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C36730 - Emergency Medical Services Billing Svcs
STAFF REPORT CITY OF PALM DESERT ADMINISTRATIVE SERVICE DEPARTMENT MEETING DATE: June 14, 2018 PREPARED BY: Stephen Y. Aryan, Risk Manager REQUEST: Approval of Five Year Agreement (Contract No. C36730) with Wittman Enterprises to provide Emergency Medical Services (EMS) Billing Services. Recommendation 1. By minute motion: a) Approve Contract No. C36730 with Wittman Enterprises to provide emergency medical services billing services; b) authorize the City Manager to execute said agreement subject to finalization and any non-substantive modification by the City Attorney; c) appropriate $110,000 for administration fees in Fund 230, Fire Tax Fund; and d) authorize the City Manager authority to take any steps necessary to effectuate the actions approved herein. Commission Action City of Palm Desert Public Safety Commission The Palm Desert Public Safety Commission reviewed this item originally on October 11, 2017, and recommended that the City Council approve (by a 5-1-1 vote) an emergency medical services billing program for cost recovery. Cove Communities Services Commission On October 17, 2017, the Cove Commission passed a resolution recommending that each Cove city (Palm Desert, Rancho Mirage, and Indian Wells) adopt a resolution establishing that each of these cities shall not balance bill residents of any Cove city for unpaid balance related to emergency medical services. A resident is defined as a person residing within the jurisdictional boundaries of Palm Desert, Rancho Mirage, and Indian Wells. The Cove Commission does not intend that their recommendation or resolution be construed to impact a City's ability to bill and/or collect from a resident's insurance provider for emergency medical services rendered. Strategic Plan & Citywide Goals One of the identified 2017 Citywide Goals, under the financial performance section, is to consider a program for cost recovery of EMS services provided to transport patients, similar to that of neighboring cities. Priority 1 of the Public Safety & Emergency Services Chapter within the Strategic Plan aims to enhance the delivery of public safety services. A cost recovery program will put the City in a better financial position to expand existing services provided by the Fire Department and to address future growth and safety concerns. Executive Summary One of the identified 2017 Citywide Goals is to consider a cost recovery program, similar to that of neighboring cities, for emergency medical services that provide emergency medical care and transports for patients. A City sub-committee consisting of two Councilmembers, a public safety June 14, 2018—Staff Report Contract No. C36730: Wittman Enterprises Page 2 of 6 commissioner, Fire Department representatives, and staff met to discuss such a program at length over several months. The committee recommended a program that mirrors the neighboring Cove cities of Indian Wells and Rancho Mirage, utilizing their service provider, Novato Fire Protection District (NFPD). On January 11, 2018, the City Council approved entering into a Joint Powers Agreement with the NFPD to provide emergency medical services (EMS) billing services, including ambulance transports and related medical care costs. However, NFPD soon thereafter indicated that they would no longer be providing such services. At this public hearing the City also approved the EMS Cost Recovery Program's write off policy and fee schedule, as identified within this report. In March 2018, Staff issued a notice inviting proposals for emergency medical services billing and cost recovery services and received seven proposals. This program enables the City to bill Medicare and other private health insurance providers for EMS and ambulance transports for all insured patients, regardless of residency. Under this proposed plan, there will be no out of pocket costs for Palm Desert, Rancho Mirage, or Indian Wells (Cove communities) residents. Wittman Enterprises indicated an estimate of approximately $3 million dollars in cost recovery, based on the City's current write off policy/fee structure and contingent upon patient calls for services/transport volume. Background Analysis On July 24, 1980, the Palm Desert City Council passed Ordinance No. 233, levying a special tax for upgrading fire prevention and protection services. In 2009, this tax was increased to its maximum levy of sixty dollars ($60.00), as permitted under the ordinance. Over the years, emergency medical services have greatly increased and constitute 75% to 80% of the Fire Department calls for service. Tax revenue collected has not covered the expenses and requires an increased financial commitment from the general fund. In FY 2017/18 this amount totaled approximately $3.7 million. There are currently four ambulances in service within the City of Palm Desert, seven days per week, and twenty-four hours per day. As a matter of protecting the community's health and safety the City maintains an additional three ambulances in reserve. The Fire Department provided approximately 5,900 ambulance transports last fiscal year, a number which increases annually and is expected to continue to do so as the city's population rises. Historically, the Cove communities of Palm Desert, Rancho Mirage, and Indian Wells have not billed insurance or individuals for Emergency Medical Services (EMS). Last year these three cities discussed exploring emergency medical services cost recovery methods that would not increase resident taxes or create a new fee. This discussion identified the best method as a program utilizing a third party to invoice insurance companies. Staff met with the Cities of Rancho Mirage and Indian Wells to discuss implementation options and informally interviewed two emergency medical services billing providers: Wittman Enterprises, LLC and the Novato Fire Protection District (NFPD). Rancho Mirage and Indian Wells subsequently entered into a Joint Powers Agreement with NFPD, a public agency, to implement EMS billing services on July 1, 2017. However, as NFPD is ending its contract with all their clients on July 1, 2018, these two cities are moving forward with entering into separate agreements with Wittman Enterprises. June 14, 2018—Staff Report Contract No. C36730: Wittman Enterprises Page 3 of 6 On January 11, 2018, the City Council approved entering into a Joint Powers Agreement with the NFPD to provide emergency medical (EMS) billing services, including ambulance transports and related medical care costs. As NFPD is no longer providing these services, Staff issued a notice inviting proposals for emergency medical services billing and cost recovery services and received seven responses. A review committee consisting of two council members and various staff reviewed the proposals, based on various measures including method of approach, qualifications and experience, staffing, and cost. However, the ultimate recommendation from the review committee came as a result of a deliberative process of those members present. The following is a ranking of these firms based on this deliberative process: 1. Wittman Enterprises (Rancho Cordova, CA) 2. Digitech (Chappaqua, NY) 3. EMS MC (Winston-Salem, NC) 4. Lifequest Services (Wautoma, WI) 5. Intermedix (Fort Lauderdale, FL) 6. Fire Recovery EMS (Arlington Heights, IL) 7. Change Healthcare EMS (Nashville, TN) The recommended vendor, Wittman Enterprises, is the only firm reviewed that had its entire business operations in California and they also have over 25 years of EMS billing experience. Their numerous clients include the cities of Beverly Hills, Newport Beach, Carlsbad, Pasadena, Huntington Beach, and San Diego, San Bernardino, and Santa Barbara Counties. Locally, they also oversee EMS billing for the Cities of Indio and Cathedral City. As such, Wittman has an existing relationship with local hospitals and proven experience in billing for Riverside County Fire Department/CalFire, who Palm Desert also contracts with for fire and EMS services. The review committee recommends entering into an agreement with Wittman Enterprises to provide EMS billing services. Under this program, patients will see no change in emergency medical response. Emergency medical personnel are currently collecting patient and insurance information. This data would be provided to Wittman, who in turn will create the appropriate invoices and communications, coordinate the collection of payments, and perform other administrative services as outlined in their proposal. Procedures are included for the treatment of insured non-residents and uninsured patients, as identified in the Write-Off Policy below. Write-Off Policy A Write-Off Policy is required and provides direction to Wittman Enterprises on how the City will or will not pursue collections on amounts not paid by insurance. The goal of this program is to collect payments from Medicare and other health insurance providers, without out of pocket costs for Palm Desert and Cove communities residents. The City will collect only what Medicare or other health insurance providers will pay and the remainder of the bill not paid by insurance (i.e. "the balance bill") will be waived. Under existing law, any non-resident is required to be balance billed. Cove residents do not fall under this requirement because of the current JPA that forms the Cove Communities Services Commission. In keeping with the goal of residents not incurring costs and not having an adversarial collections program, the Write-Off Policy will waive the full cost for any individual without insurance coverage. The City Council approved the following Write-Off Policy on January 11, 2018: June 14, 2018-Staff Report Contract No. C36730: Wittman Enterprises Page 4 of 6 Patients that reside within the jurisdictional boundaries of the Cities of Palm Desert, Rancho Mirage, and Indian Wells (Cove communities) shall not be balanced billed. The City accepts insurance payments as payments in full. All patients will receive a maximum of four (4) insurance information request notices, should insurance not be provided at the time of service. For those patients that reside outside of the jurisdictional boundaries of the Cities of Palm Desert, Rancho Mirage and Indian Wells, the City's contracted EMS/ambulance billing company will send one balance bill as required under law. Accounts that have had no activity for 90 days will be deemed uncollectable at that time and will be written off. Any patient without insurance is deemed eligible for a financial hardship waiver; the City will write the accounts off. All other billing aspects shall comply with state and federal law. Staff plans to initiate a broad public outreach campaign informing residents on this new billing program through a variety of means, including the City's website and Brightside Newsletter, before the expected initiation date. As noted, there was one dissenting vote for this program when the Public Safety Commission reviewed this matter in October 2017. Commissioner Kramer cast the sole dissenting vote and was concerned about how the City classified residents and non-residents and waiting 90 days before waiving any uncollected debt. When transporting a patient to the hospital, the Fire Department requests various health and insurance questions, including asking for the patient's address. Staff recommends that a patient's residency be based upon the response provided to the Fire Department. There may be situations where the patient has two homes and does not provide their Palm Desert address. In such cases, the patient can contact the billing vendor and request an update to their records, whereby they would be classified as a resident under this program. It is also important to note that if someone is insured; their health insurance company will be billed regardless of residency status. However, in the case of a non-resident, once an insurance payment is made any remaining unpaid amount will be submitted to them for payment in the form of a "balance bill". Under existing law, any non-resident is required to be balance billed. Staff recommends a 90 day waiting period to collect the debt and writing off any amount not collected. This period of time is in line with industry standards. Staff also does not recommend placing the City into an adversarial position to collect debt from economically disadvantaged individuals, who may also be suffering serious health issues. Fee Schedule The City Council approved fee schedule below was developed in concert with the Fire Department and included an analysis of actual costs and neighboring cities' fees. It represents the reasonable costs of providing emergency medical services in Palm Desert. Typically, private and public insurance companies pay a portion of these fees based on their own guidelines. This program will provide partial cost recovery because public or private insurance payments would be considered payment in full. In addition to billing for emergency medical services, Medicare and other health insurance providers allow for line item billing. In many cases, medical aid is provided both during medical June 14, 2018-Staff Report Contract No. C36730: Wittman Enterprises Page 5 of 6 transports and also when no medical transport is provided. The identified line item fees below will assist the City in cost recovery for different types of medical aid provided by the Fire Department. Please note that Medicare and other health insurance providers only pay a designated lower amount for such services. As with medical transports, these fees will be charged to Medicare and other health insurance providers with no out of pocket costs for Cove communities' residents. The fee schedule below will likely be identical for all three Cove cities and was derived from the cost study initiated by Indian Wells and Rancho Mirage and in concert with the Fire Department. Such action is necessary because based on the regional fire protection program, Cove residents can be served by ambulances from all three communities, irrespective of geographic boundaries. A single fee structure will help eliminate any confusion and be more efficient. Staff reviewed the City's actual expenditures to provide emergency medical services, based on an analysis of both direct and indirect costs, and confirms that the fee schedule below is consistent with the City's costs. Fee Description Fee Amount Ambulance Transportation $1,450.00 Ambulance Mileage Rate $29.00 p/mile Non-Transport Fee $425.00 Oxygen $132.00 Extra Attendant $155.00 Wait Time - per 1/2 hour $82.20 First Responder/Pre-Stabilization $400.00 Basic Life Support (BLS) Disposable Supplies $303.75 Advanced Life Support (ALS) Disposable Supplies $382.00 Twelve (12) Lead EKG $285.00 Three (3) Lead EKG $156.48 Fiscal Analysis Wittman Enterprises anticipates approximately $3 million annually in EMS cost recovery, based on the City's current write off policy/fee structure and contingent upon patient calls for services/transport volume. Actual revenue collections may vary based on factors such as changes in number of transports, payor mix, or laws affecting EMS service collections. Staff negotiated the following fee structure with Wittman Enterprises based on a flat rate of per patient transaction: Year 1-2: $18.00 per transaction Year 3-4: $19.00 per transaction Year 5: $21.00 per transaction June 14, 2018—Staff Report Contract No. C36730: Wittman Enterprises Page 6 of 6 Based on current ambulance transport totals, annualized billing costs for the five year agreement are estimated to be approximately $500,000. Billing related services and staff time will be included in the assumption for future fiscal years as ongoing expenses. LEGAL REVIEW DEPT. REVIEW FINANCIAL REVIEW CITY MANAGER b rgreaves Lori Carney Janet Moore auri Aylaian City torn \ Director of Administrative Director of Finance City Manager Service ATTACHMENTS: 1.Draft Contract No. C36730 2. Wittman Enterprises Proposal 3. City of Palm Desert Resolution No. 2018-03 EMS BILLING SERVICES CITY OF PALM DESERT PROFESSIONAL CONSULTANT SERVICES AGREEMENT 1. PARTIES AND DATE. This Agreement is made and entered into this day of , 20 , by and between the City of Palm Desert, a municipal corporation, organized under the laws of the State of California, with its principal place of business at 73-510 Fred Waring Drive, Palm Desert, California, 92260 ("City") and Wittman Enterprises, a Limited Liability Company, with its principal place of business at 11093 Sun Center Drive, Rancho Cordova, CA 95670 ("Consultant"). City and Consultant are sometimes individually referred to herein as "Party" and collectively as "Parties." 2. RECITALS. 2.1 Consultant. Consultant desires to perform and assume responsibility for the provision of certain professional Emergency Medical Services (EMS) Cost Recovery services required by the City on the terms and conditions set forth in this Agreement. Consultant represents that it is experienced in providing professional EMS Cost Recovery consulting services to public clients, is licensed in the State of California, and is familiar with the plans of City. 2.2 Project. City desires to engage Consultant to render such professional EMS Cost Recovery services for the City of Palm Desert EMS Cost Recovery Program, Contract No.C36730 ("Project") as set forth in this Agreement. 3. TERMS. 3.1 Scope of Services and Term. 3.1.1 General Scope of Services. Consultant promises and agrees to furnish to the City all labor, materials, tools, equipment, services, and incidental and customary work necessary to fully and adequately supply the professional EMS Billing consulting services necessary for the Project ("Services"). The Services are more particularly described in Exhibit "A" attached hereto and incorporated herein by reference. All Services shall be subject to, and performed in accordance with, this Agreement, the exhibits attached hereto and incorporated herein by reference, and all applicable local, state and federal laws, rules and regulations. 3.1.2 Term. The term of this Agreement shall be from June 30, 2018 to June 30, 2023 unless earlier terminated as provided herein. The City shall have the unilateral option, at its sole discretion, to renew this Agreement automatically for no more than one additional five-year terms. Consultant shall complete the Services within the term of this Agreement, and shall meet any other established schedules and deadlines. QQUQQ Q I f f fl\11 I Rif,I d 1 CONTRACT NO. C36730 3.2 Responsibilities of Consultant. 3.2.1 Independent Contractor; Control and Payment of Subordinates. The Services shall be performed by Consultant or under its supervision. Consultant will determine the means, methods and details of performing the Services subject to the requirements of this Agreement. City retains Consultant on an independent contractor basis and not as an employee. Consultant retains the right to perform similar or different services for others during the term of this Agreement. Any additional personnel performing the Services under this Agreement on behalf of Consultant shall also not be employees of City and shall at all times be under Consultant's exclusive direction and control. Neither City, nor any of its officials, officers, directors, employees or agents shall have control over the conduct of Consultant or any of Consultant's officers, employees, or agents, except as set forth in this Agreement. Consultant shall pay all wages, salaries, and other amounts due such personnel in connection with their performance of Services under this Agreement and as required by law. Consultant shall be responsible for all reports and obligations respecting such additional personnel, including, but not limited to: social security taxes, income tax withholding, unemployment insurance, disability insurance, and workers' compensation insurance. 3.2.2 Schedule of Services. Consultant shall perform the Services expeditiously, within the term of this Agreement. Consultant represents that it has the professional and technical personnel required to perform the Services in conformance with such conditions. In order to facilitate Consultant's conformance with the Schedule, City shall respond to Consultant's submittals in a timely manner. Upon request of City, Consultant shall provide a more detailed schedule of anticipated performance to meet the Schedule of Services. 3.2.3 Conformance to Applicable Requirements. All work prepared by Consultant shall be subject to the approval of City. 3.2.4 Substitution of Key Personnel. Consultant has represented to City that certain key personnel will perform and coordinate the Services under this Agreement. Should one or more of such personnel become unavailable, Consultant may substitute other personnel of at least equal competence upon written approval of City. In the event that City and Consultant cannot agree as to the substitution of key personnel, City shall be entitled to terminate this Agreement for cause. As discussed below, any personnel who fail or refuse to perform the Services in a manner acceptable to the City, or who are determined by the City to be uncooperative, incompetent, a threat to the adequate or timely completion of the Project or a threat to the safety of persons or property, shall be promptly removed from the Project by the Consultant at the request of the City. The key personnel for performance of this Agreement are as follows: [INSERT NAME, TITLE AND LICENSE/CERTIFICATION NUMBER]. 