HomeMy WebLinkAbout21-Fire Department
CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTIONO RIG I N A L
From:
Mat Fratus, Deputy Chief
Subject: Resolution authorizing the execution of an
agreement and issuance of an annual purchase
order to Advanced Data Processing, Inc. to provide
billing services for first responder, paramedic, and
membership program fees.
Dept:
Date:
Fire
August 26, 2008
MCIC Meeting Date:
September 15, 2008
Synopsis of Previous Council Action:
07/07/08
07/02/07
05115106
10/18/04
Resolution 2008-275 amending the city's master fee schedule, resolution number 2008-149
adjusting the emergency medical services (EMS) user fees.
Resolution 2007-225 authorization to extend the agreement with Advance Data Processing Inc. to
provide EMS billing services from July I, 2007 through June 30, 2008.
Resolution 2006-147 Second reading of ordinance repealing Chapter 3.72 of the San Bernardino
Municipal Code or resolution adopting revised EMS User Fee Program and authorizing execution
of amendment to agreement with ADPI.
Resolution 2004-333 approving the billing service agreement with Advanced Data Processing
West, Inc. for first responder, paramedic, and membership program fees.
RECOMMENDATION:
Adopt resolution.
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Contact Person: Mat Fratus. Deputv Chief
Phone: (909) 384-5286
Supporting data attached: Staff Report, Resolution, Agreement, and Proposal
Ward: Citywide
$111.250 (Note: net revenues
FUNDING REQUIREMENTS: Amount:
for program, after reducing for this contract, are estimated to be $333,750).
Source:
Council Notes:
(Ace!. No.) 001-201-5505
Other Professional Services
Finance:
Jr6SP 2t!:;o/?-.3s8
Agenda Item No.
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STAFF REPORT
SUBJECT
Resolution authorizing the execution of ao agreement aod issuance of ao aonual purchase
order to Advaoced Data Processing, Inc. to provide billing services for first responder,
paramedic, and membership program fees.
BACKGROUND
Pursuant to the City's bidding process, Advaoced Data Processing, Inc. (AD PI) was
awarded ao agreement to provide billing services for emergency medical service (EMS)
user fees under request for quote #F 05-008. The agreement was entered into on October
18,2004 for billing services starting July I, 2004 aod ending June 30, 2007.
On July 2, 2007, the Mayor aod Common Council approved resolution #2007-225 to
extend the agreement with ADPI to continue providing billing services for EMS from
July I, 2007 through June 30, 2008. During this extended period, Fire was considering
alternate options to continue billing services for EMS user fees aod the membership
program. Fire's research determined that it was not feasible to charge citizens a fee via
the telephone system. Nor, having American Medical Response compaoy include our
fees when they respond to ao emergency call within the city limits. Therefore, Fire
decided to go out to bid to solicit proposals for the city's EMS billing services.
On June 18,2008, a Request for Quote (RFQ) #F-08-21 was issued to solicit formal bids
for the Fire Department's Emergency Medical Services (EMS) Billing Service. Notices
inviting bids from qualified vendors were distributed to the Sao Bernardino Area
Chamber of Commerce, the City's Web Site, and advertised in The San Bernardino
County Sun Newspaper. The RFQ #F-08-21 packages were mailed to nine (9) vendors
including three (3) local vendors within the city limits. On July 16, 2008, the City
received three (3) bid responses; two (2) complete proposals aod one (1) no bid.
An evaluation committee was developed to review the bid proposals aod rated them on a
scale of 0-100. Compliaoce with technical specifications, price, aod experience were
considered. Advanced Data Processing Incorporation received the highest over-all
evaluation for EMS billing services. AD PI is able to meet the required technical
specifications aod has experienced staff.
Pursuaot to the City's bidding process, it is recommended that ADPI be awarded the
agreement under addendum RFQ #F-08-21 for EMS billing services. Fire staff
recommends that ao annual purchase order be issued for one year with the option of
renewing the contract aonually for up to three years for EMS billing services.
The term of the agreement is for one year, from July I, 2008 through June 30, 2009, with
automatic renewals for successive three single-year options unless either party gives the
other party notice of cancellation. Since implementation date of the agreement has
passed, the resolution ratifies any action taken from July 1, 2008 through the date that the
agreement is executed. The agreement provides that either party may terminate this
agreement by giving not less than thirty (30) days written notice to the other party of said
intent to terminate.
FINANCIAL IMPACT
On July 7, 2008, the EMS user fee policy was revised to authorize the approved billing
company to bill all patients that do not qualify for the low-income utility tax exemptions.
An additional $200,000 in revenue is anticipated from revising the EMS user fee program
and has been factored in the FY 08/09 budget. Therefore, the adopted revenue projection
for the EMS user fee for FY 08-09 is $430,000. Also factored into the FY 2008-09
budget is $15,000 in projected revenue from the membership program. Combined,
annual gross revenue is projected to be $445,000.
Compensation to ADPI is a percentage not to exceed twenty-five percent (25%) of
amounts collected on behalf of the Fire Department under the billing program. Therefore,
it is estimated that approximately $111,250 of the annual gross revenue will be paid to
ADPI for billing services. Net projected revenue, (after subtracting anticipated contract
costs ofapprox. $111,250 from gross projected revenue of $445,000) is $333,750.
Funds to cover this contract cost were included in the Fire Department's FY 2008-09
Budget, account #001-201-5505 (Other Professional Services). Since the contractor is
paid based on a percentage of revenues collected, should revenues exceed projections
there will be a corresponding increase in contract costs. However, the increased revenue
will more than offset any possible increases in contract costs.
RECOMMENDATION
Adopt resolution.
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RESOLUTION NO.
t(Q)[PV
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RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
BERNARDINO AUTHORIZING THE EXECUTION OF AN AGREEMENT AND
ISSUANCE OF AN ANNUAL PURCHASE TO ADVANCED DATA PROCESSING, INC.
(ADPI) FOR FIRST RESPONDER, PARAMEDIC, AND MEMBERSHIP PROGRAM FEES.
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BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
BERNARDINO AS FOLLOWS:
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SECTION J. Advanced Data Processing, Inc., is the best responsible bidder regarding billing
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services for first responder, paramedic, and membership program fees, in accordance with Bid
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Specification #F -08-21;
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SECTION 2. The City Manager is hereby authorized and directed to execute on behalf of City
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a Vendor Services Agreement with Advanced Data Processing, Inc., a copy of which is attached
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hereto, marked Attachment "A" and incorporated herein by reference as fully as though set forth at
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length;
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SECTION 3. Said agreement will be for EMS billing collection services for the period of July
],2008 through June 30, 2008 with two one-year renewal options Any action taken between July],
2008 and the date that the agreement is executed is hereby ratified. All other bids are hereby rejected.
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SECTION 4. The Purchasing Manager is authorized to issue an annual purchase order to
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Advanced Data Processing, Inc. The Annual Purchase Order shall incorporate by reference this
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Resolution by number and Bid Specification #F-08-21.
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SECTION 5. The authorization to execute the above referenced Agreement and Annual
2]
Purchase Order is rescinded if the parties to the Agreement fail to execute it within sixty (60) days of
the passage of this Resolution.
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RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
BERNARDINO AUTHORIZING THE EXECUTION OF '\'''1 AGREEMENT AL'\'D
ISSUANCE OF AN ANNUAL PURCHASE TO ADVANCED DATA PROCESSING, INC.
(AD PI) FOR FIRST RESPONDER, PARAMEDIC, AND MEMBERSHIP PROGRAM FEES.
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,
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I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor and
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Common Council of the City of San Bernardino at a
meeting thereof, held on the
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day of
, 2008, by the following vote, to wit:
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8 COUNCIL MEMBERS:
NAYS
ABSTAIN ABSENT
AYES
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ESTRADA
II
BAXTER
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BRINKER
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DERRY
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KELLEY
IS
JOHNSON
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MCCAMMACK
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Rachel G. Clark, City Clerk
City of San Bernardino
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The foregoing Resolution is hereby approved this
day of
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,2008.
Patrick J. Morris, Mayor
City of San Bernardino
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Approved as to form:
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JAMES F. PENMAN, City Attorney
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VENDOR SERVICE AGREEMENT
This Vendor Service Agreement is entered into this 1st day of July, 2008, between
Advanced Data Processing, IDe ("AD PI") and the CITY OF SAN BERNARDINO
("CITY)".
WITNESSETH:
A. WHEREAS, CITY has need for billing services for first responder, paramedic,
and membership program fees and,
S. WHEREAS, ADPI is competent, experienced and able to perform said services:
and,
C. WHEREAS, ADPl has provided the most advantageous and best responsible
proposal for the providing of such services;
NOW THEREFORE, the parties hereto agree as follows:
1. SCOPE OF SERVICES.
For the remuneration set forth in Paragraph 2, San Bernardino hereby engages the
services of ADPI to furnish billing services for first responder, paramedic, and membership
program fees in accordance with Proposal Package for RFP F-08-21: EMS Billing Services,
submitted by ADPI, DATED July 16, 2008, a copy of which is attached hereto as Attachment
"I" and by this reference made a part hereof..
2. COMPENSATION AND EXPENSES.
a. For the services delineated above, the CITY, upon presentation of an invoice, shall pay
ADPI an amount in accordance with the Price Form attached hereto as Attachment "2,"
specifically, 25% of the net amount collected for services rendered by the City under this
Agreement.
b. ADPI shall provide City of San Bernardino Fire Dept with a monthly invoice in arrears
and shall be provided payment within thirty (30) days therefrom. CITY retains the right
to challenge all or any part of an invoice.
c. No other expenditures made by ADPI shall be reimbursed by CITY.
3. TERM; TERMINATION.
The term of this Agreement shall be for a period of one year with an option for two one-
year extensions. The options shall be exercised by mutual written agreement of the parties
executed prior to the termination of the current Agreement.
This Agreement may be terminated at any time by thirty (30) days' written notice by
either party. The terms of this Agreement shall remain in force unless mutually amended in
writing by the parties. The duration of this Agreement may be extended on the same terms and
conditions, including pricing, with the prior written consent of both parties.
I
Exhibit "A"
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4. INDEMNITY.
ADPI agrees to and shall indemnify and hold the City, its elected officials, employees,
agents or representatives, free and harmless from all claims, actions, damages and liabilities of
any kind and nature arising from bodily injury, including death, violations of HIPP A or right to
privacy, or property damage, based or asserted upon any actual or alleged act or omission of
ADPI, its employees, agents, or subcontractors, relating to or in any way connected with the
accomplishment of the work or performance of services under this Agreement, unless the bodily
injury or property damage was actually caused by the sole negligence of the City, its elected
officials, employees, agents or representatives. As part of the foregoing indemnity, ADPI agrees
to protect and defend at its own expense, including attorney's fees, the City, its elected officials,
employees, agents or representatives from any and all legal actions based upon such actual or
alleged acts or omissions. ADPI hereby waives any and all rights to any types of express or
implied indemnity against the City, its elected officials, employees, agents or representatives,
with respect to third party claims against the ADPI relating to or in any way connected with the
accomplishment of the work or performance of services under this Agreement.
5. INSURANCE.
While not restricting or limiting the foregoing, during the term of this Agreement, ADPI
shall maintain in effect policies of comprehensive public, general and automobile liability
insurance, in the amount of $1,000,000.00 combined single limit, and statutory worker's
compensation coverage, and shall file a Certificate of Insurance and copies of said policies with
the CITY's Risk Manager prior to undertaking any work under this Agreement. CITY shall be
set forth as an additional named insured in each policy of insurance provided hereunder. The
Certificate of Insurance furnished to the CITY shall require the insurer to notify CITY of any
change or termination in the policy.
6. NON-DISCRIMINATION.
In the performance of this Agreement and in the hiring and recruitment of employees,
ADPI shall not engage in, nor permit its officers, employees or agents to engage in,
discrimination in employment of persons because of their race, religion, color, national origin,
ancestry, age, mental or physical disability, medical condition, marital status, sexual gender or
sexual orientation, or any other status protected by law.
7. INDEPENDENT CONTRACTOR
ADPI shall perform work tasks provided by this Agreement at the direction of the Fire
Chief, but for all intents and purposes ADPI shall be an independent contractor and not an agent
or employee of the CITY. ADPI shall secure, at its expense, and be responsible for any and all
payment of Income Tax, Social Security, State Disability Insurance Compensation,
Unemployment Compensation, and other payroll deductions for ADPI and its officers, agents,
and employees, and all business license, if any are required, in connection with the services to be
performed hereunder.
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8. BUSINESS REGISTRUION CERTIFICATE AND OTHER REQUIREMENTS.
ADPI warrants that it possesses or shall obtain, and maintain a business registration
certificate pursuant to Chapter 5 of the Municipal Code, and any other licenses, permits,
qualifications, insurance and approval of whatever nature that are legally required of ADPI to
practice its business or profession.
9. NOTICES.
Any notices to be given pursuant to this Agreement shall be deposited with the United
States Postal Service, postage prepaid and addressed as follows:
Fire Chief Michael 1. Conrad and
EMS Coordinator Bernard Horak
City of San Bernardino Fire Department
200 E. Third Street
San Bernardino, CA 92410
Advanced Data Processing, Inc
6451 North Federal Highway, Suite 1002
Fort Lauderdale, FL 33308
Nothing in this paragraph shall be construed to prevent the giving of notice by personal
servIce.
TO THE CITY:
TO ADPI:
10. ATTORNEYS' FEES
In the event that litigation is brought by any party in connection with this Agreement, the
prevailing party shall be entitled to recover from the opposing party all costs and expenses,
including reasonable attorneys' fees, incurred by the prevailing party in the exercise of any of its
rights or remedies hereunder or the enforcement of any of the terms, conditions or provisions
hereof. The costs, salary and expenses of the City Attorney and members ot his office in
enforcing this Agreement on behalf of the CITY shall be considered as "attorneys' fees" for the
purposes of this paragraph.
11. ASSIGNMENT.
ADPI shall not voluntarily or by operation of law assign, transfer, sublet or encumber all
or any part of the ADPI's interest in this Agreement without CITY's prior written consent. Any
attempted assigrunent, transfer, subletting or encumbrance shall be void and shall constitute a
breach of this Agreement and cause for the termination of this Agreement. Regardless of
CITY's consent, no subletting or assigrunent shall release ADPI of ADPI's obligation to perform
all other obligations to be performed by ADPI hereunder for the term of this Agreement.
12. VENUE.
The parties hereto agree that all actions or proceedings arising in connection with this
Agreement shall be tried and litigated either in the State courts located in the County of San
Bernardino, State of California or the U.S. District Court for the Central District of California,
Riverside Division. The aforementioned choice of venue is intended by the parties to be
mandatory and not permissive in nature.
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13. GOVERNING LAW.
This Agreement shall be governed by the laws of the State of California.
