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PSA with Advanced Data Processing, Inc gc) /.50°3(1 PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI BEACH AND ADVANCED DATA PROCESSING, INC. FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES PURSUANT TO RFP 2017-002-JC This Professional Services Agreement ("Agreement") is entered into this 3/G day of id L._ , 2019, between the CITY OF MIAMI BEACH, FLORIDA, a municipal corporation organized and existing under the laws of the State of Florida, having its principal offices at 1700 Convention Center Drive, Miami Beach, Florida, 33139 ("City"), and ADVANCED DATA PROCESSING, INC. (ADP!), a Delaware corporation and subsidiary of R1 RCM Inc., registered to do business in Florida, with an office located at 7900 NW 154th Street, Miami Lakes, FL 33016 ("Contractor"). SECTION 1 DEFINITIONS Agreement: This Agreement between the City and Contractor, including any exhibits and amendments thereto. City Manager: The chief administrative officer,of the City. City Manager's Designee: The City staff member who is designated by the City Manager to administer this Agreement on behalf of the City. The City Manager's designee shall be the Department Director. Contractor: For the purposes of this Agreement, Contractor shall be deemed to be an independent contractor, and not an agent or employee of the City. Services: ' All services, work and actions by the Contractor performed or undertaken pursuant to the Agreement. Fee: . Amount paid to the Contractor as compensation for Services. Contract Documents: Contract Documents shall mean this Agreement and City of Miami Beach RFP No. 2017-002-JC for EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES, together with all addenda thereto, issued by the City in contemplation of this Agreement, RFP, and the Contractor's proposal in response thereto ("Proposal"), all of which are hereby incorporated and made a part hereof; provided, however, that in the event of an express conflict between the Contract Documents and this Agreement, the following, order of precedent shall prevail: this Agreement; the RFP; and the Proposal. (1 • Risk Manager: The Risk Manager of the City; with offices at 1700 Convention Center Drive, Third Floor, Miami Beach, Florida 33139; telephone number (305) 673-7000, Ext. 6435; and fax number(305) 673-7023. SECTION 2 SCOPE OF SERVICES ( 2.1 In consideration of the Fee to be paid to Contractor by the City, Contractor shall provide the work and services described in Exhibit "A" hereto (the Services). Although Contractor may be provided with a schedule of the available hours to provide Its services, the City shall not control nor have the right to control the hours of the services performed by the Contractor; where the services are performed (although the City will provide Contractor with the appropriate location to perform the services); when the services are performed, including how many days a week the services are performed; how the services are performed, or any other aspect of the actual manner and means of accomplishing the services provided. Notwithstanding the foregoing, all services provided by the Contractor shall be performed in accordance with the terms and conditions set forth in Exhibit "A" and to the reasonable satisfaction of the'City Manager. If there are any questions regarding the services to be performed, Contractor should contact the following person: Fire Department City of Miami Beach 2300 Pinetree Dr. Miami Beach, FL 33140 Attn: Robert Bedell, Division Chief Email: RobertBedell(a�miamibeachfl.gov 2.2 Contractor's Services,, and any deliverables incident thereto, shall be completed in accordance with the Scope of Services in Exhibit"A", attached hereto, and as otherwise set forth in the RFP, including Appendix C of the RFP. 2.3 Except for the fee/compensation due to Contractor as provided in Section 4 of this Agreement Contractor shall be solely responsible, at Contractor's sole cost and expense, for payment of all expenses related to Contractor's performance under this Agreement, including, without limitation, payment of all annual subscription and/or software license fees due to ESO Solutions, Inc. or other third-party providers, in connection with Contractor's performance under this Agreement. SECTION 3 TERM The term of this Agreement ("Term") shall commence upon execution of this Agreement by all parties hereto, and shall have an initial term of three (3) years, with two (2) renewal options of one (1) year each, to be exercised at the City Manager's sole option and discretion, by providing Contractor with written notice of same no less than thirty (30) days prior to the expiration of the initial term. /4 Notwithstanding the Term provided herein, Contractor shall adhere to the scope of services for completion and delivery of the Services, as set forth in the in Exhibit "A", attached hereto. SECTION 4 FEE 4.1 In consideration of the Services to be provided under this Agreement, Contractor shall be compensated on a fixed fee basis, in accordance with the pricing established in Exhibit "B", Contractor Fee Schedule. As provided more fully in Appendix C of the RFP, Contractor's compensation shall be solely based on amounts actually collected on behalf of the City of Miami Beach for EMS-related,services provided by the City's Fire Rescue Department. Except as provided in Appendix C, in no event shall Contractor be entitled to any compensation from the City of Miami Beach related to Contractor's performance under this Agreement. 4.2 Payment for work completed by the Contractor shall be invoiced on a monthly basis, commencing with the first day of the month following the first full month of service. 4.3 INVOICING Upon receipt of an acceptable and approved invoice, payment(s) shall be made within forty-five (45) days for that portion (or those portions) of the Services satisfactorily rendered (and referenced in the particular invoice). In the event City disputes any part of the invoiced amounts, such dispute shall be raised in writing to Contractor within thirty (30) days of receipt of invoice or the invoice shall conclusively be deemed to be accurate and correct. Contractor shall respond to any such notice of dispute within thirty (30) days of receipt thereof. Any overdue amounts which are not the subject-of a good faith notice of dispute shall accrue interest at the Florida statutory interest rate established pursuant to Section 55.03 of the Florida Statutes. Invoices shall include a detailed description of the Services (or portions thereof) provided, and shall be submitted to the City at the following address: Accounts Payable Division Finance Department City of Miami Beach 1700 Convention Center Drive, 3rd Floor Miami Beach, FL 33139 SECTION 5 TERMINATION 5.1 TERMINATION FOR CAUSE If the Contractor shall fail to fulfill in a timely manner, or otherwise violates, any of the covenants, agreements, or stipulations material to this Agreement, the City, through its City Manager, shall thereupon have the right to terminate this Agreement for cause by providing Contractor at least thirty (30) days' prior written notice. Prior to exercising its option to terminate for cause, the City shall notify the Contractor of its violation of the particular term(s) of this Agreement, and shall grant Contractor thirty (30) days to cure such default. If such default remains uncured after thirty (30) days, the City may terminate this Agreement without further notice to Contractor. Upon termination, the City shall be fully discharged from any and all liabilities, duties, and terms arising out of, or by virtue of, this Agreement. If Client City materially fails to perform any obligation required hereunder, and such default continues for thirty (30) calendar days after written notice from Contractor specifying the nature and extent of the failure to materially perform such obligation, this Agreement shall terminate upon the expiration of said thirty (30) calendar day period. Notwithstanding the above, the Contractor shall not be relieved of liability to the City for damages sustained by the City by any breach of the Agreement by the Contractor. The City, at its sole option and discretion, shall be entitled to bring any and all legal/equitable actions that it deems to be in its best interest in order to enforce the City's right and remedies against Contractor. The City shall be entitled to recover all costs of such actions, including reasonable attorneys' fees. 5.2 TERMINATION FOR CONVENIENCE OF THE CITY THE CITY MAY ALSO, THROUGH ITS CITY MANAGER, AND FOR ITS CONVENIENCE AND WITHOUT CAUSE, TERMINATE THE AGREEMENT AT ANY TIME DURING THE TERM BY GIVING WRITTEN NOTICE TO CONTRACTOR OF SUCH TERMINATION; WHICH SHALL, BECOME EFFECTIVE WITHIN THIRTY (30) DAYS FOLLOWING RECEIPT BY THE CONTRACTOR OF SUCH NOTICE. ADDITIONALLY, IN THE EVENT OF A PUBLIC HEALTH, WELFARE OR SAFETY, CONCERN, AS DETERMINED BY THE CITY MANAGER, IN THE CITY MANAGER'S SOLE DISCRETION, THE CITY MANAGER, PURSUANT TO A VERBAL OR WRITTEN NOTIFICATION TO CONTRACTOR, MAY IMMEDIATELY SUSPEND THE SERVICES UNDER THIS AGREEMENT FOR A TIME CERTAIN, OR IN THE ALTERNATIVE, TERMINATE THIS AGREEMENT ON 'A GIVEN DATE. IF THE AGREEMENT IS TERMINATED FOR CONVENIENCE BY THE CITY, CONTRACTOR SHALL BE PAID FOR ANY SERVICES SATISFACTORILY PERFORMED UP TO THE DATE OF TERMINATION; FOLLOWING WHICH THE CITY SHALL BE DISCHARGED FROM ANY AND ALL LIABILITIES, DUTIES, AND TERMS ARISING OUT OF, OR BY VIRTUE OF, THIS AGREEMENT. CONTRACTOR WILL BE PAID ALL AMOUNTS DUE HEREUNDER FOR SERVICES SATISFACTORILY PERFORMED THROUGH THE DATE OF TERMINATION OF THIS.AGREEMENT. 5.3 TERMINATION FOR INSOLVENCY The City also reserves the right to terminate the Agreement in the event the Contractor is placed either in voluntary or involuntary bankruptcy or makes an assignment for the benefit of creditors. In such event, the right and obligations for the parties shall be the same as provided for in Section 5.2. SECTION 6 INDEMNIFICATION AND INSURANCE REQUIREMENTS 6.1 INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City of'Miami Beach and its officers, employees, agents, and contractors, from and against any and all third-party, actions (whether at law or in equity), claims, liabilities, losses, and expenses, including, but not limited to, attorneys' • fees and costs, for personal, economic or bodily injury, wrongful death, loss of or damage to property, which may arise or be alleged to have arisen from the negligent acts, errors, omissions or other wrongful conduct of the Contractor, its officers, employees, agents, . contractors, or any other person or entity acting under Contractor's control or supervision, in connection with, related to, or as a result of the Contractor's performance of the Services pursuant to this Agreement. To that extent, the Contractor shall pay all such claims and losses and shall pay all such costs and judgments which may issue from any lawsuit arising from such claims and losses, and shall pay all costs and attorneys' fees expended by the City in the defense of such claims and losses, including appeals. The Contractor expressly understands and-agrees that any insurance protection required by-this Agreement or otherwise provided by the Contractor shall in no way limit the Contractor's responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The above indemnification provisions shall survive the expiration or termination of this Agreement. 