EMERGENCY MEDICAL SERVICES BILLING AND COLLECTION REQUEST FOR PROPOSAL BID NO. EMS SUBMITTED BY:

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1 EMERGENCY MEDICAL SERVICES BILLING AND COLLECTION REQUEST FOR PROPOSAL BID NO. EMS SUBMITTED BY: LOWCOUNTRY BILLING SERVICES 5005 SUNSET BLVD. LEXINGTON, SC May 15, 2014

2 May 15, 2014 To whom it may concern, The following individuals have been empowered to represent Lowcountry Billing Services, Inc. to prospective and current clients. Their names and titles are as follows: Bryan Waters Director of Operations Erin Waters Director of Finance Todd O Dell Marketing Manager Jeff Sarokas Business Development The above named receive written correspondence at 5005 Sunset Blvd. Lexington, SC and their contact telephone number is (800) or (803) Lowcountry Billing Services proposed fees Total price are for the services outlined in Cleveland County Emergency Medical Services System, Request for Proposal, Bid number EMS Please note, William Waters, as C.E.O. of Lowcountry Billing Services, Inc. attests that the fees contained within the following proposal in response to Cleveland County Emergency Medical Services System, Request for Proposal, Bid number EMS shall remain effective for a period of 1,095 days and the proposal will comply with the requirements stated in Cleveland County Emergency Medical Services System, Request for Proposal, Bid number EMS Thank you for considering the following proposal from Lowcountry Billing Services, Inc. William Waters, C.E.O. Lowcountry Billing Services, Inc.

3 Not only has Lowcountry Billing Services, Inc. successfully operated an Ambulance Billing Company for 25 years, we have avoided legal protests for the entire time of our operation. Part of LBS s Mission Statement indicates we will be the obvious choice and best billing company for all ambulance agencies and we work very hard on a daily basis to meet our mission expectations and to remain regulatory compliant. We know timely delivery of service is required and pre-planned and proper alignment of the team allows for expeditious results. When deciding how to assign responsibilities within the operation, LBS worked backwards from our clients basic needs because our first clients and many after have told us they Need to remain compliant with laws and regulations and get paid. LBS s team approach also allows company leadership the ability to oversee the billing cycle and clearly identify bottle-necks that may have a negative impact on our client s revenue cycle. LBS project management capabilities are excellent because we understand to be great you have to be detailed, organized, and operate with a sense of urgency. For example, our current billing software, Evolution. Evolution was created by our in-house, full time Information Technology Team. This creating of our non-cookie cutter software from the ground up allows LBS to import the vast majority of epcr software and quickly adapt to Medicare, Medicaid or insurance company guideline changes. When LBS is informed of a required change, the change is normally implemented by the I.T. Team within 48 hours from the time of reporting. This ability alone is the envy of many of our competitors. Another project success story is our Continuation of Business Plan ; some refer to it as Disaster Recovery Plan. Being brief, LBS maintains redundant off-site storage and portable memory for all data. This is important because if we are forewarned about business altering event, i.e. a hurricane, ice storm, etc. we can relocate our operation, as necessary, to War-rooms throughout the Country. With an unplanned event we would assess the damage to our offices and if necessary relocate our operation to a local War-room. LBS understands the importance of the continuation of our clients revenue cycle in the event of a disaster and we also recognize the same is important for our employees. LBS understands that for a smooth transition of the billing operation there must be adequate training. Currently Cleveland County, NC uses EMSCharts for its epcr software and LBS is very familiar with EMSCharts and their current situation as an epcr provider. LBS will schedule an appointment for On-site training when the award is announced and we expect 2-3 days of minute sessions to be exposed to 100% of Cleveland County s EMS staff. LBS s training will include but not be limited to: 1. Immediately visit Cleveland County and assess operational needs and wants. 2. Include County requests into LBS On-site Training Program 3. Orientation a. Introduce LBS to Cleveland County

4 4. Points of Contact a. Exchange information b. Who to call list c. When to call vs. when to 5. Coordination with EMSCharts/ESO a. Explain b. Gain access to run data c. Coordinate meeting between Cleveland County and ESO Solutions if necessary 6. Discussion of patient demographics a. Importance of accurate information b. Insurance information c. HIPAA Compliance 7. Approved Methods of Data Transmission a. Secure website b. compliance c. Telephone Compliance 8. Visit and confirm procedures with BB&T (Lockbox) a. Provide LBS contact information b. Obtain BB&T contact information 9. 1 st 30 day review with Cleveland County a. Visit and review transition 25 years of experience has taught LBS that training programs must be designed to meet the individual needs of the client and the most successful programs include client requests that normally are not listed within the projected Scope of Services. When mitigating risks of adding a new client to our services we follow a simple procedure, we show up. By having the ability and willingness to be present for critical conversations and program implementation, LBS clients understand we will work together as a team to conquer all obstacles. Webinars and conference calls are beneficial and sometimes used, but they do not provide the assurances and comfort of on-site personal one-on-one interaction. Not only does LBS embrace our Show-up procedure, we embrace our culture. We are a South Carolina business that displays a high level of customer service. Every interaction, whether written or verbal; illustrates our willingness to treat others with courtesy, dignity and respect. Furthermore, we often use our recorded telephone conversations as training tools and guidance for our employees. Our statements are easy to read and if our clients allow, we will gladly implement a patient payment plan that meets our client s specifications. We don t believe in badgering your patients. Instead, we simply inform your patient of the balance and expect payment. In rare occurrence when a patient ignores our request for payment for 90 days, we transfer the patient s account to our in-house Enhanced Billing Department. The Enhanced Billing Department focuses on collection of your outstanding debt by using a more assertive approach that forewarns your

5 patients that alternative methods of collection may be implemented should they make the choice to not settle their debt.

