COUNCIL COMMUNICATION
TO: Honorable Mayor and Council
FROM: Pete Pilafas, Fire Chief
SUBJECT:Title
Award Professional Services Agreement for Ambulance Medical Billing to Action Ambulance Billing, LLC (Chief Pilafas)
Body
FUNDING SOURCE:
General Fund
PURPOSE:
To award the Professional Services Agreement for Ambulance Medical Billing (Agreement 500385) to Action Ambulance Billing, LLC, in accordance with City Code § 3.10.030.1.
BACKGROUND:
The Lake Havasu City Fire Department will be granted a license to operate 911 Advanced Life Support (ALS) ground ambulance transport services under the Arizona Department of Health Services (AZDHS) Certificate of Necessity (CON) Program. It is important to note that the AZDHS establishes and regulates ambulance transport rates within the state for all CON holders. During the CON application, Lake Havasu City’s ambulance transport rates are the same as River Medical, Inc., except for our standby rate.
Due to the complex nature of emergency medical transport billing and compliance with Medicare and AZDHS reporting requirements, municipal service providers commonly utilize specialized professional services to perform this function.
The City received five (5) complete responses to the Request For Proposal (RFP) issued on February 22, 2024, for ambulance billing. The RFP specified the evaluation process that would be used to evaluate the proposals. The proposal submitted by Action Ambulance Billing, LLC, was determined to meet all requirements specified and ranked the highest. The company’s experience and ability to perform were confirmed by reference checks with comparable customers.
Under the billing approach for ambulance billing, Action Ambulance Billing, LLC, will function as an extension of the City. Ambulance patients will have toll-free telephone access to a representative. Service delivery includes direct billing of private insurance companies, secondary carriers, and government agencies paying for medical services. This results in patients being billed only after these collection efforts are complete, when applicable. Action Ambulance Billing, LLC, also acts as a patient advocate and will intercede with insurance companies on behalf of patients when needed. Benefits to the City include positive customer service experiences and optimal collection rates due to Action Ambulance Billing, LLC’s, extensive knowledge and experience with billing insurance companies and governmental payers for patient services, expedited collection, and accurate data reporting.
COMMUNITY IMPACT:
The funding generated from ambulance medical billing plays a significant role in providing financial support to the city’s emergency medical services. The service users or their respective medical insurance providers bear the cost of ambulance transport, ensuring that quality emergency medical care is available to all those in need.
FISCAL IMPACT:
5.25 percent of monthly revenue collected (approximate projection of $263,000 annually) and one-time set-up fee of $500.
ATTACHMENTS:
Ambulance Billing Services Agreement
Exhibit A - Technical Specifications
Business Associate Agreement
Committee Evaluation Tabulation
Proposal - Action Ambulance Billing
SUGGESTED MOTION:Recommended ACtion
I move to award the Professional Services Agreement for Ambulance Medical Billing to Action Ambulance Billing LLC for a 3-year term with the option to renew for an additional 2-year term, authorize the City Manager to execute the Agreement, and authorize City staff to exercise the renewal option.