6.2 INSURANCE REQUIREMENTS [NOTE: INSURANCE TYPES AND LIMITS BELOW SHOULD ALWAYS BE SAME AS WHAT WAS SPECIFICED IN BID DOCUMENTS] The Contractor shall maintain and carry in full force during the Term, the following insurance: 1. Contractor General Liability, in the amount of$1,000,000; 2. Contractor Professional Liability,7in the amount of$200,000; and 3. Workers Compensation & Employers Liability, as required pursuant to Florida Statutes. The insurance must be furnished by insurance companies authorized to do business in the State of Florida. All insurance policies must be issued by companies rated no less than "B+" as to management and not less than "Class VI" as to strength by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. Contractor shall provide written notice to the City at least thirty (30) days prior to termination, cancellation or reduction in coverage in the policy. The insurance certificates'for General Liability shall include the City as an additional insured and shall contain a waiver of subrogation endorsement. Original certificates of insurance must be submitted to the City's Risk Manager for approval (prior to any work and/or services commencing) and will be kept on file in the Office of the Risk Manager. The City shall have the right to obtain from the Contractor specimen copies of the insurance policies in the event that submitted certificates of insurance are inadequate to ascertain compliance with required coverage. 1 , The Contractor is also solely responsible for obtaining and submitting all insurance certificates for any sub-Contractors. Compliance with the foregoing requirements shall not relieve the Contractor of the liabilities and obligations under this Section or under any other portion of this Agreement. The Contractor shall not commence any work and or services pursuant to this Agreement until all insurance required under this Section has been obtained and such insurance has been approved by the City's Risk Manager. SECTION 7 LITIGATION JURISDICTION/VENUE/JURY TRIAL WAIVER This Agreement shall be construed in accordance with the laws of the State of Florida. This Agreement shall be enforceable in Miami-Dade County, Florida, and if legal action is necessary by either party with respect to the enforcement of any or all of the terms or conditions herein, exclusive venue for the enforcement of same shall lie in Miami-Dade County, Florida. By entering into this Agreement, Contractor and the City expressly waive any rights either party may have to a trial byjury of any civil litigation related to or arising out of this Agreement. SECTION 8 LIMITATION OF CITY'S LIABILITY Excluding any acts of willful misconduct or gross negligence by the City and/or any violation by City of its,obligations under the Business Associate Agreement (Exhibit C attached herein), the City desires to enter into this Agreement only if in so doing the City can place a limit on the City's liability for any cause of action, for money damages due to an alleged breach by the City of this Agreement, so that its liability for any such breach never exceeds the sum of $10,000 (excluding amounts due and payable to Contractor for services performed under this Agreement). Contractor hereby expresses its willingness to enter into this Agreement with Contractor's recovery from the City for any damage action for breach of contract to be limited to a maximum amount of $10,000 (excluding amounts due and payable to Contractor for services performed under this Agreement). Accordingly, and notwithstanding any other term or condition of this Agreement, Contractor hereby agrees that the City shall not be liable to the Contractor for damages in an amount in excess of $10,000 (excluding amounts due and payable to Contractor for services performed under this Agreement) for any action or claim for breach of contract arising out of the performance or non-performance of any obligations imposed upon the City by this Agreement or the Business Associate Agreement. Nothing contained in this section or elsewhere in this Agreement is in any way intended to be a waiver of the limitation placed upon the City's liability, as set forth in Section 768.28, Florida Statutes. SECTION 9 DUTY OF CARE/COMPLIANCE WITH APPLICABLE LAWS/PATENT RIGHTS; COPYRIGHT; AND CONFIDENTIAL FINDINGS 9.1 DUTY OF CARE With respect to the performance of the work and/or service contemplated herein, Contractor shall exercise that degree of skill, care, efficiency and diligence normally exercised by reasonable persons and/or recognized professionals with respect to the performance of comparable work and/or services. 9.2 COMPLIANCE WITH APPLICABLE LAWS In its performance of the work and/or services, Contractor shall comply with all applicable laws, ordinances, and regulations of the City, Miami-Dade County, the State of Florida, and the federal government, as applicable. • 9.3 PATENT RIGHTS; COPYRIGHT; CONFIDENTIAL FINDINGS Any work product arising out of this Agreement, as well as all information specifications, processes, data and findings, are intended to be the property of the City and shall not otherwise be made public and/or disseminated by Contractor, without the prior written consent of the City Manager, excepting any information, records etc., which are required to be disclosed pursuant to Court Order and/or Florida Public Records Law. All reports, documents, articles, devices, and/or work produced in whole or in part under this Agreement are intended to be the sole and exclusive property of the'City, and shall not be subject to any application for copyright or patent by or on behalf of the Contractor or its employees or sub-consultants, without the prior written consent of the City Manager. 9.4. EXCLUDED PERSONS , If any refunds of patient accounts of City are required to be refunded to or offset by any government and commercial payer as a result of City's violation of its obligations set forth herein (an "Excluded Person Refund"), Contractor shall not be required to refund to City any • commissions or fees earned or previously paid to Contractor as a result of its collection of such Excluded Person Refund or otherwise include such Excluded Person Refunds in its calculation of Net Collections as set forth herein. City represents and warrants that all of its employees, personnel and independent contractors involved in the delivery of EMS or otherwise performing (services for City: (i) hold the licensure or certification required to perform such services, (ii) have not. been convicted of a criminal offense related to health care or been listed as debarred, excluded or otherwise ineligible for participation in a Federal health care program and (iii) are not excluded persons listed on any of the following: (a) the Office of the/Inspector General List of Excluded Individuals and Entities; (b) the General Services Administration's Excluded Parties List; and (c) the Office of Foreign Asset Control's Specially Designated Nationals List. SECTION 10 GENERAL PROVISIONS 10.1 AUDIT AND INSPECTIONS Upon reasonable verbal or written notice to Contractor, and at any time during normal business hours (i.e., 9AM — 5PM, Monday through Fridays, excluding nationally recognized holidays), and as often as the City Manager may, in his/her reasonable discretion and judgment, deem necessary, there shall be made available to the City Manager, and/or such representatives as the City Manager may deem to act on the City's behalf, to audit, examine, and/ or inspect, any and all other documents and/or records relating to all matters covered by this Agreement. Contractor shall maintain any and all such records at its place of business at the address set forth in the "Notices" section of this Agreement. 10.2 [INTENTIONALLY DELETETD] 10.3 ASSIGNMENT, TRANSFER OR SUBCONSULTING Contractor shall not subcontract, assign, or transfer all or any portion of any work and/or service under this Agreement without the prior written consent of the City Manager, which consent, if given at all, shall be in the Manager's sole judgment and discretion. Neither this Agreement, nor any term or provision hereof, or right hereunder, shall be assignable unless as approved pursuant to this Section, and any attempt to make such assignment (unless approved) shall be void. 10.4 PUBLIC ENTITY CRIMES Prior to commencement of the Services, the Contractor shall file a State of Florida Form PUR 7068, Sworn Statement under Section 287.133(3)(a) Florida Statute on Public Entity Crimes with the City's Procurement Division. 10.5 NO DISCRIMINATION In connection with the performance of the Services, the Contractor shall not exclude from participation in, deny the benefits of, or subject to discrimination anyone on the grounds of race, color, national origin, sex, age, disability, religion, income or family status. Additionally, Contractor shall comply fully with the City of Miami Beach Human Rights Ordinance, codified in Chapter 62 of the City Code, as may be amended from time to time, prohibiting discrimination in employment, housing, public accommodations, and public services on account of actual or perceived race, color, national origin, religion, sex, intersexuality, gender identity, sexual orientation, marital and familial status, age, disability, ancestry, height, weight, domestic partner status, labor organization membership, familial situation, or political affiliation. 10.6 CONFLICT OF INTEREST Contractor herein agrees to adhere to and be governed by all applicable Miami-Dade County Conflict of Interest Ordinances and Ethics provisions, as set forth in the Miami-Dade County Code, as may be amended from time to time; and by the City of Miami Beach Charter and Code, as may be amended from time to time; both of which are incorporated by reference as if, fully set forth herein. Contractor covenants that it presently has no interest and shall not acquire any interest, directly or indirectly, which could conflict in any manner or degree with the performance of the Services. Contractor further covenants that in the performance of this Agreement, Contractor shall not employ' any person having any such interest. No member of or delegate to the Congress of the United States shall be admitted to any share or part of this Agreement or to any benefits arising therefrom. 10.7 CONTRACTOR'S COMPLIANCE WITH FLORIDA PUBLIC RECORDS LAW (A) Contractor shall comply with Florida Public Records law under Chapter 119, Florida Statutes, as may be amended from time to time: (B) The term "public records" shall have the meaning set forth in Section 119.011(12), which means all documents, papers, letters, maps, books, tapes, photographs, films, sound recordings, data processing software, or other material, regardless of the physical form, characteristics, or means of transmission, made or received pursuant to law or ordinance or in connection with the transaction of official business of the City. (C) Pursuant to Section 119.0701 of the Florida Statutes, if the Contractor meets the definition of"Contractor" as defined in Section 119.0701(1)(a), the Contractor shall: (1) Keep and maintain public records required by the City to perform the service; (2) Upon request,from the City's custodian of public records, provide the City with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes or as otherwise provided by law; (3) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed, except as authorized by law, for the duration of the contract term and following completion of the Agreement if the Contractor does not transfer the records to the City; (4) Upon completion of the Agreement, transfer, at no cost to the City, all public records in possession of the Contractor or keep and maintain public records required by the City to perform the service'. If the Contractor transfers all public records to the City upon completion of the Agreement, the'Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the Agreement, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the City, upon request from the City's , custodian of public records, in a format that is compatible with the information technology systems of the City. (D) REQUEST FOR RECORDS; NONCOMPLIANCE. (1) A request to inspect or copy public records relating to the City's contract for services must be made directly to the City. If the City does not possess the requested records, the City shall'immediately notify the Contractor of the request, and the Contractor must provide the records to the City or allow the records to be inspected or copied within a reasonable time. 1 ' (2) Contractor's failure to reasonably comply with the City's request for records shall constitute a breach of this Agreement, and the City, at its sole discretion, may: (1) unilaterally terminate the Agreement; (2) avail itself of the remedies set forth under the Agreement; and/or (3)avail itself of any available remedies at law or in equity. (3) A Contractor who fails to provide the public records to the City within a reasonable time may be subject,to penalties under s. 119.10. (E) CIVIL ACTION. (1) If a civil action is filed against a Contractor to compel production of public records relating to the City's contract for services, the court shall 'assess and award against the Contractor the reasonable costs of enforcement, including reasonable attorney fees, if: a. The court determines that the Contractor unlawfullyrefused to comply with the public records request within a reasonable time; and b. At least 8 business days before filing the action, the plaintiff provided written notice of the public records request, including a statement that the - Contractor has not complied with the request, .to the City and to the. Contractor. (2) A notice complies with subparagraph (1)(b) if it is sent to the City's custodian of public records and to the Contractor at the Contractor's address listed on its contract with the City or to, the Contractor's registered agent. Such notices must be sent by common carrier delivery service or by registered, Global Express Guaranteed, or certified mail, with postage or shipping paid by the sender and with evidence of delivery, which may be in an electronic-format. (3) A Contractor who complies with a public records request within 8 business days after the notice is sent is not liable for the reasonable costs of enforcement. (F) IF THE CONTRACTOR HAS ' QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S . DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS AGREEMENT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: CITY OF MIAMI BEACH ATTENTION: RAFAEL E. GRANADO, CITY CLERK 1700 CONVENTION CENTER DRIVE MIAMI BEACH, FLORIDA 33139 E-MAIL: RAFAELGRANADO MIAMIBEACHFL.GOV PHONE: 305-673-7411 • SECTION 11 NOTICES All notices and communications in writing 'required or permitted hereunder, shall be delivered personally to the representatives of the Contractor and the City listed below or may be mailed by U.S. Certified Mail, return receipt requested, postage prepaid, or by a nationally recognized overnight delivery service. Until changed by notice, in writing, all such notices and communications shall be addressed as follows: TO CONTRACTOR: ADVANCED DATA PROCESSING, INC. do R1 RCM, INC. 401 N. MICHIGAN AVENUE, SUITE 2700 CHICAGO, IL 60611 ATTN: LEGAL DEPARTMENT TO CITY: CITY OF MIAMI BEACH FIRE DEPARTMENT; RESCUE DIVISION 2300 PINETREE DR. MIAMI BEACH, FL 33140 Attn: Chief Robert Bedell WITH A COPY TO: OFFICE OF THE CITY MANAGER 1700 CONVENTION CENTER DR. MIAMI BEACH, FL 33140 Attn: Jimmy Morales Notice may also be provided to any other address designated by the party to receive notice if such alternate address is provided via U.S. certified mail, return receipt requested, hand delivered, or by overnight delivery. In the event an alternate notice address is properly provided, notice shall be sent to such alternate address in addition to any other addresswhich notice would otherwise be sent, unless other delivery instruction as specifically provided for by the party entitled to notice. Notice shall be deemed given on the,date of an acknowledged receipt, or, in all other cases, on the date of receipt or refusal. SECTION 12 MISCELLANEOUS PROVISIONS 12.1 CHANGES AND ADDITIONS This Agreement cannot be modified or amended without the express written consent of the parties. No modification, amendment, or alteration of the terms or conditions contained herein shall be effective unless contained in a written document executed with the same formality and of equal dignity herewith. 12.2 SEVERABILITY If any term or provision of this Agreement is held invalid or unenforceable, the remainder of this Agreement shall not be affected and every other term and provision of this Agreement shall be valid and be enforced to the fullest extent permitted by law. • 12.3 ENTIRETY OF AGREEMENT The City and, Contractor agree that this is the entire Agreement between the parties. This Agreement supersedes all prior negotiations, correspondence, conversations, agreements or understandings applicable to the matters contained herein, and there are no commitments, agreements or understandings concerning the subject matter of this Agreement that are not contained in this document. Title and paragraph headings are for convenient reference and are not intended to confer any rights or obligations upon the parties to this Agreement. [REMAINDER OF THIS PAGE LEFT INTENTIONALLY BLANK] • • , IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their appropriate officials, as of the date first entered above. FOR CITY: CITY OF MIAMI BEACH, FLORIDA ATTEST: ' By: City Cler Mayor 111"----'-- Date: V"'��. 2l r Lb v ;..8� � FOR CONTRACTOR: 1.74 .'S':' % ,iADVANCED DATA PROCESSING, INC. :INCORPORATED: ATTEST: '4••• 40. B : Q3U// / Lim.' IL Lorre lierferci Exec. Ais),,,.4- tee# 0 T,�'h4l � &/✓(' Print Name and Tifle Print Name and Title Date: OA • APPROVED AS TO FORM &LANGUAGg &FOR EXECUTIQN • 7 � , — Li cc rG f cicy Atto��ey -yliote EXHIBIT A SCOPE OF SERVICES The services to be provided include, but are not limited to, obtaining patient and insurance information for emergency medical transport services provided, verifying patient insurance and patient demographic information, filing claims and sending invoices to self-pay accounts, submitting claims to Medicare, Medicaid, and insurance companies, processing third party reimbursements, and providing specific management and financial reports on a monthly basis, as specified by the City. The Contractor is required to provide Emergency Medical Services (EMS) ambulance billing and Electronic Patient Care Reporting (EPCR) services for the City's Fire-Rescue Department, in accordance with the terms, conditions and specifications contained in the Request for Proposals (RFP). C3. Specifications The Contractor under this contract will provide all services necessary to report, bill and collect for services provided by the City's FIRE-RESCUE DEPARTMENT. Requirements include the acquisition, placement, support, maintenance and connectivity of rugged mobile computer laptop devices in fire rescue vehicle as well as desktop client software at all the City's Fire-Rescue. Stations to capture, generate and modify patient care reports, gather and archive patient care data, gather and report performance statistics, generate and process insurance billing and payments, collect and remit funds to the City. The awarded Contractor shall set up, maintain and provide all comprehensive aspects of the EMS reporting, billing and collection services, as required by the scope of services herein contained. These services shall include but not necessarily be limited to: 1. Contractor shall provide sufficient staffing to ensure the smooth and efficient operation of Emergency Medical Transport Reporting, Billing and Collection Services contract. 2. . Contractor shall provide full-time Project Manager and/or Customer Service Representatives ("CSR") assigned to the City's contract for EMS transport billing and collection services, available during normal business hours, Eastern Standard Time (EST) five (5) days a week,- Monday through Friday, that are able to communicate (read, write and speak) fluently in English, Spanish and Creole; however, it is not required that each CSR speaks in all the three (3) languages, but there must be available CSRs to conduct business in each language, as necessary. 3. Contractor's computer help desk support, or approved third-party support, must be available seven (7) days a week, twenty-four (24) hours a day, with the ability to provide • technical assistance, trouble shooting, and correcting issues that may arise with the computer, laptop systems hardware, software and connectivity and provide application support to users entering EPCR reports and accessing the quality control application from desktop platforms. 4. Contractor shall have a local office within Broward County, FL., Palm Beach County, FL., Monroe County, FL., Collier County, FL., Lee County, FL., or Miami- Dade County, FL., as of the date of the issuance of this Request for Proposal. The local office should have staff capable of meeting with City staff on an as-needed basis. Statement of Work. 1. A comprehensive electronic patient care report that captures necessary patient care information and computer aided dispatch data required to fulfill the requirements of, FIRE- RESCUE DEPARTMENT, the receiving hospitals, insurance, Medicare, and Medicaid billing as well as capture the required data necessary to fulfill the State of Florida comprehensive EMS aggregate report requirements. 2. Access via the Internet a website that houses the FIRE-RESCUE DEPARTMENT's patient care procedures and protocols. 3. Connectivity via Bluetooth to Physio-Control's Lifepak 15 defibrillators. 4. Wireless connectivity between EPCR reports writing laptop computers, contractor's servers, Physio Controls' LifeNet Internet gateway and FIRE-RESCUE DEPARTMENT patient care protocols. 5. _In the event that the City requires additional laptops, any additional costs incurred, will be negotiated at time of necessity. 6. Perform invoicing, collection, and generation of any and all insurance forms and filings, record maintenance and preparation of standard,and/or custom reports, as requested or required by FIRE-RESCUE DEPARTMENT. 7. Prepare quarterly State of Florida aggregate EMS reports. 8. Grant desktop computers at all FIRE-RESCUE DEPARTMENT fire stations access to patient care reports for statistical reporting and quality control processing. 9. Perform training for FIRE-RESCUE DEPARTMENT personnel on an as needed basis on desktop and laptop EPCR and quality control applications. 10. Maintain all thirteen (13) and five (5) spare rugged laptop computers in working condition. The contractor agrees to replace or correct any malfunctioning hardware or software within. twenty-four hours of FIRE-RESCUE DEPARTMENT's written notification of failure or breakage. 11. Establish a two-way data exchange system with billing hospitals with the ability to electronically transfer (e-Transfer) all EPCRs to the hospital and receive patient and related billing information back from the hospitals. Technical Specifications. Computer / Hardware / Software/ Report Writing and Computer Aided Dispatch ("CAD") Requirements: 1. Contractor shall be required to supply and maintain thirteen (13) primary and five (5) spare (total of 18 units) rugged and mobile tablets and/or laptops with cellular connectivity, capable of generating and capturing real-time patient care and computer aided dispatch data for the formulation of a comprehensive patient care report and for reporting purposes. 2. Systems shall be configured as follows: Win7 (Win8.1 Pro COA), Intel Core i5- 3610ME 2.7GHz, 10.1":XGA Multi Touch + Digitizer LCD, 128GB (or greater) 2 Solid State Drive, 4GB, WiFi, Bluetooth, 4G LTE Multi Carrier, GPS Receiver, Dual Pass (Upper:WWAN/Lower:WLAN), TPM .2, 5MP or greater Camera, and Emissive Backlit Keyboard, or approved equal configurations. 3. Internet Explorer or equivalent with cellular connectivity to FIRE-RESCUE DEPARTMENT procedures and protocols site and any other websites requested by FIRE-RESCUE DEPARTMENT. 4. Connectivity via Bluetooth to EPCR client software and Physio Control's LifePak 15 manual cardiac defibrillators. 