14. SUCCESSORS AND ASSIGNS.
This Agreement shall be binding on and inure to the benefit of the parties to this
Agreement and their respective heirs, representatives, successors, and assigns.
15. HEADINGS.
The subject headings of the sections of this Agreement are included for the purposes of
convemence only and shall not affect the construction or the interpretation of any of its
prOVISIons.
16. SEVERABILITY.
If any provision of this Agreement is determined by a court of competent jurisdiction to
be invalid or unenforceable for any reason, such determination shall not affect the validity or
enforceability of the remaining ierms and provisions hereof or of the offending provision in any
other circumstance, and the remaining provisions of this Agreement shall remain in full force
and effect.
17. REMEDIES; WAIVER.
All remedies available to either party for one or more breaches by the other party are and
shall be deemed cumulative and may be exercised separately or concurrently without waiver of
any other remedies. The failure of either party to act in the event of a breach of this Agreement
by the other shall not be deemed a waiver of such breach or a waiver of future breaches, unless
such waiver shall be in writing and signed by the party against whom enforcement is sought.
18. ENTIRE AGREEMENT; MODIFICATION.
This Agreement, including Attachments "I" and "2," constitutes the entire' agreement and
understanding between the parties, and supersedes any prior agreements and understandings
relating to the subject matter of this Agreement. To the extent there is a conflict between this
Agreement and the attachments, the contents of this Agreement shall have priority. This
Agreement may be modified or amended only by a written instrument executed by all parties to
this Agreement.
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VENDOR SERVICES AGREEMENT
ADVA1'iCED DATA PROCESSING, INC., and CITY OF SAN BER.'\'ARDlNO
FOR EMS BILLING SERVICES
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day
and date first above shown.
Dated:
Dated:
ADV ANCED DATA PROCESSING, INC.
CITY OF SAN BERNARDINO
By:
By:
Its:
Lori Sassoon
Acting City Manager
Approved as to Form:
James F. Penman, City Attorney
\
By:
VENDOR SERVICE AGREEMENT
This Vendor Service Agreement is entered into this 1st day of July, 2008, between
Advanced Data Processing, Inc ("ADPI") and the CITY OF SAN BERNARDINO
("CITY)".
WITNESSETH:
A. WHEREAS, CITY has need for billing services for first responder, paramedic,
and membership program fees and,
B. WHEREAS, ADPI is competent, experienced and able to perform said services:
and,
C. WHEREAS, ADPI has provided the most advantageous and best responsible
proposal for the providing of such services;
NOW THEREFORE, the parties hereto agree as follows:
1. SCOPE OF SERVICES.
For the remuneration set forth in Paragraph 2, San Bernardino hereby engages the
services of ADPI to furnish billing services for first responder, paramedic, and membership
program fees in accordance with Proposal Package for RFP F-08-21: EMS Billing Services,
submitted by ADPI, DATED July 16, 2008, a copy of which is attached hereto as Attachment
"I" and by this reference made a part hereof..
2. COMPENSATION AND EXPENSES.
a. For the services delineated above. the CITY, upon presentation of an invoice, shall pay
ADPI an amount in accordance with the Price Form attached hereto as Attachment "2,"
specifically, 25% of the net amount collected for services rendered by the City under this
Agreement.
b. ADPI shall provide City of San Bernardino Fire Dept with a monthly invoice in arrears
and shall be provided payment within thirty (30) days therefrom. CITY retains the right
to challenge all or any part of an invoice.
c. No other expenditures made by ADPI shall be reimbursed by CITY.
3. TERM; TERMINATION.
The term of this Agreement shall be for a period of one year with an option for two one-
year extensions. The options shall be exercised by mutual written agreement of the parties
executed prior to the termination of the current Agreement.
This Agreement may be terminated at any time by thirty (30) days' written notice by
either party. The terms of this Agreement shall remain in force unless mutually amended in
writing by the parties. The duration ofthis'Agreement may be extended on the same terms and
conditions. including pricing, with the prior written consent of both parties.
4. INDEMNITY.
ADPI agrees to and shall indemnify and hold the City, its elected officials, employees,
agents or representatives, free and harmless from all claims, actions, damages and liabilities of
any kind and nature arising from bodily injury, including death, violations of HlPP A or right to
privacy, or property damage, based or asserted upon any actual or alleged act or omission of
ADPI, its employees, agents, or subcontractors, relating to or in any way connected with the
accomplishment of the work or performance of services under this Agreement, unless the bodily
injury or property damage was actually caused by the sole negligence of the City, its elected
officials, employees, agents or representatives. As part of the foregoing indemnity, ADPI agrees
to protect and defend at its own expense, including attorney's fees, the City, its elected officials,
employees, agents or representatives from any and all legal actions based upon such actual or
alleged acts or omissions. ADPI hereby waives any and all rights to any types of express or
implied indemnity against the City, its elected officials, employees, agents or representatives,
with respect to third party claims against the ADPI relating to or in any way connected with the
accomplishment of the work or performance of services under this Agreement.
5. INSURANCE.
While not restricting or limiting the foregoing, during the term of this Agreement, ADPI
shall maintain in effect policies of comprehensive public, general and automobile liability
insurance, in the amount of $1,000,000.00 combined single limit, and statutory worker's
compensation coverage, and shall file a Certificate of Insurance and copies of said policies with
the CITY's Risk Manager prior to undertaking any work under this Agreement. CITY shall be
set forth as an additional named insured in each policy of insurance provided hereunder. The
Certificate of Insurance furnished to the CITY shall require the insurer to notify CITY of any
change or termination in the policy.
6. NON-DISCRIMINATION.
In the performance of this Agreement and in the hiring and recruitment of employees,
ADPI shall not engage in, nor permit its officers, employees or agents to engage in,
discrimination in employment of persons because of their race, religion, color, national origin,
ancestry, age, mental or physical disability, medical condition, marital status, sexual gender or
sexual orientation, or any other status protected by law.
7. INDEPENDENT CONTRACTOR.
ADPI shall perform work tasks provided by this Agreement at the direction of the Fire
Chief, but for all intents and purposes ADPI shall be an independent contractor and not an agent
or employee of the CITY. ADPI shall secure, at its expense, and be responsible for any and all
payment of Income Tax, Social Security, State Disability Insurance Compensation,
Unemployment Compensation, and other payroll deductions for ADPI and its officers, agents,
and employees, and all business license, if any are required, in connection with the services to be
performed hereunder.
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8. BUSINESS REGISTRATION CERTIFICATE AND OTHER REQUIREMENTS.
ADPI warrants that it possesses or shall obtain, and maintain a business registration
certificate pursuant to Chapter 5 of the Municipal Code, and any other licenses, permits,
qualifications, insurance and approval of whatever nature that are legally required of ADPI to
practice its business or profession.
9. NOTICES.
Any notices to be given pursuant to this Agreement shall be deposited with the United
States Postal Service, postage prepaid and addressed as follows:
Fire Chief Michael J. Conrad and
EMS Coordinator Bernard Horak
City of San Bernardino Fire Department
200 E. Third Street
San Bernardino, CA 92410
Advanced Data Processing, Inc
6451 North Federal Highway, Suite 1002
Fort Lauderdale, FL 33308
Nothing in this paragraph shall be construed to prevent the giving of notice by personal
servIce.
TO THE CITY:
TO ADPI:
10. ATTORNEYS' FEES
In the event that litigation is brought by any party in connection with this Agreement, the
prevailing party shall be entitled to recover from the opposing party all costs and expenses,
including reasonable attorneys' fees, incurred by the prevailing party in the exercise of any of its
rights or remedies hereunder or the enforcement of any of the terms, conditions or provisions
hereof. The costs, salary and expenses of the City Attorney and members of his office in
enforcing this Agreement on behalf of the CITY shall be considered as "attorneys' fees" for the
purposes of this paragraph.
1 I. ASSIGNMENT.
ADPI shall not voluntarily or by operation of law assign, transfer, sublet or encumber all
or any part of the ADPI's interest in this Agreement without CITY's prior written consent. Any
attempted assignment, transfer, subletting or encumbrance shall be void and shall constitute a
breach of this Agreement and cause for the termination of this Agreement. Regardless of
CITY's consent, no subletting or assignment shall release ADPI of ADPI's obligation to perform
all other obligations to be performed by ADPI hereunder for the term of this Agreement.
12. VENUE.
The parties hereto agree that all actions or proceedings arising in connection with this
Agreement shall be tried and litigated either in the State courts located in the County of San
Bernardino, State of California or the U.S. District Court for the Central District of California
,
Riverside Division. The aforementioned choice of venue is intended by the parties to be
mandatory and not permissive in nature.
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13. GOVERNING LAW.
This Agreement shall be governed by the laws of the State of California.
14. SUCCESSORS AND ASSIGNS.
This Agreement shall be binding on and inure to the benefit of the parties to this
Agreement and their respective heirs, representatives, successors, and assigns.
15. HEADINGS.
The subject headings of the sections of this Agreement are included for the purposes of
convemence only and shall not affect the construction or the interpretation of any of its
proVISIOns.
16. SEVERABILITY.
If any provision of this Agreement is determined by a court of competent jurisdiction to
be invalid or unenforceable for any reason, such determination shall not affect the validity or
enforceability of the remaining terms and provisions hereof or of the offending provision in any
other circumstance, and the remaining provisions of this Agreement shall remain in full force
and effect.
17. REMEDIES; WAIVER.
All remedies available to either party for one or more breaches by the other party are and
shall be deemed cumulative and may be exercised separately or concurrently without waiver of
any other remedies. The failure of either party to act in the event of a breach of this Agreement
by the other shall not be deemed a waiver of such breach or a waiver of future breaches, unless
such waiver shall be in writing and signed by the party against whom enforcement is sought.
18. ENTIRE AGREEMENT; MODIFICATION.
This Agreement, including Attachments "I" and "2," constitutes the entire agreement and
understanding between the parties, and supersedes any prior agreements and understandings
relating to the subject matter of this Agreement. To the extent there is a conflict between this
Agreement and the attachments, the contents of this Agreement shall have priority. This
Agreement may be modified or amended only by a written instrument executed by all parties to
this Agreement.
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VENDOR SERVICES AGREEMENT
AD\' ANCED DATA PROCESSING, INC., and CITY OF SAN BEAAARDINO
FOR EMS BILLING SERVICES
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day
and date first above shown.
Dated:
Dated:
ADVANCED DATA PROCESSING, INC.
CITY OF SAN BERNARDINO
By:
By:
Its:
Lori Sassoon
Acting City Manager
Approved as to Form:
James F. Penman, City Attorney
17//71CIi/llE/UT ''1''
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, dpi
intermedix
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6451 North Federal Highway, Suite 1002
Fort Lauderdale, FL 33308
Proposal Package For
RFP F-08-21: EMS Billing Services
City of San Bernardino
San Bernardino, California
July 16, 2008
Proposal Opening 3 p.m. Local Time
EMS BILLING SERVICE CONTRACT CHECKLIST
[J Copy of Contractor License III Bid Content and Fonns. General Specificallon ~35. Instructions to Bidder(s}!
Bidders
Please see Appendix A for our Certificate of Good Standing in California as well as our
Delaware Articles of Incorporation to satisfy this requirement.
[J Bidder Experience, Competency, Qualification and Profile (Vendor Document) III
Bid I Bid Content Forms
Please see the body of this Proposal, pages 1-18 of the document.
[J Non-Collusion Affidavit (City Form) Instructions to Bidder(s)! Bidders
Please see Appendix B for our signed and notarized Non-Collusion Affidavit.
[J Listing of Proposed Subcontractor (City Form) III Bid / Bid Content and Fonns
Please see Appendix C for our signed Subcontractor's List.
[J Price Form (City Form) instructions to Bidders. III Bid Content and Fonns
Please find our Price Form in a separate, sealed envelope as requested.
[J Authorized Signatures Instructions to Bidders
As specifically referenced in the body of our proposal, page 1, and marked in bold type,
"all forms will be signed by Doug Shamon, our President and CEO, who is fully
authorized to represent ADPI in every capacity. "
[J Bidder Identification III Bid Content and Fonns
Please find our Bidder Identification on the Cover Page of our proposal, as well as on
the outside of the sealed package as requested.
[J Addendum Received III Bid Content and Fonns
Our proposal acknowledges receipt of the addendum as specifically referenced in the
body of our proposal, page 1, and marked in bold type via the text "Addendum received
on July 8, 2008. n
~ 90 Day Bid Validity Statement III Bid Content and Forms
As specifically referenced in the body of our proposal, page 1, and marked in bold type,
"This proposal and its contents may be incorporated, in whole, into a written contract and
will remain valid for a period of 90 days following the date of submittal."
~ Authorized Signatures III Bid Content and Forms
Again, as specifically referenced in the body of our proposal, page 1, and marked in bold
type, "all forms will be signed by Doug Shamon, our President and CEO, who is fully
authorized to represent ADPI in eve/}' capacity. "
~ References III Bid Content and Forms
Please see Appendix D for our References.
~ Calendar Day Acknowledgment of Delivery of Materials or Services General
Specifications #9
As specifically referenced in the body of our proposal, page 2, Contract Transition, and
marked in bold type, "As your current billing services provider, we anticipate no
additional CSB personnel or significant transition period will be required. "
~ Proper Identification and Submittal of Bid/Bid Package, and Price Form Instructions to
Bidders
Please find our package identified and submitted as specified in the instrlictions.
Bidders are reauested to submit this checklist completed with all bid documents.
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TABLE OF CONTENTS
Table of Contents..........................................................................................................2
Proposal Contact Information ...................................................................................... 3
Presentation............................ ..... ............... .................................... ....... ......... ...... ........ 1
Project Su mma ry _........ _........................... ............. .............. ........................................ ................... ......... .................. 1
Contract Transition....."........ '................".................. ............. ............ ,....... ............ ..................... ................ ..... n........ 2
Prelimi nary Work Pia n............... ....................................... ........................................ .......... ........ .................. ............ 2
Proposed Time-Table for Deliverables During the First Year ................................................................................... 2
Customization of Services for the City of San Bernardino........................................................................................ 3
Performance Methods....... ............................................. ........................................................... .......... .......... .......... 3
Accou nt Services.......................... ... ..... ,.'..................... .............. ......... ....... ..... ,_"............. ..'."... ......... .................. ..... -, 8
Cu stamer Service '....... ............................. n' _.,..... .................... ..,....."..... ..................................... '.,....... ...... ............ 10
Ma nagement Reports............................. ................. ........................................... ............... ........ ........... ........ .......... 11
Demonstrated Knowledge of and Compliance with the Following ........................................................................12
Cost Proposal................ _................................... ........... ....... ........................................ ......... ........... .......... ........ ...... 13
Innovation .............................................. ...... ........ .................. ........ ....... .......................... ........ .......... ........ ............. 13
Additional Information ............. ....... ........ .................................. ....... ....... ......... ........................................... ........... 14
2. Exceptions and Deviations.....................................................................................15
3. Appendices ........................................,....................................................................16
4. Proposal Close........................................................................................................ 17
City of San Bernardino
RFP F-08-21: EMS Billing- Services
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PROPOSAL CONTACT INFORMATION
Proposal Contact:
Rick Fossier
Vice President of Business Development
14087 Triple Crown Drive
Alpharetta, GA 30004
Phone: (770) 442-8627
Fax: (770) 442-8628
City of San Bernardino
RFP F-08-21: EMS Billing Services
3
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PRESENTATION
PROJECT SUMMARY
Please accept this document as a formal proposal from Advanced Data Processing - a subsidiary of Intermedi.
