dallas County’s choice. Copies of the checks and EOBs are given to the Dallas County account manager to be posted and reconciled to the patient accounts. Please explain your process. 10. Provide the County with an itemized report of all invoices and claims billed, monies collected and outstanding balances on a monthly basis to and in a format required by the County.