5. Device must have the ability to attach picture and documents to EPCR. 7. Contractor shall provide a stock of digitizer stylus/pens on a regular basis at no cost to the City. 8. Lifenet PC Gateway version 4.0 or 5.0 or current version for processing and transmission of node summary reports from Lifepak 15 defibrillators to receiving FIRE-RESCUE DEPARTMENT station computer(s). Prepare and process quarterly FIRE-RESCUE DEPARTMENT's State of Florida EMS pre- hospital data collection report, in a format designated by EMS Tracking and • Reporting System (EMSTARS). 9. Process EPCR computer aided dispatch data generated from the current Miami Beach CAD by Tyler Technology(previously New World Systems) computer system using the current interface. 10. The ability to enter data on an EPCR while reviewing protocols, websites, etc., simultaneously on the tablet. 11. Contractor shall provide capabilities to change, modify, or add fields in underlying software. 12. Contractor shall provide the ability to add a field to document law enforcement case numbers on all motor vehicle accidents/incidents. Invoicing I Billing 1 Collections Requirements. 1. The Contractor shall employ, maintain and assign an adequate number of competent and qualified professionals, as deemed necessary by the Department to meet the performance requirements. Contractor shall be responsible for the invoicing, collection, and generation of any and all insurance forms and filings, record maintenance and preparation of standard and/or custom reports, as requested or required by the FIRE-RESCUE DEPARTMENT. 2. ' The invoices for services rendered shall contain the following information: a. Account number of Patient. b. Invoice number. - c. Invoice date. - d'. Name of Patient. e. Name of responsible person if different from patient. f. Complete address of Patient. g. Date of transport. h. Cost of transport including cost breakdown (mileage &oxygen). i. Incident number. j. Transport mileage from and to. k: Insurance coverage and instructions (if applicable). I. Billing inquiry telephone number, 800-phone number if not local for satisfaction ry of the receivable and customer satisfaction. 3. Contractor shall mail bills/invoice forms to patients within five (5) days of receipt of the patient information. This is to include return envelope and address specified by the City of Miami Beach. 4. Patient invoices: All invoices and reporting shall be automated. 5. Contractor shall be responsible`for sending follow up bills at thirty-day (30), sixty-day(60), and ninety-day (90) intervals. 6. Contractor shall mail proper insurance,forms or electronically process to third party payer as required or requested by the patient. (This is to include envelope and address specified by the City of Miami Beach). 7. Contractor shall post all payments as received directly or electronically within one (1) business day. 8. The Contractor shall agree to make every effort to locate and correct any incorrect billing address for billable patients. 9. Contractor shall agrees to include in the invoice mailing a citizen satisfaction survey and a return, self-addressed and postage paid envelope that will be provided by the City of Miami Beach. Said survey is expected to be no more than one page in length and of a size not to exceed 81/2 x 11 inches. 10. Contractor will check hospital information twice per self-pay account(if necessary) to Obtain/verify patient insurance and contact information. 11. Contractor shall conduct any follow-up required to obtain the necessary insurance information to process invoices for payment. Record of telephone calls and contact shall be maintained and any payment on an account shall be recorded per account. 12. Accept the hard copy or electronic information pertaining to patients' pay or billing documentation from FIRE-RESCUE DEPARTMENT for all patients transported by FIRE- RESCUE DEPARTMENT. 13. Patient invoices:All invoices and reporting systems shall be automated. 14. Contractor shall be responsible for all usual and customaryycosts incurred as a result of billing and collecting accounts, such as software, credit card processing fees, equipment and the installation of data and phone lines. 15. Contractor shall maintain and update all billings for ambulance services (accounts) to include update of address and telephone numbers obtained through billing and collection efforts. Report shall be provided as necessary. 16.,In the event Contractor received payment for services which are later disallowed (such as bad checks paid directly to FIRE-RESCUE DEPARTMENT, or adjustments) by FIRE- RESCUE DEPARTMENT, FIRE-RESCUE'DEPARTMENT may offset the amount disallowed from any payment due Contractor. 17. Contractor shall not add a charge of any kind to a billed account. 18. To the extent necessary to fulfill its billing and collection efforts under the awarded contract, Contractor is granted limited authority to sign in an administrative capacity on behalf of FIRE-RESCUE DEPARTMENT the following types of standard forms and correspondence: probate claim filings; letters to patients and their representatives verifying that an account is paid in full; form verifying FIRE-RESCUE DEPARTMENT tax exempt status; and insurance filings and related forms. Contractor has no authority to sign any document on behalf of FIRE-RESCUE DEPARTMENT, which imposes liability on FIRE- RESCUE DEPARTMENT. 19. All written billing and collection correspondence must be approved by an FIRE-RESCUE DEPARTMENT designee. All payments and correspondence shall be directed to the mailing address designated by FIRE-RESCUE DEPARTMENT. 20. Contractor agrees to negotiate and arrange modified payment schedules for those individuals unable to pay the full amount when billed. 21. Contractor agrees to refund patient or insurance company refunds within forty-five (45) days of receipt and agrees to all applicable Florida Statutes. 22. Contractor must provide the City of Miami Beach with a refund request including all pertinent information relating to refund payments to patients and/or insurance company. (Contractor to describe procedure in their proposal submittal). 23. Contractor will process all third party reimbursements within one (1) week after receipt of appropriate billing information from primary payer. 24. Contractor shall not settle any accounts for less than the amount indicated by FIRE- RESCUE DEPARTMENT without the prior written approval of the FIRE-RESCUE DEPARTMENT designee. 25. Contractor shall provide copies of remittance advice as required by FIRE-RESCUE DEPARTMENT. 26. Contractor shall post all payments received directly or electronically within one (1) business day and process refund requests with the month following an overpayment. 27. Contractor shall maintain proper insurance forms used by third party payers as required or requested by the patient in either the manual or electronic method. Either way, the contractor shall include information on where to send payments to FIRE-RESCUE DEPARTMENT. 28. Contractor shall expeditiously begin the billing and collection process for those Accounts provided to Contractor by FIRE-RESCUE DEPARTMENT based upon established rates. The method utilized by Contractor to process the accounts shall be a means approved by FIRE-RESCUE DEPARTMENT Contract Administrator. 29. Contractor shall be responsible for contacting the sender of monies when there is insufficient information to identify which account the payment is being applied to. FIRE- RESCUE DEPARTMENT shall not be required to pay Contractor any collection fees on account until the corresponding account number can be identified. 30. Contractor shall reconcile thenumber of transports collected with those transmitted to Contractor and contact a FIRE-RESCUE DEPARTMENT designee to report any discrepancies. 31. If this Agreement is terminated, all accounts will be returned to FIRE-RESCUE DEPARTMENT regardless of payments made on account or arrangement made. Upon termination, Contractor will inform any billed account with whom they are dealing to make future payments directly to FIRE-RESCUE DEPARTMENT or other firm identified by FIRE- RESCUE DEPARTMENT. 32. FIRE-RESCUE DEPARTMENT is the owner of all information submitted to the Contractor. If this )Agreement is. terminated, all accounts will be returned to FIRE-RESCUE DEPARTMENT regardless of payments made on account or arrangement made. 33. If this Agreement is terminated contractor agrees to provide a raw flat file containing all relevant data that would be needed to re-create an EPCR for any purpose. The contractor agrees to provide the City a one-time column header file w/ a brief description of each ,column's data and how it pertains to the formulation necessary to re-create the EPCR for the purposes mentioned above. 34. Contractor should include sample bill forms and,the messages that will be used on each successive bill mailed, as part of the response. All text, format, and color of printing and stock are subject to approval by the City of Miami Beach. Billings should be at maximum intervals of thirty-five (35) days, except for the first invoice that should be rendered within ten (10) days of service. 35. Contractor shall be required to establish a method to accept and process credit card payments from patients through an online and a pay-by-phone solution. The City can be the merchant for the solution but the contractor shall be responsible for all fees associated with the credit card acceptance solution. 36. Contractor shall provide a process for collecting information from local law enforcement agencies and gross billable and payments on all incidents involving motor vehicles. 37. Contractor shall show the ability to increase collection rates annually. 38. Contractor shall have a mechanism in place to find a revenue source for all patients outside of contacting the hospitals. 39. Contractor shall be able to provide litigation services as it may relate to MVA (Motor Vehicle Accident/PIP Claims) incidents should the need arise. These services will only be executed based on direction from the City on an as-needed basis. Medicare and Medicaid Requirements. 1. Contractor shall provide prompt submission of Medicare, Medicaid and insurance claims within seventy-two (72) hours after receiving a completed EPCR, when all information necessary to file the claim is present. 2. Contractor will provide Medicare/Medicaid billings in accordance with all Federal, State and Local laws and Medicare/Medicaid rules and requirements. 3. Contractor shall provide Electronic Claims processing for Medicare and Medicaid and re- file Medicare, Medicaid or insurance claims, as necessary to obtain payment. 4. Contractor shall,be prepared to assess service levels prior to billing and classify services into levels that meet Medicare and Medicaid transport criteria. These service levels may, in a limited number of cases, differ from what is indicated on internal documents based upon interpretation and must be brought to FIRE-RESCUE DEPARTMENT'S attention to determine if changes may be necessary. 5. Contractor will provide support for Medicaid or Medicare audits. 6. Contractor shall provide Electronic Claims Processing for Medicare and Medicaid to the City's lock box. Compliance with Applicable Federal,State and Local Laws and Requirements. 1. Provide Health Insurance Portability and Accountability Act ,(HIPAAr privacy practice requirements to all patients transported in accordance with current regulatory requirements. 