Corporation (ADPI) in response to the City of San Bernardino (CSB) RFP F-QS-21: EMS Billing Services and
subsequent Addendum received on July S, 200S. This proposal and its contents may be incorporated, in whole,
into 0 written contract and will remain valid for a period of 90 days following the date of submittal. Further, all
forms will be signed by Doug Shaman, our President and CEO, who is fully authorized to represent ADPI in every
capacity. Our proposal includes supplying billing and collections services for the City of San Bernardino as well as
the continued administration of the City's subscription program. We appreciate the opportunity to respond to your
needs and believe this proposal clearly represents our capabilities to offer you the finest EMS billing services in the
country.
Our key management staff has fully reviewed your RFP and will demonstrate within our proposal that ADPI
remains uniquely qualified to provide the best available solution to the requirements of the City's RFP. As the
City's current provider of these services, we are extremely knowledgeable in regards to the challenges of billing for
first responder EMS fees as well as the opportunities that are present to enhance collection results. Specific to
discussing avenues to improve reimbursement, we. note the following and will expand upon each of these
opportunities within our proposai
1. The current mix of commercial insurance claims submitted (11%) can be improved based upon
the ability to capture face sheets from the receiving facilities, and each point of increase will
mean thousands of net dollars to the City;
2. The response to question #35 in the RFP Addendum indicates that City Council is considering a
proposal to allow the department to bill patients over the age of 65;
3. The City has peers in the first responder space within the State who are billing higher fees, and
this too will have a positive impact on results for San Bernardino.
We have been fortunate to provide these same services to the City of San Bernardino since October 2004 and look
forward to the opportunity to continue this service relationship. While there are inherent difficulties in billing for
first responder services such as the lack of any payment options with both Medicare and Medi-Cal, we believe that
steps can be taken to improve results for the City moving forward based on the valuable services provided by the
men and women of the San Bernardino Fire Department, and ADPI remains prepared to serve the City in this role if
we are afforded the opportunity.
City of San Bernardino
RFP F-OB-21: EMS Billing Services
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CONTRACT TRANSITION
City Requirement: Explain how your firm would hondle the transition fram the existing contract to the new contract
if your firm were the successful vendor. Specificolly address how your firm would provide, in a timely manner, the
contract deliverables listed, Scope of Contract Work. A smooth continuation of billing and collection services must
be provided so that the City can deliver uninterrupted and efficient customer service to its citizens.
As your current billing services provider, we anticipate no additional CSS persannel or significant transitian period
will be required for the implementation of the described billing system. Our proposal to the City will include a
number of revenue enhancement ideas as referenced in our Project Summary above, and all of these
recommendations can be implemented as quickly as the City will allow.
PRELIMINARY WORK PLAN
City Requirement: Describe the phases into which the contract logically can be divided and perfarmed. This
narrative should pravide an overview of the tasks for each part of the contract. List the equipment your firm would
employ. State how much lead-time, if any, your firm would need to adapt to this system once the contract is
awarded. Explain what preparations would be undertaken during the lead-time. Describe the maintenance support
your automated system would have.
.
As the City's current provider, ADPI is fully prepared to continue working all accounts generated by CSB and sent to
our operations staff for processing with none of the potential points of error that can occur during a transition.
Over the past year, we have introduced our proprietary IMX billing system to the City, allowing for real-time web-
based access to your accounts from any internet-enabled computer. Now on top of this system, we are in the
process of rolling out our ad hoc Business Objects reporting tool, providing the City expanded reporting
capabilities. All processing and support operations will continue to be delivered out of our <?akland, CA o.ffice
under the leadership of Mr. Marl Moriuchl and his staff.
PROPOSED TIME-TABLE FOR DELlVERABLES DURING THE FIRST YEAR
City Requirement: Provide a proposed timetable for all contract activities addressed in the Preliminary Work Plan
which must occur fram the date of contract award and throughout the first contract year.
As described above, as CSB's current provider, our time-table for deliverables requires no operational or process
changes on the part of the City or on the part of ADPI. Regarding the timetable for the revenue enhancement
ideas suggested in our Project Summary, these issues will move at the speed which the City determines.
Additionally, AD PI will continue to work on providing enhanced capabilities as part of our regular service
relationship with the City, some examples of which are the ad hoc reporting tool listed directly above, the
potential use of predictive dialer technology to enhance collection numbers for those patients for whom we are
unable to bill insurance, and the enhancement of collection techniques from the City's receiving facilities to
optimize the amount of private insurance information being captured and billed.
City of San Bernardino
RFP F-08-2.1: EMS Billing Services
2
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CUSTOMIZATION OF SERVICES FOR THE CITY OF SAN BERNARDINO
City Requirement: Explain the factors your firm will consider in tailoring the billing and collection services to the
needs of City employees and the City's EMS users, Nate any modifications to your standard billing and callectian
services that will be undertaken to ensure that this contract is customized to the special requirements of the City of
San Bernardino.
Billing for first responder services produces the need for system modifications based on payer requirements as
well as City requirements, For example, ADPI's billing system utilizes many front-end insurance gathering
techniques to find patient insurance information. However because first responder fees can not be billed to either
of the two major federal insurers, our system must automatically remove insurance information when the patient
is found to have either Medicare or Medi-Ca!, and bill the patient directly" Additionally if the patient is found to be
over the age of 65 within the current C5B rules, our system has to be modified to ensure that those claims are not
sent out.
It is important to note that while the two examples listed above are based upon limitations put forth within City
and payer requirements, we understand how essential it is that we adhere to these factors in order to properly
and efficiently processes the City's first responder claims" As your current provider, ADPI already has each of these
requirements factored in to our system as it relates to the City of San Bernardino.
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PERFORMANCE METHODS
City Requirement: Address the following-
Intake Procedures: Describe the procedures for importing, receiving and processing the Patient Core Report
information from the Fire Department.
Private Insurance Accounts: Describe the procedures for biJ1ing private insurance companies. Detail the procedures
for handling rejected claims,
Self Pay Accounts: Describe the procedures for billing individual users, including how your firm would produce, print
and send bills and notices. As an exhibit to this item, provide samples of correspondence, bills, notices and
envelopes your firm would use, Describe the procedures for handling bills returned by the Postal Service as
undeliverable, including what efforts will be taken to pursue those accounts,
Insufficient Information and Uncollectible Accounts: Describe what actions your firm would toke before declaring an
account as having insufficient information or being uncollectible. Describe the procedures for obtaining
supplemental billing information,
BILLING PERFORMANCE METHODOLOGY AND TECHNICAL APPROACH
Our approach to EMS billing and collections involves combing the people, processes, and technology to maximize
the revenue per call for each EMS encounter, ADPI processes are engineered to focus on the uniqueness of the
EMS patient encounter. We understand that EMS agencies lack the ongoing patient/provider financial relationship
City of San Bernardino
RFP F-08-21: EMS Billing SelVices
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that is common in other healthcare entities, such as physician and hospital care, as there is no admission or patient
registration department. Additionally, the individuals who are providing care are also responsible for gathering
billing information from severely ill or injured patients frequently resulting in gaps and errors in patient
information. Recognizing these constraints, we have constructed processes that optimize the use of critical
internal and externai resources on the front end whiie performing billing for residents and non-residents of the
City.
Our billing and collection services can be segmented into distinct processes from PCR Creation to Reporting, with
each step of the process guided by Compliance and Account Management teams as depicted in the illustration
below.
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Each step in the process contains specific objectives that contribute to the maximization of revenue per patient
encounter through an engineered series of edits, feedback mechanisms, and controls that enable us to operate
effectively and efficiently and delineate the inherent segregation of duties. Every patient bill is "touched" during
each phase of our process and always with the underlying goal of achieving maximum reimbursement.
THE FRONT END PROCESS: PCR CREATION AND PCR TRANSFORMATION
Objectives:
1. To capture every call and bill within 24 hours of receipt.
2. To ensure proper coding/pricing: resulting in the maximum allowable reimbursement for all services provided
by your staff.
3. To ensure absolute compliance with all federal, state and locai reguiations.
4. To create "clean claims," resulting in fee recovery in the fastest possible manner.
5. To place insurance carriers as the primary guarantor and patients as the secondary
City of San Bernardino
RFP F-08-21: EMS Billing Services
4
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July 16, 2008
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Throughout the peR creation and transformation process, a number of systems and tools are utilized as described
below and depicted in our PCR Process Flow below.
ADPI PCR Process Flow
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PCR Informotion Flow
Incident information will be documented using patient care reports (PCR) per the City's current process. PCRs will
be transmitted to ADPI via our secured website as has already been established with your data collection software,
Healthware Solutions. PCR data will be immediately imported into CodeQ, ADPl's proprietary front-end coding
software. We will continue to work with the City to schedule the consistent delivery of patient run reports, as is
already in practice between our two organizations.
PCR Transformation
Our quality edits identify and correct inconsistencies in information that would result in a delay or rejection of the
insurance claim. Our proprietary front-end edit application, CodeQ-Sweep, analyzes numerous data quality and
integrity eiements from demographic anomalies like incomplete addresses, non-conforming social security
numbers and missing date-of-birth information. Patient encounter information is analyzed through a series of
automated filters and system edits that produce the required codification, although this is not at issue with the San
City of San Bernardino
RFP F-08-21: EMS Billing Services
5
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July 16, 2008
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Bernardino claims. As a rule, we provide our certified coding staff with objective criteria for establishing
appropriate code levels when necessary. Only coders with intensive training and appropriate certification are
allowed to code encounters. CodeQ-Sweep also provides workflow controls that result in faster "clean" claim
generation, therefore resulting in fewer denials. Because CSB claims are all billed at the flat $200 rate, much of the
normal coding functionality we provide to our transporting clients becomes unnecessary, adding to the efficiency
with which ADPI can move CSB claims from receipt to billed claims.
Code Q
As new accounts are loaded into the system, the run report is reviewed and cleared for billing. The coder is also
able to read the narrative from the patient care report.
Electronic Eligibility
Eligibility inquiries occur during the PCR Transformation phase when patient records are passed through ADPI's
eligibility algorithm. Our eligibility system uses industry standard ANSI electronic eligibility requests to identify
patient insurance coverage from a number of sources, including data obtained from hospitals within the City
through our hospital liaison program. All patient encounters are run through this eliglbmty process to obtain all
additional valid patient information. Extensive edits and Account Specialists are in place to ensure that the data
used is current and applicable to the current call. If insurance information has not been identified at the scene, the
patient account is run through a series of electronic eligibility transactions to retrieve appropriate information.
Following are the most frequently used resources:
_ Medicare electronic eligibility (if found for a CSB patient, information is removed and billed as a self-pay if
no commercial secondary insurance is found)
- Hospital interfaces
- Insurance eligibility via clearinghouse
_ Cascading electronic private insurance eligibility
- Skip tracing
Often times we are not only missing insurance information but patient demographics are incomplete. Before
sending a patient bill, ADPI performs the following steps:
_ Skip tracing via Accurint to find missing patient demographics.
_ Deliverable address reviews utilizing Mellissa Data.
Any information obtained is matched to the patient account in our system before it moves on to the billing process
phase.
City of San Bernardino
RFP F-08-21: EMS Billing Services
6
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July 16, 2008
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THE BILLING PROCESS
Objectives:
I. To file a clean claim within 24 hours of completion.
2. To file electronically to as many third party payers as possible.
3. To bill patients on a timely basis.
Billing the Payer
Commercial insurance claims are processed through our claims clearinghouse, within 24 hours of completion or
printed and mailed if electronic delivery is not available. Copies of PCRs or explanation of benefits statements are
attached to claims when applicable.
Once accounts are updated and if the patient is deemed to be the guarantor, they will be sent an
invoice/statement, Invoices contain! in addition to accurate charges for services, a request for patient insurance
information and instructions on how to provide such information. Insurance information can be provided by
patients via mail (with enclosed courtesy return-payment envelope), through a dedicated phone line or on our
secure patient website, www.emsclaims.net. We can also include customized letterhead, messages, and inserts
such as surveys, questionnaires, comment cards, and notices for your subscription program to be included in your
statement mailings (optional). Mailings request forward address corrections to reduce undeliverable mail and cycle
time.
Account Screen
From the main account screen, both our clients and our employees can view all relevant patient demographics,
charges, transactions, and incident information. Each transaction can be hyperlinked to PDF images of scanned
documents. Employees and client users having financial role access can also print patient statements on-demand
(in case a patient walks into our offices or your finance office, for examplel. ADPI employees are also able to edit
demographic information using the Web-Edit button.
Billing Cycle - Statements
Within ADPI's normal processing environment, best practices have called for re-billing performed four times at
regular intervals (cycle billing) with review of accounts determining if collection action is required. Between
statement one and statement two, if a response has not been received by the patient, our auto-dialing phone
system will generate a phone call to the patient in order to obtain insurance information or to set.up payment
arrangements. This is new functionality that we have introduced, and we believe it will pay substantial dividends
with San Bernardino accounts. We prefer to maintain accounts for a year because we often receive delayed
payments up until the 1 year mark. Of course we will continue to meet the requirements of the City's cycle unless
C5B agrees that a different billing cycle can produce better results as put forth by ADPI at any point.
