Title
A Resolution Of The City Commission Of The City Of Hollywood, Florida, Authorizing The Appropriate City Officials To Execute An Agreement With Change Healthcare Technology Enabled Services, LLC For Emergency Medical Billing Services, Based Upon The City Of Lauderhill RFP No. RFP 2017-008 And In Accordance With Section 38.41(C)(5) Of The Code Of Ordinances (Piggyback).
Strategic Plan Focus
Public Safety
Body
Staff Recommends: Approval of the attached Resolution.
Explanation:
The Department of Fire Rescue and Beach Safety has been providing emergency ambulance treatment and transport services to the citizens of Hollywood since the late 1970’s. Since then, the nature and scope of these services has evolved from simple Basic Life Support (BLS) medical care and transport to today’s Advanced Life Support (ALS) medical care including trauma, cardiac arrest, overdose, OBGYN and complex pediatric medical protocols. Transport services are ruled under strict State and Federal laws, regulations and medical oversight. These medical and transport services are provided to all residents and visitors, regardless of medical insurance status or ability to afford the cost of the services.
As the national EMS information collection standards evolved throughout the years, all EMS agencies have been mandated to standardize their collection and reporting methods to meet the requirements of the national the EMS database known as NEMSIS, the National EMS Information System. On the State level, the Florida Prehospital EMS Tracking and Reporting System (EMSTARS) program was created to provide for the collection and transmission of electronic incident level data from EMS providers to The Florida Department of Health. EMS providers who participate in data exchange with the Florida Department of Health and the EMSTARS database must adhere to all the policies and reporting requirements stipulated in subsection 64J-1.014(1), F.A.C.
Historically, the Department has experienced a marked increase in call volumes and demand for EMS services and transports. The original transport billing methods and processes were performed by the Memorial Healthcare System and by the early 2000’s, the City decided to rely on the services of billing and collection vendors due to the large amount of transactions and complexities of Medicare, Medicaid, Private Insurance and Self Pay methodologies.
The Department has utilized the services of Advanced Data Processing Inc. (ADPI) for emergency medical transport billing and collection services for longer than anticipated as the needs of the Department have evolved throughout time. ADPI has been the vendor for the aforementioned billing and collection services since 2006 and in 2015 the Department agreed to have ADPI provide consulting services for Revenue Recognition and to enroll in the Florida EMS PEMT (Public Emergency Medical Transports) Medicaid program, and provide ongoing consulting/costing services for both the Florida CPE (Certified Public Expenditures) PEMT and the IGT (Intergovernmental Transfer) PEMT which includes Medicaid Managed Care Organizations (MCO) transport revenue programs.
In Fiscal year 2020, the Department of Fire Rescue and Beach Safety entered into an eighteen-month agreement as the Seventh Amendment to the Rescue Ambulance Billing & Related Professional Services Agreement with ADPI. This agreement was entered between the City of Hollywood as a third-party business associate and ADPI as the billing company for Emergency Rescue and Transport Services and ESO Solutions Inc. for the provision of Emergency Patient Care Reporting (EPCR) software. The EPCR software is installed on all laptop computers of our front-line units and configures the reporting data as per the State and National requirements of data collection and reporting.
The current eighteen-month agreement allowed for the flexibility of transferring the acquired software into any upcoming billing and collections agreement or process as well as providing the immediate needs of hardware for all our Advanced and Basic Life Support units in the City. The agreement was crafted in order to provide the appropriate span of time to allow our EMS Branch to seek the best custom solution moving forward.
With the assistance of the Department of Financial Services, the Division of Procurement Services and the City Attorney’s Office, Fire Rescue identified the possibilities of entering into a request for proposal, an in house process for billing and collections services and/or entering a piggyback contract to suit the Department’s needs for the provision of EMS services.
The Department has performed market research and has determined that for efficiency and operational purposes it is in its best interest to piggyback the terms of the City of Lauderhill’s Master Agreement with Change Healthcare Technology Enabled Services, LLC for handling accounts for ambulance services, collection efforts, data capturing, reporting systems and dedicated technology support.
Fiscal Impact:
Based on prior year collections, the estimated net revenue is $3.7 million. The City will be responsible for paying:
1) A service fee of 9.6% of net revenue for EMS billing. The percentage fee includes (i) 5.5% for the billing services; (ii) 1.8% for the 22 units of hardware and the software set forth in the Equipment Quote, attached hereto (collectively, “Equipment”); and (iii) 2.3% for a full-time on-site employee dedicated to hardware issues.
2) A service fee equal to 9.6% for supplemental payment recovery assistance services.
3) A fixed fee of $9.00 per Medicaid account for billing services and HIPAA related form costs of $0.65 per record.
The estimated cost to the City for these services is $565,819 which may result in an overall savings of approximately $75,000 compared to the current contract cost (dependent on actual billable incidents).
Revenue related to EMS billing will be deposited into account number 001.215001.34200.342610.000000.000.000.
Funding for the fees related to this agreement will be requested in subsequent fiscal years in account number 001.215001.52200.631170.000000.000.000.
Recommended for inclusion on the agenda by:
Mark Miller, Deputy Chief of Operations
Dan Booker, Fire Chief
George R. Keller, Jr., CPPT, Deputy City Manager