2. Comply with'all applicable Federal, State, and local laws as they apply to the services being provided, such as but not limited to the Federal Debt Collection Practices Law. This further includes all requirements to maintain confidentiality for all medical and patient information as related in state and local laws or rules and regulations as well as HIPAA laws. ; 3. Contractor shall facilitate proper security of confidential information and proper shredding of all disposed materials containing such proprietary information in accordance with Florida Law regarding records retention privacy act. Customer Service. /1. Respond to all patients' requests and inquiries, either written or verbal, in a TIMELY manner not to exceed two (2) business days. 2. Agrees to provide and furnish all material and personnel required,for the performance of the Agreement. - 3. Contractor shall provide Customer Service Representative (CSRs), available,during normal business hours, which are able to read, write and speak fluently in English, Spanish and Creole. These CSRs shall be able to assist patients and/or other third party payees in all billing inquiries in a timely and courteous manner. Customer calls will be facilitated as local within the County or through a "toll free" exchange, which will be published on all invoices. Contractor shall respond within three (3) business days to FIRE-RESCUE DEPARTMENT and patients on requests for information or records. All scripts and protocol for answering and placing calls shall be agreed upon prior to the commencement of services between Contractor and FIRE-RESCUE DEPARTMENT. A record of telephone calls and contacts shall be maintained. 4. Contractor shall be responsible for the mailing of all forms, i.e., HIPAA, customer survey and related forms. Contractor shall be responsible for all associated costs. 5. Contractor shall respond promptly to all patient requests and inquires, either written or , verbally in a timely and courteous manner. This and all communications should be in a format that can be tracked by both City and Contractor and shall comply with all applicable Federal, State and Local laws as such laws apply to the services being provided. '6. Contractor shall provide and furnish all materials" and personnel required for the performance of the Agreement. 7. Contractor shall provide a designated liaison for patient/payer concerns. 8. Contractor shall provide a 1-800 number and 24/7 (365 days) computer help desk support for the EPCR report writing laptop and desktop hardware, software and its connectivity. Document Maintenance. 1. Contractor will maintain any and all documentation records and patient information in a safe and secure manner that will allow inspection and audit by the City of Miami Beach or its agents upon proper notification. 2. Any and all data created by FIRE-RESCUE DEPARTMENT and collected by the Contractor is owned by the City of Miami Beach and shall be returned upon request in a format agreeable to City. 3. Contractor shall`provide access to its database and a data dictionary for FIRE-RESCUE DEPARTMENT to use for report writing capabilities. Communications with City of Miami Beach Staff. 1. Contractor shall attend meetings with the FIRE-RESCUE DEPARTMENT staff when requested to review contract operations. 2. Contractor shall participate in a yearly audit conducted by FIRE-RESCUE DEPARTMENT consistent with Generally Accepted Accounting Principles- GAAP. This audit will cover the common set of accounting principles, standards and procedures used to compile annual financial statements. 3. Contractor will notify FIRE-RESCUE DEPARTMENT of any changes in federal, state or local laws, rules, regulations and codes that affect this subsequent agreement. 4. Contractor shall designate a Program Manager responsible for all matters related to the Contract, including performance. A toll free number and the name of the Project Manager shall be provided upon commencement of this Agreement. The Project Manager shall be available during FIRE-RESCUE DEPARTMENT'business hours of 8:30 am to 5:00 pm, Monday through Friday, and shall respond to FIRE-RESCUE DEPARTMENT within one (1) hour. 5. Upon request by FIRE-RESCUE DEPARTMENT, a written response shall be provided to all complaints received by FIRE-RESCUE DEPARTMENT of any alleged actions taken by Contractor and/or its agents. The response shall be provided by Contactor's Project Manager and shall be received by FIRE-RESCUE DEPARTMENT within thirteen (13) days from the date the request is sent to Contractor. The response shall address all questions and statements made by FIRE-RESCUE,DEPARTMENT concerning the alleged actions. 6. Contractor shall provide FIRE-RESCUE DEPARTMENT with a read-only access to accounts at locations determined by FIRE-RESCUE DEPARTMENT. 7. Contractorshall provide all necessary developing, copying, faxing, mailings, and all other such related services at no additional cost to FIRE-RESCUE DEPARTMENT. 8. Contractor shall maintain and inform FIRE-RESCUE DEPARTMENT regarding the following: 1. Records of current fees. I '2. Industry approved billing codes. 3. Description files. 4. Current laws applicable to billing of patients for transports. 5. Records of nation-wide and local trends in transport fee schedule and inform FIRE-RESCUE DEPARTMENT of any changes. _ 9. FIRE-RESCUE DEPARTMENT, its staff, Contractor, and/or contractors shall have the right to visit the offices of Contractor and/or its agents periodically for inspection of the facilities and operations used in the performance of any resultant agreement. 10. For record keeping purposes (not related to billing/collection cycle),/Contractor shall retain all account information for a minimum of three (3) years. Training for City of Miami Beach Staff. 1. Contractor shall provide training to appropriate FIRE-RESCUE DEPARTMENT personnel regarding the gathering of necessary information and proper completion of its EPCR laptop and desktop software. 2. Contractor shall provide minimum annual basic and on-going training to appropriate FIRE- RESCUE DEPARTMENT personnel`regarding HIPAA compliance. Training may be in the classroom or electronically so long as it is consistent. Certificate must be supplied to employee upon completion of training. 3. Contractor shall provide a series of training programs at locations designated by the City to educate field personnel on the proper utilization of its quality control software application as well as other features available within the reporting software. i 4. All training shall be at no charge to the City. Communications with Miami Beach Serviced Hospitals. 1. Contractor shall agree to maintain a working arrangement with all FIRE-RESCUE DEPARTMENT-serviced hospitals including Business Associates Agreement/Electronic Access with hospitals. 2. Contractor shall provide FIRE-RESCUE DEPARTMENT with a copy of all letters of complaint within ten (10) days of receipt, and indicate what action'was taken to achieve an acceptable resolution. 3. Contractor shall maintain a working arrangement with all of the FIRE-RESCUE DEPARTMENT serviced hospitals and requests that hospitals provide a copy of patient fact sheets or be provided with demographic and insurance information. Electronic Data Transfer. 1. Electronic Data Transfer: Contractor shall be able to receive and send data electronically. All data being sent to FIRE-RESCUE DEPARTMENT should be transmitted electronically and shall ensure that such transmissions are in compliance with HIPAA and other federal, state and local laws, rules, regulations and codes. 2. Contractor will provide rugged mobile computer laptop specified EPCR units as field computer devices, perform all requisite software installation on such units, as well as facilitate web browser access from , desktop units supplied by FIRE-RESCUE DEPARTMENT. Installation, access and units will be provided by qualified company representatives:, 3. Contractor will provide support for additional modules that could be added to the system already installed without significant disruption to service. Should FIRE-RESCUE DEPARTMENT desire to modify hardware quantities, such changes will require written notification. 4. Server maintenance, upgrades and software changes should all be administered automatically from Contractor's development facility (or alternate location at Contractor's discretion) and downloaded to field tablets during power up/down sequencing. 5. The Contractor must be able to provide up to fifteen (15) temporary laptop or similar devices upon request. The temporary units will be utilized for large events or during periods of peak staffing. 6. The PCR software must be able to verify and capture patient address from a driver's license or social security number via the cell connection. 7. The Contractor will, be required to update all hardware equipment provided to the City every three (3)years. EPCR Software and Patient Reporting Capabilities. 'Information to be gathered by EPCR software should include the following patient information, but not be limited to: 1. Incident Address with Zip Code. 2. Social•Security Number. 3. Address. 4. Telephone Number. 5. Date of Birth, Weight,Age, Gender and Race. 6. Family Physician. 7. Medicaid State. 8. Medicaid Number. 9. Medicare Number. 10. Medicare Plus Plan Name. 11. Insurance Number. 12. Group Number. 13. Secondary Insurance Number. 14. Secondary Group Number. 15. Guarantor Information. 16. Documentation of patient or guardian release of patient information for billing, including a digitized patient or guardian signature captured in multiple languages, and supports hand writing recognition. 17. Supports additional billing inputs (i.e., additional supplies such as foam usage or additional medications). 18. Information about the medical condition and complaints of the patient including, but not limited to: a. Cause of injury. b. " Trauma triage. c. Patient position information. d. Medical condition(s) and systems details. e. Narratives by the care providers regarding the incident.- f. Ability to enter multiplies patients. 19. Unlimited primary,and secondary assessment information including, but not limited to: a. Glasgow Coma Scale(GCS) scoring automatically calculates a total. b. Revised trauma score, scoring automatically calculates a total. c. Pupil size and,reaction. d. Capillary refill. e. Respiratory assessment. f. ECG. g. Ectopy. h. Blood glucose level. i. • Skin color. j. Temperature. k. Moisture. Lung sounds. m. Times of vital signs. n. Appearance Pulse Grimace Activity Reparations (APGAR) scores (if applicable). o. Neurological assessment information. p. Medical history including, but not limited to: i. Prescription medications—with Pick List input. ii. Allergies. iii. Pre-existing conditions. iv. Current conditions. q. Blood pressure; be able to indicate Palp and Mast. r. SPAO2. s. LOC. t. Pulse Rate; strength and regularity. u. Allow the user to set either the "within normal limits" or "not assessed" value to each defined assessment area (body part) by click of a single button. 20. All examination of and treatment provided to the patient including, but not limited to: a. Medical control contact name and time of contact physician. b. Patient protocol. c. Method of contact. d. Airway intervention. e. Breathing intervention. f. Circulatory intervention. g. Intravenous intervention. h. , Input/output therapy. i. Provides patient weight conversion to metric for medications. j. Call summary information, including all patient information entered. 21. Data about the care providers including, but not limited to: a. Vehicle number. b. Primary attendant's (Attendant No. 1) name and license number. c. Attendant No. 2's name and license number. d. Attendant No. 3's name and license number. e. Attendant No. 4's name and license number. f. Exposure information, including medic name, time, exposure type, description, supervisor notified, exposure report completed, loss of work. 22. Prehospital information including, but not limited to: a. Call times. b. Scene location information, including County, zip code, response and scene. c. Response districts. d. Special scene conditions. 23. Patient destination information including, but not limited to: a. Receiving hospital with State of Florida four-digit identifier code. b. Reason for selecting a destination selected from pick list. c. Transport urgency(lights and siren, routine, etc.). d. Call disposition BLS, ALSI,ALSII. ' e. Refusal of care by patient. r 24. Odometer readings to determine distances including, but not limited to: a. From ambulance starting point to incident scene. b. From incident scene to patient destination. 