City of San Bernardino
RFP F-OB-21: EMS Billing Services
7
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July 16, 2008
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Audits will be performed in many cases before submission af the claim. Far example, some claims are audited
before submission to the carrier and proprietary medical necessity codes will be assigned to each claim,
Web-Edit
ADPI employees are able to edit patient demographic and insurance information, For instance, an employee can
tag a Power of Attorney document with a barcode so that it can be scanned into our system, All of this
functionality is already available to the City of San Bernardino and can be demonstrated to anyone in the City who
would like to further understand the functionality ADPI offers as part of our core service offering,
ACCOUNT SERVICES
City Requirement: Describe 011 controls that would be established to insure an accurate accounting of fee payments
or any ather farms of payment, i,e, credit cards and/or Internet. Nate the location where payments would be
mailed and/or delivered in person, Detail the procedure far accepting and processing payments bath by mail and in
person, In this section, describe all bookkeeping procedures to be used, Also describe all ather records your firm
must keep, such as files, books and documents, As an exhibit to this item, provide a sample of the monthly invoice
to be sent to the San Bernardino City Fire Department far services rendered,
ADPI ACCOUNT SERVICES AND PAYER RESPONSE MANAGEMENT
Objectives:
L To post payments and balance within 24 hours of receipt,
2, To provide appropriate account level payment detail within 48 hours of receipt,
3. To provide effective customer service to patients who contact our office.
4, To provide timely and effective response to payer's denial or request for additional information,
Payment Handling
Currently, all payments are sent to ADPI for deposit into San Bernardino's bank account, Ideally, all payments
would be sent to a San Bernardino lock box, All payments in both environments are processed in a secure fashion
and AD?1 is provided with posting information and patient correspondence on a daily basis. Upon receipt of
payment documentation (typically 24 hours after deposit date), payments are posted to the appropriate account
and reconciled to the bank deposit,
Payment Review
Each payment received from a third party is reviewed to ensure accurate reimbursement, If a "short pay" exists,
the account is noted for our exception processing which results in an appeal to the third party carrier for payment,
If patterns develop, we work directly with the appropriate representatives of the carrier to resolve them, We have
been successful in resolving a significant amount of "short pays" for our clients,
City of San Bernardino
RFP F-08-21: EMS Billing Services
8
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Juiy 16, 2008
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Correspondence
All patient and insurance correspondence is reviewed and accounts are updated with information within 24 hours
of receipt. Trend analyses are done to constantly refine the filing process and to identify specific third party
correspondence issues.
Denial Management and Reporting
Our denial management program manages submission of clean claims to avoid denials and in the event of a denial,
aggressively pursues payment. The system electronically posts payments and denials for payers who send
electronic remittance. Depending on denial type, we initiate a series of actions related to the denial reason. For
example, if a claim is denied due to policy number, we contact the patient to obtain the correct insurance
information.
Our reports track denials by type. These reports can be part of a regular monthly report package or run as ad hoc
reports. The accurate mining of this denial data is the most critical element of our denial management process.
Once the top denial reasons are targeted, we dedicate resources to diagnose consistent causes with the goal of
preventing on-going denials.
Overpayments/Refunds
Our system automatically flags credit balance accounts, generating a special report that lists all accounts to be
researched. Refund requests are presented to the client in report format with supporting documentation (e.g.
copies of all remittance documentation and account payments), an explanation of recipient, amount of refund,
and where to mail the refund check. We complete all documentation that must accompany the refund request.
We retain copies of all receivable-related correspondence indexed by deposit batch date. We also provide the
information in Excel format for simple check processing. Once submitted by ADPI to the City of San Bernardino, it
then becomes the department's responsibility to process and issue a refund check to the appropriate payer.
Specialty Cases
In the case of patient hardship, we will arrange for a payment plan of no less than ten dollars per month or
another amount designated by the City. The account is marked as a payment plan and is withheld from collections
as long as payments are being made. We do recommend credit card payments in lieu of payment plans.
All "special" cases or write-off policies will be speCifically cited by the City and must be approved by authorized
individuals. These cases will be marked in our system and handled according to your specific requirements.
ERA Browser
We receive ERA (electronic remittance advice) from many payers.
City of San Bemardino
RFP F-OB-21: EMS Billing Services
9
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July 16, 2008
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ERA Log
Our system can "auto-post" responses from the received ERA's. Sometimes an employee may wish to drill-down
into the ERA elements to figure out exactly what the system did when it posted the transactions. .our system is
able to tell our employees in plain English what happened, and it also notes where corrections were able to be
made on the account (such as name spelling corrections, etc.) automatically.
Manual Posting
For payers that send printed EOSs instead of ERAs, we have a web-based posting system that is used by our
employees. All data is checked before committing the transactions to our database. An audit trail is always kept
with the UserlD that posted the transactions to ensure the best QA processes.
Daily Check Posting
ADPI performs checks and balances at numerous levels to ensure all the money posted balances at the end of each
day. .our Regional Directors use internal reports to verify the total amount of money posted each day at each of
ADPI's regional offices around the country.
CUSTOMER SERVICE
City Requirement: Describe the procedures and controls that your firm will use to respond to, and to resolve
inquiries, complaints and requests for account information from users, insuronce companies, lawyers and others.
Describe where this function would be performed and by whom. Explain how your firm would keep the Son
Bernardino City Fire Deportment informed of the number and types of complaints received. Describe the timeliness
and methods for responding to the Son Bernardino City Fire Department requests. Describe service to those
customers of the City with particular emphasis on the following:
. Ability to provide live telephone support via local and long-distance toll-free Numbers
. Days and hours that telephone support is available
. Availability of a bilingual (English/Spanish) speaking staff
. Policies and procedures on handling investigation of errors and discrepancies
. Patient information updates, and disclosure of policies regarding potential discounts, refunds, payments,
etc.
. Timeliness of posting of payments, distribution of statements and refunds, and
. Patient notification as to account change of status or resolution of issues.
PATIENT AND CLIENT CUSTOMER SERVICE
ADPI is committed to providing the highest level of service to our accounts at both the client and patient levels. To
this end we have implemented systems that provide dedicated toll free access, multi-lingual CSRs for foreign
language patients and active customer service hours from 8:30 a.m. to S:OO p.m. daily PST, excluding holidays. In
addition to these hours, we often make outbound calls that extend into early evenings and Saturday mornings
when necessary. Our goal for all patient calls is to significantly reduce patient wait time by consistently achieving
City of San Bernardino
RFP F-08-21: EMS Billing Services
10
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July 16, 2008
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no more than 10 seconds call waiting and monitoring all calls for accuracy, courtesy, and type of phone call.
Further, we offer patients the option to provide insurance information to us through our web site, eliminating the
need to mail in information or make a phone call. All activity is documented in the system's patient notes section
with standard note codes used in all possible instances.
It is of utmost importance to our Customer Service Team to maintain a professional and courteous demeanor and
do everything possible to assist your patients with getting their issues resolved. Our customer service personnel
are instructed on how to gently handle each patient or payer call as a representative of the City. With a "soft
collect" approach, easy payment arrangements and a translator service, we make it easy for your patients and
payers.
Just as it is our goal to ensure that patients receive excellent customer service, we are also invested in the
satisfaction of the City throughout the process. Therefore we provide you with access to a dedicated Regional
Director who knows the day to day operations of your account at all times, and who is charged with the primary
goal of making sure that all of your needs are being met and that we are successfully increasing your revenue.. Any
operational, process, or report changes on the City's behalf would be communicated to Mori Moriuchi, your
Regional Director, who will ensure that changes are made accordingly. Our team is dedicated to responding to
your inquiries within one business day of initial contact.
Finally, ADPI hosts a yearly client meeting to inform all clients of industry updates, bring in keynote speakers for
industry perspective, and to gather our clients and operations teams for feedback sessions. We also bi-annually
publish a client newsletter that provides informative industry articles and company-specific updates. ADPI is an
avid supporter of the industry and targets our sponsorships and leadership opportunities to organizations that
benefit the EMS/Fire-Rescue industry.
MANAGEMENT REPORTS
City Requirement: Describe all information your firm would include on monthly management reports, and how it
would be derived. Describe the quality contrals you would use to ensure accuracy of reporting. Ihclude discussion of
preformatted standardized forms; flexible reporting capabilities (including ability for City to create new reports
and/or modify existing standardized reports) and report modification and data retrieval.
ADPI is pleased to provide our clients with the tools to be constantly informed about their financial status and
operations through our powerful reporting solution utilizing Business Objects. These tools provide real time access
to all information entered into the ADPI system by the City of Son Bernardino and are available 24 hours a day 7
days a week via the internet and our secure servers. Every peR, patient account, call statistic, demographic
resource, financial information, etc., is continuously available via any internet capable computer. All information is
encrypted for security, and is maintained and backed-up in multiple, geographically separated locations, utilizing
our mirrored, multiple-redundant system. Accounts collected, individual patient accounts, medic statistics, call
statistics, and financial statistics are all available in a dynamic, real.time format. As soon as information is entered
via a medic's patient care report or by our staff processing account activities, that information is available to
authorized users. Within nanoseconds from the time the run report is sent to ADPI and entered in our system, the
City of San Bernardino
RFP F-08-21: EMS Biiling Services
11
@ADPHntermedix
July 16, 2008
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account is generated and the statistics concerning that call have been added to the various reports throughout the
system, In addition to management reports, you will also have secure on-line access to AU clinical
documentation sent to ADPI related to your patient calls, from the EKG strips and basic run report to any
additional supporting data scanned and indexed for each individual encounter.
We provide an assortment of standard reports that are grouped into three general categories: financiai reports,
patient records, and medic/department statistics and are available through our website, Sample reports are
included in Appendix E following the proposal. Should the City require a specific report not included in our suite of
available reports, a simple emaii or telephone request to our in-house programming staff will initiate the addition
of that report typically within 24-48 hours. If the custom report is one that you will need to run on a consistent
basis, we will simply add it to your "Reports" menu that you can access from the system at any time.
DEMONSTRATED KNOWLEDGE OF AND COMPLIANCE WITH THE FOllOWING
City Requirement: Demonstrated knawledge at and campliance with:
Health Insurance Partability and Accountability Act (HIPAA), Health Core Financing Administratian (HCFA)
Regulations, reports showing clear audit trails in accordance with Generally Accepted Accounting Practices,
ADPI seeks to supply the most productive, efficient and compliant emergency services billing and collection
services in the industry for all of our clients. We comply with all state, federal and local rules and regulations, with
close attention to and abiding by regulations specific to our industry, We have put forth an extensive and
aggressive complianc~ program, Our adherence to current Federal HIPAA guidelines relating to privacy and
security implementation further emphasizes our commitment to compliance on behalf of our clients, We set
standards and employ audit checks on these standards to ensure we produce clean claims that get paid. All
auditing is done in compliance with generally accepted GAA practices, AD PI has had an active compliance program
in place since 1999 when the DIG first presented the voluntary Compliance Program Guidance for Third-Party
Medical Billing Companies. We certify that the ADPI compliance plan is compliant with the intent and activities
included in the U.S. DIG Compliance Program Guidance for Third Party Medical Billing Companies established
December 18, 1998. This plan is enforced from our President down to the coders, encompassing every individual
within ADPL
All ADPI systems comply with HIPAA requirements of Security, Privacy, and transmission of data. Further, we have
included a detailed description of our System Architecture and Security as Appendix F that speaks to encryption of
electronic data sent to AD PI from your field units or participating hospital and demonstrates our commitment to
providing the highest level of security within the framework of ADPI's systems and technology.
City of San Bernardino
RFP F-OB-21: EMS Billing Services
12
@ADPI.lnlermedix
July 16, 200B
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COST PROPOSAL
City Requirement: The vendor sholl submit 0 proposal based on 0 percentage of collection. The cost proposal must
contain data to support the proposed charges. The proposed charges must be stated far each of the following
accounts:
. Private Insurance
. Self Pay Accounts
. Paramedic Membership pragram Fees/Renewal
. Miscellaneous Other Costs
Vendor shall identify and provide the costs for any additional charges that may become billable to the City, which
haves not been identified above. Any increase or extra cost for billing services during the term of this contract will
require an agreement from both parties. Once the agreement has been reached, a new contract with the
amendments will require finai approval fram the Mayor and Common Council. Vendor shall provide the City with a
monthly invoice in arrears for compensation. The City will provide payment to vendor within thirty (30) days of
receipt of billing from vendor. The City will retain the right to challenge all or any part of an invoice. Vendor
understands that if there is a substantial drop in collections, The City is requiring a formal communication of the
decline, the potential reason for the decline, and recommendations to correct the problem.
As required in the City's RFP format, ADPI has completed the pricing forms as supplied and submitted under
separate cover.
INNOVATION
Describe innovative methods for increasing revenue cof/eetion that reflects advances in technology or collection
strategies that the vendor can pravide. Vendor shall outline such strategies or technologies and pravide examples
of how their use improved revenue for specific agencies.
As described in our Project Summary, we believe a number of imminent opportunities exist to improve the billing
results we generate far CSB. Specifically, we note the following:
. The current mix of commercial insurance for claims we are submitting on behalf of CSB totals only 11% of
all claims. While the demographics of San Bernardino are certainly not the same as those in Corona, CA,
where ADPI also provides first responder billing, we believe that a good portion of the 37% of commercial
insurance billed in Corona is the direct resuit of receiving face sheets from the hospitals to which patients
are ultimately transported. We believe that with some additional focus by the staff of ADPI and CSB to
collect hospital face sheets, the City will see your insurance percentage rise commensurate with our
experience. Furthermore, where average payment per account on commercial insurance claims exceeds
$150 per account and results in a net collection percentage greater than 75%, those claims that remain in
the private pay group continue to suffer from the payer characteristics of this group, seeing collections
per account of less than $25 in both San Bernardino and Corona.
City of San Bernardino
RFP F-08-21: EMS Billing SelVices
13
@ADPI-Intermedix
July 16, 2008
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. The current average charge in San Bernardino is only $200, whereas in Corona the average charge is $350
for the same first responder services. We submit that if CSB would raise its fees to a similar level, this too
would have a dramatically positive impact on your revenue. Specifically, ADPI's financial model predicts
that such a fee increase could produce as much as an additional 40%+ in revenue to the City.
. The City has a policy of not charging individuals over the age of 65. Whiie we understand the nature of
this policy, we also believe that given the intent to optimize revenue from these valuable services that the
City's Fire Department provides, this policy is stifling collections that could be coming in to the City. While
the City's over-65 population skews Iowan a national level, they still represent a large subset of the
claims produced by the City. Thus, ADPI recommends that the City consider the financial advantages of
exploring this additional revenue stream from those patients over 65 with the ability to pay.
ADDITIONAL INFORMATION
tnformatian nat specifically requested in the faregaing sectians but which is cansidered essential to the proposal
may be presented in this section. Some suggestions of additional informotian include, but are not limited to, copies
af relevant media reprints and promotional brochures of your firm.
For your review, we have included copies of our two most recent industry newsletters, The EMS Informant. as well
as the past two editions of our Compliance Newsletter, demonstrating the level of detail at which we view the
entire EMS billing industry, in Appendix G. We would be pleased to provide additional copies along with other
Issues should the City wish to review ADPI's approach in greater detail.
ADPI is currently processing claims for more than 30 clients in the State of California, and we have a very strong
desire to continue to serve the City of San Bernardino. To demonstrate this, we have put forth a fee proposal that
is significantly more aggressive than our current rate; additionally, we have included some flexibility in approach,
contingent upon the City's willingness to effect changes in your current transport fees and data collection efforts.
We are making major commitments in the California marketplace and will continue to bring tectmology capaoity
and operational focus to bear on the results we produce. Given these goals and our aggressive fee rate offer to
the City, we aim to demonstrate the level of seriousness with which we are responding to your RFP and how this
will continue to reflect on the performance we deliver as your service provider.
