Description
The City of Albany, Procurement Division, is seeking proposals from qualified vendors to provide comprehensive ambulance billing and revenue cycle management services for its emergency, non-emergency, and critical care transport operations. The selected vendor shall provide end-to-end billing services from receipt of electronic patient care reports (ePCRs) through final payment collection while ensuring compliance with all applicable federal and state regulations. The scope of services includes electronic claim submission, claims review, patient billing and customer service, comprehensive revenue cycle management, secure integration with the County's electronic patient care reporting (ePCR) system, and compliance with all applicable HIPAA, HITECH, CMS, Medicare, Medicaid, False Claims Act, PCIDSS, and other regulatory requirements governing ambulance billing and patient information.
• The vendor shall provide services that include electronic claim submission for Medicare, Medicaid, commercial insurance, managed care, workers' compensation, Veterans Affairs, liability, and self-pay accounts.
• The vendor shall provide claims review, coding validation, eligibility verification, insurance discovery, denial management, appeals processing, and accounts receivable follow-up to maximize reimbursement.
• The vendor shall provide patient billing and customer service, including payment processing, payment plans, dispute resolution, and multilingual support when available.
• The vendor shall provide comprehensive revenue cycle management designed to improve collections, reduce denials, minimize accounts receivable aging, and maximize reimbursement.