3.2.5 City's Representative. The City hereby designates Lori Carney, Director of Administrative Services, or her designee,to act as its representative in all matters pertaining to the administration and performance of this Agreement ("City's Representative"). Consultant shall not accept direction or orders from any person other than the City Manager, City's Representative or her designee. City's Representative shall have the power to act on behalf of the City for review and approval of all products submitted by Consultant, but not the authority to enlarge the Scope of Work or change the total compensation due to Consultant under this Agreement. The City Manager shall be authorized to act on City's behalf and to execute all necessary documents which increase the Scope of Work or change the Consultant's total compensation, subject to the provisions contained in Section 3.3 of this Agreement. n(1(1(1(1(11(J(1111 1 41A 1 A I CONTRACT NO. C36730 3.2.6 Consultant's Representative. Consultant hereby designates 'INSERT NAME, TITLE, AND LICENSE/CERTIFICATION NUMBER', or his/her designee, to act as its representative for the performance of this Agreement ("Consultant's Representative"). Consultant's Representative shall have full authority to represent and act on behalf of the Consultant for all purposes under this Agreement. The Consultant's Representative shall supervise and direct the Services, using his/her best skill and attention, and shall be responsible for all means, methods, techniques, sequences, and procedures and for the satisfactory coordination of all portions of the Services under this Agreement. 3.2.7 Coordination of Services. Consultant agrees to work closely with City staff in the performance of Services and shall be available to City's staff, consultants and other staff at all times. 3.2.8 Standard of Care; Performance of Employees. Consultant shall perform all Services under this Agreement in a skillful and competent manner, consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California. Consultant represents and maintains that it is skilled in the professional calling necessary to perform the Services. Consultant warrants that all employees and subconsultants shall have sufficient skill and experience to perform the Services assigned to them. Finally, Consultant represents that it, its employees and subconsultants have all licenses, permits, qualifications and approvals of whatever nature that are legally required to perform the Services, and that such licenses and approvals shall be maintained throughout the term of this Agreement. As provided for in the indemnification provisions of this Agreement, Consultant shall perform, at its own cost and expense and without reimbursement from the City, any services necessary to correct errors or omissions which are caused by the Consultant's failure to comply with the standard of care provided for herein. Any employee of the Consultant or its sub- consultants who is determined by the City to be uncooperative, incompetent, a threat to the adequate or timely completion of the Project, a threat to the safety of persons or property, or any employee who fails or refuses to perform the Services in a manner acceptable to the City, shall be promptly removed from the Project by the Consultant and shall not be re-employed to perform any of the Services or to work on the Project. 3.2.9 Laws and Regulations. Consultant shall keep itself fully informed of and in compliance with all local, state and federal laws, rules and regulations in any manner affecting the performance of the Project or the Services, including all Cal/OSHA requirements, and shall give all notices required by law. Consultant shall be liable for all violations of such laws and regulations in connection with Services. If Consultant performs any work knowing it to be contrary to such laws, rules and regulations, Consultant shall be solely responsible for all costs arising therefrom. Consultant shall defend, indemnify and hold City, its officials, directors, officers, employees, agents, and volunteers free and harmless, pursuant to the indemnification provisions of this Agreement, from any claim or liability arising out of any failure or alleged failure to comply with such laws, rules or regulations. 3.2.9.1 Employment Eligibility; Consultant. By executing this Agreement, Consultant verifies that it fully complies with all requirements and restrictions of state and federal law respecting the employment of undocumented aliens, including, but not limited to, the Immigration Reform and Control Act of 1986, as may be amended from time to time. Such requirements and restrictions include, but are not limited to, examination and retention of documentation confirming the identity and immigration status of each employee of the Consultant. Consultant also verifies that it has not committed a violation of any such law within the five (5) years immediately preceding the date of execution of this Agreement, and shall not violate any such law at any time during the term of the Agreement. Consultant shall avoid any .„,nc,c,ClIG.G.11‘21 I 521AI A I CONTRACT NO. C36730 violation of any such law during the term of this Agreement by participating in an electronic verification of work authorization program operated by the United States Department of Homeland Security, by participating in an equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, or by some other legally acceptable method. Consultant shall maintain records of each such verification, and shall make them available to the City or its representatives for inspection and copy at any time during normal business hours. The City shall not be responsible for any costs or expenses related to Consultant's compliance with the requirements provided for in Section 3.2.9 or any of its sub-sections. 3.2.9.2 Employment Eligibility; Subcontractors, Consultants, Sub-subcontractors and Subconsultants. To the same extent and under the same conditions as Consultant, Consultant shall require all of its subcontractors, consultants, sub-subcontractors and subconsultants performing any work relating to the Project or this Agreement to make the same verifications and comply with all requirements and restrictions provided for in Section 3.2.9.1. 3.2.9.3Emplovment Eligibility; Failure to Comply. Each person executing this Agreement on behalf of Consultant verifies that they are a duly authorized officer of Consultant, and understands that any of the following shall be grounds for the City to terminate the Agreement for cause: (1) failure of Consultant or its subcontractors, consultants, sub- subcontractors or subconsultants to meet any of the requirements provided for in Sections 3.2.10.1 or 3.2.10.2; (2) any misrepresentation or material omission concerning compliance with such requirements (including in those verifications provided to the Consultant under Section 3.2.10.2); or (3) failure to immediately remove from the Project any person found not to be in compliance with such requirements. 3.2.10 Insurance. Without limiting Consultant's indemnification of City, and prior to commencement of Work, Consultant shall obtain, provide and maintain at its own expense during the term of this Agreement, policies of insurance of the type and amounts described below and in a form that is satisfactory to City. General Liability Insurance. Consultant shall maintain commercial general liability insurance with coverage at least as broad as Insurance Services Office form CG 00 01, in an amount not less than $1,000,000 per occurrence, $2,000,000 general aggregate, for bodily injury, personal injury, and property damage. The policy must include contractual liability that has not been amended. Any endorsement restricting standard ISO "insured contract" language will not be accepted. Automobile Liability Insurance. Consultant shall maintain automobile insurance at least as broad as Insurance Services Office form CA 00 01 covering bodily injury and property damage for all activities of the Consultant arising out of or in connection with Work to be performed under this Agreement, including coverage for any owned, hired, non-owned or rented vehicles, in an amount not less than $1,000,000 combined single limit for each accident. Professional Liability (Errors & Omissions) Insurance. Consultant shall maintain professional liability insurance that covers the Services to be performed in connection with this Agreement, in the minimum amount of $1,000,000 per claim and in the aggregate. Any policy inception date, continuity date, or retroactive date must be before the effective date of this agreement and Consultant agrees to maintain continuous coverage through a period no less than three years after completion of the services required by this agreement. 99999 91660\11 I g3614_I CONTRACT NO. C36730 Workers' Compensation Insurance. Consultant shall maintain Workers' Compensation Insurance (Statutory Limits) and Employer's Liability Insurance (with limits of at least $1,000,000). Consultant shall submit to City, along with the certificate of insurance, a Waiver of Subrogation endorsement in favor of the City of Palm Desert, its officers, agents, employees and volunteers. Umbrella or Excess Liability Insurance. Consultant may opt to utilize umbrella or excess liability insurance in meeting insurance requirements. In such circumstances, Consultant may obtain and maintain an umbrella or excess liability insurance policy with limits that will provide bodily injury, personal injury and property damage liability coverage at least as broad as the primary coverages set forth above, including commercial general liability and employer's liability. Such policy or policies shall include the following terms and conditions: • A drop down feature requiring the policy to respond if any primary insurance that would otherwise have applied proves to be uncollectible in whole or in part for any reason; • Pay on behalf of wording as opposed to reimbursement; • Concurrency of effective dates with primary policies; and • Policies shall "follow form" to the underlying primary policies. • Insureds under primary policies shall also be insureds under the umbrella or excess policies. Fidelity Coverage. If applicable, Consultant shall provide evidence of fidelity coverage on a blanket fidelity bond or other acceptable form. Limits shall be no less than $1,000,000 per occurrence. Cyber Liability Insurance. Consultant shall procure and maintain Cyber Liability insurance with limits of $1,000,000 per occurrence/loss, which shall include the following coverage: a. Liability arising from the theft, dissemination and/or use of confidential or personally identifiable information; including credit monitoring and regulatory fines arising from such theft, dissemination or use of the confidential information. b. Network security liability arising from the unauthorized use of, access to, or tampering with computer systems. c. Liability arising from the failure of technology products (software) required under the contract for Consultant to properly perform the services intended. d. Electronic Media Liability arising from personal injury, plagiarism or misappropriation of ideas, domain name infringement or improper deep- linking or framing, and infringement or violation of intellectual property rights. e. Liability arising from the failure to render professional services If coverage is maintained on a claims-made basis, Consultant shall maintain such coverage for an additional period of three (3) years following termination of the contract. QQQUUUIhhll\1IIHi 1d I CONTRACT NO. C36730 OTHER PROVISIONS OR REQUIREMENTS Proof of Insurance. Consultant shall provide certificates of insurance to City as evidence of the insurance coverage required herein, along with a waiver of subrogation endorsement for workers' compensation. Insurance certificates and endorsements must be approved by City's Risk Manager prior to commencement of performance. Current certification of insurance shall be kept on file with City at all times during the term of this contract. City reserves the right to require complete, certified copies of all required insurance policies, at any time. Duration of Coverage. Consultant shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property, which may arise from or in connection with the performance of the Work hereunder by Consultant, his/her agents, representatives, employees or subconsultants. Primary/Non-Contributing. Coverage provided by Consultant shall be primary and any insurance or self-insurance procured or maintained by City shall not be required to contribute with it. The limits of insurance required herein may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of City before the City's own insurance or self-insurance shall be called upon to protect it as a named insured. City's Rights of Enforcement. In the event any policy of insurance required under this Agreement does not comply with these specifications, or is canceled and not replaced, City has the right, but not the duty, to obtain the insurance it deems necessary and any premium paid by City will be promptly reimbursed by Consultant, or City will withhold amounts sufficient to pay premium from Consultant payments. In the alternative, City may cancel this Agreement. Acceptable Insurers. All insurance policies shall be issued by an insurance company currently authorized by the Insurance Commissioner to transact business of insurance or is on the List of Approved Surplus Line Insurers in the State of California, with an assigned policyholders' Rating of A- (or higher) and Financial Size Category Class VII (or larger) in accordance with the latest edition of Best's Key Rating Guide, unless otherwise approved by the City's Risk Manager. Waiver of Subrogation. All insurance coverage maintained or procured pursuant to this agreement shall be endorsed to waive subrogation against the City of Palm Desert, its elected or appointed officers, agents, officials, employees and volunteers, or shall specifically allow Consultant or others providing insurance evidence in compliance with these specifications to waive their right of recovery prior to a loss. Consultant hereby waives its own right of recovery against the City of Palm Desert, its elected or appointed officers, agents, officials, employees and volunteers, and shall require similar written express waivers and insurance clauses from each of its sub-contractors. Enforcement of Contract Provisions (non estoppel). Consultant acknowledges and agrees that any actual or alleged failure on the part of the City to inform Consultant of non-compliance with any requirement imposes no additional obligations on the City nor does it waive any rights hereunder. Requirements Not Limiting. Requirements of specific coverage features or limits contained in this Section are not intended as a limitation on coverage, limits or other requirements, or a waiver of any coverage normally provided by any insurance. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue and is not intended by 99999.91660\31 183614.1 CONTRACT NO. C36730 any party or insured to be all inclusive, or to the exclusion of other coverage, or a waiver of any type. If the Consultant maintains higher limits than the minimums shown above, the City requires and shall be entitled to coverage for the higher limits maintained by the Consultant. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. Notice of Cancellation. Consultant agrees to oblige its insurance agent or broker and insurers to provide to City with a thirty (30) day notice of cancellation (except for nonpayment for which a ten (10) day notice is required) or nonrenewal of coverage for each required coverage. Additional Insured Status. General liability and automobile liability policies shall provide or be endorsed to provide that the City of Palm Desert and its officers, officials, employees, agents, and volunteers shall be additional insureds with regard to liability and defense of suits or claims arising out of the performance of the Agreement, under such policies. This provision shall also apply to any excess/umbrella liability policies. Prohibition of Undisclosed Coverage Limitations. None of the coverages required herein will be in compliance with these requirements if they include any limiting endorsement of any kind that has not been first submitted to City and approved of in writing. Separation of Insureds. A severability of interests provision must apply for all additional insureds ensuring that Consultant's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the insurer's limits of liability. The policy(ies) shall not contain any cross-liability exclusions. Pass Through Clause. Consultant agrees to ensure that its sub-consultants, sub-contractors, and any other party involved with the project who is brought onto or involved in the project by Consultant, provide the same minimum insurance coverage and endorsements required of Consultant. Consultant agrees to monitor and review all such coverage and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this section. Consultant agrees that upon request, all agreements with consultants, sub- contractors, and others engaged in the project will be submitted to City for review. Citv's Right to Revise Specifications. The City reserves the right at any time during the term of the contract to change the amounts and types of insurance required by giving the Consultant ninety (90) days advance written notice of such change. If such change results in substantial additional cost to the Consultant, the City and Consultant may renegotiate Consultant's compensation. Self-Insured Retentions. Any self-insured retentions must be declared to and approved by City. City reserves the right to require that self-insured retentions be eliminated, lowered, or replaced by a deductible. Self-insurance will not be considered to comply with these specifications unless approved by City. Timely Notice of Claims. Consultant shall give City prompt and timely notice of claims made or suits instituted that arise out of or result from Consultant's performance under this Agreement, and that involve or may involve coverage under any of the required liability policies. Additional Insurance. Consultant shall also procure and maintain, at its own cost and expense, any additional kinds of insurance, which in its own judgment may be necessary for its proper protection and prosecution of the Work. 99999.91660\31183614.I CONTRACT NO. C36730 Safety. Consultant shall execute and maintain its work so as to avoid injury or damage to any person or property. In carrying out its Services, the Consultant shall at all times be in compliance with all applicable local, state and federal laws, rules and regulations, and shall exercise all necessary precautions for the safety of employees appropriate to the nature of the work and the conditions under which the work is to be performed. Safety precautions, where applicable, shall include, but shall not be limited to: (A) adequate life protection and lifesaving equipment and procedures; (B) instructions in accident prevention for all employees and sub-contractors, such as safe walkways, scaffolds, fall protection ladders, bridges, gang planks, confined space procedures, trenching and shoring, equipment and other safety devices, equipment and wearing apparel as are necessary or lawfully required to prevent accidents or injuries; and (C) adequate facilities for the proper inspection and maintenance of all safety measures. 3.3 Fees and Payments. 3.3.1 Compensation. Consultant shall receive compensation for all Services rendered under this Agreement at the rates set forth in Exhibit "B" attached hereto and incorporated herein by reference. 3.3.2 Payment of Compensation. Consultant shall submit to City a monthly invoice which indicates work completed and hours of Services rendered by Consultant. The invoice shall describe the amount of Services provided since the initial commencement date, or since the start of the subsequent billing periods, as appropriate, through the date of the invoice. City shall, within 30 days of receiving such invoice, review the invoice and pay all non-disputed and approved charges thereon. If the City disputes any of Consultant's fees, the City shall give written notice to Consultant within thirty (30) days of receipt of an invoice of any disputed fees set forth therein. 3.3.3 Reimbursement for Expenses. Consultant shall not be reimbursed for any expenses unless authorized in writing by City, or included in Exhibit "B" of this Agreement. 