City of San Bernardino
RFP F-Oa-21: EMS Biiling Services
14
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July 16, 2008
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2. EXCEPTIONS AND DEVIATIONS
ADPI takes no exceptions to the CS8 requirements as listed in this RFP,
City of San Bemardino
RFP F-OB-21: EMS Billing Services
15
@ADPI-Intermedix
July 16, 200B
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3. APPENDICES
Appendix A - Contractor licensing: Certificate of Good Standing-CA; Delaware Articles of Incorporation
Appendix B - Non-Coliusion Affidavit
Appendix C - Subcontractor's list
Appendix D - References
Appendix E - Sample Reports
Appendix F - System Architecture and Security
Appendix G - January 2008 EMS Informant, July 2008 EMS Informant; May 2008 Compliance Newsletter, June
2008 Compliance Newsletter
Appendix H - Sample Correspondence: Sample Patient Invoice; Sample ADPllnvoice to the City
City of San Bernardino
RFP F-OB-21: EMS Billing Services
16
@ADPI.intermedix
July 16, 2008
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4. PROPOSAL CLOSE
ADPI would like to thank you for the opportunity to present our proposal to continue provision of EMS First
Responder Billing for the City of San Bernardino. As indicated in our response. we beileve that ADPI offers the City
a solution that is unparalleled in terms of the level of expertise and commitment we will continue to bring as your
EMS billing service provider, and all at what we believe you will find to be a highly competitive fee rate.
We offer proven recommendations to enhance your results. There are no "switching" costs or risks by continuing
our business relationship, and our company is committed to this relationship with the City and to improving results
for the services provided. As indicated, we beileve that historical results can be improved dramatically given some
meaningful attention to some field-related and administrative changes on the side of CSB and additional eiements
of improvement that AD PI is committed to making on our end as your service provider.
If you shouid have any further questions concerning the contents of this proposal or any other issues we can heip
clarify. please do not hesitate to contact Rick Fossier, ADPI's Vice President of Business Development, at 770-442-
8627. Again, thank you and we iook forward to the opportunity to grow our relationship with the City of San
Bernardino.
City of San Bernardino
RFP F-08-21: EMS Billing Services
17
@ADPI-Intermedix
July 16, 200B
State of California
Secretary of State
CERTIFICATE OF STATUS
FOREIGN CORPORATION
I, BRUCE McPHERSON, Secretary of State of the State of California, hereby
certify:
That on the 20th day of May, 2004, ADVANCED DATA PROCESSING, INC., a
corporation organized and existing under the laws of Delaware, cornplied with
the requirements of California law in effect on that date for the purpose of
qualifying to transact intrastate business in this State; and
That the above corporation is entitled to transact intrastate business in the State
of California as of the date of this certificate. however, subject to any licensing
requirements otherwise imposed by the laws of this State; and
That no information is available in this office on the financial condition, business
activity or practices of this corporation.
IN WITNESS WHEREOF. I execute
this certificate and affix the Great Seal
of the State of California this day of
August 17, 2006.
BRUCE McPHERSON
Secretary of State
ch
NP-25 (REV 03l31105)
. asp 05 P4201
..
Vefaware
PAGE 1
'11ie :First State
I, HARRIET SMITH WINDSOR, SECRETARY OF StATE OF THE STATE OF
!.AWARE, DO HEREBY CERTIFY "ADVANCED DATA PROCESSING, INC." IS
Y INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE AND IS
LEGAL CORPORATE EXISTENCE SO FAR AS
OFFICE SHOW, AS OF THE SECOND DAY OF
FURTHER CERTIFY THAT THE SAID "ADVANCED DATA
ESSING, INC." WAS INCORPORATED ON THE EIGHTEENTH DAY OF
ER, A.D. 2002.
CERTIFY THAT THE FRANCHISE TAXES
NOT BEEN ASSESSED TO DATE.
....1t~ J.,. .. i '- .9?-~
Harriet Smith Windsor, Secre:ory or Sate
8300
AUTHENTICATION: 2016068
DATE: 10-02-02
NON. COLLUSION AFFIDAVIT
TO THE COMMON COUNCIL, CITY OF SAN BERNARDINO
In accordance with Title 23, United States Code, Section 112, the undersigned hereby
states under penalty of perjury:
That he/she has not, either directly or indirectly, entered into any agreement,
participated in any collusion, or otherwise taken action in restraint of free competitive
bidding in connection with RFP F-08-21.
Business Name Advanced Data Processing, Inc.
Business Address 6451 N. Federal High....ay, Suite 1002, Ft. Lauderdale, FL 33308
Signature of bidder X r:) k.-
Fort Lauderdale, FL
Place of Residence
\111h lulu'
Subscribed and sworn before me this -, day of 4-' ~o Or) .
Notary Public in and for the County of fir OVIi [l r d , State of CaliferFlia. f I Dn d Cl
My commission expires [)ert?mb:.r /, J-OU 6 , 20 Of) . I p?(JonCtIl~ WCMY
. ...1Il1lZAClC
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SUBCONTRACTOR'S LIST
RFP F-08-21
EMS Billing
As required by California State Law, the General Contractor bidding will hereinafter state the
subcontractor who will be the subcontractor on the job for each particular trade or subdivision
of the work in an amount in excess of one-half of one percent of the General Contractor's
total bid and will state the firm name and principal location of the mill, shop, or office of each.
If a General Contractor fails to specify a subcontractor, or if he specifies more than one
subcontractor for the same portion of work to be performed under the contract in excess of
one-half of one percent, he agrees that he is fully qualified to perfonm that portion himself and
that he shall perfonm that portion himself.
DIVISION OF NAME OF FIRM OR LOCATION
WORK OR CONTRACTOR CITY
TRADE
NONE
s~r
REJECTION OF BIDS
The undersigned agrees that the City of San Bernardino reserves the right to reject any
or all bids, and reserves the right to waive infonmalities in a bid or bids not affected by
law, if to do seems to best serve the public interest.
~;~:\~';~ . . :.;",}:,~;~:}~I~~"':',:~;~{~>~ :;f~~~~~;~~~:~":7~,. {~:-,;;:';,~~:<~~~~:~:: ~ ~ .:~ ",.~_ ;~;
We have chosen the specific references listed below either due to geographic proximity, size of account or simply
those agency leaders who know our company very well and will give the City assurance and confidence that we will
provide the same level of service and attention to all of our customers, regardless of account volume. We
encourage you to call our references and should the City want to speak to any of our 235+ clients specifically, we
would be pleased to provide any account contacts requested.
EMS Agency Contact/Title Description of Services Address Phone/em ail (if applicable)
Chief 815 West Sixth Street . Phone: 951-736-2460
City of Corona Mike Porter First Responder Billing Corona, CA 91720 Mike.oorter(ii)cLcorona.ca.us
Debra Pryor, EMS billing/collections 2100 Martin Luther King Jr Way Phone: 510-981-5500
Berkeley Fire Fire Chief or 5,700 annual transports 2nd Floor d orvor(ii) ci. berkelev. ca. us
Department Rod Foster, Client since April 2002 Berkeley, CA 94704 rfoster(&lcLbe rkelev .ca. us
Captain Regional Director: Mori Moriuchi
EMS billing/collections
Albany Fire Marc McGinn, 1,500 annual transports 1000 San Pablo Avenue Phone: 510-528-5773
Department Fire Chief Client since April 2003 Albany, eA 94706 mmceinn(lilalbanvca.ore
Regional Director: Mori Moriuchi
EMS billing/collections
San Francisco Julia Dawson, 60,000 annual transports 698 Second St Phone: (415) 558-3445
Fire Department eFa Client since San Francisco, CA 94107 iulia.dawson(ii)sfeov.ore
Regional Director: Mori Moriuchi
Wayne EMS billing/collections
Littleton Fire Zygowicz 3,500 annual transports 2255 West Berry Avenue Phone: 303 795 3864
Department Division Chief Client since Littleton, CO 80165 wzv!!owicz(a)littletonlZov.or2
Regional VP Pamela Olkowski
EMS billing/collections
Englewood Fire Stephen Green 2,200 annual transports 3615 South Elati St Phone: (303) 762-2476
Department EMS Chief Client since Englewood, CO 80110 sereen(ii)enelewood2ov.ore:
Regional VP Pamela Olkowski
Denver Health EMS billing/collections
and Human Peg Burnette 48,000 annual transports 666 Bannock Street Phone: 303 436 6076
Services eFa Client since Denver, CO 80204 cburnettetWdhha.orl!:
Regional VP Pamela Olkowski
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Standard reports are grouped into three general categories: financial reports, patient records, and
medic/department statistics. We have included the following examples of some of our typical reports.
Financial Reports
There are several standard financial reports available to authorized personnel as designated by the client. These
reports are available for every month the client has been with ADPI-IMX (and using this data collection system).
Gross Revenues, Assignment! Adjustment, and Financial Class Reports
4~O,DOO
411.000
460.0'0
375,000
150,000
125.000
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eJ Ollila.. Collected GrODh 0 ftPPTIPPPI! G.aDh [J C...stom lIooort.
Collected Dollars Per Month
Mv_.1004 l-4av-20M Jul.21lM 5.,_Z004 ,"v.20M J.....lO.5 lolu_200S !<Iay_2005 j~I*2005 Sop_zoos NOY-lOtS J...~lOOIi
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The graphs shown above on the Financial Statistics page are the same reports but for two separate clients,
reflecting the level of customization that will be available to you. The basic information in both reports reflect the
actual dollars collected per month, with an average collected per month also depicted via the level line across the
graph. In the top example, that client also wished to track the revenue based upon individual stations, so their
individual levels of revenue are depicted as well. This is shown since inception of the agreement between the
provider and ADPI-IMX. In the second example, also utilizing an unidentified but actual client, you can see where
the amount collected each month has varied from just under $250,000 in March 2004, to slightly more than
$300,000 in January 2006 and is reflected by the blue line. The level red line reflects the average of all the
amounts collected over the entire contract; in this case showing slightly more than $300,000 monthly.
Accounts Collected Report (Receipts by Payer Type and Carrier)
Financial Account
Volunteer Fire Dept.
aiDing Cycle 01-01-2007 to 01-31-2007
Fee Paid EMS PaiclIntennedix
__ $3541.,.51 SI73Z.:U
. .._..__.._."_J},~~lJ!-~L~~~~! Y~P.~.~J.~ay] [Jvn..!.~~~~~~P.!.[.?"c:.!.~~o:L~.::L___ "
1018 items found
".-.--.-.-..---"-.--..--
---- ---
2007-01-02 2005-09-29 SO.OO 0,00 PatientPaym,nt
2007-01-02 2005-03-05 1510.30 0.00 fll\emori,IHerrnanHulthcar,
2007-01.02 2006-11-0$ 1549.22 0.00 Memarif,1 Herm"n H..IthcI,..
2007-01-02 2006-03-10 1.60 0.00 HUlNln" Choice' Care
2007-01-02 2004-08-Z1 25.00 0.00 PatientP.yment
2007-01-02 ZOO$.Q4-08 ZO.OO 0.00 P.oentPlyment
2007-01-02 6 200S-D8-26 947.50 0.00 OmeIJaSuilders
2007-01-02 6 2006-06-14 535.92 0.00 Blue Cross & Slue Shield of T')(
2007-01.02 6 2006-06.14 "90.97 0.00 akle Cross" Blue Shield of TX
Z007'01.02 6 2006-09-18 "Al 0.00 Patient Payment
2007-01.02 , ZOO6.03.31 20.00 0.00 p,tientP,yment
Z007.01.02 , 2005.10.20 Z5.00 0.00 PlltilllntPayment
2007.01.02 6 Z006-11'Z5 719.Z5 0.00 TX Children's Health Plan CHIP
2007-01-02 6 2006-o~28 ""'1.00 0.00 Crime Victim,' Campensetion
ZOO7-01~02 2006'10-21 ZZ.66 0.00 Amerivroup
ZOD7-01.0Z 2006.09.09 39.22 0.00 Amerigroup
2007-01.02 2006-05.12 4.34 0.00 Ameri9~p
2:007-01-02 2006-07-25 Z8.38 0.00 Amerivroup
2007-01-0Z Z006o(J9-Z3 39.88 0.00 AmeriIJroup
2(l07-o1.0Z , 2006.1O-Z3 175.00 0.00 TPC-Provressive Insur"nce
IZ007.01-0Z 6 Z006-10-18 Z34.60 0.00 Patient Payment
This is an example of the Accounts Collected report available to the designated personnel of each individual client.
The agency determines who in their department will have access to this information. In this example, the posted
date reflects the actual date that the payment was made on the account. Scan ID is the number assigned by ADPI-
IMX to the document related to that account, such as an EOB and/or a check for payment. Account # is the system
assigned patient account number for that particular patient. Paid EMS is the actual payment amount received by
ADPI-IMX for processing. Paid IMX is a custom column for those accounts in which a payment was made directly
to another designated receiver for any reason. The fee is the calculated amount due to ADPI-IMX for servicing that
account, based upon the percentage rate established in the service agreement. The insurance name is the name
of the primary insurance responsible for that payment. Items listed in the Scan ID, Account #. and Patient Name
columns are hyperlinks. Clicking on any of these items takes you to additional information about the account.
The database can be sorted by simply clicking on the column header for that particular column.
Accounts Aging Reports
Accounts Aging Report
New Braunfels Fire Dept (2005.Q6.Q1 -2005-12-31)
NAME
. .
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i133534 j05-4389-01 il0-27-2005
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11410.491000 . (000 .1141049
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1204615 10.00 1000 j204615
, i , .
This is an example of our typical accounts aging report. This type of information is only available to those persons
designated by the Client as requiring this level of access.
Accounts Receivable Status Report
Accounts Detail
EMS (2006)
1II_=-_mII_i
~edicare ;154500 ;558,92 :98608 !O.OO ,)CLOSED I
[.__"_._._......_ _ , !Contract 12229.04 397.69 :um.35 :000 :CLOSED:
r-=:~-----!Medicare-i915_00--397_69 :51731 iO.oo :CLOSED i
kr/A i;:" jooo 000 iO 00 1000 !CLOSED
[' , ante I I
I :Unknown !O 00 0.00 !OOO [000 [CLOSED
I [CLOSED
I
J/~__ _ iCLOSED
11II...
!204~99 i69076 IOl-_?1~2?06
:204437 1690n !OI-Ol-2006
I~~~ :01-01-2006
I
;204560 169079
~E'<'_?~;: ':;,~
\01-01-2006
i
:204572 :69080 :01-01-2006
~r----:
;~ !69081 j01.01-2006
, ,
,------ ,-------,----
'204677 169083 101-02-2006
'204678 169082 101-02-2006
:204856' -169086 -- :Ol-02~2ci~6- -~-
i
i204894 [69084 101.02-2006
'CLOSED
I.
iCLOSED
I
[OPEN
,
i~ i i
12085 75 '0 00 ,0 00 '208575
!Insurance I i
---- ,Medicare i802M'-m~8-- :66282-;000-
:Medicilfe 1870,00 370.18 :49982 lO.OO
CLOSED
'CLOSED
2~911 ;69089
i204920 :69087
:01.02-2006
:01.02-2006
Patient Payment per Transport and Patient Payment per Encounter
[J Dollars Collected Graph 0 PPPT/PPPE Graph C Custom Reports
Patient Payments Per Transport & Encounter
62~
60.
m
S50
S2S
so.