6 Processing of ambulance runs is performed at our location in Lexington, South Carolina. Lowcountry Billing Services acts as the point of contact in all billing matters including: patient inquiries and complaints, attorney requests and information requests by other persons or agencies legally permitted to have such information. Upon receipt of ambulance run data, LBS creates a patient and an electronic record of the run detailing the services provided by the EMS team. During this process the run data is compared to already existing data to determine if a new patient record is needed or if the most recent run information is to be added to an already existing patient record. In the event that the patient does not exist in our system and demographic information is sparse or missing there are many tools at our disposal for completing the demographic information such as Lexus Nexus, other web-based tools and even county website tools when available. During this same process of loading and comparing patient data to the Lowcountry Billing Services data base, we use an address scrubbing software to verify and confirm address integrity. Upon the return of any mail that may be returned for the various reasons from the United States Postal Service, the mail is scanned back into the Lowcountry Billing Services system. Staff dedicated to the research of address correction is then notified. This staff will research these accounts with the various website tools previously mentioned. After the patient data is properly introduced into LBS s billing software the run is created and the next step is the validation of insurance information. Again, there are many tools to aid the staff in creating an accurate claim to file. The policy number is validated against historical records compiled over the long tenure of Lowcountry Billing Services. When a policy number is not found or eligibility is in question then research begins with insurance company websites for confirmation. LBS employs a team of professionals for a Q&A process of all runs being entered. In this phase of execution, details such as the service level are scrutinized and evaluated. In this same step, origins and destinations are also confirmed for accuracy. While the staff is examining the details of the service provided by the EMS Team, the system is also checking for mismatched information, alerting the user of any abnormalities the system may discover in its examination of the data. Details such as Procedures and Drugs are compared to the service level. Response and dispatch modes are also compared to solidify emergent or non-emergent transport qualification. These extra steps are taken to aid in the goal of a clean claim the first time submitted. If insurance coverage cannot be confirmed for the patient LBS will then start the billing process. The first mailing to be generated will be an invoice of the service received from the EMS Team indicating the itemized charges. This invoice requests that the patient pay the amount due, return the form with all appropriate insurance information or contact the office of Lowcountry Billing Services directly. Furthermore, the invoice also provides an area for the patient to make

7 corrections to personal information that may affect the billing process such as name spellings, date of birth, etc. If an insurance company is initially billed, an invoice is not sent to the patient until a payment or other response is received from the billed insurance company. Please note, the first mailing the patient receives will also include a Notice of Privacy Practices and Patient Comment Card. If the billed insurance company fails to send a payment or other response within a predetermined timeframe, then an action report is generated to alert for a follow up of a claim. Patients who do not pay or provide any valid insurance information will next receive two additional notifications, statements set apart with 30 day intervals or as predetermined by the County then the patient will receive a delinquent notice. Patients who are making payments will receive an updated monthly statement reflecting the remaining balance due. After the predetermined series of statements have been mailed to the patient, a final letter will be mailed to the patient notifying them that the debt will be turned over to the Setoff Debt Collection Program. Lowcountry Billing Services files electronic files directly to the major insurance carriers: Medicare, Medicaid and the Blue Cross family. We use the third part processors Emdeon and Availity for all other carries that are known to accept electronic claims. With the implementation of the national standards for insurance filings, the vast majority of insurance companies receive electronic submissions of claim data. Thus, eliminating the need for paper claims and speeding up the collections process. In an on- going effort for precision, Lowcountry Billing Services also processes data coming back from insurance companies that would indicate eligibility, policy number, name validity and many other potential communications that the insurance companies provide back as a response from electronic submission. However, when the need for paper claims submission arises, Lowcountry Billing Services will provide to the requesting insurance company a HCFA 1500 claim form as and other supporting documentation required to successfully process the claim.

8 LBS patient statements: First Mailing Statement, Comment Card and Notice of Privacy Practices

9 Front of Comment Card, included in first mailing Back of Comment Card

10 Second Mailing

11 Final mailing to include Cleveland County s North Carolina Setoff Debt collection letter.

12 LBS s creation of our billing software has allowed us to create not only reports that are widely recognized in the industry, we often have the ability to create reports specific to our clients reporting criteria. LBS understands the need for individualized client data and are willing to assist when able Sample reports below:

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15 LBS not only complies with Federally mandated HIPAA laws, we are dedicated to reviewing our programs on a quarterly basis to identify and implement opportunities for improvement. Our Compliance Program is extensive and includes direction for HIPAA Compliance, as well as LBS s Red Flag plan. See Compliance Plan Binder

16 LBS is uniquely positioned to assist Cleveland County not only with ambulance billing and collections but also with the continual refresh of the county epcr software and supporting hardware at an annual estimated cost of $39,560. Lowcountry Billing Services proposes a 5.75% fee for performing ambulance billing and collections. Please note, the 5.75% proposed fee includes $39,560 for Accrual Funds that are earmarked for Cleveland County s annual software and hardware Refresh. Thank you for considering Lowcountry Billing Services to be a service provider for Cleveland County and we look forward to a successful business relationship.