3.3.4 Extra Work. At any time during the term of this Agreement, City may request that Consultant perform Extra Work. As used herein, "Extra Work" means any work which is determined by City to be necessary for the proper completion of the Project, but which the Parties did not reasonably anticipate would be necessary at the execution of this Agreement. Consultant shall not perform, nor be compensated for, Extra Work without authorization from the City Council or City Manager, as applicable, per the Palm Desert Municipal Code. 3.3.5 Rate Increases. In the event that this Agreement is renewed pursuant to Section 3.1.2, the rate set forth in Exhibit "B" may be adjusted each year at the time of renewal as set forth in Exhibit "B." 3.3.6 Prevailing Wages. Consultant is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. If the Services are being performed as part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, Consultant agrees to fully comply with such Prevailing Wage Laws. City shall provide Consultant with a copy of the prevailing rates of per diem wages in effect at the commencement of this Agreement. Consultant shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the Services available to interested parties upon request, and shall 00000 OIA(.fWfl 12 AId I CONTRACT NO. C36730 post copies at the Consultant's principal place of business and at the project site. Consultant shall defend, indemnify and hold the City, its officials, officers, employees, agents, and volunteers free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 3.4 Accounting Records. 3.4.1 Maintenance and Inspection. Consultant shall maintain complete and accurate records with respect to all costs and expenses incurred under this Agreement. All such records shall be clearly identifiable. Consultant shall allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to the Agreement for a period of three (3) years from the date of final payment under this Agreement. 3.5 General Provisions. 3.5.1 Termination of Agreement. 3.5.1.1 Grounds for Termination. City may, by written notice to Consultant, terminate the whole or any part of this Agreement at any time and without cause by giving written notice to Consultant of such termination, and specifying the effective date thereof, at least seven (7) days before the effective date of such termination. Upon termination, Consultant shall be compensated only for those services which have been adequately rendered to City, and Consultant shall be entitled to no further compensation. Consultant may not terminate this Agreement except for cause. 3.5.1.2 Effect of Termination. If this Agreement is terminated as provided herein, City may require Consultant to provide all finished or unfinished Documents and Data and other information of any kind prepared by Consultant in connection with the performance of Services under this Agreement. Consultant shall be required to provide such document and other information within fifteen (15) days of the request. 3.5.1.3 Additional Services. In the event this Agreement is terminated in whole or in part as provided herein, City may procure, upon such terms and in such manner as it may determine appropriate, services similar to those terminated. 3.5.2 Delivery of Notices. All notices permitted or required under this Agreement shall be given to the respective parties at the following address, or at such other address as the respective parties may provide in writing for this purpose: Consultant: WITTMAN ENTERPRISES 11093 Sun Center Drive Rancho Cordova, CA 95670 ATTN: [INSERT NAME AND TITLE] City: CITY OF PALM DESERT 73-510 Fred Waring Drive Palm Desert, CA 92260 ATTN: Lori Carney, Director of Administrative Services Such notice shall be deemed made when personally delivered or when mailed, forty-eight 99999.91660\31183614.1 CONTRACT NO. C36730 (48) hours after deposit in the U.S. Mail, first class postage prepaid and addressed to the party at its applicable address. Actual notice shall be deemed adequate notice on the date actual notice occurred, regardless of the method of service. 3.5.3 Ownership of Materials and Confidentiality. 3.5.3.1 Documents & Data; Licensing of Intellectual Property. This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings and data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subconsultants to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subconsultant prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were prepared by design professionals other than Consultant or provided to Consultant by the City. City shall not be limited in any way in its use of the Documents & Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 3.5.3.2 Confidentiality. All ideas, memoranda, specifications, plans, procedures, drawings, descriptions, computer program data, input record data, written information, and other Documents & Data either created by or provided to Consultant in connection with the performance of this Agreement shall be held confidential by Consultant. Such materials shall not, without the prior written consent of City, be used by Consultant for any purposes other than the performance of the Services. Nor shall such materials be disclosed to any person or entity not connected with the performance of the Services or the Project. Nothing furnished to Consultant which is otherwise known to Consultant or is generally known, or has become known, to the related industry shall be deemed confidential. Consultant shall not use City's name or insignia, photographs of the Project, or any publicity pertaining to the Services or the Project in any magazine, trade paper, newspaper, television or radio production or other similar medium without the prior written consent of City. 3.5.4 Cooperation; Further Acts. The Parties shall fully cooperate with one another, and shall take any additional acts or sign any additional documents as may be necessary, appropriate, or convenient to attain the purposes of this Agreement. 3.5.5 Attorney's Fees. If either party commences an action against the other party, either legal, administrative or otherwise, arising out of or in connection with this Agreement, the prevailing party in such litigation shall be entitled to have and recover from the losing party reasonable attorney's fees and all other costs of such action. 3.5.6 Indemnification. 3.5.6.1 Scope of Indemnity-To the fullest extent permitted by law, Consultant shall defend (with counsel of City's choosing), indemnify and hold the City, its officials, officers, employees, volunteers, and agents free and harmless from any and all claims, demands, causes of action, costs, expenses, liability, loss, damage or injury of any kind, in law or equity, to property or persons, including wrongful death, in any manner arising out of, pertaining to, or incident to any acts, errors or omissions, or willful misconduct of Consultant, its 00000 01/J,11\11 I S (,14 I CONTRACT NO. C36730 officials, officers, employees, subcontractors, consultants or agents in connection with the performance of the Consultant's Services, the Project or this Agreement, including without limitation the payment of all damages, expert witness fees and attorney's fees and other related costs and expenses. Consultant's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by Consultant, the City, its officials, officers, employees, agents, or volunteers. If Consultant's obligation to defend, indemnify, and/or hold harmless arises out of Consultant's performance as a "design professional" (as that term is defined under Civil Code section 2782.8), then, and only to the extent required by Civil Code section 2782.8, which is fully incorporated herein, Consultant's indemnification obligation shall be limited to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant, and, upon Consultant obtaining a final adjudication by a court of competent jurisdiction, Consultant's liability for such claim, including the cost to defend, shall not exceed the Consultant's proportionate percentage of fault. 3.5.7 Entire Agreement. This Agreement contains the entire Agreement of the parties with respect to the subject matter hereof, and supersedes all prior negotiations, understandings or agreements. This Agreement may only be modified by a writing signed by both parties. 3.5.8 Governing Law. This Agreement shall be governed by the laws of the State of California. Venue shall be in Riverside County. In addition to any and all contract requirements pertaining to notices of and requests for compensation or payment for extra work, disputed work, claims and/or changed conditions, Consultant must comply with the claim procedures set forth in Government Code sections 900 et seq. prior to filing any lawsuit against the City. Such Government Code claims and any subsequent lawsuit based upon the Government Code claims shall be limited to those matters that remain unresolved after all procedures pertaining to extra work, disputed work, claims, and/or changed conditions have been followed by Consultant. If no such Government Code claim is submitted, or if any prerequisite contractual requirements are not otherwise satisfied as specified herein, Consultant shall be barred from bringing and maintaining a valid lawsuit against the City. 3.5.9 Time of Essence. Time is of the essence for each and every provision of this Agreement. 3.5.10 City's Right to Employ Other Consultants. City reserves right to employ other consultants in connection with this Project. 3.5.11 Successors and Assigns. This Agreement shall be binding on the successors and assigns of the parties. 3.5.12 Assignment or Transfer. Consultant shall not assign, hypothecate, or transfer, either directly or by operation of law, this Agreement or any interest herein without the prior written consent of the City. Any attempt to do so shall be null and void, and any assignees, hypothecates or transferees shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. 3.5.13 Construction; References; Captions. Since the Parties or their agents have participated fully in the preparation of this Agreement,the language of this Agreement shall be construed simply, according to its fair meaning, and not strictly for or against any Party. Any term referencing time, days or period for performance shall be deemed calendar days and not 000000lu(.0,2,14utn 1 CONTRACT NO. C36730 work days. All references to Consultant include all personnel, employees, agents, and subconsultants of Consultant, except as otherwise specified in this Agreement. All references to City include its elected officials, officers, employees, agents, and volunteers except as otherwise specified in this Agreement. The captions of the various articles and paragraphs are for convenience and ease of reference only, and do not define, limit, augment, or describe the scope, content, or intent of this Agreement. 3.5.14 Amendment; Modification. No supplement, modification, or amendment of this Agreement shall be binding unless executed in writing and signed by both Parties. 3.5.15 Waiver. No waiver of any default shall constitute a waiver of any other default or breach, whether of the same or other covenant or condition. No waiver, benefit, privilege, or service voluntarily given or performed by a Party shall give the other Party any contractual rights by custom, estoppel, or otherwise. 3.5.16 No Third-Party Beneficiaries. There are no intended third party beneficiaries of any right or obligation assumed by the Parties. 3.5.17 Invalidity; Severability. If any portion of this Agreement is declared invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect. 3.5.18 Prohibited Interests. Consultant maintains and warrants that it has not employed nor retained any company or person, other than a bona fide employee working solely for Consultant, to solicit or secure this Agreement. Further, Consultant warrants that it has not paid nor has it agreed to pay any company or person, other than a bona fide employee working solely for Consultant, any fee, commission, percentage, brokerage fee, gift or other consideration contingent upon or resulting from the award or making of this Agreement. For breach or violation of this warranty, City shall have the right to rescind this Agreement without liability. For the term of this Agreement, no member, officer or employee of City, during the term of his or her service with City, shall have any direct interest in this Agreement, or obtain any present or anticipated material benefit arising therefrom. 3.5.19 Equal Opportunity Employment. Consultant represents that it is an equal opportunity employer and it shall not discriminate against any subconsultant, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex, or age. Such non-discrimination shall include, but not be limited to, all activities related to initial employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or termination. 3.5.20 Labor Certification. By its signature hereunder, Consultant certifies that it is aware of the provisions of Section 3700 of the California Labor Code which require every employer to be insured against liability for Worker's Compensation, or to undertake self- insurance in accordance with the provisions of that Code and agrees to comply with such provisions before commencing the performance of the Services. 3.5.21 Authority to Enter Agreement. Consultant has all requisite power and authority to conduct its business and to execute, deliver, and perform the Agreement. Each Party warrants that the individuals who have signed this Agreement have the legal power, right, and authority to make this Agreement and bind each respective Party. 3.5.22 Counterparts. This Agreement may be signed in counterparts, each of 99999.91660\31183614.1 CONTRACT NO. C36730 which shall constitute an original. 3.6 Subcontracting. 3.6.1 Prior Approval Required. Consultant shall not subcontract any portion of the work required by this Agreement, except as expressly stated herein, without prior written approval of City. Subcontracts, if any, shall contain a provision making them subject to all provisions stipulated in this Agreement. CITY OF PALM DESERT WITTMAN ENTERPRISES, LLC By: By: Mayor or City Manager [INSERT NAME AND TITLE] [If Corporation, TWO SIGNATURES, President OR Vice President AND Secretary OR Treasurer REQUIRED] ATTEST: By: [INSERT NAME AND TITLE] By: _.. [INSERT NAME] City Clerk APPROVED AS TO FORM: By: Best Best & Krieger LLP City Attorney OOUO[1 01 J1J1,1 1142 IA I A 1 CONTRACT NO. C36730 EXHIBIT "A" SCOPE OF SERVICES EMS COST RECOVERY SERVICES INTRODUCTION The City of Palm Desert is requesting proposals from qualified organizations to enter into a contract for the provision of cost recovery services for the Emergency Medical Services (EMS) provided by Palm Desert, through contract with the Riverside County Fire Department. Qualified organizations must have extensive experience and specialize in the invoicing, categorizing, recording, monitoring, supervising, and managing of EMS cost recovery systems/services. SCOPE OF WORK The organization that is awarded a contract for this RFP process (hereinafter " Consultant" or "Proposer" depending on context) shall at all times comply with the Health Insurance Portability and Accountability Act (HIPAA) and all other applicable federal, state, and local laws. All services are to be provided as a per-billing fee for each incident. No "up front" or ongoing costs will be borne by the City of Palm Desert, nor will Palm Desert provide any staff to support the contract. Proposers shall be responsible for modifying their billing systems to capture all necessary data generated from this program as an electronic file and provide a description of the electronic file needed to receive data transmitted from Palm Desert's fire services provider. Proposers shall work with Palm Desert and Riverside County Fire Department to identify data input gaps, errors or other data needs, and describe a means of obtaining solutions to these problems. Proposers shall provide information on their organization's experience with related software, including a complete list of their customers who are utilizing such software and the name and contact information of the software companies utilized. Proposers shall provide a complete package describing billing and collections, follow-up, account posting, and accounts receivable reconciliation and reporting services. The City currently transports approximately 6,000 patients per year through contract with the Riverside County Fire Department. The City anticipates directly providing ambulance transport services via four 24hr fire based ambulances. As noted, the City's contracted fire services provider operates under an integrated, cooperative, regional fire protection system. Under this system, neighboring cities that contract with the County Fire Department may on occasion provide emergency medical services in Palm Desert, irrespective of geographic boundaries. The neighboring communities of Rancho Mirage and Indian Wells work closely with the City of Palm Desert on mutual public safety matters. There is a formal body called the Cove Communities Services Commission,composed of elected officials from each community, which meets quarterly to discuss such issues. The three "Cove Cities" will utilize an identical and established fee structure; therefore, Indian Wells and Rancho Mirage residents shall not be billed for EMS transport and related services provided by Palm Desert. The selected vendor will need to follow this policy and may be required to communicate with Novato Fire Protection District, who is the vendor for the other two cities, on billing related activity. 99999.91660\31183614. 1 CONTRACT NO. C36730 The list below describes the minimum services required of Consultant: 1. Provide all tested and working software, tested and working hardware, and technical support associated with the billing mad receivables process and debt collections to support up to 10,000 collections for Emergency Medical Services. The software and hardware shall ensure complete and uninterrupted back up with a date recovery system, should a disaster or other unforeseen interruption occur. All software and hardware costs shall be borne by Consultant. 2. Provide pick up and receipt of billing forms(hard copy or electronic),correspondence,and reports from the Riverside County Fire Department during normal business, unless otherwise specified by the City Representative. All costs are to be borne by Consultant. 3. Have the capability to fully integrate and support Riverside County Fire's selected Electronic Patient Care Reporting System (ePCR) application. 4. Provide a monthly reconciliation of the data received from Riverside County Fire Department's patient care records with the amount it has billed to customers explaining differences, if any. 5. Maintain the software and hardware necessary to fulfill all of Riverside County Fire Department's requirements. Support service and maintenance of the software and hardware is the responsibility of Consultant for the duration of the contract. 6. Maintain updated and current technology that will continuously provide the highest level of reimbursement and customer service possible. 7. Transmit billing data electronically to all customers accepting electronic claim submission. Contractor shall have the ability to provide itemized billing statements based on Palm Desert's EMS Cost Recovery fee schedule and provide itemized billing receipts in both paper and electronic formats depending on the needs of the customer. 8. Have the ability to receive patient care documentation on paper and electronically. Verify the receipt of these documents and return confirmation to the Riverside County Fire Department. 9. Research and follow up on all accounts with inadequate billing information to include: a. b. Contact the Riverside County Fire Department for missing and/or incomplete information that may be found in the Riverside County Fire Department's reports. c. Contact receiving hospital for missing and/or incomplete billing information needed from the admitting/registration records. d. Contact patient family members or emergency contacts for information. e. Refer to zip code/street directories for acquisition of incomplete/missing address information. f. Mail inquiries to the patient. 10. Generate appropriate itemized charges from approved fee schedules provided by the City of Palm Desert. 11. Meet or exceed mutually agreed upon collection targets. 99999.91660\31 183614. 1 CONTRACT NO. C36730 12. At a minimum of every 30 days, provide to the City of Palm Desert a list of accounts deemed uncollectable that includes the reason why the account was unable to be collected. 13. Review all patient records and report to the City of Palm Desert all accounts deemed delinquent per a pre-defined timetable. 14. Provide quarterly analysis identifying at a minimum percent of collection, timelines from billing to receiving payment, number and types of complaints and other data deemed necessary for business planning and future analysis. 15. Forward refund requests and associated back-up documentation in a timely manner to the City of Palm Desert for processing. 16. Screen each document for completeness of data and level of services, codes, and procedures for billing purposes. 17. Provide a monthly report of customer complaints and compliments with follow-up information to the City of Palm Desert in hard copy or by electronic media. 