... 4;~ :
Q :
0.4S0t
~ 42S ~
.... ,
~400j
:3 3iSj
3so1
,
325j
300j
275j
2501
Z2Sj
I
Jll.n-2G04 Ma.r_ZOI>4 Ma....-2GI>4 JI.lI-ZG04 Sep-2GI>4 Nov-Z004 lan-ZOOS Mar_ZOOS lolay_ZOOS Jul_ZOOS Sep_20GS Nov_200~
Momh
I... S/Transpon.. SjEncounler -A""9 SIT - AIIQ S/EI
The above graph is also part of the Financial Statistics section of the web access reports. It reffects the Patient
Payments per Transport (PPPT shown in red) and the Patient Payments per Encounter (PPPE sh.own in blue.) The
graphs reflect the variances for each month the agreement between the provider and ADPI-IMX has been in effect,
depending upon the circumstances of the actual amounts received. In this example, the PPPT for this agency is
averaging approximately $500.00 per transport. This type of information is extremely valuable for budget
planning, as it is easily seen that at $500.00 per transport average collected, an agency that transports 3800
patients annually could expect to collect $1,900,000.00.
The downward trend near the end of the graph is normal, as it reflects those accounts that have been billed, but
may not have been collected at the time the graph was prepared. Since this information is dynamic real-time
information, this chart could change slightly throughout the day as payments are posted to the individual patient
accounts by ADPI-IMX.
Patient Reports
In addition to the actual run reports for all patients and any supplemental documents that are associated with
each report, other patient reports can be accessed from the secure website.
72-Hour Patient Manager
72 Hour Patient Manager
[Show All] [Refresh Data}
[J,n] [F,b] [Mar] [Ap,] [M.y] [lun] [Jul] [Auo] [Sep] [Oct] [N,,] [Oee]
... .J~.l.I~.lJ"J[g.l..[EJ[FI[9]J~.lI!J[J.ltKJJ~I.I~UN)J?!.t"lJSIJ.~.lJ~lJ.~J'!l!.~JJ~U_XJt:.J.E.l.......
15 items found
~ Patient 0 Gander ~ 4ge ~ DOB 0 Address It] Priority 0 Addendum
~ Call Type ~ Dispatch Time 0 Disposition EJ Incident' 0 QI 0 Charges
i1~.::Jl~~-'--~
female 27 1980-02-19 Priority 2: Medical
Female 65 1941-12-05 Priority 2 Diabetic
Male 43 1963-05-18 Priority :2 Oth "
Female 3. 1968-03-26 Priority 2: Cardiac
Female 6 2000-03-27 Headache
Female 00 1927-03-01 Priority 2: Stroke
Female 51 1955-12-02 Priority 1 MVA
Male 17 1989-12-17 MVA
Male 0 1999-02.28 MVA
Female 67 1940-02-22: Prioritr2: Medical
Male 47 1960-02-08 Priority 1 Unknown
Female 60 19Z6-11.Z3 Priority 1 Oiabetic
Male 52 1954-12-16 Priority 2 Choking
Male 11 1995.04.19 Animal Bite
Female 26 1980-06-19 Unconscious
Expo~ optic:l~,s: iI Excel I~PDF
~:'~~:i't::J'';~ ctt'ti: ~,;
2007-03-2710:28
2007-03-2714:55
2007-03-2715:52
2007-03.2718:53
2007-03-2721;37
2007-03-2814:39
2007-03-2818:35
2007-03-2818:50
2007-03-2618:50
2007-03-2821:09
2007-03-2909:42
2007-03-2912:31
2007-03-2913:34
2007-03-2918:26
2007-03-2923:38
200709
200709
200709
200709
200709
200709
200709
200709
200709
200709
200709
200709
This report displays all patient encounters within the last 72 hours. It can be sorted by using the checkboxes at the
top of the report. A similar report listing all patients since contract inception is also available, sorted by year and
month. As with other reports, clicking any of the column headers will sort the Individual report by that column.
For example, clicking on the Call Type column header will sort the report alphabetically based on that column,
resulting in the Animal Bite call being first, with the resulting reports in alphabetical order based on the type.
Medic and Department Statistic Reports
The following sample reports show the type of medic and department statistics are available to designated
personnel.
Call Volume and Call Location Reports
~".: ~ ~. t#~f"'.~,:..": ~-t'1CA:LLSBYDME1JFDAY - ~~;' r - <~-" "; '~r)
I
_____ElID____BiTOT!
! i 13 r-t8~i22I32I29I12:~i7rs--;-tOr-o-liJ66i
i060~1~____: 86% : 78% i 56% i 29%[ 24% ~l 57% : 60% ! 26% ~! 55% i 0'% _' 37% I
; _ : 2 i 0 : 5 i 27 I 40 . 22 : 5 ; 2 'I 9 : 11 : 4 ! 9 i 136 I
1200 1759 13% _: 0% ; 3~o/c : 36% j 30% i 29% L 23~ . _2OC(o_ 34% _! 44% _! 22%_: ax'/?_! _ 30% I
---o--.-;-o---,-sr--J2"'i""Oj~c___o,---g--'-i4iJi791
;1800-2359 ! . I - I ' ' : i
; 0% ' 17% : 0% . 20% l 24% : 13% l 4% _l 0% ! 30%[16% : 22% ! ~/o : 17%
i~~- --~~~-4~-~~-~i~~~J;~r~~.T~~rYr:~-I-~.-~1
pme: t,_ _ ~ 7"', ..:~~
4118
m"'....&"'''...._........................____1 TOT I
~: 2 ro-i 0 ;-01 0 ! o. I 0 r-o-r-o-!1I1~1
~'m ~.~ ~'~ ~'~ ~'~Imll%:~;
o 0 0 0 0 0 0 0 r-o-c--o~i
: I : I
~ 1% ~ ~ i% ~i~,~,~,~I~i~!~1
;---------:........--~'-----'-----------'-----~I
o 0 0 0 0: 0 0 0 : 2 : 1 0 , 4 i
~ ~ 1% ~ ~ ~;~:~-~:~i~:~I~1
o 0 0 0 0 0 0 ~--o~1
~;~,~,l%,l%~~,I%,~,mi~i~i~
-----O-:-O-;~C___O_____OC___OC___O:~___O~~~~i
'~:~i~:~~~i~ ~:l%:~:~,~i~:~i
----O:----O-I1~~~~:]~~.~,:Oil11
:~!~ll%i~l~i~'~il%;l%!~~~,~_:~!_l%
41 16 ~ii7Ii8~;25n3T34--124--r7---n-' 326 'I
4~ 2mi31%:2%:2~!2~i~:~!4~i~13mi3~13~%
o 0 r-o~~~c---o,--o:-O-~~C---O~I
,mmi~!~'~lm,~!~:~:~i~_m!_~_
:l1~!18no~~'----g-~~~:1314;1133
: 10% ' 9% : 19~~~ ; 14% : 13% , 14% l 10% : 70/0 ! 8% 06%; 12% '_ 14% :l2'lA.
~:---o:o~~!--o:-----OiOC--Oi-----o-c___o!o-!"2
I , ; I , . ; , I I ! ' :
I 0% ~ O%! 0% ~~i_OO~O ~i 0% ~l 0%_, 0% :~i 0%__
~"_~" .-"$;;" "" --"-f'; ;,- -~ , " '- CAllrOCAIIONSBYMONTI{','''~ / '- ,>c:.~' ',' ~ 1 . -, ' ,~
Jlige -~~"" ':;~
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4124
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4126
4127
4127'
4128
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I
mmEaiI____mEl__1 re'T,i
1 ~~:6~;tO~'1O~!6:~l11!86i
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-~:---O~~~~:~'~~~:--]~~~1
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o 0 2 2 o-~C--O-!O'1o1
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~ ~ ~ ~ ~ 4% 2% ~ 1% ~ ~!l% m!
- . ,. ",,'., ,
------,----~.-------.---.-
;-:: -:.. )'<;~ '.:' -:.~ <~ DISPATCHED CAIJ':. TYPES PER:MONTIr ' '.1',
eanl'ype"~ ~",~, '~", ".
Abd Pam
PJlergl.cRx
Animal Bite
Assault
Auto Ped
1 ,1 1 1 I 1 I 1 ! 1 1 0 3 3! 2 ! 16 i
~ ~,~;~:~:~:~m~ ~ ~,~ ~
~~~~~~~~~~~r_s_i1.~!
0% ~ ~ 1% ~ ~ ~ ~ ~ 0% 1% ~ ~
Back Pam
o 1 0 0 0 0 0 2 7
~ ~ ~ ~ ~ ~ ~ m!~,~:~i~i~
o 0 0 0 0 0 0 0 n1~~~hi
~ ~:~,~:~ ~ ~ ~:m'~:~:~'ml
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, I , ,I , ,I
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2 1 4 2 3 2 1 3 0 I, 21
~ ~ 1% ~ ~ ~ ~ ~ ~ ~,~i~i~
3 6 9 6 8 10 7 2 11~r_s_:-9'781
~ ~ M ~ ~ m ~ ~ M'~:~M~
o 0 0 0 0 1 0 0 0 O! 0 I-------o-~I
. ,
~ ~ ~ % ~ ~ ~ ~ ~ ~;~i~:~
,-----~-,-----I
B"""
CO POlson
CPR
Cardiac
Cluldbu1h
Chokmg
DOS
Diabetic
Drowning
Medic Statistics, Including Individual Medic Encounter and Refusal Counts
MEDIC MANAGEMENT REPORT
EMS
~easll::J
2006
OOet.ils 0CaItnU OPercents DDruqs
I~'
-,;jitlil= ,~IClIIi_ ~~~ tMll~ -~~-_..-=
'" 111 . 20 " 11
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I3l " a 15 " 11
" " 0 " 51 15
lB. lOS a " .. 11
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'" " . " .. "
!So " 13 " 52 "
,eo " 0 " ., "
- .55 " 0 20 45 "
" , " 2l " "
, . " .. "
Response Time Reports
ReSIIOMeT1raes
-.....,~I
29
:: I
" '
"
"
"
"
l5
"
"
"
"
35
~~ """'&...1fii&iiii~tP'-':.- ~~IifiiiiiJiio~'1ii1i!ii- -.o!I~_ .
911 call o.t:"':OO M-82 TrtnSlIOnand n..,ent 42:09 04:.",00 "08396 ONltn 2OONI2-04 , 04:4':00
911 can 14:26,00 M-ez TranfJIort"'dlnltment 4127 14:30:00 413887 01-tl19l1 2OD1-CZ-Q5 . 14:%6:00
911~1 15:13:00 _f-30 Tr..lment,trwuport 41Z7 15:20:00 413n5 01-196 21107.02.05 , 1$:13:00
......,
5111 911C1ln 09:51:00 M-82 T,...tment,notranspOft 4209 09:$2:00 417693 07-198 2007-0%-06 , 09:50:00
'''. 'Ueall 17:.2:00 M-82 No tn.tmaM, no transport 4209 17:+4:00 418807 07-2:01 2007-02-06 , 17:41:00
5111 '\111 call 18:'6:00 1'1.82: NOlntllnMnt,notr.nfllClrt 4209 11:315:00 418117 07.202 2007.02.06 , 11~~5:oo
"00 911l:l1ll 06:45:00 M.12 TrlnSDortlndtreMment 4127 06:48,00 419573 07-204 2007-02-07 , 06'43:00
"" 911l:l1l1 08:49:00 1'1-82 Tr<<lsportll'ldl7ettrnent 4127 011:49:00 421889 07.201 2007-02'01 . 0$:49:00
4906 911l:l111 U:31:00 1'1.82 Trlnsportlndtrl.tmlnt 4209 12:3Z:00 421984 07.210 Z001-02'01' , U:30:OO
4620 911l:l1U 14:55:00 M.82 Trlnsport and tre.tmlnt 4121 14:58:00 422056 01-%12 2001-02-01 , 14:55:00
4800 911l:l111 U:06:00 f'3D Tre~nt,notraMport 4Z10 13;01:00 422119 01.(1211 2001-01-D1 , 13:05;00
"00 911l:l1" 12:36:00 11I-82 Tr..tmlnl,tr,nsport 41Zt1 1Z~39 :00 422606 01.213 2001-02-08 S 12:34:00
n1fu5ld
'" 911l:l1l1 13:45:00 1'1-12 TrMlsportlhdtnlltrMnt "" 13:41:00 422614 01.215 2001-0Z-0I . 13_:00
.... 911l:l1ll 21;14:00 1'1-82 Tr,nsportlndtl'..tmlnt 4210 21:21:00 422122 0"0211 2001.02-08 21~13: 00
4'41 911l:l1ll 14;15:00 I'I-IZ Trlnsportll\dtnlltment 42D9 14:11:00 423160 01.220 2001-02.09 14:13:00
no 911l:l111 19:22:00 1'1.12 Trlnsportlndtnltmlnt 4121 19:25:00 425291 01.222 Z001'OZ-09 19l21:00
5125 911l:l1l1 11 :43~OO 1'1.12 F,III AVUnfoundld/Nopt 4209 425668 01-223 2001'02-10 11:42:00
"" 911l:l1U 11:45:00 "'.U No trletmlnt, no trlMport "" 11:46loo 425180 01-221 2001.112.10 17:44l00
E~po~~S .i1E)(~1 J 'ii PD_~
Drug Usage Report
Intubation Report
~~
y
N
y
y
y
N
N
y
N
y
y
Ii!I!!!ill
A-4'
A-41
A-4'
A-4'
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A-4'
A-4'
A-4'
A-4'
A-41
A-4'
Drug Us.,e Repol1
"''''---- ,~
2006-12-10 _050
ZO06-12-1' _Aspirin
2006-12-16 _H.!dol
2006,12-17 _Aspirin 1
2006-12-17 _NTG Sprn Z
2006-12-22 _Albuterol 1
2006-12-23 _Aspirin 1
2006-12-23 _Ltsix 1
2006-12-23 _NTG Spray Z
ZOO6-1Z-Z5 _NTG Spray l
2006.12-29 _wix 1
Iablb_tio" Report
1iIll4__~
JR<;.~"""--"-
.~
1
1
,
1
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1
,
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200700198
01953
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200702104
200702649
200702649
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200706872
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363930
376323
376323
376147
380362
392015
392015
414167
567719
567719
615825
2007-01-02
2007-01-18
2007-01-18
2007-01-18
2007-01-20
2007-01-25
2007-01-25
2007-02-05
2001-03-03
2007-03-03
2007-03-13
so',- ~<, ",~,'_. ~.~_.: . '~. '-.:-:' "'": .'i;N"DI-Xl;'-"< ,.r~: "'~~~:;;.~;~:">:i=,~-' '- --'~ __ ~,~l~'-"
.J 'y ,-..,' . ~ ,., iAPP-i: tt'."""'->r~"" ~ -!-~." ,- - ~,,!
