CITY COUNCIL AGENDA ITEM
ACTION REQUESTED:
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Approve the award of Option Year One to Contract 17-039, EMS and Non-EMS Billing Services, to Andres Medical Billing, Ltd. for an amount not to exceed 3.1% of total dollars collected for EMS billing services and to Fire Recovery USA, LLC for an amount not to exceed 20% of total dollars collected for non-EMS billing services
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DEPARTMENT: Fire Department
SUBMITTED BY: Mark Puknaitis, Chief
BOARD/COMMISSION REVIEW:
N/A
BACKGROUND:
The City began outsourcing billing and collection support for ambulance transport and emergency response (EMS services) in 2004. In 2017, Fire Department response to motor vehicle accidents and vehicular fires (non-EMS services) was added. The City uses service providers rather than in-house staff to bill and collect for EMS and non-EMS services because of the specialized nature of the billings. The vendors in this market have experience filing with Medicare, Medicaid, and other private insurance carriers and claims processing centers, which increases the collection of revenue for the City.
The City Council awarded Contract 17-039 to Andres Medical Billing, Ltd (Andres) and Fire Recovery USA, LLC (Fire Recovery) on June 20, 2017 for a three-year term from July 1, 2017 to June 30, 2020, with two, one-year options to extend. The purpose of the contracts is to partner with a service provider to provide a turn-key solution to bill and collect EMS and non-EMS fees for the City.
DISCUSSION:
During the original term of the contract, Andres and Fire Recovery successfully processed EMS and non-EMS claims for the City.
EMS Services (Andres):
During the first 33 months of the three-year contract, Andres billed $39,250,947. Per the City's ordinance and Medicare/Medicaid maximum allowances for EMS services, Andres is required to write off a significant portion of the billable charges. Of the $39,250,947 billed, $4,560,374 was written off for City residents and another $17,805,061...
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