18. Maintain accurate data and report quarterly on records for all accounts including but not limited to, all customer contacts, notices, mailings, itemizations, miscellaneous requests, inquiries, correspondence documents, accounting records, and transactions. The City requires data fields to support on- going planning, and statistical analysis. All records shall be made available to the City upon request. Contractor shall guarantee the confidentiality, security, and safety of all files, documents, and information provided by the City. 19. Provide the City with monthly detail and summary financial reports in Excel or similar format for each billing type (e.g., patient transport, assessment at scene, first responder fee.) The reports shall contain, at a minimum, the following information: a. Amount Billed b.Amount Collected c. Amount Refunded d.Amount Written Off 20. Exercise its best ethical, prudent, lawful, and professional efforts to secure payments on all accounts referred by the Fire Department; however, no delinquent accounts shall be sent to collections. All activities shall comply with HIPAA and all other applicable federal, state, and local laws. 21. Post all payment to accounts and process refunds and adjustments in a correct and timely manner in accordance with the procedures approved by the City of Palm Desert. All bills to customers shall state the "City of Palm Desert" as the payee and their payments deposited directly in full (i.e., without deducting Consultant's fees) to a designated bank account. All credit card transactions shall also be processed in the same manner. Consultant shall provide a detailed invoice to the City on a monthly basis. 99999.91660\31183614. 1 CONTRACT NO. C36730 22. Handle all telephone calls and correspondence in a timely, professional, courteous, and compassionate manner. 23. Be responsible for all customer billing inquiries and retrieval of records during normal business hours. 24. Any notification to Consultant that an attorney is handling a personal injury case for a patient shall result in Consultant sending a lien to the attorney that will request that the attorney and patient both execute the lien. Consultant shall have a process to follow up on the status of these lien accounts. Consultant shall also immediately notify the City of Palm Desert whenever it is made aware that there is possible legal action being taken against the City of Palm Desert or the Riverside County Fire Department. 25. Assign a customer service representative(s)to provide customer service and answer any billing- related questions. 26. Provide a nationwide toll-free telephone number(s) for billing inquiries. 27. Routinely meet with City of Palm Desert staff to discuss problems, special needs, future changes, and updates in software, technology, statistical data requests, or other issues. 28. Monitor all billing and regulatory changes affecting reimbursements and adjust its system to ensure regulatory compliance. Update the City of Palm Desert of such changes with an explanation of how it will affect City and its customers. 29. Provide continuous training for Consultant's staff, updating them immediately on all changes in the industry or government regulations that may have an impact on services being provided to the City of Palm Desert. 30. Provide assistance and on-site training for City of Palm Desert staff on developing procedures to ensure that the City is in compliance with all applicable federal, state, and local laws. 31. Coordinate all disputed claims with the designated City's representatives. 32. Agree to negotiate in good faith with the City of Palm Desert at the termination of the contract, the best manner to transition active accounts. Contractor agrees to deliver to the City a computerized file of active accounts, in a format agreeable to the City. 33. Have current administrative support, technical support, and fiscal capability to provide and manage the proposed services of more than 10,000 bills, collections, data analysis, and support technical hardware and software advancements each year. Have the current capability to ensure an adequate audit trail. 34. Produce specialized "on request" reports containing any or all of the previously listed information in a timely manner or based on a standardized schedule. 35. Have the ability to customize billing forms and follow-up letter per City of Palm Desert requirements. 99999.91660\31183614. 1 CONTRACT NO. C36730 36. Upon request, make all books and records available to both internal and external auditors. 37. Coordinate with existing service provider to transition current accounts with minimal disruption to service. 38. Upon implementation of contract, be able to process any backlog of billing within 30-days of the implementation date. 99999.91660\31183614. 1 CONTRACT NO. C36730 EXHIBIT "B" COMPENSATION The following fee structure is based on a flat rate of per patient transactions: Year 1-2: $18.00 (Eighteen Dollars) per transaction Year 3-4: $19.00 (Nineteen Dollars) per transaction Year 5: $21.00 (Twenty-One Dollars) per transaction In the event that this Agreement is renewed pursuant to Section 3.1.2, the rates set forth above may be increased or reduced each year at the time of renewal, but any increase shall not exceed the Consumer Price Index, All Urban Consumers, Los Angeles-Riverside-Orange Counties, without City Council approval. 99999.91660\31 I g 3614. I COPY March 29, 2018 z h• WI ro 3 3 ro LA 3 CITY OF PALM DESERT ca RFP No. C36730 Emergency Medical Services (EMS) Billing & Cost Recovery Services i * r• Wittman Enterprises, LLC 11093 Sun Center Drive Rancho Cordova, California 95670 www.webillems.com Setting the Standard for EMS Billing RFP Contact: Russ Harms Director Of Business Development (916) 669-4628 Direct Line rha rms@webi llems.cam TABLE OF CONTENTS SECTION 1: COVER LETTER AND REQUIRED FORMS 3 Letter from our CEO 1 z Introduction 2 RFP Required Forms Table/Graphic N 3 SECTION 2: METHOD OF APPROACH D- A. Scope of Work 3 B. 24-Hour Access 3 C. Sub-Consulting Partners 3 ° D. City of Palm Desert Staff 4 E. Patient Disputes 4 F. Changes to Policies and Procedures .5 G. Medicare Enrollment Application 5 H. Reporting Requirements 5 SECTION 3: QUALIFICATIONS AND EXPERIENCE Corporate Status 7 Wittman Enterprises, LLC: a limited liability company 7 Contracts/Services Similar to Palm Desert (Proprietary& Confidential) 7 Firm's Qualifications, Experience,Abilities 7 Qualifications 7 Experience 7 26Years EMS Billing Experience 8 Together We Achieve the Extraordinary: Performance History 8 California EMS/Fire Partners (Proprietary& Confidential) Table/Graphic Performance 9 EMS Partner Satisfaction 9 Dedicated ResponseTime Commitment 9 Sub-Consulting Partners See Section 2: Method of Approach, p. 3 Letters of Recommendation.. Table/Graphic References (Proprietary& Confidential) 10 SECTION 4: STAFFING Key Personnel Experience 11 3 Company Representative 11 Key Personnel 12 Contract ManagementTeam I SupervisionTeam Table/Graphic OperationsTeam I Experience Table/Graphic Southern California-Area InsuranceTeam Specialists Table/Graphic Workload Accomplishment 14 SECTION 5: COST PROPOSAL Cost Proposal 15 Service 15 Client Performance Comparison Table/Graphic Cost Sheet Table/Graphic Professional Services Agreement 16 APPENDIX 1: Standards, Policies, Ethics, Customer Service, Auditing, and KPIs APPENDIX 2: Sample Reporting and GEMT Reporting (Proprietary & Confidential) APPENDIX 3: Electronic Resources and Access to Records APPENDIX 4: Addenda Acknowledgement SECTION 1: COVER LETTER AND REQUIRED FORMS Letter from our CEO March 29, 2018 Thank you for the opportunity to provide the City of Palm Desert our RFP response for EMS Billing & Cost Recovery Services. Since 1991 Wittman Enterprises, LLC has provided fcp our clients complete ambulance and fire billing services in compliance with current local, state, and federal laws and statutes.We follow and exceed currently accepted standards for accurate,consistent, and bet EMS billing practices while maximizing revenue reimbursement, honoring your collections philosophy, and treating each of your patients, citizens, and visitors as our own. We serve more than 90 public EMS clients in California 8_ and are the largest California-based billing company with the client base,patient database, and experience with California departments (and multiple California payors)for the most effective EMS billing and cost recovery program possible. W As an extension of your EMS/Fire program,Wittman Enterprises will maintain a strong customer service accountability platform that provides your team with direct phone numbers and real access to all management staff, starting with me. Specialized staff will be assigned to your team so that the City has direct access to the person(s) on our team who can most help with whatever situation may arise. Our Client Liaison team is always available to help identify key resources you may need to get the results you need.We use all the resources necessary to provide the best in customer service and collect for our clients: (on average) 10-20% more in net revenue than most of our competitors. We look forward to nurturing a longstanding partnership with the City of Palm Desert: providing what you want when you need it. I welcome the opportunity to provide a full response to the needs of your program that demonstrates our understanding of your project requirements and allows us to address the many positive nuances of your program, and our enthusiastic support of it. I encourage you to contact any of our references to hear firsthand the very positive relationship we so value with our EMS/Fire partners. I appreciate this opportunity to introduce our qualifications and commitment to your City and your EMS/Fire teams.As CEO of Wittman Enterprises, LLC I am authorized to bind our company into contract and negotiate on behalf of Wittman Enterprises, LLC. Our legal correspondence information is listed below my signature block. Our only office is in Rancho Cordova, California. My best, Corinne Wittman-Wong, C 0 Wittman Enterprises, LLC (established 1991) 11093 Sun Center Drive I Rancho Cordova, CA 95670 (916) 669-4608 direct line I (855) 611-0056 toll free I cwittmanwong@webillms.com City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 1 Introduction Based on your RFP, the City of Palm Desert seeks qualified organizations like Wittman Enterprises, 3 LLC with extensive experience, specializing in the invoicing, categorizing, recording, monitoring, 3 supervising, and managing of EMS cost recovery systems/services.We bring 26 years of California N EMS/Fire billing experience, and with your neighboring communities: San Bernardino County Fire (since 2007);Cathedral City(since 1996);and City of Indio (since 1997). • We are pleased that our high standards of performance exceed Palm Desert's demands for the m following fundamental objectives and minimum services required as listed in Exhibit "A" of your 3 RFP C4 ro • (Since 1991)Wittman Enterprises provides • We follow and exceed currently accepted Q our clients complete ambulance billing standards for accurate, consistent, and a services and solutions, accounts receivable best EMS billing practices.We are licensed, 9, management services, and collection insured, bondable, and HIPAA compliant for E services for BLS,ALS, and non-transport the State of California. W services in compliance with current local, • Wittman Enterprises provides EMS billing um state, and federal laws and statutes, in and collection services to more than 90 accordance with HIPAA regulations. public departments in California from our • We are dedicated exclusively to the EMS single Sacramento-area location. industry and choose to be expert in the EMS • We will maximize revenue for the City while billing and collection industry rather than honoring your collections philosophy and diversify into any other medical billing fields. treating each of your patients,citizens, and • We efficiently and effectively file claims with visitors as our own. governmental programs such as Centers for Medicare and Medi-Cal t"CMS") and the VA, as well as commercial health insurance. Electronics Cash If Claims Receipts Department Department City of 0 IP - Prim • Impost and Claim 4 Desert a • Entry(DAILY( Or ' Insurance and Private ❑ 1" Pay Follow-Up /*I-N REGULATORY 0 t COMPLIANCE Claim Review,Coding and 4A/QC(1-3 DAYS) —_ 1 = V Payments Posted 1^�� 0 V (WITHIN 24 HOURS( =--__ - - ((.)) _``' - �� - - - - - - -` Billing Department Customer + •~Electronic Claim Submission p Service To All Payors(DA$LY) Department — - Transmission Department City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing&Cost Recovery Services I 2 VENDOR APPLICATION FORM FOR CONTRACT NO.C36730 EMS COST RECOVERY SERVICES U, TYPE OF APPLICANT: ® NEW ❑CURRENT VENDOR .. s Legal Contractual Name of Corporation: Wittman Enterprises, LLC Q Contact Person for Agreement: Corinne Wittman-Wong, CEO A Corporate Mailing Address: 11093 Sun Center Drive City,State and Zip Code: Rancho Cordova, CA 95670 E-Mail Address: cwittmanwongpwebillems.com Phone: 916.669.4608 Fax: Contact Person for Proposals: Russ Harms Title: Director of Business Development E-Mail Address: rharms@webillems.com Business Telephone: 916.669.4628 Business Fax: Is your business:(check one) ❑ NON PROFIT CORPORATION ❑FOR PROFIT CORPORATION Is your business:(check one) ❑ CORPORATION ®LIMITED LIABILITY PARTNERSHIP ❑ INDIVIDUAL ❑SOLE PROPRIETORSHIP ❑ PARTNERSHIP ❑UNINCORPORATED ASSOCIATION DISQUALIFICATION QUESTIONNAIRE The Proposer shall complete the following questionnaire: Has the Proposer,any officer of the Proposer,or any employee of the Proposer who has proprietary interest in the Proposer,ever been disqualified,removed,or otherwise prevented from bidding on,or completing a federal, state,or local government project because of a violation of law or safety regulation? Yes No X if the answer is yes,explain the circumstances in the following space. City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS)Billing &Cost Recovery Services I Table/Chart COMPANY PROFILE& REFERENCES Company Profile 3 ira Company Legal Name: Wittman Enterprises, LLC Company Legal Status(corporation,partnership,sole proprietor etc.): Limited Liability Company Active licenses issued by the California State Contractor's License Board: N/A CD Business Address: 11093 Sun Center Drive I Rancho Cordova, CA 95670 to Website Address: www.webillems.com S N Telephone Number: 855.611.0056 (toll free) Facsimile Number: a Email Address: Length of time the firm has been in business: 26 years Length of time at current location: 5 years Is your firm a sole proprietorship doing business under a different name: Yes X No If yes,please indicate sole proprietor's name and the name you are doing business under: co Is your firm incorporated: Yes x No if yes,State of Incorporation: Federal Taxpayer ID Number: 68-0456021 Regular business hours: „_ • i .••• Regular holidays and hours when business is closed: Varies by year-usually similar to federal holidays Contact person in reference to this solicitation: Russ Harms,Director of Business Development Telephone Number: 916.669.4628 Facsimile Number: Email Address: rharms@webillems.com Contact person for accounts payable: Walter Imboden,President/CFO Telephone Number: 916 669.4602 Facsimile Number: Email Address: wimboden@webillems.com Name of Project Manager: Stephanie Cooper-Noe Telephone Number: 916.669.4607 Facsimile Number: Email Address: scooper-noe@webillems.com City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I Table/Chart See Section iii: Qualifications and Experience References m COMPANY PROFILE&REFERENCES (Continued) Submit the company names,addresses,telephone numbers,email,contact names,and brief contract descriptions of at least five clients, preferably other municipalities for whom comparable projects have been completed or submit letters from your references which include 'ts the requested information. Company Name Telephone Number: ro Contact Name: Contract Amount: cQ Email: Address: Q Brief Contract Description a Company Name: Telephone Number Contact Name' Contract Amount: co u7 Address: Email: Brief Contract Description: Company Name: Telephone Number: Contact Name: Contract Amount: Email: Address Brief Contract Description: Company Name Telephone Number: Contact Name: Contract Amount: Address: Email: Brief Contract Description: Company Name Telephone Number: Contact Name: Contract Amount Email Address Brief Contract Description: City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing&Cnst Recovery Services l Table/Chart See Section iv: Staffing $. STAFFING PLAN 1. Primary Staff to perform work under this Agreement Name Classification/Title Years of Experience to rt ro Cr_ 2. Alternate staff(for use only if primary staff are not available) Name Classification/Title Years of Experience -• 5 ca Substitution or addition of Proposer's key personnel in any given category or classification shall be allowed only with prior written approval of the City Project Manager. The Proposer may reserve the right to involve other personnel, as their services are required. The specific individuals will be assigned based on the need and timing of the service required.Assignment of additional key personnel shall be subject to City Project Manager approval. City reserves the right to have any of Contractor personnel removed from providing services to the City under this Agreement.City is not required to provide any reason for the request for removal of any Contractor personnel Cost Sheet Please see Cost Sheet in SECTION 5: COST PROPOSAL (p. 15) City of Palm Desert:REP No.C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I Table/Chart SECTION 2: METHOD OF APPROACH oOai A Scope of Work 00 g C 0 ro • 24-Hour Suh�ansulting • ,•, Access Partners - Q. • Submittal of this Proposal can be taken as prima scope •0 Palm y facie evidence that we have full knowledge of the °t'"°'t` E. F Staff N requested scope, nature, quality, and quantityOfsputes Policies and q P 9 Y Procedures Q of the work to be performed, and detailed icii0 requirements and conditions under which the H. c m Reporting work is to be performed. Our proposal represents Requirement i care Requirement Enrollmenttb our understanding of the Request for Proposal • • • Application 0 a based on the information provided in your REP. .-- 11 o m Live Operator Assistance 0 ,,i nil Patient Service Representatives are 4 W Lo �� private for the follow-up on insurance, private pay, and balance-billed accounts.They are responsible for over 10,000 calls weekly to and from patients while processing patient insurance information and working through any patient o 00 concerns, needs, or disputes. Our Customer Service Representatives are available Monday through Friday from 8:00 AM to 4:30 PM PST to serve your patient needs. Our toll-free number has multiple lines available for patients, clients, NIF insurance companies,attorneys,and third parties to call for information or to discuss account status. Our system accepts voice mail messages and routes calls to appropriate person and/or voicemail box 24 hours per day. Our phone system was recently updated ensuring the most effective solution and intuitive routing of calls for both the City and your patients. B 24-Hour Access Our full Portal System (Client Portal, Patient Portal, Credit Card Payment Portal, and Collections Portal) is available 24 hours a day, 7 days a week. Please see Section 4:STAFFING (p. 111-for key staff contact information. 