- '_"__~ . . :~..,~~~,~::~~~~,~_~:~;:-,:r'~7'~:-.~"~C'": ~,~~~:
., '.".' ',,' SYST:EM;1).RCHI:rEC'flJRE;AND.sEClJR1:r.Y:,"'..~-',. , " ..';~"
:!'.,,_ -,..;r,: ~ . ,:::;-,{'<!_'j;U" ~',.~ ,'\',--'~>'i<1""";>;;!,~j."rl",,~.~^~"~~~-~;'_~-!i'';;.'.,-,,;:.;:...;.2,,,,~~_:-1__"'';J''~_'n d"~~~ ,':t ,,~-"-~
Computer Facilities/Disaster Recovery
We have included specific information below concerning the technology employed by ADPI-IMX in our operations.
Our proprietary Intermedix billing platform (IMX) has been exclusively designed by our company to provide our
customers with the most effective and actionable information and approach in the ambulance billing industry. The
personnel who have developed our platform continue to manage and expand our capabilities, and as such, we are
not reliant on any third-party vendor to make changes or adaptations to our system based upon client requests.
ADPI-IMX's billing platform is highly-advanced, providing excellent management toois and extreme security. Our
servers are hosted in highly secure high-tech data centers in Austin, Texas and Houston, Texas, Physical access to
the building is secured by guards. Physical access to the server room is secured via biometric security requiring-a
handprint (Austin) or a fingerprint (Houston).
We use Secure Socket Layer (SSL) encryption on all communications to and from our web servers outside our
domain and pOint-to-point 128 bit encrypted Virtuai Private Network (IPsec) communication between our
operations centers and the data centers.
Our systems architecture includes full redundancy and real-time replication to five servers in three locations. All
web services include load-balancing technologies to ensure maximum system response time. Our systems
architecture is depicted below:
System Architecture
~ ~ r'=~-"
~
JK Apache Tomcat
Con nector
. MyS,cil
readNvrite
~ Tomcat
EMR
I Triptix Web Service I
Key
I I ntermedix Application I
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.' lexisNexis'
Every production server is protected by lirewall rules (using Linux "iptables" or OpenBSD "pl.") Rules block
essentially all incoming traffic and blocked packets are logged. Only allowed SSL entry points can access the
servers. Our Columbus billing ollice is protected by the AT&T Network-Based Firewall. In addition to real-time
database replication committed to five servers within milliseconds, we write to L TO-2 tape backups daily and store
offsite.
-~
'c.
10Mb MUltihOmed~_
Data Connection .-
Austin Facility
A>/ 10Mb Multihomed
,y Dala Connection
)\
I"
A T& T 3Mb Data Connection
Columbus Campus
We monitor the system using advanced monitoring technologies. The system emails our software support team
anytime an exception occurs on the development or production servers. We instantly know if anything goes
wrong. We proactively monitor our system including system bandwidth at key egress/ingress p~ints with system
logs which are viewed nightly as shown below:
I~ .....rlll..F........K
:1'0....1(-....-_...
! '-.; . L...>' t!!? E;:t 1--' _,,...,>_.~u<___
i .---. . . .' .". .....
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1,1'!,w~:.........:..:_~,_uu u. .......,.l.~.v...... u." .~.::~.~~_,.::,..:..... ....n..~..ul"
'. ~ '-..' _ ,'... '.. -. "', .1. .J.;',!". '.' ..... - :.:, .'
i :t .... :t .... ,'::: ;,'., I.,:, .
I ~ u u ~ ~ w . . .. Z .. 1:0 ~ P U ~ U ~ p u ~ uP. . . 1 ~ U ~ w U ~ u
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Client Access
Each identified website user will be supplied with a login name and password. The login information is only
supplied to those employees designated and agreed upon by the department. These employees will gain access to
real-time patient information, documentation, and client specific billing information. From our system you are
able to monitor all aspects of your billing operations, including but not limited to: EMT{paramedic documentation,
call statistics, transport statistics, and many other reports. The reports that Waukesha will look at are the same
reports that ADPI-IMX has access to. These reports will be used to monitor your account and to set benchmarks
for future revenue goals and enhancements.
Disaster Recovery
ADPI-IMX developed and owns our proprietary billing software. Our in-house programming staff allows us the
flexibility to work with client's needs and eliminates the concern that a software vendor will stop operating and
leave the City with no solution. We are your total solution partner, which gives you the confidence that things will
happen quickly and according to your needs.
Our server infrastructure is built with redundancy and fault tolerance as one of the primary design goals. To
ensure uninterrupted availability and disaster recovery, ADPI-IMX utilizes a multiple server, mirrored, redundant,
geographically separated system of servers. Multiple power feeds and network feeds are provided by both
facilities. In addition, diesel generators are at each site to provide .backup power if the utility companies are
unable to provide resources. Our environment has proven to be a stable environment with more than adequate
back-up capabilities.
Every server has redundant power supplies, each fed with separate power distribution mains. As well, every server
has at least two network interfaces, each connected to different network switches. Digital images are
continuously backed up between facilities using the rsync utility. Databases are continuously backed up between
cities using the database's native data replication feature. These backups and securities will serve as ADPI-IMX's
disaster recovery plan in the case of an emergency.
Web sessions are replicated between servers in the web cluster. If one web server were to fail, "the end-user
would not even realize the session had moved to a different node in the cluster.
All servers use RAID. Our standard server RAID configuration involves using two RAID arrays in each server. The
first array is a two-disk RAID-l mirror for the OS partition. The second is a four disk RAID-S array containing the
important data files. We pay Dell for premium support for our production servers, and if any replacement parts
are necessary, the parts are shipped and received at our co-location facilities within four hours. Physical access to
our hardware at the co-location facilities is restricted to authorized personnel only. Even further, both facilities
also require biometric identity scans in order to gain physical access to the server.
Remote access to servers is restricted to authorized IT system personnel only. All remote access is protected and
encrypted using SSH (Secure Shell). Only certain IP addresses are permitted remote access.
All internet-facing servers are protected by firewalls. Inbound and outbound port access is very restricted (for
example, non-secure ports such as telnet and standard FTP not permitted). The firewalls also provide logging and
auditing services. Employee access to external web sites is restricted to a certain list of approved sites all related
directly to required job functions. Mail servers use spam detection software ("spam assassin") and virus detecting
software ("ClamAV") to protect employees email.
<'^
.
Failover capac:tty is possible due to the various redundancies in the system architecture as previously discussed.
Backups are continuous, also as previously described.
Additionally, the foliowing steps are in place to insure data integrity;
. Nightly backups of all data
. Real-time replication of billing and patient related data
. Regular oversight on all aspects of the backup plan
. Backups stored in locations that ensure protection in case of emergencies
. RAID protection which accounts for hardware failure of servers that store data
. Billing representatives login info meets HIPAA requirements for complexity
. Firewall protection
. Internal network access is limited to authorized VPN users that are trained to not share logins with anyone
. Internal access to the building is secured via a card swiping access system
. All access in to and out of the ADPHMX offices are logged electronically
. These access logs are monitored
The Compliance
Adviser
National Provider Identifier
. A new term to add to our abbreviation knowledge base is NPI,
or National Provider Identifier. The NPI is a unique
identification number for all covered health care providers,
including ambulance services. This number is used on all
insurance claim submissions including Medicare and Medicaid.
The NPI replaces separate individual numbers assigned by
each insurance carrier for service providers.
. Required use of NPls became effective last month as part of
HIPAA's Administrative Simplification Standard. By having a
unique number for each health care provider, information can
be more easily shared between providers and health plans for
billing and payment purposes.
Management Spotlight:
Janice Metzger C.P.A., Vice President
Houston Regional Office
I
mtermedix
June 2008
Inside this Issue:
National 1
Provider
18n'."",
MillUlllfll'Mnt 1
SpDtllght
T1Ht CompliMH:.
Hotline
Ongoillg Tnlining 2
Disclosures of PHI 3
EMS Abbrerilltlons 3
-- 4
C"trlttHlnts,
CDnc.",.
Oversees billing operations for 110 clients in Texas, Oklahoma, Georgia;
includes initial billing, follow-up, client visits and calls, and resolving payor
issues
10+ years ambulance billing experience (Part A-hospitals, Part B, and now a
billing company)
Participated in state ambulance associations to facilitate improved policiesl
procedures. This included working on teams with Medicare, Medicaid, state,
and local legislators for increased funding, rule interpretations, enacting new
laws, rules, policies, and adoption of condition codes
Spoken at state and national ambulance conferences
_' ~".,,~'_~':"'_'~h'"
-",'
;'.;,
"
~
2
.... 2
The Compllaince.........
The Compliance Hotline
1-877 -277 -2329
. Many questions have come up this month regarding our Compliance Hotline. As mentioned in
previous Compliance Advisers, a third'party company hired by ADPI Intermedix supplies this
service. Once the call is answered, some preliminary pieces of information are discussed. Callers
are asked if they wish to give their name or remain anonymous. At the end of the call, anonymous
callers are given a reference number which they are to use when following-up. The company
contacts our Compliance Department and the issue is then addressed with the speCific office,
Managers, etc. No caller.specific information Is given to the Compliance Department. The
responsible parties are given 2-3 weeks to report back to Compliance. At that time, callers may
call the hotline back for an update on their inquiry/issue. If they wish, they may call an additional
time and discuss things even further. Callers are never retaliated against for making calls to the
hotline. We rely on this service to give us vital information on how we are doing and areas which
could benefit from changes. If employees are not comfortable going through the traditional chain of
command (Supervisors and Managers) they are encouraged to call this line. It is available 24 hours
a day, 7 days a week, 365 days a year. Occasionally, situations arise where employees are not sure
if their concern warrants a call to the Compliance Hotline. If this happens, they are more than wel.
come to call or email someone within their own Management team Dr the Compliance Department
for advice. The only way we can continually grow as a company is by employees taking an active
role in the way we operate as a whole.
. _~u
'I. =~,@,;; ,
. II!" "'-'
~
,
"
Ongoing Training
. Jillyan Thompson traveled to our Houston office to perform the annual Compliance and HIPAA
training. This was the first of our 2008 annual office visits. She and Joe McCloskey will be In
Ohio and Miami during July for the training as well, with Denver and Oakland to follow.
. Vice President Janice Metzger also gave a presentation for information specific to Texas
Medicare and Medicaid. The staff had good questions and came away with a better under-
standing of Compliance and HIPAA rules and regulations.
. Joe McCloskey also had initial Compliance training with Okeechobee County, a new client In
upstate Florida this month.
8th EdltlOft
P_ge 3
Disclosures of PHI
. HIPAA greatly limits the disclosures EMS personnel can make.
. Anyone dealing with Customer Service phone calls should keep in mind that we must have specific
patient releases on file from attorneys. If an attorney sends a signed patient release of information
(letter of representation I for a specific date of service, we can only send them information for that
date. If they call back requesting information for additional dates of service, they must send
additional signed letters pertaining to those dates. A single signed letter encompassing multiple
dates is acceptable, but all requested dates must be clearly noted.
. We must have a patient's permission before speaking to others about their account. If a spouse,
daughter, son, aunt, neighbor, etc. calls to discuss someone else's account, the patient must have
given their consent beforehand. We cannot disclose any information without the patient's
permission. If a patient is deceased and the caller says they have power of attorney, ask them to
mail or fax proof of POA. After such proof is received, we may discuss that account.
. We are allowed to receive information from someone other than the patient, but the person
supplying that information must be noted in the account in case something turns out to be incorrect
and we need to know how we got it.
. If Managers or staff members have questions about this, you are encouraged to contact the
Compliance Department for further clarification.
Common EMS Abbreviations
. Back by popular demand; . Dx: Diagnosis . PE: Physical Exam
many employees have said . Fx: Fracture . Peripheral: toward the surface
these abbreviations have . h/o: History of PMH: Past Medical History
.
been very helpful as
references in everyday job . Hx: History . po: Per Oral (medication)
functions. . 1M: Intramuscular . POA: Power of Attorney
. 10: Intraosseous (through bone) . Posterior: towanllfrom the back
. ALS: Advanced Life Support . IV: Intravenous . PR: Per Rectum
. A & 0: Alert & Oriented . LaC: Loss of Consciousness . RMA: Refused Medical Assistance
x1:time . MCD: Medicaid . ROM: Range of Motion
x2: place . MCR: Medicare . Rx: Treatment or Prescription
x3:person . MV A: Motor Vehicle Accident . SOB: Shortne.s Of Breath
x4: situation . MIA: Mot Applicable . STAT: immediately
. Anterior: toward/from the front . NPI: Nat'1 Provider Identifier . TKO: To Keep Open
. BLS: Basic Lile Support . NIV: Nausea & Vomiting . TNT: Treatment No Transport
. crc: Chief Complaint . NKA: No Known Allergies . VS: Vital Signs
. cIa: Complains of . aTe: Over The Counter . we: Wheelchair
ADPI Intermedix
Corporate Office:
6451 N Federal Hwy
Sui te 1002
Fort Lauderdale, FL 33308
Questions, Comments, Concerns
. As always, we welcome any and all questions, comments and concerns regarding The
Compliance Adviser.
. Send questions through management or directly to .Jillyan Thompson @
ithomDson2@emsclaims.com.
. Thanks once again to all those who contributed ideas and Information to this edition of
The Compliance Adviser, especially Janice Metzger in Houston and Kimberly Clark In the
Columbus office.
I
View our web I
video at: I
www.imDactmovie I
.com/adD I
I
I
"Do the right
thing. "
The Compliance
Adviser
Intermedix Corporation
. Doug Shamon, President and Chief Executive Officer, recently
sent a letter to all employees announcing two major develop-
ments within our company.
. The first was about our corporate name change from MCI
to Intermedix Corporation. Intermedix Corporation is comprised
of EPBS Intermedix, ADPI Intermedix and Revenue Rescue
Intermedix (the fire billing portion of our company).
. The second was about Ken Cooke joining our team as the
new Chief Operating Officer. Ken most recently worked at Price
Waterhouse Coopers as their US and Global Chief Information
Officer as well as the managing partner for Enterprise Solutions
Center. As such, he oversaw all internal support functions and
managed more than 1,800 employees.
We all welcome Ken and look forward to having him as a
member of our Senior Management Team going forward.
The Compliance Hotline
1-877 -277 -2329
As a reminder, the Compliance Hotline Is available 24
hours a day, 7 days a week. Callers may choose to remain
anonymous and anonymous callers will be assigned an
individual code number for follow.up purposes. The
hotllne Is a valuable tool for our avarllrowing company
and employees should use it If they do not feel
comfortable going directly to their own Management
team.