25. Desk top software: a. Provide the exact same interface and functionality as the mobile software with the exception of any pen-based, character recognition functionality that cannot be supported on desktop computers. b. Software should provide for monitoring_of all supplies utilized and give administration users the ability to access the data through report writing tools. Security Controls - User Access Control and Security. The software should allow for an array of user access control and security that can vary by module and security level from,no access to complete insert/delete/edit capability anywhere in the software system. In addition, the system should: 1. Have a hierarchy of security (logon, record, field, function, object, and user-group) to allow or prevent specified users (or groups of users) to access specified programs at specified levels of data entry, editing, updating, deleting, and reporting functions. 2. The software should require a valid logon ID and possess two levels of security with different password levels. One is to be used for system administration and configuration and the'other for field personnel. 3. The system should also provide a complete audit trail of every transaction or modification executed by each user. 4. System locks, which allow user to "lock" terminal without shutting system down and "unlock" terminal with password, allowing users to step away from the terminal -temporarily and prevent unauthorized use. 5. Restrict download of confidential data to high-level security-authorized users to prevent • loss/misuse of confidential data and information. 6. Provide a means to print transaction error/alteration logs as needed and specified, depending on application. 7. Automatic timeout or keyboard lock after a defined period of inactivity. 8. List all users logged on to the system at any time, and track this usage by user, date, time, and station. 9. Log off users' after specified number of unsuccessful log on attempts and display message for user to contact the system administrator. 10. Allow specified intervals for mandatory password changes. 11. Automatically log off users who have logged off improperly. 12. Revoke a user's access upon too many unauthorized logon attempts. 13. Validity test: critical fields can be checked against a format, a formula, or a table to see that data contained in a field is admissible. Examples: System requires all Advanced Life Support Calls have two vital signs. 14. Range checks: critical fields can be checked against a table or formula to determine if the data entered is within a given range of values. Examples: vehicle mileage not to exceed four digits. 15. Completeness check: critical fields can be checked for a non-empty range and processing action determined according to a specified table. Example: system will not allow the call to be closed without the patient name first and last being entered. 16. Real time error checking: error checking described above is done at the time of input and errors are flagged to operator either by a user understandable message or operation halt as specified. 17. Time Stamping: All transactions shall be time stamped by the internal clock of the system and this may be modified in the field and exists for all interventions. Reports. Pursuant to the.Scope of Services, the Contractor shall perform all services and/or work necessary to complete the following tasks and/or provide the following items: 1. Contractor to provide the City with monthly reports reflecting all new placements from the City, all accounts that are currently active with the contractor, the contractor's collection results, and aging reports reflecting the City's receivable in an aged format. 2. Records/Reports: Contractor will keep full and accurate accounts of services performed by FIRE-RESCUE DEPARTMENT, billing and collections, received and other records related to the Emergency Medical Transport Billing and Collection Services. 3. Contractor will prepare and provide FIRE-RESCUE DEPARTMENT Administration monthly reports as required by FIRE-RESCUE DEPARTMENT. 4. Contractor shall provide, on a monthly basis, a copy of all monthly financial activity, billing and receivable reports, consistent with GAAP on the account. Reports Compilation and Listing. The Contractor shall maintain a computerized database of all accounts,,and shall provide the Department with reports to show management and financial information. The Contractor at a minimum will provide all reports provided to the Department by the incumbent. The Department will provide samples or all current reports to the Contractor. The format of reports required under this contract will be determined by the Department. In addition to the reports described below, the Contractor shall provide any custom reports at the request of the Department in a mutually agreeable timeframe at no additional cost to the City. Monthly reporting is produced after month closing and provided to FIRE-RESCUE DEPARTMENT no later than the 21st of each month. Contractor will generate reports within twenty-four (24) business hours of receiving and posting the last day of the month's receivables from the bank. All reporting will be in the manner as requested by FIRE-RESCUE DEPARTMENT. The following,_are major reports that Contractor shall produce for FIRE- RESCUE DEPARTMENT: 1. Collection Statistics—Gross/Net Consumption Shows overall monthly computation of gross collection percentages providing number of accounts billed and accounts not billable. The total amounts are summarized. 2. Billing and Collection Statistics—Monthly Summary Provides a running month,summary of charge, aggregate transports by unit, aggregate percentage collection by unit, adjustments and payments for the closing month period showing gross and net collection percentages for each period. Summarizes totals for each type activity and computes average collections for both' gross and net. Note: All payment activity is reflected against the original month billed in order to reflect true collection percentages. 3. Insurance Report—#of Bills with Outstanding Balance by Class Provides summary showing by running (billed) month the number of patient bills having an outstanding balance. Shows balance and number of bills outstanding by class. 4.. Collections—by Payer Class, Unit and Geographic Area Provides a running month summary for the closing month period of collections by Payer Class (Self-Pay,\Medicare, Medicaid and Private insurance), by Unit and by geographic area. The report also shows for each running month the mix or, percentage (%) of total collected against that month's billing for each class. Also shows number of accounts collected by class and percentage (%) of total. 5. ' Ambulance Unit Report—Gross Billings this Month by Ambulance Unit Shows all billing (new charges) processed and summarized total billing for period by transport unit. 6. Accounts Receivable—Summary Provides summary for period ending of Accounts Receivable showing gross billing, payments received/processed, reflected write-offs and adjustments, reversals and ending balance. 7. ,Account Activity—Monthly Billing Report(Charges) Shows all billing (new charges) processed alpha sorted by Last Name and summarized. , total billing for period. 8. Account Activity—Monthly Payment Report(Receivables) Provides a batch oriented listing of all payments processed including check number and type of payment (self-pay, Medicare, Medicaid, private insurance). Report reconciles against bank deposit and ties back to EOB detail for secondary filing, refund processing and adjustments. 9. Collections—Summary to Date, Monthly Running Shows receivables as applied to "original billed month." 10. Monthly Refund Schedule Report provided by account detail of associated payments reflecting an overpayment and necessary refund to be processed. 11. Refund Request Provides for previous billing month, with a separate sheet per account, requesting refund on overpayment accounts. This includes all information pertinent to determining refund. 12. Distribution of Charges and Collections This report will track the charges. payments and financial class mix of all patients for a given month. 13. Aged Receivable Report This report will have outstanding invoices sorted by date for current, thirty, sixty, ninety and over ninety,days. This report will provide totals for these categories. 14. Patient Alpha Listing ' This report lists all invoices alphabetically by patient name. n 15. Monthly Payment Listing This report lists payments, bad checks, required charge offs, and refunds posted to each patient's account. 16. Overpayment Reports This report lists all patients due refunds as a result of overpayment of account. 17. Additional Information Reports may include any statistical,information pertaining to medical calls including but not limited to - intubation analysis, IV success rates, chief complaint call volumes and number of cardiac arrests and trauma calls. Responsibilities of the City of Miami Beach. 1. The City of Miami Beach will comply with all Federal, State and Local laws, rules and regulations as applicable to the services being contracted. 2. The City of Miami Beach will agree to use the Contractor for all medical billings exclusively for the service specified herein as long as the contract agreement is in force. 3. The City of Miami Beach will make every effort to obtain the proper billing address for all billable patients prior to forwarding to the Contractor. 4. The City will pay the Contractor additional fees for any postage increases that may occur during the contract period. However, this fee will only be the actual cost of increase. Service Fees. The Selected Contractor shall perform EMS Billing and collection services on behalf of the FIRE-RESCUE DEPARTMENT, and shall conform to the following: 1. All monies collected by the Selected Contractor shall be deposited in the designated lockbox. 2. At the end of each calendar month Selected Contractor shall send an invoice to the Department with collection details of all Department transports entered in the Selected Contractor's billing system from thepreceding month. 3. The fees shall be based upon contractor performance and expressed as a percentage of actual collections remitted to the City of Miami Beach. This fee shall be all-inclusive. No additional payments,shall fall due under this contract except for any refunds due contractor due to patient overpayment refunds. 4. The Contractor shall be entitled to fees on all collections for billings during Contract term, up to six (6) months after expiration or termination of Contract. The Department will be entitled to a refund of fees due to refunds on collections for billings during Contract term, up to one (1) year after expiration or termination of Contract. Florida Certified Public Expenditure (CPE) Program.- 1. At the request of the City, the Selected Contractor shall provide ongoing consulting/costing services to enroll and/or maintain the City of Miami Beach in the Florida Certified Public Expenditure (CPE) Program for Emergency Medical Transportation (PEMT) and the Intergovernmental Transfer(IGT) PEMT which includes Medicaid managed care transports revenue programs. 