1011. Sub-Consulting Partners InfoSend (Anaheim,CA): Technosoft (Southfield, MI): Change Healthcare (Nashville,TN): Invoicing and Mailings Pre-billing and pre-cash receipt Electronic insurance eligibility exchanged through a secured posting data processing checker (formerly Emdeon, and HIPAA-compliant method exchanged through a secured Capario) and fully executed Business and HIPAA-compliant method Associate Agreements. and fully executed Business Associate Agreements. City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing&Cost Recovery Services I 3 City of Palm Desert Staff 3 Wittman Enterprises looks forward most efficient and effective billing system to regular contact with City and Fire partnership between the provider (City staff for direction on specific accounts, of Palm Desert) and Wittman Enterprises, balance adjustments, QA/QI, and other the following are the basic provider M procedures requiring your authorization. responsibilities generally accepted as Occasionally, when we have exhausted current standards of best practice.All our resources and need help completing programs are customized to meet and missing information, clarifying unclear or exceed the needs of our clients-following incomplete narratives, we may request as many standards of best practice as a, assistance from our regular City/Fire practically possible. Q contacts that are often able to acquire the information from their own resources. • Submit necessary transport information, However, as your billing partner,Wittman including pay source information and generally does not require additional patient condition,to Wittman Enterprises tasks from City/Fire staff as it is our job to for billing purposes. `Q support your billing and reimbursement • Forward to Wittman all necessary program. information relating to patient transport services, payments and patient eligibility. We are a full-service billing agency that conducts effectively the full range of • Provide clarifications when questions tasks associated with ambulance billing. arise regarding documentation. As part of creating and maintaining the 411 Patient Disputes We recognize that most patients are Wittman Enterprises' goal is that each citizens of your community, so our goal is client and patient reach a live person to function as an extension of the City of when they call into our business office Palm Desert.We provide extensive training located near Sacramento, CA. If our EMS and look for individuals with the ability partners or their patients do not reach a to be compassionate and empathetic live person during regular business hours, while efficiently resolving calls.There are they will be provided the option to leave managers and directors available at all a voicemail and offered instructions on times to assist if custdmer issues cannot submitting an email inquiry.Wittrhan be resolved to the patient's expectations personnel will respond the same day by our customer service department. during normal operating hours or within 24 All customer service staff is located in business hours when that is not possible. our single Rancho Cordova facility. For If any complaint received by our service contact information please see Section 4: department involves care-related concerns, STAFFING (p. 11)-Heather Montano and Wittman will contact the City and/or Fire Rachel Troche. Department directly for resolution. City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 4 fit Changes to Policies and Procedures g. 3 NMI We ensure compliance with Cai.Therefore,we pledge to remain H IPAA local, state, and federal laws responsible and knowledgeable regarding COMPLIANT by continually educating any program updates to Medicare and ��� ourselves on any changes Medi-Cal for the duration of the contract or differences that may apply between period. Furthermore, we will inform the jurisdictions.As a matter of policy,Wittman City and the public of any significant Enterprises, LLC stays current with any changes to policies and procedure through `4 program updates to Medicare and Medi- emails, newsletters, conference calls, etc. V, a ID Medicare Enrollment Application 03. From the beginning of your project, we we compile all necessary information, anticipate and manage for you processes documentation, signatures, etc., and `4 such as: Medicare compliance and submit enrollments and revalidations revalidation; reconciliation of payments on your behalf.Additionally, we pay the from legacy billing accounts; responses to required federal and/or state processing fee legal and other requests; and customization up front for you and charge on your next of a reporting program surpassing your monthly invoice. program needs. In partnership with you Reporting Requirements Meeting Reporting Requirements The City of Palm Desert will have access to our Client Portal and client reporting system allowing authorized City and EMS/Fire personnel to obtain invoices, account balances, billing reports, and other hands-on account management tools. Daily, monthly, quarterly, annual, and special reporting can be provided in PDF and Excel format. Our reporting system allows interface with Crystal reporting software. For example, Palm Desert's customized reporting program might include specific details such as: Number of Reports Received I Number Billed and BillType Calls Not Billed Gross Charges Contributions Allowed or Write Down Net Charges Adjustments J Payments I Refunds Balance Owed I Number of Bills and Amounts Sent to Collections I Pending Claims at Collections J Write Offs /Aging Reports City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing&Cost Recovery Services 1 5 Reporting Library This is a small sample of our extensive reporting library. In fact,we have well over 200 system- generated reports as well as more than 100 customized reports to meet the reporting needs of all of our clients. Utilizing our in-house programmers, we are able to design reporting programs to fit all of our clients' needs. • Management Summary /Ticket Survey Summary by Payer N ro ,I Incident Survey Summary by Trip Date J Year-To-Date Revenue 3' J Aging: Current Payer (aging data) Cash Receipts Summary 7- CD ▪ Credit Summary !Activity Summary by Vehicle J Activity Summary by Payer Refund Report si NOTE: for reporting examples, please see Appendix 2 (p. 8) ° rR Meeting Monthly Reporting Requirements tn Our month-end correspondence with you includes Cash Receipt Reports that reconcile all deposits, receivables, billings, patient accounts, adjustments,dishonest checks, and refunds.All other processes and functions at Wittman Enterprises, LLC are ongoing. Financial and performance reports are detailed and easy to read. On-Demand (ad hoc) reports are our specialty and are provided at a moment's notice at no additional charge.These reports provide detailed accounting for account adjustments of any type and track revenue by period. Our reports are Accurate and Easy to Read. Robust and Individualized.Accessible. NOTE:for reporting examples,please see Appendix 2(p. 8) • A/R Aging Report:This report can be either a • Management Summary Report:The report is detail or summary report based on trip date run by fiscal year. It provides an accounting (date of service), patient, or payer. It can by financial class of total trips and dollars be customized to track a specific payer or billed each month, with a cumulative year-to- payers and date ranges and lists how many date tracking. It also provides an accounting ambulance claims are still outstanding for of the dollars received each month by any given time period. financial class with a cumulative year-to-date • Ticket Survey Report: Detail or Summary can tracking. be run by date of service, payer or patient or • Ad Hoc Reports: On-demand reports are our combination thereof.Ticket Surveys are used specialty and are provided at no additional to provide the number of accounts input into charge. Our billing software collects and the system in a given month and under the tracts numerous data elements whether input payer mix category.This information provides manually or electronically downloaded. From revenue projection information and can be the large data field our ad hoc reports are used to verify that all tickets sent have been available and on-line for Palm Desert review received. and can contain month-end and real-time • Year-to-Date Revenue Report:This report information as required. provides a snapshot of the last twelve months at any time. It offers totals in all Your monthly reports can be emailed, dropped categories including Medicare and Medi-Cal to your FTP mailbox, or sent to you via U.S. write-downs, monthly amount of delinquent Mail —depending on the City's preferences. accounts and refund amounts. It is a very effective performance analysis tool in monitoring our performance as it reflects our ongoing collection rate, both gross and net, for a twelve-month period. City of Palm Desert:RFP No.C36730. Emergency Medical Services IEMS) Billing&Cost Recovery Services I 6 SECTION 3: QUALIFICATIONS & EXPERIENCE Q A 1.Corporate Status N/A 2.Wittman Enterprises,LLC:a limited liability company • , Wittman Enterprises is a limited liability company (since 1991y operating out of our single office at 11093 Sun Center Drive I Rancho Cordova, CA 95670. Our Board of Directors is: CEO Corinne Wittman-Wong 5 President/CFO Walter lmboden ro Vice President.. Kathryn Garcia COO David Wittman R 3.Contract/Services Similar to Palm Desert See page 8 4. Firms Qualifications,Experience,Abilities See below na Qualifications 7 Wittman Enterprises has customized service innovations for our partners in the EMS transport industry since 1991.We serve more than 90 public EMS clients in California. We are the only California-based billing company with the client base, patient database, and experience with California departments and payers necessary for the most effective EMS billing program possible. The importance of our business model is that any number of claims will be handled with the same quality assurance. Our products and services are designed to ensure that EMS providers like the City of Palm Desert are reimbursed in a timely manner for services they provide.We get our EMS partners their maximum reimbursement available by custom fitting your needs with our proven solutions. Experience We provide industry-leading services to our EMS partners to help you continue providing cost- effective programs and responsive services enhancing the quality of life in the City of Palm Desert, while balancing the financial accountability needs of your citizens.With a proven commitment to customer and patient service Wittman Enterprises conducts your business as if your patients were our own.This starts with valuing customer service with everything we have done as a company since 1991 (living up to our Dedicated Response Time Commitment;providing Ongoing and Comprehensive StaffTraining;maintaining well-qualified Bilingual Staff;meeting regularly with our partners quarterly, etc.). • City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS)Billing&Cost Recovery Services I 7 26 Years EMS Billing Experience g. Wittman Enterprises was founded 26 years ago with the promise of providing expert and personal attention to our EMS partners and their EMS billing programs.This will never change. • Wittman is dedicated exclusively to • From the beginning of your project, the EMS/Fire industry and chooses to we anticipate and manage for you be expert in that industry rather than issues such as Medicare compliance diversify into other medical billing fields. and revalidation, reconciliation of =° payments from legacy billing accounts, • Our excellent reputation is gained from responses to legal and other requests, professional relationships with providers and customization of a reporting program and third-party payers, as well as from surpassing your specific needs. 94 our sensitive yet collection-oriented Q communications with patients and their • Since our only business is EMS/Fire representatives. billing, our specialized staff is dedicated and expertly trained in this field. • We have a long and successful history of meeting and exceeding client expectations and service deadlines. Together We Achieve the Extraordinary: Performance History Through streamlined efficiency, talented staff, selective automation, and continuous improvement,Wittman has a long record of strong collection returns for our clients on billed charges.Wittman Enterprises generally outperforms our competitors by 10%to 20% in gross collections for our EMS partners. Substantial successful and reliable performance in providing our services for public ambulance departments can be seen in all of our client histories; however, please consider the following examples: City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing&Cost Recovery Services I 8 California EMS/Fire Partners (Proprietary and Confidential) Wittman Enterprises conducts all of our work and provides all services from our single 3 location in the Sacramento, California area.All production and patient service activities are conducted at 11093 Sun Center Drive in Rancho Cordova, California. R. h N St v v 4 RE City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I Table/Chart Performance With a proven commitment to customer and patient service Wittman Enterprises conducts your business as if your patients were our own.This starts with valuing customer service with everything we have done as a Company since 1991 (living up to our Dedicated Response Time Commitment;providing ongoing and comprehensive Staff Training; availability of our Bilingual Staff;meeting regularly with our partners quarterly, etc.). We also strive to provide up-to-the minute looks directly into our billing system and multiple ways to view records, reports, and other valuable information through our Client Portal. For ePCR interfacing and ultimate billing accuracy we work closely with most ePCR vendors like ImageTrend to ensure the quality of data we receive on your behalf for the billing process. a ;a. Finally, from all of these important areas we constantly monitor the quality of our work on your program through a series of KPIs customized to ensure the success you should expect.We are transparent to the point that our EMS partners have as much access to data and trends as they need to evaluate the success of our team at meeting your goals. 5' EMS Partner Satisfaction The City of Palm Desert can count on Wittman Enterprises to continue conducting diligent, regular, and uninterrupted billing and collection services in a professional businesslike manner. Our personal approach and higher levels of service greatly exceed industry standards. Your expectations and overall satisfaction are attained through ongoing and regular training, continuous improvement, and our comprehensive auditing program. Wittman maintains our industry-leading lowest claims-per-staff ratio (generally 30% lower than our competitors) based on upholding the standard of practice our clients expect. Our comprehensive and ongoing training program allows us to continuously improve the business activities that we conduct on behalf of the City and ensure that you continue to receive the maximum legal reimbursement available. We do not strive to be the largest EMS billing company but expect to be the best. The secret to our clients' successful reimbursement is ultimately the personal attention we apply to each of their accounts. Simply put, it is the dedication to our process that combines the best in technology with the commitment of people to perform the hard work necessary to pursue elusive insurance Payers, successfully appeal Medicare and insurance denials, and work effectively through difficult reimbursement issues such as Medi-Cal cutbacks. The significant efforts we undertake as a commitment to our EMS partners allow us to meet and exceed client expectations (and requirements as set forth in your RFP} and achieve high client/customer satisfaction.We stand behind the work we conduct on behalf of our clients and work closely with each of them to make sure they are completely satisfied with our performance. Dedicated Response Time Commitment Wittman Enterprises'goal is that each client and patient reach a live person when they call into our business office located in Rancho Cordova. If our EMS partners or their patients do not reach a live person during regular business hours,they will be provided the option to leave a voicemail and offered instructions on submitting an email inquiry.Wittman personnel will respond the same day during normal operating or within 24 business hours when that is not possible. City of Palm Desert: REP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 9 5.Sub-Consulting Partners Please see SECTION 2: Method of Approach, p. 3. 6. Letters of Recommendation See below 3 m z 4-e h• 010 MFTRppo `� tr. ►`',y Sacramento Metropolitan Fire District a, 10545 Armstrong Ave.,Suite 200•Mather,CA 95655•Phone(916)859-4300•Fax(916)859-3702 FIRE m TOM HARMS Fire Chief ar 0 0 February 5,2018 Re: Wittman Enterprises, LLC c0 To Whom It May Concern: It is with pleasure that I write this letter of recommendation and offer my observations and experiences with Wittman Enterprises,LW and their staff. Sacramento Metropolitan Fire District has been a business partner with Wittman Enterprises, LLC for over 18 years.Wittman's ethical standards and business practices are given a high priority by all members of their staff.They provide regular training and updates to their clients,resulting in enhanced cost recovery efforts. The Wittman staff strives to work with our Finance and EMS divisions to maximize efficiencies within the Sacramento Metropolitan Fire District.We have found them to be very responsive to requests for information and customized reports. Claims are processed and submitted in a timely manner, and their staff has a high level of attention to detail and expertise in working with a wide range of health insurance companies.They stay current on industry trends and changes and ensure that their clients are informed of these changes. They also distribute patient surveys to assist us in continually improving patient care of the community that we serve. Sacramento Metropolitan Fire District has a strong and reliable business partner in Wittman Enterprises, LLC. It is without reservation that I recommend them as an advantageous addition to any agency that is looking for a medical billing agency. • Please feel free to contact me with any questions in regards to our experience with Wittman Enterprises, LLC. • Randall Hein Assistant Chief—Director of EMS Sacramento Metropolitan Fire District Serving Sacramento and Placer Counties City of Palm Desert:RFP No. C36730. Emergency Medical Services SEMS) Billing &Cost Recovery Services I Table/Chart • en CITY OF HUNTINGTON BEACH e 2000 Main Street Phone:(714)536-5411 California 92646 www huntingtonbeachca gov FIRE DEPARTMENT David A.Segura h• Fire Chief v, m 5 uo February 8,2018 e To Whom It May Concern: su The City of Huntington Beach has utilized Wittman Enterprises since I993 and have found their o rn customer service standards to be of the highest caliber. They provide excellent quality service and demonstrate flexibility in their approach to billing,which yields a higher revenue return for the `^ City of Huntington Beach. R' 5' uo I recently requested their assistance regarding a partial restructuring of our internal billing process. Wittman Enterprises met with me and my staff and were collaborative and cooperative,providing process improvements that have saved us time and money. Although there arc a number of companies that provide thine services,I would recommend Wittman Enterprises,I.I,C for your EMS billing services. If you have any questions or require further information,please contact Jane Cameron,FireMed Coordinator,at 714-375-5097. Si erely, David A.Segura Fire Chief "Smoke Detectors Save Lives" City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing&Cost Recovery Services I Table/Chart 7. References (Proprietary& Confidential) As a single-location leader in EMS billing, we encourage you to contact any of our references, 3 including any of our clients that may not be listed for this proposal.We know that hearing about their experiences with Wittman Enterprises will differentiate us from our competition.Wittman Enterprises is eager to provide service to the City of Palm Desert and build that same strong working partnership with you. V+ ro ro N 01 Q O m V. W 0 City of Palm Desert: RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 10 SECTION 4: STAFFING a 3 sv Key Personnel Experience Wittman Enterprises, LLC agrees that, once assigned to work under this contract, key personnel shall not be removed or replaced without written notice to the City. "If key ' y personnel are not available for work under this contract for a continuous period exceeding y thirty calendar days, or are expected to devote substantially less effort to the work than ro initially anticipated,the Contractor shall immediately notify the City (RFP, p. 6)" 7" The secret to our clients' successful reimbursement is the personal attention we give to i their accounts. It is the dedication to our process that combines the best in technology with a' the commitment of people to perform the hard work necessary to pursue elusive insurance 0 payers, successfully appeal Medicare and insurance denials, and work effectively through o difficult reimbursement issues such as Medi-Cal cutbacks.The significant efforts we m undertake as a commitment to our partners allow us to meet and exceed expectations and achieve the highest client/customer satisfaction. m cc Company Representative Stephanie Cooper-Noe (CMC,CACO, CAPO), Client Liaison 11093 Sun Center Drive Rancho Cordova, CA 95670 I (916) 669-4607 direct line scooper-noe@webillems.com City of Palm Desert:AHD No.C36730. Emergency Medical Services(EMS}Billing&Cost Recovery Services I 11 Key Personnel Corinne Wittman-Wong,Chief Executive Officer Corinne has been with Wittman Enterprises, LLC for more than 24 years.As CEO she is responsible for the strategic planning and vision of the company. Her strong knowledge of the industry integrates completely with her experience of working in all departments of the company and provides her with a unique perspective on our CD company's philosophy and goals. She administers the supervision of our clients' accounts, and the adherence of policies and procedures set forth by the company, St while facilitating and encouraging leadership qualities, innovativeness, and direction of our employees. a Waiter Imboden, President/CFO For 29 years Walter has worked in the EMS billing industry. He oversees all aspects of the day-to-day production and operations of the company, monitoring both production and personnel. He directs the billing and collection processes ensuring adherence to 5 our clients' contract requirements. He develops office procedures that are designed to enhance and expedite workflow. Over the years while working in every department at Wittman Enterprises, LLC Walter has developed strategic,tactical, and short- term operations that enable him to provide invaluable guidance and training to our department managers. Kathryn Garcia,Vice President In her 24 years with Wittman, Kathryn has worked and managed all departments.This provides her the perspective and experience to help the City with any special requests or circumstances. Kathryn oversees the billing team and the cash receipts team. She provides the City with special reports to aid the balancing process for trips, refunds, and deposits. She also creates, reviews and distributes all client month-end reports. Joe Balkema,Executive Director, IT Joe brings 25 years of programming experience with C#,VB,ASP JavaScript, and