Intermedix
Corporation
May 2008
5th Edition
Inside this issue:
CorptHIIt. Nllme 1
Chmrg.
Compli."~ Hotline 1
HIPAA InfomMthM 2
Ongoing Train;", 2
Disclosures of PHI 3
MediC.1 Terminology 3
Que.,io".. 4
Comments,
Cone....._
,...
LM
l"~
.
......~
..
.
AdvWer
...
What Does HIPAA Do?
. It gives patients more control over their health information.
. It sets boundaries on the use and release of health records.
. It establishes appropriate safeguards which health care providers must achieve to protect PHI
privacy.
. It holds violators accountable with imposable civil and criminal penalties if they violate privacy
rules.
. It strikes a balance when public responsibility supports disclosures to protect public health.
. It enables patients to find out how their information may be used and about certain disclosures of
their PHI that have been made.
. It limits release of information to the minimum reasonably needed for the purpose of disclosure.
. It gives patients the right to examine and obtain a copy of their health records and request
corrections.
. It empowers individuals to control certain uses and disclosures of their health information.
Other HIP AA Information
. g: Who must comply with HIPAA privacy standards?
. A: As required by Congress, HIPAA covers
Health plans,
Health care clearinghouses,
Health care providers who conduct certain financial and administrative transactions
electronically.
. g: Why Is HIPAA needed?
. A: Prior to HIPM, PHI could be distributed for reasons which had nothing to do with a patient's
treatment. HIPAA establishes Federal safeguards to protect the confidentiality of medical
Information. Health care providers have always tried to protect PHI. However, In today's world,
keeping paper records in locked filing cabinets doesn't cut It. With Information held and sent
electronically, HIPAA provides clear standards for the protection of PHI.
Ongoing Training
. The Compliance Department will begin the annual Compliance and HIPAA training In June. We will
be traveling to each of our Regional offices to address our own Compliance program, the need for
employees to remain informed about what we do, and new and ongoing HIPAA Information.
_&1_
Pa.e3
Disclosures of PHI
. HIPAA greatly limits the disclosures EMS personnel can make.
. There are six allowable law enforcement disclosures:
1. Required by law
2. Identification and loeation purposes
3. Crime victims
4. Decedents (coroners and funeral directors for non..crime--related deaths)
5. Crime on premises
6. Reporting crime in emergencies
. We are required to comply with an official subpoena from an agency with subpoena power. Some
examples of official subpoenas are the Office of Inspector General, a state investigative agency or a
state medical board. We are only to disclose the requested information and should maintain a record of It.
We should also notify patients because they can object to it if they so desire.
. We must respond to a request for information from a patient or their legal representative. A letter from an
attorney must have a signed authorization from the patient advising the release is permissible. If a
patient is requesting this information on their own, their request does not need to be notarized. However,
if It is an attorney's request, it must be notarized.
. g: If someone has health care POA for an individual, can they obtain access to that individual's medical
record?
. A: Ves, an individual with a health care POA will have the right to access the medical records of the
individual related to that rapresentation.
. g: Does HIPAA allow parents the right to se. their children's medical records?
. A: Yes, unless the state or loeallaws prohibit it, unless the minor obtained car. at the direction of a court
or a person appointed by the court, or unless the parent agrees the minor and health care provider have a
confidential relationship.
Common EMS Abbreviations: How many do you know?
. ALS: Advanced Life Support . Hx: History . po: Per Oral (medication)
. A & 0: Alert & Oriented . 1M: Intramuscular . POA: Power of Attomey
xi: time . 10: I"traosseous (through bone) . Posterior: towardlfrom the back
x2: place . IV: Intravenous . PR: Per Rectum
x3: person . LOC: Los. of Consciousness . RMA: Refused Medica. Assistence
x4: situation . MY A: Motor Vehicle Accident ROM: Range of Motion
.
. Anterior. towardlfrom the front N/A: Not Applicable
. . Rx: Treatment or Prescription
. BLS: Basic Life Support
. NN: Nausea & Vomiting . SOB: Shortness Of Breath
. clc: Chief Complaint
. N KA: No Known Allergies . STAT: Immediately
. c/o: Complains of
. aTe: Over The Counter . TKO: To Keep Open
. Dx: Diagnosis
. PE: Physical Exam . TNT: Treatment No T...nsport
. Fx: Fracture
. Peripheral: toward the surface . VS: Vital Signs
. h/o: History of
. PMH: Paat.... ..A-cat HistaIy . WC: Wheelchair
Intermedix
Corporation
Corporate Office:
6451 N Federal Hwy
Suite 1002
Fort Lauderdale, Fl. 33308
. Cory.pljpnce
1fr:~ . ,'r~: I'~ ":: I:t
'n;t-~>~ .'~ ~ j;: ~~~
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:" ~ ;>'~. ~,fll.,
. "
See you soon!
Questions, Comments, Concerns
. As always, we welcome any and all questions, comments and concerns regarding The
Compliance Adviser.
. Send questions through management or directly to JUlys" Thompson @
IthomDson2<<.f1emsclaims.com.
. Thanks once again to all those who contributed Ideas and Information to this edition of
The Compliance Adviser.
View our web
I video at: .
I wWW.lmoactmoVle
.com/ado
"Do the right
thing. "
San Bernardino Fire Dpartment
PO Box 510
Alameda, CA 94501
1.llIlllllIIlIlllamllll 1'29258833
Return Service Requested
San Bernardino Fire
Toll Free Main 800 339 1159
June 26, 2008
Emergency Medical
Services Bill
Date or Service: 05-12-2008
11.1.."1,1"0.1.1..1,111I1.1",11.1.1",1,,1,,,11..11,,,11.1
San Bernardino Fire Dpartment provided you emergency medical services on the above mentioned service date. At this time, we
.- lrA,~ liUt ~.airt~nc~.ff<in:-Y yOY l"..'e WsYR<lGe ~cipate-in ""l'i'rogrn....whic!l:will:pay for \h_~ ~=
services, please complete and sign the reverse side of this biD and return in the enclosed envelope.
If you do not have insurance, please call 800 339 1159 to set up a payment plan. The amount due is your responsibility.
S f.\ 1 DIEN I OF .\CCOl \ r
05-12-2008
Emergency Medical Services
200.00
AMOUNT DUE
DUE DATE
$200.00
07-26-2008
_,__________h'_.7._'__n________.._.._..h,'n _nn__....... Detach and Return ___nO_no. ................... ..--.-------...__...._..______
_ . ... _ To Pay by Master Card@,Visa@ or Discover@, ~ete the foUowing:
'tardN_DJ]].:-EIm:EEIIJ "LLLLJ . -- - EXPii'ifiooUite[D 1m
x
Signature autbori2ing paymcm according to terms of your card issuer agreemml. Date
Please note that if paying by aedit card your statement will list lntennedix, Inc.
as the men:hanL
ACCOUNT# 01782520 IIIIIHnllllllll~11II11
Amount Due $ 200.00
Payment Amount $
Due Date 07-26-2008
San Bernardino Fire Dpartment
PO Box 510
Alameda, CA 94501.9610
11.1",1"1.1.1.11",, "IIIo1I11I1'III.III1I1IN.IllIuul..U
Please make checks payable to:
San Bernadino Fire Dept
WbOD you pay by cbocIt YCHI aud10rize lIS to _ yuw- paymcul dcclroaieally.
Funds may be witbdrawn &om your account as sooa as the same day we rec:eivt
your pa_lfwe _ yuw- dIocI: eIectroaically you will... _ Y""''''''
bacI: liomyour_ illslih11ioo; _.IlIo-.o WIll_ClOY"'"
--
IMXBIIJ.3 000329P 1 935000324 178102055 ~RE
DO NOT SEND CASH
In order 10 process your claim, please provide your insurance: information below and mail the form to
SIlA BernardlDo Fire DpartOleDt, PO Box 510, Alameda, CA 94501 or fax ilto our toll-free number 1-510-632-5580
Do you have insurance? YesD No 0 (If you do flot have insurance, complete!l!l!Y the Patient Information section.)
Pc'T121l1 lrlpl1l1...J!lOn IRcqU:lcd Jnll)nnJ.l on)
Ml
o
Patienfs Sex
M 0 F 0
crr-atm ~[[TI] mial ii~lumErrTI
Telephone Number (Include Area Code)
OJ:] - OJ:] - DID
I authorize any bolder of medical or other informatioo about ~ to release to the Social Security Administration or its imcrmc:diarics or c:arricr5 or
any other govermne:ot agcocy or iasurance carrier responsible fur paymc:ut any information ~ fa- this relatcd Medicare or odx::r claim. I peamit
a copy of this au1borizarion to 'oeused in place afme origjoal and request payment ofmc:dical insurance benefits to tbescrvice provider.
Medicare ID ( Include leners and numbers)
Railroad 0
\h..dk,l.C Illfi1rJI1L llOll
P.lt __Ill 11:"1);d! tl' II'h'Pll,JLi11'
Stale
[IJ
Policy Holder's First Name
Ml Policy Holder's Last Name
o
Insurance ldentificatioo NumberlLetters
Patient~ RelatiOllship to Insured
Self 0 Spouse 0 Other 0
Primary 0
s';""'dary 0
__.,StaUL_ 7TPrnrJ.. _______
[IJ ITIITI
,\LCllL'l't llllllr;. In<,lIIJIlCC 11'lml11JlIOll
If services were. related to an accident or injury, please provide any additiooal insurance information for the responsible
party, such as homeowners, automobile, workers' compensation, or liability.
Insurance Company Name Patient's Relationship to Insun:d
Self 0 Spouse 0 Othet 0
Insurance Contact Phone Number
OJ:] - OJ:] - DID
PQlicy Holder's Last Name
For oftice use only - Patient Account Number 01782520
I l1li IIWIIUI linE 11191111111
I
Intermedix
6451 N. Federal Highway
Suite 1002
Fort Lauderdale, FL 33308
United States
www.emsclaims.com
Bill To Client
San Bernardino Fire Dept.
200 East Third Street
San Bernardino CA 92410
United States
Item
Charges per Accounts
Adjustments
Patient Credit Card Payments
Description
May 2008
May 2008 Credit Card Fees
Credit card collections
Thank you for your business.
Invoice
>D,*~( , , IrivoiCe #
5/3012008 INV3102
T~tmS
Net 30
Amount
3
Total
(1".
.
/J TT/lc II ~ c/o T ';Z"
PRICE FORM
Enclose in a separate envelope for evaluation. Failure to complete this entire
price form may result in an incomplete bid.
REQUEST FOR PROPOSALS: RFP F-08-21
DESCRIPTION OF RFP: EMS Billing Services
COMPANY NAME/ADDRESS: Advanced Data Processing, Inc.
6451 N. Federal Highway, Suite 1002
Ft. Lauderdale, FL 33308
NAME/TELEPHONE NO. OF
AUTHORIZED REPRESENTATIVE Doug Shamon, President and CEO
954-308-8705
ANNUAL PURCHASE ORDER
Effective on or about July 2, 2008 through June 30, 2009, plus three single year options, for
City's partial requirements, on an as-needed basis, with no guaranteed usage for EMS Billing
Services.
Option year one, if exercised, shall be effective July 2, 2009 through June 30, 2010.
Option year two, if exercised, shall be effective July 2, 2010 through June 30, 2011.
Ootion vear three, if exercised, shall be effective July 2, 2011 through June 30, 2012.
Actual option year pricing shall be negotiated with the successful Bidder(s) prior to exercising
of any given option year. Option years shall become effective only upon issuance by the City
of a duly authorized Purchase Order.
Please provide detailed Firm Fixed Price cost information in the spaces provided below, and
any other incidental or additional costs required to complete the Technical Specification
requirements.
PRICE FORM (continued)
The below cost proposal must contain data to support the proposed charqes.
1. Vendor purposes to be compensated for such services an amount equal to:
25% of net collections or an alternate Percent (%) of bill collections, (please state percentage.)
flat rate per incident of $12.00"
2. State the purposed charges for each of the following accounts:
a. Private Insurance
--$-25% of net collections or $12.00 per incident..
b. Self Pay Accounts
_$. ?~;O;... nf nAt r.nIlFH,,;tinm::; nr $1'00 per incident*-
c. Paramedic Membership Program Fees/Renewal
_$ 25% of membership fee collections or
! 1,5(}5 c11II IUCllly .
d. Miscellaneous Other Costs
.-.$ not aoolicable
3, Vendor shall identify and provide the costs for any additional charges that may
become billable to the City, which have not been identified above.
" no additional charges
~
~
~
Hln keeping with the request of San Bernardino our pricing proposal is expressed as a percentage of collections. We have
provided an alternative flat fee per incident pricing option for the County to consider. ADPI-IMX agrees to negotiate our percentage
of collections fee on an annual basis in the future based upon changes made by the County relative to the fees being charged by
the County to your patients and based upon data collection activities on the part of the County which could increase the amount of
insurance found on your patient accounts. If the County were to select the flat fee alternative provided, this price would be subject
to increase annually based upon the medical portion of the Consumer Price Index.
(Attach additional sheets if necessary, including supporting data for purposed charges.)
PRICE FORM (continued)
Are there any other additional or incidental costs that will be required
meet the requirements of the Technical Specifications? Yes / No
answered "Yes", please provide detail of said additional costs:_
ur firm in order to
. circle one). If you
Please indicate any elements of the Technical Specifications that cannot be met by your firm. -
ADPI HAS NO EXCEPTIONS
Have you included in your bid all informational items and forms as reqUested@ No
(circle one). If you answered "No", please explain:
This offer shall remain firm for 90 days from RFP close date.
Terms and conditions as set forth in this RFP apply to this bid.
NOT APPLICABLE
Cash discount allowable % days; unless otherwise stated, payment terms are:
Net thirty (30) days.
In signing this bid, Bidder warrants that all certifications and documents requested herein are
attached lInd properly completed and signed.
From time to time, the City may issue one or more addenda to this RFP. Below, please
indicate all Addenda to this RFP received by your firm, and the date said Addenda was/were
received.
Verification of Addenda Received
Addenda No:
Addenda No:
JULY 7, 2008
Received on:
Received on:
Addenda No: Received on: /4_r
AUTHORIZED SIGNATURE: ~Yl.-.--
PRINT SIGNER'S NAME AND TITLE: Doug Shaman
President and CEO
DATE SIGNED:
July 14, 2008
COMPANY NAME & ADDRESS:
Advanced Data Processing, Inc.
6451 N. Federal Highway, Suite 1002
Ft. Lauderdale, FL 33308
PHONE: 954- 308 - 8705
FAX:305-521-0778
EMAIL: dshamon@intermedix.com
IF SUBMITTING A "NO BID", PLEASE STATE REASON(S) BELOW: