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REQUEST FOR CITY COUNCIL AGENDA ITEM <br />Appropriation <br />Agenda Date Requested:November 9, 2020 <br />N/A <br />Source of Funds: <br />Requested By:Lisa Camp, Chief <br />Department:Administration/EMS <br />N/A <br />Account Number: <br />N/A <br />Amount Budgeted: <br />ReportResolutionOrdinance <br />Amount Requested:N/A <br />Exhibits: Evaluation Summary from respondents <br />Budgeted Item:YesNo <br />EMERGICON Proposal for City Council <br />SUMMARY& RECOMMENDATION <br />Presently, the La Porte EMS processes all EMS medical claimsin-house. EMS has on <br />staff one full-time Billing Specialist that oversees the total emergency medical billing <br />process. The City of La PorteEMS call volume is increasing each year, which correlates <br />to an increase in thevolume of EMS medical claims. Currently, this is more work than <br />one Billing Specialist can efficiently handle. <br />The only change that La Porte EMS is looking to make in the emergency medical billing <br />process to be able to process more claims through to payment, streamlining our internal <br />costs and consistent follow-up on medical claims. By contracting with an experienced <br />external emergency medical billing service each claim will be reviewed, coded and <br />billed. Additionally, claim payments will be reviewed for low pay, no pay, denials, and <br />compared to the expected pay rate from approved Federal and State schedules. The <br />service will follow-up on all claims (10 days for Medicaid claims, 14 days for Medicare <br />claims and 35-45 day follow-up for commercial insurance). The review of all EMS <br />medical claims during these processes will insure that the claim is paid correctly and <br />Specialist to work on claims from 2018 to 2020, as well as providing one-on-one <br />customer service and administrative functions supporting EMS. <br />The City of La Porte Purchasing DepartmentpublishedRequest for Proposal (RFP) <br />#20510for an EMS Billing Service on August 13, 3030 and August 20, 2020. A total of <br />five (5) responses were received and opened on September 3, 2020. The proposals <br />were reviewed by theevaluation committee comprised of Assistant City Manager, La <br />Porte EMS Chief and City Comptroller. Theevaluation criteria included: <br />Ability to Perform Required Services <br /> <br />