BBX, along with more than 16 years of SQL knowledge and reporting design. He has installed more than 30 billing systems nationwide.At Wittman he designs multiple client-focused programs and reporting mechanisms, and streamlined our working environment by designing a document management system to go paperless: scanning over 3,000 documents daily. Stephanie Cooper-Noe,Client Liaison For more than 21 years Stephanie has provided ambulance billing leadership and customer service to our clients. She develops our Compliance and Documentation Webinars,trains employees and monitors their compliance with the company's HIPAA program, designs client-specific reports, oversees Medicare Revalidations, and provides the conduit between client finance departments,fire departments, and Wittman Enterprises, LLC, Certifications: Certified Medical Billing Associate. City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 12 Russ Harms,Director of Business Development Russ brings 26 years of management leadership, direction of progressive operations, 3 and the building of strong client partnerships to Wittman Enterprises and our clients. He specializes in organizational development and management, strategic planning, performance management, continuous improvement, business development, leadership development, and change management. Education: Master of Arts, English; Bachelor of Arts, English. ro Jennifer Gentry,Client Liaison (ePCR Interface) Jennifer has been with Wittman Enterprises for over 20 years. She facilitates the integration of ePCR systems with our ZOLL billing system.Jennifer works with each Q client to ensure that we have the most effective information import possible through a customized mapping process. Jennifer is also the co-moderator of our Medicare Compliance Committee and works on our Medicare documentation training program for staff and clients. Certifications: Certified Ambulance Coder. Jennifer Bump, Division Manager (Customer Service/Training Coordination) For more than 14 years Jennifer has been with Wittman Enterprises. She began in Customer Service, working on private insurance accounts as a specialist,working incoming and outgoing calls, and ultimately as the lead over the revenue assurance team. Later she took over as manager of our Customer Service Division. Currently she is a division manager for Customer Service, directing the specialist team working on all governmental payers. She oversees the Quality Assurance Department over cash receipts and all of the Customer Service Department, and coordinates the company training programs. Heather Montano,Division Manager(Customer Service/Phone Services) Starting 14 years ago, Heather began as a Customer Service Representative for Wittman Enterprises,working private pay accounts, private insurance accounts, incoming correspondence and incoming calls. Next, she was promoted to Customer Service Department Lead and then Department Supervisor where she handled client concerns and patient billing anomalies and issues. She has extensive knowledge of our Billing Program and Reporting systems. Currently Heather is the Division Manager of the Patient Services Department, overseeing inbound and outbound calls, private correspondence, auditing, and quality assurance for all calls. Nicole Powers, Division Manager (Support Services/Electronic Billing) Nicole has been with Wittman for over 16 years. She oversees the receiving and importing of all Patient Care Reports (PCRs), document scanning, and claim submissions (electronic billing)via paper and electronic means to all payers. Nicole continuously streamlines electronic processes and updates automation to ensure appropriate timelines are met to ensure the most timely and efficient reimbursement for our clients. City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 13 Contract Management Team Supervision Team Corinne Wittman-Wong, CEO Jennifer Bump, Division Manager: Insurance (916) 669-4608 (916) 669-4612 cwittmanwong@we bill ems.com jbump@webillems.com Walter lmboden, President/CFO Jennifer Gentry (CAC), Client Liaison: ePCR y. (916) 669-4602 (916) 669-4621 wimboden@webillems.com jgentry@webillems.com Kathryn Garcia,Vice President Heather Montano, Division Manager: S° (916) 669-4606 Patient Services kwolf@webillems.com (916) 669-4627 hmontano@webillems.com a David Wittman, COO ;? (916) 669-4601 Nicole Powers, Division Manager: dwittman@webillems.com Electronic Billing (916) 669-4624 Russ Harms, npowers@webillems.com Director of Business Development (916) 669-4628 Pakou Vang, Division Supervisor:Cash Receipts rharms@webillems.com (916) 669-4617 pvang@webillems.com Joe Balkema, Executive IT Director (916) 669-4620 Kelly Burgess (CAC), Division Supervisor: jbalkema@webillems.com Data Entry (916) 669-4605 kburgess@webillems.com Operations Team/Experience: Jessica Ceccato, Insurance Lead 72 years Judy Vang (CAC),Client Liaison:Insurance 11 years Rene Wittman,Cash Receipts Lead 21 years AngelasThao (CAC),Data Entry Lead 8 years Rachel Troche,Patient Services Lead 74 years Sharon Haney (CAC), Division Supervisor 10 years Southern California-Area Insurance Team Specialists Our team of insurance specialists are trained and experienced with their assigned client payors so that they can manage all aspects of submission, payments, and appeals. For our Southern California partners the following specialists provide the practical experience necessary to get you your highest legal reimbursement possible: Brittany Bump Christine Marshall California commercial and government Med-Cal and Medi-Cal HMO accounts specialist accounts specialist (VA, Department of Corrections, Blue Shield/Blue Cross of Julia Robinson California, Secure Horizons, Pacificare California Medicare and Medicare HMO of California, Kaiser, etc.) accounts specialist City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I Table/Chart Workload Accomplishment Our EMS billing and collection success is tied directly to the ratio of PCRs to the number of 3 quality people assigned to your project.We believe that people are the key to our success. Wittman innovates by fully embracing automated and technological advances while wholly recognizing that our quality service is reliant upon our talented people providing b you the best level of service. Our approach provides the lowest claims-per-employee-ratio, . generally resulting in 10-20% higher collection rates than our competitors. ro I Ito rf 10-20% CL Higher Collection . RatesThan Ourco Competitors 5 a a ***** LOWEST CLAIMS-PER-EMPLOYEE RATIO Wittman Enterprises works from our single location in the Sacramento, California area at 11093 Sun Center Drive, Rancho Cordova, California.All departments are dedicated to the personal attention of our clients and their patients' needs. Our staff is divided into teams to efficiently address workflow processes and are further divided based upon your location.Wittman maintains our industry-leading lowest claims-per-staff-ratio(generally 30°/) lower than our competitors) based on upholding the standard of practice our clients expect.Through training, forecasting, hiring, and expansion of our EMS partner base, we constantly maintain that staffing ratio of approximately 4,000 claims per staff(compared to approximately 8,000-12,000 or more claims per staff for most of our competitors). For complete project coordination,Wittman's Client Liaison team is the conduit from you to our operations.We look forward to meeting with City/Fire personnel to discuss the goals of our business partnership, the services we provide, and any other topics required for the quality performance of EMS/Fire cost recovery on behalf of the City of Palm Desert. Stephanie Cooper-Noe (Client Liaison) will be your main point of contact. Please remember too that Russ Harms (Director of Business Development), Corinne Wittman-Wong (CEO), and Walter lmboden (President/CFO) are always available to you and your team. 1.Assigned Staff Statement Wittman Enterprises agrees that once assigned to work under this contract, key personnel shall not be removed or replaced without written notice to the City. 2. Staffing Changes Statement We agree to notify the City about any key personnel changes. However, most of our staff is long-term and averages 7-10 years of professional experience Please see Section 4: STAFFING (p. 11). City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 14 SECTION 5: COST PROPOSAL t. Wittman Enterprises, LLC is pleased to offer the City of Palm Desert all billing,collections, financial reporting, and accounts receivable management described in our proposal based on the following fee schedule options. Proposals are valid for 180 days following - submission. Please note that most of our EMS partners prefer (and we recommend)the Live Cash !° method of processing payments. Payments and correspondence are sent directly to us, processed, and posted to the account and deposited into the City's bank account.We do not usually suggest use of a lockbox since they tend to be expensive (and therefore must be included in our proposed fees) and often unnecessary. However, since requirements Q vary greatly from agency to agency regarding payments and funds received,Wittman Enterprises will work closely with the City of Palm Desert to customize this function during the initial set-up process.This includes working with a lockbox-oriented program and "dead cash" based deposits depending on your preference (we have more than 100 clients with u, customized methods—some of them choose to use the lockbox deposit-based system). We welcome the opportunity to revise our fee estimates should the City decide they do not wish to use a lockbox as part of their program. Services Proposed Fee Year 1 $18.60 per imported incident •Ambulance Billing and Collection (ePCR ticket) • First Responder Billing and Collection Year 2-4 •Assessment (treat-no-transport) Billing and Collection $19.60 per imported incident • Patient Satisfaction Surveys (10% of patient contacts) (ePCR ticket) • Notice of Privacy Practices Year 5 $21.60 per imported incident (ePCR ticket) Service We are a full-service billing agency from the point of data entry to the last cent collected. Our fees contain the full range of EMS billing services including: • • Accurate, efficient, and experienced • Unlimited access to Client Portal billing staff • Insurance finding and pre-verification • ePCR integration • Assignment authorization verification • Each document confirmed, and screened • Destination hospital contact/patient • Electronic billing to Participating Payers demographics • Billing private insurance • Toll-free number (calls answered by real • Employee background checks people) • Bilingual staff • Personalized reporting • Client Liaison team • Relentless Claim Appeals team • Lower claims-per-staff ratio City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 15 Preliminary Projections g. Based on the information provided in your RFP and subsequent o&A responses and Addenda, we confidently present the preliminary projections in the following tables (Projection i is based on your resident write-down program I Projection 2 demonstrates additional revenue that would be recouped by the City if their program was less generous in resident write-downs).We do not believe that any California-based biller will be able to provide as much in actual reimbursement as Wittman Enterprises has demonstrated most recently with the City of Sacramento and the City of South San Francisco.Wittman has a proven record of collecting 10-20% more than our competitors. Out-of-state billing 3 to companies will not be able to arrive at these reimbursements either, due to their lack of billing and collection experience in the State of California.We encourage you to check with Sacramento, South San Francisco, and any of our clients who have switched from vendors Q to Wittman Enterprises. Specifically: a' a *We estimate that Wittman Enterprises would collect approximately $571 in average revenue collected per transport. Broken down for a contract term,Wittman will collect approximately $15,165,364 in payments (charging only $454,300 as our fee over the same period). Projections based on information from the City's RFP and supplemental RFP information, and provided in this proposal, could increase or decrease, based on factors such as changes in number of transports, changes in payor mix, or changes in laws affecting EMS service collections. Please see next pages for:Projection 1 and 2 charts. City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I Table/Chart r0j, NN.to to S y to g —1. ,ym m g,n m' 33 'm m 4 Larn 0 5. 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A Lt.i Lh m m .i A if.in C ym mM1+ LALA m I..LA LJ CA ci La W O T LLaV n L cn a ❑sn.0 ❑ E mV m rnomr r 7 a. x I- r A F La w s m mCA m GaNwh1h10 p =m1 A O V - YJ ❑ L ....I07 ^Im ' m q CA A X. La ,.I A r n r...F- 7m . w oAI 0'er coi.J m p N ❑ La N In e G w Ln ne V A w L.. q A A ki 7 ❑ NN y.fn HI.n!n N i. .I.. CA m F 1.4 61 6, 61mAmsA 0 l C M . V L ❑ Q a+ co CA IV A M V O N'La w A V V CA A n 6a w V. w w w A0 /{� ev .V A NON .- •D W V y y J LW.. eV.l O CAA❑ CA /-'[� N N tit M tl.to V.to N 9 N iy1 kn. 111 I''A';a d ❑ O N N m�( O m m N o4 (" r W a.- ❑ ❑ o v �7 N A w CA L W O.A Ln O, W T W A C.N V m = lJ fO d A Ib m W m ❑W V W Cr LO 07 0 .Q 0 Co m A.e cam CD [S 0 w w Q. °. 0- tiNoe u h .< g$ gtt ar IR p CV n -hh CD 0 (.0 Q) CD City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMSY Billing&Cost Recovery Services I Table/Chart Client Performance Comparison g. a, w ' ro V. a a 3' City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing & Cost Recovery Services l Table/Chart EMS COST RECOVERY SERVICES COST SHEET 3 z SCHEDULE OF COSTS Total Base Proposal(written in figures and must be a per billing cost): m rb Year 1:$18.60 per incident(all inclusive per proposal) 7 Years 2-4:$19.60 per incident(all inclusive per proposal $ Year 5:$21.60 per incident(all inclusive per proposal) m S!l Total Base Proposal(written in words): Q Year one:Eighteen dollars and 60 cents per incident(all inclusive per proposal) Years two through 4:Nineteen dollars and 60 cents per incident(all inclusive per proposal) Year rive:Twenty-one dollars and 60 cents per incident(all inclusive proposal) Where there is a discrepancy between words and figures WORDS WILL GOVERN. Please check your calculations before submitting your proposal;the City will not be responsible for Proposer's miscalculations. Subconsultant Information Does this proposal include the use of subconsultants? • Yes Initials C W W Exceptions or Clarifications: Please see Section v: Cost Proposal I Professional Services Agreement Proposer: Wittman Enterprises, LLC____ Address: 11093 Sun Center Drive I Rancho Cordova, CA 95670 Telephone: 855.611.0056 (toll free) Fax: Email: cwittmanwong@webillems.com City of Palm Desert: RFP No.C36730. Emergency Medical Services(EMS) Billing&Cost Recovery Services I Table/Chart Professional Service Agreement Our proposal represents our understanding of the Request for Proposal and Sample Contract provided in your RFP. If we are the successful bidder for your project, respectfully we request clarification and/or negotiation on key points of the contract at a mutually- agreeable time for all parties in the near future. Specifically, but not necessarily limited to: Sections 3.5.6.1 and 3.5.6.2:Scope of Indemnity and Additional Indemnity Obligations We believe that all parties in a partnership are allowed the privilege of reasonable indemnification and feel that this section written as-is may not provide Wittman Enterprises, LLC similar protections. For example, it is possible that we might erroneously s bill a claim based on information provided to us by the City and yet be held liable for such an erroneous claim.We feel that this is a point where constructive negotiation and o. additional discussion may be a reasonable request for both parties at a future date. Q 0 m 07 3 • City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 16 -e h H rr,V. 3 N Appendices CL m 3 to APPENDIX 1: STANDARDS, POLICIES, ETHICS, CUSTOMER SERVICE (PROPRIETARY AND CONFIDENTIAL) Privacy And Security Compliance With the recent national news that a national ambulance billing company experienced a Z. breach of their security protocols, resulting in the unauthorized attainment and alleged disclosure of HIPAA-protected personal patient information,Wittman Enterprises would like to reassure our valued EMS partners that as a matter of practice we exceed current HIPAA 3 regulation requirements and take every possible precaution to maintain the integrity of `o private health information. HIPAA Compliance Our HIPAA compliance program was designed and audited by David Nevins, former President of the California Ambulance Association, and member of the American Ambulance Association Reimbursement Committee.Additionally, we ensure compliance with local and state laws by continually educating ourselves on any changes or differences that may apply.As a matter of policy,Wittman Enterprises, LLC stays current with any program updates to Medicare and Medi-Cal.Therefore, we pledge to remain responsible and knowledgeable regarding any program updates to Medicare and Medi-Cal for the duration of the contract period.Wittman recognizes the confidential nature of the MOA's patient accounts and agrees not to disclose any HIPAA-restricted, protected health information, and to maintain the integrity of transmitted health information transmitted for billing purposes.We also follow carefully the FederalTrade Commission's rules on identity privacy, "Red Flag Rules," which require we maintain strict controls aimed at preventing identity theft. HIPAA-Required Safeguards for Health Information • Your billing associate "agrees to implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of e-PHI that it creates, receives, maintains, or transmits on behalf of" you. • They must"alert [you] of any security incident (as defined by HIPAA Security Rule) of which it becomes aware and the steps it has taken to mitigate any potential security compromise that may have occurred and to provide a report to [you] of any loss of data or other information system compromise as a result of an incident" • The Minimum Necessary rule is the basis of HIPAA. It deals with the access of Protected Health Information (PHI) and requires that an employee only have access to the amount of PHI that is needed for them to get their job done as outlined in their regular job description. Exceeding H I PAA Safeguard Requirements Wittman Enterprises, LLC has developed a fraud and abuse compliance program to be a comprehensive statement of the responsibilities and obligations of all employees regarding submissions for reimbursement to Medicare, Medi-Cal, and other government payers for services rendered by clients of Wittman Enterprises, LLC.We have established, and regularly maintain, control standards and procedures to ensure that private information remains secure. City of Palm Desert:RFP No.C36730.Emergency Medical Services(EMS) Billing & Cost Recovery Services I 1 Adherence to Privacy Laws Wittman Enterprises, LLC maintains compliance with all statutes of the California Privacy 3 Protection Act, or the Federal Privacy Requirements, whichever are most stringent. More specifically the following: • Medical Information,Collection for Direct Marketing Purposes- Civil Code section 1798.91 1 h • A business may not orally or in writing request medical information directly from an individual regardless of whether the information pertains to the individual or not, and use, share, or otherwise disclose that information for direct marketing purposes, without the consent of that patient. • Medical Information Confidentiality- Civil Code sections 56-56.37 a • No provider of health care, health care service plan, or contractor shall disclose medical information regarding a patient of the provider of health care or an enrollee or subscriber of a health care service plan without first obtaining authorization,except if order by a court, hoard commission or agency for purposes of adjudication, or by subpoena. • Patient Access to Health Records - Health &Safety Code section 123110 • It is the intent of the Legislature in enacting this chapter to establish procedures for providing access to health care records or summaries of those records by patients and by those persons having responsibility for decisions respecting the health care of others. Every person having ultimate responsibility for decisions respecting his or her own health care also possesses a concomitant right of access to complete information respecting his or her condition and care provided. Wittman Enterprises Privacy Policies Responsibility of Managers It is the responsibility of each manager to ensure that activities in his/her area of responsibility are conducted in accordance with Wittman's compliance policies. Employee Education Wittman Enterprises provides employees rigorous, initial and regular training necessary and appropriate to ensure material compliance with applicable laws. EmployeeNendor Screening It is our policy to make reasonable inquiry into the background of prospective employees and vendors. Determinations are made as to whether they have been (a) convicted of a criminal offense related to healthcare; or ibl listed by a federal agency as debarred, excluded or otherwise ineligible for federal program participation.Wittman Enterprises reviews the DHHSIOIG cumulative sanction report accessed on the World Wide Web at IGNet,the web site of the Federal Inspector General. Monitoring and Auditing Wittman Enterprises, LLC has adopted an audit policy to assist in its efforts to monitor the accuracy of claims and the security of PHI. We devote such resources as are reasonably necessary to ensure that audits are (1) adequately staffed; (2) by persons with appropriate knowledge and experience to conduct the audits; (3) utilizing audit tools and protocol City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 2 which are periodically updated to reflect changes in applicable laws and regulations. Additionally, we routinely audit employee desk and cubicles to insure that PHI is being §• disposed of and/or stored in adherence to company policy. Cell phones and other electronic 3 3 devices capable of recording or taking pictures are prohibited on the work floor. Physical Storage Security Reports, records, notes, and other PHI-containing files are to be kept in secure areas at all times (locked file cabinets and offices,for example), except when in current use. Storage and Disposition of Paperwork: ( • While working, all employees will store HIPAA-sensitive paperwork in file folders on their desks. 