CITY COUNCIL AGENDA ITEM
ACTION REQUESTED:
title
Approve the award of RFP 25-025, EMS Billing Software Solution, to ImageTrend for an amount not to exceed $168,268.94 and for a five-year term
body
DEPARTMENT: Fire Department
SUBMITTED BY: Mark Puknaitis, Fire Chief
BOARD/COMMISSION REVIEW:
N/A
BACKGROUND:
Per Naperville Municipal Code Section 1-8B-4, the Fire Department is responsible for maintaining and providing ambulance (EMS) and other emergency services (non-EMS) within the City, and within such additional areas which are to be served under contract. The Code also establishes the amounts to charge residents and non-residents for responding with City resources.
Historically, the City has outsourced EMS and non-EMS billing services due to staffing limitations in both the Fire and Finance departments. By outsourcing, the City ensured dedicated collection efforts, compliance with Medicaid/Medicare requirements, private insurance regulations, and industry best practices. Non-EMS services billed and collected included specialized responses such as motor vehicle accidents and vehicle fires.
The City currently outsources this service; however, the Fire Department has experienced a decline in collected revenue and an increase in outstanding accounts receivable resulting from poor denial management and untimely filing issues. These issues have negatively impacted the City’s revenue cycle and prompted the Fire Department to seek alternative solutions for ambulance billing services.
Compounding the problem, the ambulance billing industry has consolidated significantly in recent years, leaving few viable options for contracting with a third-party vendor. Other fire departments in the area have reported similar challenges. This further reinforces the decision to pilot in-house billing operations.
Performance Data (2023-2025):
|
Year |
Call Volume |
Avg. Collected per Trip |
Total AR |
Total Revenue |
|
2023 |
10,913 |
$620 |
$5,038,180 |
$8,617,891 |
|
2024 |
11,639 |
$541 |
$5,527,785 |
$8,391,572 |
|
2025 (YTD) |
7,986 |
$504 |
$6,328,128 |
$5,823,497 |
In March 2025, the Fire Department issued RFP 25-025 EMS Billing Software Solution. This solicitation was issued to select a vendor to provide a software platform that would allow staff to perform EMS billing in-house.
DISCUSSION:
|
Advertisement Date: |
March 10, 2025 |
Notices Sent: |
131 |
|
Opening Date: |
April 3, 2025 |
Planholders: |
24 |
|
|
|
Proposals Received: |
5 |
Responses were received from the following vendors:
|
ESO Solutions Inc |
MP Cloud Technologies |
|
Contenda |
ImageTrend |
|
Forte Holdings Inc |
A selection team comprised of staff from the Fire, IT, and Finance Departments evaluated the responses, which were scored based upon the criteria set forth in the RFP:
1. Capability, Capacity and Qualifications of the Proposer (20%)
2. Suitability and Quality of the Software (30%)
2. Suitability and Quality of the Approach (30%)
3. Milestones and Deliverables (20%)
After reviewing and scoring the responses, the selection committee invited the top three vendors, MP Cloud Technologies, ImageTrend, and ESO Solutions, to conduct demonstrations. Following the completion of the demonstrations, the selection committee rescored the vendors. The table below provides a summary of the final qualification scores:
|
Vendor |
Qualification Score |
|
MP Cloud Technologies |
86.5 |
|
ImageTrend |
85.5 |
|
ESO Solutions |
68.7 |
The initial scoring ranked MP Cloud as the top vendor. Staff was impressed with the software demonstration, particularly its AI integration for coding. However, during contract negotiations, it became clear that the additional costs and required external vendor agreements outside of the MP Cloud contract were not acceptable.
As such, negotiations with ImageTrend, the second-highest scoring vendor, were initiated. Given that ImageTrend is already the primary software provider for EMS Patient Care Reports through the department’s hospital system, its solution offered the advantage of simplified integration with the existing EMS software.
Once the ImageTrend software is implemented, the Fire Department will begin a six-month pilot program billing Medicaid and non-EMS calls in-house. If successful, a transition to fully in-house EMS and non-EMS billing would occur.
The term of the award is five years from the date of execution of the order form. The Fire Department selected the five-year agreement option with ImageTrend to secure a better rate, as the typical year-over-year cost increase is 7%, but under the five-year term, the annual increase is limited to 5%. If the pilot were unsuccessful, or the City opted to remain with a third-party service provider, the contract could be terminated under a non-appropriations clause.
FISCAL IMPACT:
CIP #: N/A
The ImageTrend billing software will be expensed to the Software and Hardware Maintenance account listed below. Moving forward, costs associated with commissions paid to third-party vendors will decrease, thus offsetting the cost of the software solution. Currently, the City pays about $330,000 per year for billing commissions. The Fire Department is confident that in-house billing services will generate higher revenue at a reduced cost.
|
Account Number |
Fund Description |
Total Budget Amount |
|
22101100-532312 |
General Fund |
$259,850 |