7 • When on break or lunch, employees will store HIPAA-sensitive paperwork in a designated desk drawer away from direct sight. a. • For overnight storage HIPAA-sensitive paperwork will be stored in locked cabinets • Stored files are accessible to authorized clerical personnel, supervisors, and upper cc, management only. Destruction of Paperwork: • Paperwork will be discarded into designated locked bins. • Bins are collected bi-weekly and the contents shredded per HIPAA regulations. Electronic Access and Storage Security: • Secure Server Room with Keypad Entry • Multi-Layer Hardware/Software Firewalls with Access Rules giving access to only the servers we specify. • Corporate Anti-Virus. • Corporate Web Filtering with Anti-Virus and Spam, which are logged and monitored. • Server MonitoringTools to manage Disk Capacity, Memory Utilization, and CPU Utilization. • Email Archiver that stores and monitors all email traffic with a built in policy violation alerts. OIG Compliance Program Guidance The DIG's Compliance Program Guidance for Third-Party Medical Billing Companies is a • voluntary set of guidelines intended to help "in developing effective internal controls that • promote adherence to applicable federal and state law, and the program requirements of federal, state and private health plans"Wittman Enterprises, LLC carefully follows applicable recommendations from the report to ensure comprehensive compliance with all appropriate statues and standards of practice as they pertain to Medicare, Medi-Cal, and HIPAA. Seven Key Elements OIG Compliance Program: Per the DIG,Wittman's policies and procedures include the following seven elements: 1. Wittman Enterprises maintains written standards of conduct that have been developed for and are continually updated to reflect clear compliance rules, expectations, training, monitoring, and address potential fraud. City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 3 2. Stephanie Cooper-Noe is our chief compliance officer along with Corinne Wittman-Wong. They chair the Compliance Committee that meets quarterly or more frequently as needed addressing changes in compliance policies and recommended standards of practice. 3 3. All new employees participate in a detailed HIPAA and privacy training program.Additionally, employees receive regular training updates to remain current on all policies and standards of practice. ti 'tea 4. Wittman follows the "Red Flag Rules" which require "whistleblower" protections that v encourages the submissions of complaints and observations, with appropriate levels of protection from retaliation for the employee. 5. The Compliance Officers and Committee are tasked with responding immediately to any 14) allegations of improper/illegal activities and the enforcement of appropriate disciplinary d action against employees who have violated internal compliance policies, applicable statues, Q regulations or federal, state, or private payer health care program requirements.Any such investigations also include the participation ofWittman's Director of Human Resources. 6. Wittman Enterprises, LLC uses a comprehensive auditing program to regularly monitor individual employee compliance as well as Wittman control policy compliance to identify any deviation from the required policies and procedures. 7. As stated in #5, Stephanie Cooper-Noe and Corinne Wittman-Wong lead the Compliance Committee and lead any appropriate investigations through correction of any systemic problems if they should be discovered. Wittman Enterprises Standards of Conduct Our written policies span over two hundred pages in length to address the myriad of procedures and compliance issues that must be identified, regulated, and enforced. Employees receive annual training and are required to sign a new confidentiality statement at the beginning of each calendar year. Policies include: • Wittman Enterprises, LLC Compliance Policies • Corporate Compliance Standards • Management and Organization Policy • Employee Education Policy • EmployeeNendor Screening Policy • Enforcement and Discipline Policy • Monitoring and Auditing Policy • Policy on Reporting, Investigating, and Correcting Compliance Problems • Wittman Enterprises, LLC Medicare and Medi-Cal Billing Compliance Procedures • Billing Compliance Audits • New Employee Billing Compliance Audits • Syllabus for ComplianceTraining • HIPAA Business Associate Agreement City of Palm Desert:RFP No.C36730.Emergency Medical Services EMS) Billing &Cost Recovery Services 1 4 Access to Records Wittman Enterprises ensures that its use, disclosure of and requests for PHI are in accordance with the Minimum Necessary requirements under HIPAA.We make every reasonable effort to limit the amount of PHI that we use, disclose, or request to the Minimum Necessary to accomplish the intended purpose of the use, disclosure or request. , Internal Use v. Wittman's Privacy Officer is responsible for identifying those persons or categories of persons in our workforce who need access to PHI to carry out their duties, and shall, for £ each such person or class: • Identify the category or categories of PHI to which access is needed in order for the persons or class to carry out their duties;and a. • Identify any conditions that should apply to each person's or class'access to PHI. • Approved personnel shall only have access to PHI when they are on duty. Each department is responsible for overseeing and making reasonable efforts to ensure that p7 personnel under its supervision only obtain access to the limited type of PHI that is required to carry out their duties.All Requests from any department for changes in access to PHI by its personnel shall be directed to the Privacy Officer for approval. Routine Disclosure to Third Parties For disclosures that Wittman Enterprises makes on a routine, recurring basis,we may use protocols to limit the PHI disclosed to the Minimum Necessary to achieve the purpose of the disclosure.The Privacy Officer is responsible for ensuring that all departments and functions within the Organization identify disclosures of PHI that they make on a routine, recurring basis.The Privacy Office is responsible for assisting each applicable department to create standard protocols to be applied to reasonably ensure that routine disclosures only include the Minimum Necessary PHI. Protocols under this section must address the following: • The protocol must set forth the type of PHI that can be disclosed. • The protocol must identify the types or categories of persons to whom the PHI identified in the protocol can be disclosed. • The protocol must identify any applicable conditions to providing the disclosure. Non-Routine Disclosure toThird Parties All disclosures that are not routine and recurring must be reviewed on an individual basis in accordance with this section.The Privacy Officer, together with the compliance committee, shall be responsible for developing criteria to be applied to analyze non- routine disclosures to determine the Minimum Necessary PHI that can appropriately be disclosed.All non-routine disclosures must be forwarded to the Privacy Officer for review and approval prior to making the disclosure.The Privacy Officer shall be responsible for reviewing each such non-routine disclosure and determining the Minimum Necessary PHI that can be included in the disclosure. Finally,the PHI requested for disclosure by the following entities shall be deemed to be the Minimum Necessary for the stated purpose and do not require individual review by the Privacy Officer: • Disclosures to a public official in accordance with applicable law, if the public official represents that the information requested is the Minimum Necessary; City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 5 • The information is requested by another Health Care Provider, Health Plan, or Health Care Clearinghouse; �. • The information is requested by a professional who is a member of Wittman's workforce or is a 3 Business Associate of Wittman Enterprises for the purpose of providing professional services to the Organization, if the professional represents that the information requested is the Minimum Necessary for the stated purpose(s); or • A person is requesting PHI for research purposes and he or she has complied with the Organization's policy on research and provides documentation to that effect. In the event a workforce member believes that a request for a disclosure involving PHI from a person or entity is not the Minimum Necessary, such workforce member must raise his or her concerns with the Privacy ❑fficer.The Officer is responsible for evaluating such requests for disclosure and determining whether it is reasonable for Wittman Enterprises to rely on such request. Auditing In addition to continuous training and quality control protocols, we perform audits continuously with seven independent auditors and a supervisor located in our office.They perform various audits including pre-billed claims, submitted claims, denied claims, etc.Wittman's internal auditing program scrutinizes all of our work to ensure records are not missing, minimum content criteria is preset,fee schedules are accurate and applied correctly, billing codes are appropriate and itemized charges are captured. Our auditing team reviews thoroughly a minimum 10% of the work that each employee completes during the week.Auditors randomly select accounts for audit based on production reports from the previous week. Our meticulous efforts are designed to ensure compliance (whether we are billing Medicare, Medi-Cal, private insurance, or patients)focusing on every step from initial billing, account follow up, and the posting of payments.Additionally, we audit charges, credits, level of service, schedules, payers, customer service quality and thoroughness, and provide key feedback to customer service representatives and management staff. Each Wittman Enterprises department is evaluated from their own specific auditing form in regards to job functions and their effectiveness at meeting quality, compliance and productivity standards. If any anomalies are identified through our auditing efforts, we devote the necessary resources to pinpoint areas for improvement and revise protocols, retrain staff, and test solutions to avoid future refrains. Finally, all new hire staff are continually audited until their audits regularly reach a consistent 95% success rate. Positive audit results are linked directly to our strong procedures and processes,training, and form our rigorous internal auditing program. In our 26 years in business Wittman Enterprises, LLC has never received a negative external audit. We keep accurate and up-to-date records of all bilis, payments, and correspondence related to billing functions to ensure a positive outcome to any audit and encourage the City,Fire Department, and its authorized agents to inspect and audit all data and records relating to our perfojmance under the contract.Wittman Enterprises is always at your disposal during any audit procedure,ensuring immediate compliance with request for information. City of Palm Desert:RFP No.C36730.Emergency Medical Services(EMS) Billing&Cost Recovery Services I 6 Key Performance Indicators Tracking and examining accounts receivable, and Payment Average(revenue) are useful 3 tools helping us judge how "quickly" and efficiently we are getting our clients their maximum and legal reimbursements.This doesn't work as well as a snapshot in time but rather as a comparison tool from period to period.Additionally,A/R Days are monitored I regularly to ensure the most consistent and effective results possible, analyzing how long R. it takes from the billing date to when we receive payment on your behalf. In this example, the account's AIR Days are calculated by: CD 5 • Getting the Average Charge per Day: last 3 months charges divided by the number of days in those 3 months; r 3 Total Charges for #of Days in this February March April the 3 Months 3 Month Period m $486,938 $529,350 $490,601 $1,506,889 92 3 • and Dividing the A/R Balance by the Average Daily Charge, giving us how many days of charges are outstanding. Average Charge per Day A/R Balance A/R Days $16,379.23 $1,022,531 62 When the work is being managed appropriately your outstanding AIR should not usually be more than three months of charges. Much of this key information will be provided in your Year-to-Date Revenue Report along with several other Key Performance Indicators (KPls). Additionally, our operations director uses department KPIs to analyze trends, performance, and to address any anomalies before they become issues. Billing Department Customer Service Department • Trending ofTransports Workflow Timeliness • Month-End Report Comparisons and • Hospital Data Exchange Reconciliations • Mail Returns Cash Receipts Department • Private Mail • Payments monitored for timeliness and • Medicare Signatures unusual trends • Missing or incorrect phone numbers • RefundsTrending City of Palm Desert: RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 7 APPENDIX 2: SAMPLE REPORTING (PROPRIETARY AND CONFIDENTIAL) Incident Scrubbing Analytics M N fC 5 St Ql Q Q 0 m U, 06 3 • City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing&Cost Recovery Services I 8 Program Analytics: Activity Summary a Activity Summary by Payot inimimumpo MM ME MIN ION IMM _ ■ l� ilk • ■ • NM I� ilk l� 0. un co 3 City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS)Billing&Cost Recovery Services I 9 c g- m [D � r-f h CID C R 3 3 Q} N Q a o m . 1 N m 5. City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS)Billing&Cost Recovery Services I 10 [U � 3 CD •e h CD ro CD C to CD m CD ❑ a � o m CO to City of Palm Desert:RFP No.C36730. Emergency Medical Services (EMS) Billing&Cost Recovery Services I 11 s co r *. � r 3m — Z a, N D N m n w m `b z m ti m n H m 0) 'm > a 7- 2 • m 5 D m 2 EL c5i (I) Q 2 C o 00 3 C m a m CD m -C -N _ m 5 m m rF 0 Q 0) City of Palm Desert:RFP No,C36730, Emergency Medical Services(EMS)Billing&Cost Recovery Services I 12 a m z -H Fri 0 v, TS �. H fY n v, a. z v a cn C cc 0 ❑] 0 City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing&Cost Recovery Services I 13 - (1) a icy) -� su D r— m CD m ✓- D b i• a) 1 N a) o ap vp ( n St (I) m m —CI v+ 0 D a i a o m a CD co. Ei+ = ) tzi co CD 0 City of Palm Desert: RFP No.C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 14 C� 3 Q c o- ti n 5 CD 0 a m w 5 C4 City of Palm Desert: REP No. C36730. Emergency Medical Services EMS) Billing &Cost Recovery Services I 15 GEMT Reporting g. With the recent implementation of the California GEMT program,Wittman Enterprises provided leadership throughout the process,working closely with the designers of the n, program (Sac Metro, Chief Scott Clough,etc.), providing several training opportunities for our clients and designing reports specifically related to the information needed when applying for GEMT and IGT monies. N 1.74 GEMT SupportTimeline: Pre-GEMT Rollout • Worked with Sac Metro and the State, providing transport numbers and calculations to them as they worked on their cost sheets • After the bill passed (AB 678) and became GEMT officially, we worked with our California clients through the entire set-up process: attending State-sponsored GEMT instruction meetings; helping provide rough projections of potential GEMT income based on Medicaid transport information;sponsored a webinar where Chief Scott Clough answered the most frequently asked questions from our clients about the GEMT co • Set up a section of our website for easy-to-find links and references associated with the GEMT program (please see www.webiliems.com/GEMT-Program-Resources/). • The unofficial "rough" projections required by the State were needed to estimate what each provider was likely going to submit when the official program began. We provided the following unofficial formula to help clients get a rough idea of their numbers: • Take the total amount of your direct EMS cost and add that to your indirect cost • Divide that number by your total number of Medicaid transports. • This would give you an average cost of transport • Multiply the average cost by the number of Medicaid transports and submit that as your estimate. GEMT Support Timeline: Post-GEMT Rollout • Provided customized GEMT reports for participating clients as they filled out their required cost reports. • Fielded calls with questions regarding the cost reports and how to use the Wittman reports to help them complete the GEMT cost reports. • Provided regular email and phone call updates reminding clients when their first cost reports were due and providing them their customized transport reports to help them complete the reports. City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 16 GEMT REPORT: Med-Cal Fee for Service (CEMT transports) 3 • co 3 rr ro Vt a 11 m m J PROPRIETARY AND CONFIDENTIAL In the event that copies of this presentation are requested from the City of Palm Desert,Wittman Enterprises,LLC respectfully requests that this be redacted in its entirety from any and all copies provided via a Freedom of Information Act and/or simitar state and local Acts.Its inclusion constitutes Proprietary and Confidential information.Unauthorized release of such confidential infor- mation puts us at an unfair disadvantage with future competitors if the information is released to the public in general. City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 17 GEMT REPORT: Medi-Cal HMO (GEMT transports) A 3 Z. Ln IL tr m Q 0 co 7 City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS) Billing &Cost Recovery Services I 18 GEMT REPORT: (Total Number of MTS Transports) 1. a h rf f9 7 CL n. m 5 City of Palm Desert: RFP No. C36730. Emergency Medical Services EMS) Billing &Cost Recovery Services l 19 APPENDIX 3: ELECTRONIC RESOURCES AND ACCESSTO RECORD Secure email a We provide the City access to our Secure Email Program from Axway. It provides multiple tiers of security that can be used individually or in combination to block threats at the DMAZ and within the enterprise network, and secure inbound and outbound email traffic at the content and network levels. MailGate SC simplifies management of one ro comprehensive secure email solution for inbound, outbound and encryption, providing 3 secure file delivery without impacting your current environment. `Q File Transfer Protocol (FTP) Access The City will be provided access to our FTP site.We receive email notification anytime reports or other information are uploaded to the site.There is no file size limitation for 9 client uploads. w Client Portal and Electronic Dashboard Wittman Enterprises offers secured Internet access to our billing system via our Client Portal, 24 hours a day. No additional software is required for the City of Palm Desert to access the information through our secured server. It is accessed with a secured login that is password protected. Information accessed from the Porta! is in real time, allowing authorized City and Fire personnel to view each claim wherever it is in the billing and collection process. Access to the Client Portal is granted only to pre-authorized City and Fire personnel with permission to view such information and is strictly limited to the City of Palm Desert's information.All patients may be referenced by name, date of service, incident, and run number.Your staff can print invoices for patients and run reports for their own use.Additionally,the City's specialized reports can be made available through this site. Our billing software system is Microsoft Windows-based which enables data export by authorized staff for easy manipulation (Excel, PDF, Crystal, etc.). It also allows for a clear and traceable audit trail for initial client verification, billing notification, and phone contact. Moreover, our software automatically updates each individual account detailing date, change, or billing function.All history and noted entries become a permanent record and all charges are maintained for a complete payment history. Finally,the Portal provides an "electronic dashboard," accessible 24 hours a day that provides a one-screen synopsis of the current state of the EMS billing operation, based on the preferences selected by each Client Portal authorized user. City of Palm Desert:RFP No. C3673O. Emergency Medical Services(EMS) Billing&Cost Recovery Services I 20 Client Portal Wittman Enterprises offers secured Internet access to our billing system via our Client Portal, 3 24 hours a day. No additional software is required for the City of Palm Desert to access 7 the information through our secured server. It is accessed through a secured login that is password protected. Information accessed from the Portal is in real time, allowing authorized City and Fire personnel to view each claim wherever it is in the billing and collection process. , ro .r l4 CLIENT E 3 CO Portal Login VariatO a Please enter your User ID and Password and click Secure Login User ID: - Password: Secure Login If you are experiencing any problems logging in, please call{855Y 611-0056 City of Palm Desert:RFP No. C36730.Emergency Medical Services(EMS) Billing &Cost Recovery Services I 21 Client Portal — Main Dashboard [ I portal.webilMma.com [, 3 w • • Mina •Uaah6oard\,. cowrie, . l Preferences...,. RePart' _ \ Transports 1 L�Z^C• 41 10110001..1$ Th...Ch3.0 a•s [::• . .1 , .rv,:>_........... aa Link Ev,e:,..:a::,: :...,.:. .0.belR. P1 ..1h..Elu'Mu 10 Rn , 1.1r0 e.,enan.,, i. ,. -•.. _ --- 1 - N Wee and Total#Of Billable Calls 155071 Total#Of Billable Calls 15507) %D 0seal. ®Road Moms Ser.Juan Medical Cents. — 1 Panel Panels Raiser Hoap,rai.Nunn Seenm.nte ID Chen 5•re'Loom+) ALS1 2681 teL Davit Medea.Center ........Me-.. • Saner MMic.l Cent.,Se.ee..rn,e e�®�^fi.r'.y •- 3 ALSO 141 A�• es Ital ne -3EFJ ........ l�r'1 �,MISRpiIyH_.,.wr _Rase Sire oale eaertXr1/1 ALSO Deaeeaed Palied Si S1 Frcs[11165 enaar OW, - �5 Son Q.t.:etJJ6'Ie1T ....... _.. Kaiser Sonar aPnsoilleel ih di cremwrt.. ......_... 01 -" AseesvnenI Nan Iran Suns pnaII i Metrical e.rrte. aver. i -._.. eP _ Mercy General Hosphai Sec memento -'- , CL BLS 11 I _... Mwcy hospital Folsom v ---_-.... Mothodott hoFpialSrramema s® ....'_.. or ------ VA Hosenal.saeremeua'MeMec la- 9LSE rrraara�� •• Ftrrrimerced ar 5•Leno _.............. I' '�'"r'"".1 a,me.Amaummend O Firer ResponderMonona,Sutter Sos[ei Mnnnai Hoav lal 5eaa None -, t",144 ',;.1 n gm i(SO luq AO) BM X.011 tin par - m K. Calls 0 2oa 100 600 100 I000 IMD 160) Calls LA op Total Aging Dollars($15,850,183.07) Total A Of Billable Calls 155071 • Over 180 S3.112.010 Sit None ,4 •121-180 $L, Met Auln insurance ■24 ____...._.. . _.... Custody it ............. _—_ _.._ lnsurarlce ^r�r3 1 91.120 S1,1 1.a11. Z Insurance Elelaranic 263 __................_..._.___......_. 81-li0 $1,596,87773 Kaiser '2 --- Naiser Aledicar fen r 7G 31-60 S7093,598..23 Kaiser-Medicare . 154 Current �55.220,B03.85 • MCPVMCaid 175R MCal1MCa id HMO ':'7 r, ,r� ,r,� a ....9 'rC Medicare ,1':1 -O - '0 -q, 'o -q, -c�, Medicare HMO +01 0 0Oa qoq 'b 2o 'b `b Other r1 - ?5 4 % . -a� �04 Privare Pay i01 ao 00 -00 00 tg 00 Workars Compenswion 112 0 200 400 600 800 1000 1.200 1700 0allsrs Calls City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS}Billing&Cost Recovery Services I 22 Client Portal - Statistics 3 I portal webiiems.com L', 7 M na ain-Dash Statistics Prafaranses Reporting Transports L."' J ,§emir Giwia __. _ _ y-.yl ro. art Due ou01'2'11i the than Wok,.rep+nserr[,the musing information from the a-PCR for all of the rliflarcM hieing efemenis. °'-' d S1arc Dare UMW' V ..n JAP°1.1 '°".._... 'fatal # of ePCRs(5834) 5. in Last Name 35 r. D. First Name 2 1i LA Signature 2068 3 insurance Name .38 a a Insurance ID 516 W W T o Patient Address 0 m e Patient City 383 enPatient State it 382 r , m Patient Zip Code 376 a Patient Gender III _ W _ Patient SSN 1f 12 - --- Patient DOB _35E ---__ _ . _ Patient Phone 5654 Mileage 1150 r r _ ^ Incident Location 0 Destination 1030 ji - I L I + 0 1000 2000 3000 4000 5000 6000 #Of Calls City of Palm Desert:RFP No.C36730, Emergency Medical Services(EMS) Billing&Cost Recovery Services I 23 Client Portal — Preferences g III portal.webillems.com Ci M re ee -t Main Dashboard Statistics Preferences ) Reporting \ Transports [Log Ofi y 11 N m Instructions Instructions Instructions_ s•se .a.•- --. •� irrm ll lr wia'itit 7 Click the Change Button,then enter your changes and then click If you have more than one company, Please select up to 10 charts to ua on the"SAVE"button.To cancel your changes,click the"CANCEL click on the name that you want as display on the Main-Dashboard and 5 button. your preferred company. click the update button. tri Customer Information Assigned Com allies Chart Choices a eL iii Note Name: Wittman Enterprises,LLC 0Primary Payor Categories-By Date Q Range o Email-Login ID: 11.Change I rn Password Change Show 10Ticket Status-By Date Range K vi Default Tab: C ain-Dashboard ' Update l l Current Payor Categories-By Date co r Default Ticket Search l Date Of Service j Update Range D Q Level Of Service-By Date Range System Information iiiiialanegailialigo Q Drop Off Facilities-By Date Range Wittman Go Live: 5/12/2017 Account Created: 5/72/2017 Account Representative:Heather Montano Q Mail Returns-Grouped By Type Cash Representative: P.a3sou Vang 0 Aging-Total Outstanding Dollars Billing Representative: Sharon Halley As Of Today Last Password Last Login: 6/27/2017 I Reset: 6/27/2017 Users Guide: Click Here... C]Payment Average-From First Bill To First Payment By Date Range For All Payors 14cC988L.BV4I6..e._,....yu:�..y.�...��w... ....._,... - - Customer Information: CD View/Print Statement: Q Main Tab: Q Billing Information: I. View/Print Invoice: Q StatisticaTab: Q Trip Notes Information: Q View/Print Receipt: Q Re port ingTeb: Q Customer History information: I View PCR: Q T ansportTa PI Q Services Information! 0 View PCR Only: 0 Month End Tab: Q Diagnosis&Alerts Information' I Collection Agency 0 DownloadTab: Q . Trip History Information: Q Profit Centers Only! 0 City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing&Cost Recovery Services 1 24 Client Portal — Reporting g. 3 O portaI.webillams.com [, r9 Main-Dashboard Statist ic3 Preferences Reporting Transports Ir131b --• ' - ... �. Select a report t0 o'swbolow ar':l'. • y an choose your v5ti0ns and men el teaLft Display Room m ,—k Report Run Dot 0/29/17 ar 3:17:05 PM rF :Activity Sum marypy Payee Ceteawr Sample Company Name Active,Sam in ry by voh.o to Activity Summary Payor Category:'Date From'.04/01/2417-04/3012c171 5- Actively Sam ma ry Grouped by Vohiole f0 Aging Detail byCurrent Payor Profit Canter Mona] 1A Cal l Type Count by Patient Age P..r.•.r,.. i. a,r ¢. �...-.i,.r Cvirr an,n N.i C .I. P..,,Rli .v. ...c evn� (II4 P.Ic,,,•l. 6.•in.. ryr. 2a = 0— Coal,Receipts Journal by Dot.Polled Insuranor 903 1,627,107.06 30,122.52 7597584.54 000 096.686.20 275.513 5,00a.92 599,8316E 1.762.55 Cash Receipts Journal SubReport Q Med-a.re 2.100 4.430700.50 3.461.092.99 949907.51 1.002.97 916.195,07 1.102.32 415.43 100,1321.512 435.32 -0. Charge List Charge type Detail Med-CallMe9eald 1,716 9060905.64 2808268.64 255.037.20 -0.09 178,83.58 23.029.93 14867 59.590.75 151.30 • Chief Complaint Count by Client Age Pdvata 707 845.906.94 0.00 845906.44 2351.53 27.040.02 46,531.35 0.06 769,574.04 1,156.17 Closing eatance Summary CD Custody 1 1,735.91 1,337.77 398.11 6,60 390.11 0.00 OAO 0.00 398.14 CD Credil Type Derail Dry Run Report Sub-109.1.for:(none] 5507 59.964,35626 513,311,821.92 53,645,531.33 53,103.61 52,049,104.01 570,919.19 59 576.02 50.00 5395.145.0 Month End Sates Journal Dal ail Patient under 18 Ticket Survey by Payor Category Titter Survey Derail by trip Date Ticket Survey Summary byTrip Dale Report Deecriytien A Thl.bhp date•ba..d aocaeundn7 report, Which 1a grouped by pdmary p.yer. displays all shlrges end credit.,as well es bola nee and average totals- _ _ Seardt Criteria ManCare:`01A 1.20171 •: 51en 0.re:184302D17 piaplay Options Report Courtesy of Wittman Enterprrees,LLC Page 1 of 3 play Report Mart[Nor City of Palm Desert:RFP No.C36730. Emergency Medical Services(EMS) Billing& Cost Recovery Services I 25 Client Portal -Transports O portal.webillams.cam Cr d T. 7 na Main-Dashboard Statistics Pr eft re aces Reporting Transports LoR� x� Saadt Opuom ]eardt Result., __.._a........,. . . -. O Date Of Service gm •Cwtamor Name Jab Profit C•ntr ty --Atkin* Lef• b!!. .QM WW-Jflni/ Fifyy Qlt}e4 1 .- pA.44.d._. V. ❑Incident Number 0001 A 2015-10-26 293236 12314567 POWERS.NICOLE 1992-01-22 S0.00�Y O Run Number 0001-A 2015-10-16 293236 12314566 POWERS,NICOLE 1982-01-22 50.00 Z ❑Social Security Number I 0001 A 2015.16-09 293236 12314565 POWERS,NICOLE 1982.01-22 50.00 Date oreirm 0001•A 2015-10•13 293236 12314564 POWERS.NICOLE 1982.91.22 50.00 [fl r•8earr tAda F1001•A 2015 16 23 303234 12314563 POWERS.NICOLE 1982-01-22 50.00 M ■Partial(Slew.Reaun 7imal coo-A 20155-10-18 303236 12314562 POWERS,NICOLE 1982-01-22 50.00 3 CL 0001-A 2015.10-30 313236 12314561 POWERS,NICOLE 1962-01.22 50.00 Co labeler Exact lFer fiesuaTimel v Feel Name 0001-A 2015-10-12 313236 12314560 POWERS.NICOLE 1982-01-22 50-00 a • 0001-A 2015-10-04 323236 12314569 POWERS,NICOLE 1962-01-22 50.00 O Leal Name 0001-A 2015-10-11 323236 12314568 POWERS,NICOLE 1932.01.22 50.00 rN Powers - - 1 j 0001•A 2015-10.29 323236 72314576 POWERS,NICOLE 1962.01.22 50.00 g [loot.A 2015-10-19 333236 12314588 POWERS,NICOLE 1982-01-22 50.00 W. ®Show Zero Balance Calla L4 ©Canoelre,l Calla Only 0 Shawfldtut.[untrnucwry Display Cells I I Rain I Client Portal -Transport Detail --- -�--T ^- -- (1l portal.wsbillems.com [. . !! _. .. _ _.... ._.. .. _.. ... ...•..s • Preiened Company p1• .. • Ir. Main•Dashboard ' sutoi05 Preferences Reporting Transport Detail I Lop QR Customer Information Company Name. I Wittman E.nterpri685.LLC_ . Service Date: (lawns V-= L. Stamm tent Customer Name, I Powers,Ni r. 1 Nicole^ Incident Number nyw I ce Address: i 123 Jump St- Run Number r 3237 i Receipt City,State&Tip: :Rocklin.CA 95765 1 Last 4 of SSN: I B7 _89 _Patient Care Report Phoney 119161232-1234 _ __ Transporting Age: .3 --1 I Pant Pegg Date of Birth: I O1F22/1982 J SerVi COS L. ._. ` ,Wnipil. .. • l • :a ... _._._..a. .ir �.j_ _ Tnp His[prY-_ L Customer HtstwY_Lj Piclr•Up Facility - Drop-Ott Facility -- I Facility: Mercy Medical Comer-M0roed I Facility: 1 Maw Hospital-Bakersfield I Address: 301 E 13th 5t. _ I Address: l 2215Truxlen Aye. • Clio.State&21p: i Merce0d.CA 95341 1 City,State&Zip: LBakeisfield CA 93301 Phone: 112091 365 7000 —1 Phone: I i6611 632 a006 I Lorra>f ••- -. Profit Center •• • •• • Roepppneo Iona: Nona Profit Center None 1 DIWAIdIIone =None �— Ron Information- -- Call Type: RL51 Advanced Life Support I PHo4ty: Emergency J transport Erner:paniy Dispatch Con nnente This is a 1esi. City of Palm Desert:RFP No. C36730. Emergency Medical Services (EMS) Billing&Cost Recovery Services I 26 Additional Portals 3 1 r- All Portals are available , PATIENT 24 hours a day,7 days a week. COLLECTIONS b v We respond to patient inquiries T. ro• within one business day. h 111111111111. f 1 5 ro Provides patients with CREDIT CARD We have created a m Portal access.Each invoice, PAYMENT Collections Portal for the 3 G. statement,and letter most commonly requested °' mailed to patients provide f . items from collection a a website link for them Q 13 agencies based on input m to access,login,provide from our clients.This portal ri insurance information,make %Mi. provides:reviewing accounts m a payment,or simply inquire electronically,printing to about their bill. invoices,printing patient care reports,and printing 1500 billing forms. \..__ J ea City of • Wittman Palm Desert Enterprises clr"" n! ciEl Pan IOW IIIi J City of Palm Desert: RFP No.C36730. Emergency Medical Services IEMSI Billing&Cost Recovery Services 1 27 APPENDIX 4: ADDENDA ACKNOWLEDGEMENT g. /14. EliPr- try 3 m I ADDENDUM NO. 1 RFP FOR EMS BILLING & COST RECOVERY SERVICES CONTRACT NO. C36730 0 MARCH 21, 2018 In case you do not see your question answered in this written addendum, p4 please note that we are awaiting a response back from the Riverside County Lrzt Fire Department on some submitted questions. We anticipate a second addendum addressing these inquiries to be issued by March 23, 2018. 1. Since the text limit is 20 pages for our response, are we allowed to put our filled out Required Forms in the appendices section?My assumption is that Appendices will not count towards the 20 allowable RFP response pages. As noted in the RFP: Proposal should be typed and should contain no more than 20 typed pages using a 12-point font size, including transmittal letter and resumes of key people, but excluding Index/Table of Contents, tables, charts, graphic exhibits,letter of recommendations,and requested forms. The underlined items will not count towards the 20 allowable RFP response pages. 2 Beyond explaining our reporting process in the 20-page RFP response,are we allowed to put sample Reports in the appendices section?My assumption is that Appendices will not count towards the 20 allowable RFP response pages. Sample reports will be considered as a separate attachment, but please limit it to five(5)pages or less, if possible. 3. Method of Approach,#2: Can you please clarify what services would need to be provided during the 24-hour response time commitment?Our services are provided during regular business hours and our Client Portal is available 24/7. For our internal use, we would require an emergency contact(s) that can be contacted at any how-,in the event of an emergency. This information would not be made public. On a related note,any customer inquiries or requests left as an email or voicemail message, shall be responded to within 24 hours, or if over the weekend/scheduled holiday, within the next business day. 4. Qualifications&Experience,#12 Since the text limit is 20 pages for our response, are we allowed to put our Standards, Policies, HIPAA, etc. documents in our Appendices section?My assumption is that the Appendices will not count towards the 20 allowable RFP response pages. Yes, you are permitted to place the aforementioned items in your Appendices section, but please limit the length of these items to ten (10) pages or less, if possible. City of Palm Desert:RFP No. C36730. Emergency Medical Services(EMS)Billing&Cost Recovery Services I 28 -n" '101 - m co ADDENDUM NO. 2 RFP FOR EMS BILLING & COST RECOVERY SERVICES CONTRACT NO. C36730 MARCH 22, 2018 a a' 0 1. How many transports did the City provide, for each of the last three fiscal or calendar years? s The Riverside County Fire Department indicated that this data was not o readily available. 2 Do you charge for non-transports? If so, what is your rate and how many non- transports did the City have in the last three fiscal or calendar years? Yes, the City has a non-transport fee of$425. Please see Resolution 247E-03 (Section 2: Approval of the Fee Schedule) as provided in Addendum No. 1. The Riverside County Fire Department indicated that the total non-transports data was not readily available. 3 The City provides 5,900 transports annually, what are the total transports sorted by ALS, ALS 2, & BLS? The Riverside County Fire Department indicted that it categorizes all these transports as ALS. 4. Please provide a breakdown of FY 2017 transports by primary payor for the following categories? a Medicare b. Medicaid c. Commercial Insurance d. Patient Pay The City has never billed for EMS services, so this information is not available. City of Palm Desert:RFP No.C36730.Emergency Medical Services(EMS) Billing &Cost Recovery Services I 29 RESOLUTION NO. 2018-03 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PALM DESERT, CALIFORNIA, APPROVING THE EMERGENCY MEDICAL SERVICES BILLING PROGRAM FEE SCHEDULE AND RELATED WRITE-OFF POLICY WHEREAS, the City of Palm Desert ("City") incurs costs related to provision of emergency medical services to residents who both reside inside and outside City limits; and WHEREAS, in an effort to develop cost recovery processes related to such emergency medical services, the City Council will consider an Emergency Medical Services Billing Program ("Billing Program') to be initiated on December 15, 2017, which program will allow the City to bill Medicare and other health insurance providers for emergency medical services as part of individuals' existing insurance coverage with no out-of-pocket costs for Cove Communities residents; and WHEREAS, a Cove Communities resident is defined as an individual who resides within the jurisdictional boundaries of the Cities of Palm Desert, Rancho Mirage, and Indian Wells (Cove Communities); and WHEREAS, The City of Palm Desert shall not bill residents, as defined above, for any unpaid balance related to emergency medical services; and WHEREAS, the City of Palm Desert reserves the right to bill and/or collect from a resident's and non-resident's insurance provider for emergency medical services rendered. WHEREAS, as part of the Billing Program, the City must establish a fee schedule ("Fee Schedule") that will establish the fees to be charged Medicare and other health insurance providers; and WHEREAS, the Fee Schedule was established based on the reasonable costs of providing emergency medical services, as determined in the Fee Development Analysis prepared December, 2017; and WHEREAS, goal of the City's Billing Program is to only collect from Medicare and other health insurance providers as a means of achieving partial cost recovery for the City when billing Cove Communities residents, as the City will collect only what Medicare or other health insurance providers will pay and the remainder of the bill will be waived under the write-off policy ("Write-Off Policy") set forth under Section 3 of this Resolution; and WHEREAS, patients residing outside of the jurisdictional boundaries of the Cities of Palm Desert, Rancho Mirage and Indian Wells, will receive a balance bill as set forth under Section 3 of this Resolution; and RESOLUTION NO. 2018-03 WHEREAS, the Write-Off Policy will also waive the full bill for any individual without insurance coverage as set forth under Section 3 of this Resolution; and WHEREAS, on December 14, 2017, the City Council conducted a properly noticed public hearing to consider approval of the Fee Schedule, at which testimony and evidence, both written and oral, were presented to and considered by the City Council. NOW THEREFORE, BE IT RESOLVED THAT THE CITY COUNCIL OF THE CITY OF PALM DESERT HEREBY: Section 1. Recitals That the recitals set forth above are true and correct. Section 2. Approval of the Fee Schedule That the City Council hereby approves adoption of the Fee Schedule, as set forth below: Fee Schedule Fee Description _ Fee Amount Ambulance Transportation $1,450.00 Ambulance Mileage Rate $29.00 per mile Non-Transport Fee $425.00 Oxygen $132.00 Extra Attendant $155.00 Wait Time —per hour _ $82.20 First Re ponderfPre-Stabilization $400.00 Basic Life Support (BLS) Disposable Supplies $303.75 Advanced Life Support (ALS) Disposable Supplies _I $382.00 Twelve (12) Lead EKG $285.00 Three (3) Lead EKG $156.48 Section 3. Approval of the Write-Off Policy That the City Council hereby approves adoption of the Write-Off Policy, as set forth below: Patients that reside within the jurisdictional boundaries of the Cities of Palm Desert, Rancho Mirage, and Indian Wells (Cove Communities) shall not be balanced billed. The City accepts insurance payments as payments in full. All patients will receive a maximum of four(4) insurance information request notices, should insurance not be provided at the time of service. For those patients that reside ❑utside of the jurisdictional boundaries of the Cities of Palm Desert, Rancho Mirage and Indian Wells, the City's contracted EMS/ambulance billing company will send one balance bill as required under law. Accounts that have 725000100 I l30203277 I 1)RAS:'r 10/4/17 2 RESOLUTION NO. 2018-03 had no activity for 90 days will be deemed uncollectable at that time and will be written off. Any patient without insurance is deemed eligible for a financial hardship waiver; the City will write the accounts off All other billing aspects shall comply with state and federal law. Section 4. Severability That the City Council declares that, should any provision, section, paragraph, sentence or word of this Resolution be rendered or declared invalid by any final court action in a court of competent jurisdiction or by reason of any preemptive legislation, the remaining provisions, sections, paragraphs, sentences or words of this Resolution as hereby adopted shall remain in full force and effect. Section 5. Repeal of Conflicting Provisions That all the provisions heretofore adopted by the City or the City Council that are in conflict with the provisions of this Resolution are hereby repealed. Section 6. Effective Date That this Resolution shall take effect upon its adoption. Section 7. Certification That the City Clerk shall certify to the passage and adoption of this resolution and enter it into the book of original resolutions. PASSED, APPROVED, AND ADOPTED by the City Council of the City of Palm Desert, California, on this 11th day of January 2018, by the following vote, to wit: AYES: HARNIK, KELLY, NESTANDE, WEBER, and JONATHAN NOES: NONE ABSENT: NONE ABSTAIN: NONE S ATHAN, MAYOR ATTEST: RA LLE D. KLASSE , CITY CLERK CITY OF PALM DESERT, CALIFORNIA 72500 Of M11302O3277.I DRAFT WWI 3