1 2. , Description of Consulting Services and Revenue Recognition Process Contractor shall provide consulting services to enroll The City of Miami Beach annually in consulting/costing services for both the Florida Certified Public Expenditures (CPE) Program for Emergency Medical Transportation, and proposed IGT (Intergovernmental Transfer) PEMT which includes Medicaid managed care transports revenue program. • Drafting application materials and responding to requests for additional information necessary for the provider to gain approval to participate in the Ambulance Supplemental Payment Programs. • Preparing a fiscal impact study and presenting results to department/state.stakeholders to demonstrate benefits of a Continuing Public Expenditure ("CPE") Program, Medicaid Managed Care supplemental payment, and uninsured CPE (if applicable) program to the provider. • Identifying eligible costs and developing appropriate cost allocation methodologies to report only allowable costs for providing emergency'medical services to Medicaid and, as applicable, uninsured populations. • Preparing the annual Medicaid cost report for EMS on behalf of provider. • Conducting analysis of the provider's financial and billing data in order to prepare and submit annual cost reports, the mechanism for providers to receive additional revenue under Ambulance Supplemental Payment Programs. • Providing comprehensive desk review support,, including but not limited to conducting reviews of all cost settlement files, performing detailed analysis of billing reports generated by .Medicaid agencies to ensure that all allowable charges and payments are encompassed in the calculation of the final settlement, and drafting letters and providing supporting documentation to meet Medicaid requirements and expedite settlement. • Performing relevant analysis to determine a viable Medicaid managed care supplemental payment methodology. • Executing Medicaid managed care supplemental payment calculations in adherence with the approved methodology. • Determining enhanced supplemental payments realized by provider, as necessary. • Conducting comparative analysis to identify significant trends in billing and financial data. • Providing charge master review to ensure that the provider is optimizing charges to drive revenue generation. • Meeting with the Florida Agency,for Health Care Administration (ANCA) and Client to further develop the supplemental payments program for both Medicaid managed care and uninsured patient transports. • Respond to, and represent Client on any AHCA or CMS audit, review or communication regarding any PEMT cost report prepared by lntermedix and delivered to AHCA on behalf of the Client. All revenue realized by the City from the Certified Public Expenditure (CPE) Program for Emergency Medical Services and Medicaid Managed Care Supplemental Payment Program shall be paid in full directly to Client. Revenue realized as a result of the Certified Public Expenditures, (CPE) for Emergency Medical Services (EMS) shall be determined by the Medicaid cost settlement determined through the Medicaid cost report. Revenues realized through the Medicaid Managed Care Supplemental Payment Program will be defined through an additional amendment, if necessary, after the approval of the specific methodology as defined by the Florida Agency for, Healthcare Administration, and successfully implemented by Intermedix and City. Intermedix will not receive any compensation until the CPE for Emergency Medical Services settlement or Medicaid Managed Care Supplemental Payment revenues are received by the City. Intermedix will invoice and receive revenue upon the receipt of revenue received by City for either initiative, meaning revenue does not have to be generated for both the CPE for Emergency Medical Services and the Medicaid Managed Care Supplemental Payment program, rather revenue simply needs to be generated for either initiative to allow the lntermedix to generate invoices. Intermedix will invoice City based on the final CPE for Emergency Medical Services settlement or Medicaid Managed Care Supplemental payments within thirty(30) days of receipt of funds by the City. City will remit payment to Intermedix within thirty (30) days of invoice receipt. Additional revenues generated for the uninsured patient population, will also be invoiced within thirty (30) days of receipt of revenues by the City. The contingency fees to be paid associated with the respective successful implementation and generation of incremental Medicaid revenues as a result of the CPE for Emergency Medical Services and Medicaid Managed Care Supplemental Payment programs are in accordance with the percent of City revenues as indicated on the firm's BAFO Proposal Tender Form. EXHIBIT B CONTRACTOR FEE SCHEDULE f See next page] • r RFP 2017-002-JC EMERGENCY MEDICAL TRANSPORT BILLING AND.COLLECTION SERVICES • APPENDIX E BAFO PROPOSAL TENDER FORM Proposer affirms that the prices stated on the cost proposal form below represents the entire cost of the items in full accordance with the requirements of this RFP, inclusive of its terms, conditions, specifications and other requirements stated herein,and that no claim will be made on account of any increase in wage scales, material prices,delivery delays,taxes, insurance,cost indexes or any other unless a cost escalation provision is allowed herein and has been exercised by the City Manager in advance. The Cost Proposal Form shall be completed mechanically or,if manually, in ink. Proposal Tender Forms completed in pencil shall . be deemed non-responsive.All corrections on the Cost Proposal Form shall be initialed. The numbers are provided based on the City's current contract and/or last fiscal year performance available. The City does not guarantee the same amount for future contract years. Proposer must calculate and state the extended total amount for each line, Items 1-6, culminating in a Grand Total Price to be entered below. Item Description Estimated amount Percentage Cost i Extended Total (a). (b) (aXb=c) 1 Cost for Billing Services $2,000,000.00 , 7.70% $154,000 SUB-TOTAL $154,000 Extended Tota'. Item Description I Estimated Quantity Unit Cost (Quantity_X_Unit_Co 2 Medicaid Account Billin• Service 2,200 $9.00 $19,800 SUB-TOTAL $19,800 Extended Tota Item Description Quantity Unit Cost (Quantity_X_Unit_Co Lease of Computers: 3 (Shall include all associated hardware, 18 $0.00 $0.00 software, licensin• and maintenance fees. - SUB-TOTAL $0.00 Extended Total Item Description Quantity Unit Cost (Quantity_X_Unit_Cost) Lease of Special Event Computers:, 4 (Shallinclude all associated hardware, 15 ( $0.00 $0.00 software,licensin• and maintenance fees. SUB-TOTAL $0.00 Extended Tota Item Description Annual$Amt. Percentage Cost (Ann.$Amt_X_%) 5 Certified Public Ex•enditure Pro•ram CPE $300,000 9.0% $27,000 SUB-TOTAL $27,000 1 Extended Tota •u e• • •I i 'u• •. • •1 'y U1' Co (• .ni ni .i 6 Privac Notices 7500 $0.00 $0.00 SUB-TOTAL $0.00 GRAND TOTAL,(ITEMS 1`=6) $200,800 EXHIBIT C BUSINESS ASSOCIATE AGREEMENT [See next page] • 1 \ BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ("BA Agreement") supplements and is made part of the Underlying Agreement(as defined below). This BA Agreement is entered into between The City of Miami Beach ("Covered Entity") and Advanced Data Processing, Inc., a subsidiary of R1 RCM Inc., a Delaware Corporation ("Business Associate"), effective as of the Effective Date of the Underlying Agreement. WHEREAS, Covered Entity and Business Associate have entered into, or plan to enter into, an agreement or other documented arrangement (the "Underlying Agreement"), pursuant to which Business Associate may provide services for Covered Entity that require Business Associate to access,,create and use Protected Health Information ("PHI")that is confidential under state and federal law; and WHEREAS, Covered Entity and Business Associate intend to\protect the privacy and provide for the security of PHI disclosed by Covered Entity to Business Associate, or collected or created by Business Associate pursuant to the Underlying Agreement, in compliance with they Health' Insurance Portability and Accountability Act of 1996, Public Law 104-191 ("HIPAA"), and the regulations promulgated there under, including, without limitation, the regulations codified at 45 CFR Parts 160 and 164 ("HIPAA Regulations"); the Health Information Technology for Economic and Clinical Health Act, as incorporated in the American Recovery and Reinvestment ,Act of 2009, and its implementing regulations and guidance issued by the Secretary of the Department of Health and Human Services (the "Secretary") (the "HITECH Act"); and other applicable state and federal laws, all as amended from time to time, including as amended by the Final Rule issued by the Secretary on January 17, 2013 titled "Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information Nondiscrimination Act; Other Modifications to the HIPAA Rules"; and WHEREAS, the HIPAA Regulations require Covered Entity to enter into an agreement with Business Associate meeting certain requirements with respect to the Use and Disclosure of PHI, which are met by this Agreement. NOW, THEREFORE, in consideration of the mutual promises contained herein and the exchange of information pursuant to this Agreement, the parties agree as follows: 1. Definitions. Capitalized terms used herein without definition shall have the meanings ascribed to them in the HIPAA Regulations or the HITECH Act, as applicable unless otherwise defined herein. 2. Obligations of Business Associate. a. Permitted Uses and Disclosures. Business Associate shall only Use or Disclose PHI for the purposes of (i) performing Business Associate's obligations under the Underlying Agreement and as permitted by this Agreement; or (ii) as permitted or Required By Law; or (iii) as otherwise permitted by this Agreement. Business Associate shall not Use or further Disclose PHI other than as permitted or required by this Agreement or as Required By Law. Further, Business Associate shall not Use or Disclose PHI in any manner that would constitute a violation of the HIPAA Regulations or the HITECH Act if so used by Covered Entity, except that Business Associate may Use PHI (i) for the proper management and administration of Business Associate; and (ii) to carry out the legal responsibilities of Business Associate. Business Associate may Disclose PHI for the proper 'management and administration of Business Associate, to carry out its legal responsibilities or for payment purposes as specified in 45 CFR § 164.506(c)(1) and (3), including but not limited to Disclosure to a business associate on behalf of a covered entity or health care provider for payment purposes of such covered entity or health care provider, with the expectation that such parties will provide reciprocal assistance to Covered Entity, provided that with respect to any such Disclosure either: (i) they Disclosure is Required By Law; or (ii) for permitted Disclosures when Required By Law, Business Associate shall obtain a written agreement from the person to whom the PHI is to be Disclosed that such person will hold the PHI in confidence and will not use and further disclose such PHI except as Required By Law and for the purpose(s) for which it was Disclosed by Business Associate to such person, and that such person will notify Business Associate of any instances of which it is aware in which the confidentiality of the PHI has been breached. b. Creation and Use of De-Identified Data. Business Associate may de-identify any and all PHI, provided that any process or mechanism used to de-identify the data meets the requirements of 45 C.F.R 164.514(a)-(b). Business Associate may use or disclose (and permit others to use or disclose) such de-identified data on a perpetual unrestricted basis, but in no case shall Business Associate attempt to run or develop any keys, codes or algorithms that may be used to re-identify the data. c. Appropriate Safeguards. Business Associate shall implement administrative, physical, and technical safeguards that (i) reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI that it creates, receives, maintains or transmits on behalf of Covered Entity; and (ii) prevent the Use or Disclosure, of PHI other than as contemplated by the Underlying Agreement and this Agreement. d. Compliance with Security Provisions. Business Associate shall: (i) implement and maintain administrative safeguards as required by 45 CFR § 164.308, physical safeguards as required by 45 CFR § 164.310 and technical safeguards as required by 45 CFR § 164.312; (ii) implement and document reasonable and appropriate policies and procedures as required by 45 CFR § 164.316; and (iii) be in compliance with all requirements of the HITECH Act related to security and applicable as if Business Associate were a "covered entity," as such term is defined in HIPAA. e. Compliance with Privacy Provisions. Business Associate shall only Use and Disclose PHI in compliance with each applicable requirement of 45 CFR § 164.504(e). Business Associate shall comply with all requirements of the HITECH Act related to privacy and applicable as if Business Associate were a "covered entity," as such term is defined in HIPAA. To the extent Business Associate is to carry out one or more of Covered Entity's obligation(s) under'Subpart E of 45 CFR Part 164, Business Associate shall comply with the requirements of Subpart E that apply to Covered Entity in the performance of such obligation(s). f. Duty to Mitigate. Business Associate agrees to mitigate, to the extent practicable and mandated by law, any harmful effect that is known to Business Associate of a Use or Disclosure of PHI by Business Associate in violation of the requirements of this Agreement. g. Encryption. To facilitate Business Associate's compliance with this Agreement and to assure adequate data security, Covered Entity agrees that all PHI provided or transmitted to Business Associate pursuant to the Underlying Agreement shall be provided or transmitted in a manner which renders such PHI unusable, unreadable or indecipherable to unauthorized persons, through the use of a technology or methodology. specified by the Secretary in the guidance issued under section 13402(h)(2) of the HITECH Act. Covered Entity acknowledges that failure to do so could contribute to or permit a Breach requiring patient notification under the HITECH Act and further agrees that Business Associate shall have no liability for any Breach caused by such failure. 3. Reporting. a. Security Incidents and/or Unauthorized Use or Disclosure. Business Associate shall report to Covered Entity a successful Security Incident or any Use and/or Disclosure of PHI other than as provided for by this Agreement or permitted by applicable law within a reasonable time of becoming aware of such Security Incident and/or unauthorized Use or Disclosure (but not later than ten (10) days thereafter), in accordance with the notice provisions set forth herein. Business Associate shall take (i) prompt action,to cure any such deficiencies as reasonably requested by Covered Entity, and (ii) any action pertaining to such Security Incident and/or unauthorized Use or Disclosure required by applicable federal and state laws and regulations. If such successful Security Incident or unauthorized Use or Disclosure results in a Breach as defined in the HITECH Act, then Covered Entity shall comply with the requirements of Section 3.b below. The Parties acknowledge and agree that this Section constitutes notice by Business Associate to Covered Entity of the ongoing existence and occurrence of attempted but Unsuccessful Security Incidents as defined herein. "Unsuccessful Security Incidents" will include, but not be limited to, pings and other broadcast attacks on Business Associate's firewall, port scans, unsuccessful log-on attempts, denials of service and any combination of the above, so long as no such incident results in unauthorized access, use or disclosure of PHI. b. Breach of Unsecured PHI. The provisions of this Section 3.b are effective with respect to the Discovery of a Breach of Unsecured PHI occurring on or after September 23, 2009. With respect to any unauthorized acquisition, access, Use or Disclosure of Covered Entity's PHI by Business Associate, its agents or subcontractors, Business Associate shall (i) investigate such unauthorized acquisition access, Use or Disclosure; (ii) determine whether such unauthorized acquisition, access, Use or Disclosure constitutes a reportable Breach under the HITECH Act; and (iii) document and retain its findings under clauses (i) and (ii). If Business Associate Discovers that a reportable Breach has occurred, Business Associate shall notify Covered Entity of such reportable Breach in writing within thirty (30) days of the date Business Associate Discovers such Breach. Business Associate shall be deemed to have discovered a Breach as of the first day that the Breach is either known to Business Associate or any of its employees, officers or agents, other than the person who committed the Breach, or by exercising reasonable diligence should have been known to Business Associate or any of its employees, officers or agents, other than the person who committed the Breach. To the extent the information is available to Business Associate, Business Associate's written notice shall include the information required by 45 CFR § 164.410(c). Business Associate shall promptly supplement the written report with additional information regarding the Breach as it obtains such information. Business Associate shall cooperate with Covered Entity in meeting Covered Entity's obligations under the HITECH Act with respect to such Breach. 4. Business Associate's Agents. To the extent that Business Associate uses one or more subcontractors or agents to provide services under the Underlying Agreement, and such subcontractors or agents receive or have access to PHI, Business Associate shall sign an agreement with such subcontractors or agents containing substantially the same provisions as this Agreement. 5. Rights of Individuals. a. Access to PHI. Within ten (10) days of receipt of a request by Covered Entity, Business. Associate shall make PHI maintained in a Designated Record Set available to Covered Entity or, as directed by Covered Entity, to an Individual to enable Covered Entity to fulfill its obligations under 45 CFR § 164.524. Subject to Section 5.b below, (i) in the event that any Individual requests access to PHI directly from Business Associate in connection with a routine billing inquiry, Business Associate shall directly respond to such request incompliance with 45 CFR § 164.524; and (ii) in the event such request appears to be for a purpose other than a routine billing inquiry, Business, Associate shall forward a copy of such request to Covered Entity and shall fully cooperate with Covered Entity.in responding to such request. In either case, a denial of access to requested PHI shall not be made without the prior written consent of Covered Entity. \ , b. Access to Electronic Health Records. If Business Associate is deemed to use or maintain an Electronic Health Record on behalf of Covered Entity with respect to PHI, then, to the extent an Individual has the right to request a copy of the PHI maintained in such Electronic Health Record pursuant to 45 CFR § 164.524 and makes such a request to Business Associate, Business Associate shall, provide such Individual with a copy of the information contained in such Electronic Health Record in an electronic format and, if the Individual so chooses, transmit such copy directly to an entity or person designated by the Individual. Business Associate may charge a fee to the Individual for providing a copy of such information, but such fee may not exceed Business Associate's labor costs in responding to the request for the copy. The provisions of 45 CFR § 164.524, including the exceptions to the requirement to provide a copy of PHI, shall otherwise apply and Business Associate shall comply therewith as if Business Associate were the "covered entity," as such term is defined in HIPAA. At Covered Entity's request, Business Associate shall provide Covered Entity with a copy of an Individual's PHI . maintained in an Electronic Health Record in an electronic format and in a time and manner designated by Covered Entity in order for Covered Entity to comply with 45 CFR § 164.524, as amended by the HITECH Act. c. Amendment of PHI. Business Associate agrees to make any amendment(s) to PHI in a Designated Record Set that Covered Entity directs or agrees'to pursuant to 45 CFR § 164.526 at the request of Covered Entity or an Individual, and in the time and manner designated by Covered Entity. • d. Accounting Rights. This Section 5.d is subject to Section 5.e below. Business Associate shall make available to Covered Entity, in response to a request from an. Individual, information required for an-accounting of disclosures of PHI with respect to the Individual, in accordance with 45 CFR § 164.528, incorporating exceptions to such accounting designated under such regulation. Such accounting is limited to disclosures that were made in the'six (6) years prior to the request and shall not include any disclosures that were made prior to the compliance date of the HIPAA Regulations. Business Associate shall provide such information as is necessary to provide an accounting within ten (10) days of Covered Entity's request. Such accounting must be provided \without cost to the Individual or to Covered Entity if it is the first accounting requested by an Individual within any twelve (12) month period; however, a reasonable, cost- based fee may be charged for subsequent accountings if Business Associate informs Covered Entity and Covered Entity informs the Individual in advance of the fee, and the Individual is afforded an opportunity to withdraw or modify the request. Such accounting obligations shall survive termination of this Agreement and shall continue as long as Business Associate maintains PHI. e. Accounting of Disclosures of Electronic Health Records. The provisions of this Section 5.e shall be effective on the date specified in the HITECH Act. If Business Associate is deemed to use or maintain an Electronic Health Record on behalf of Covered Entity, then, in addition to complying with the requirements set forth in Section 5.d above, Business Associate shall maintain an 'accounting of any Disclosures made through such Electronic Health Record for Treatment, Payment and Health Care Operations, as applicable. Such accounting shall comply with the requirements of the rHITECH Act. Upon request by Covered Entity, Business Associate shall,provide such accounting to Covered Entity in the time and manner-specified by Covered Entity and in compliance with the HITECH Act. Alternatively, if Covered Entity responds to an Individual's request for an accounting of Disclosures made through an Electronic Health Record by providing the requesting Individual with a list of all business associates acting on behalf of , Covered Entity, then Business Associate shall provide such accounting directly to the requesting Individual in the time and manner specified by,the HITECH Act. f. Agreement to Restrict Disclosure. If Covered Entity is required to comply with a restriction on the Disclosure of PHI pursuant to Section 13405 of the HITECH Act, then Covered Entity"shall, to the extent necessary to comply with such restriction, provide written notice to Business Associate of the name of the Individual requesting the restriction and the PHI affected thereby. Business Associate shall, upon receipt of such notification, not Disclose the identified PHI to any health plan for the purposes of carrying out Payment or Health Care Operations, except as otherwise required by law. Covered Entity shall also notify Business Associate of any other restriction to the Use or Disclosure of PHI that Covered Entity has agreed to in ' accordance with 45 CFR§ 164.522. 6. Remuneration and Marketing. a. Remuneration for PHI. This Section 6.a shall be effective with respect to exchanges of PHI occurring six (6) months after the date of the promulgation of final regulations implementing the provisions of Section 1.3405(d) of the HITECH Act. On and after such date, Business Associate agrees that it shall not, directly or indirectly, receive remuneration in exchange for any PHI of Covered Entity except as otherwise permitted by the HITECH Act. b. Limitations on Use of PHI for Marketing Purposes. Business Associate shall not Use or Disclose PHI for the purpose of making a' communication about a product or service that encourages recipients of the communication to purchase or use the product;or service, unless such communication: (1) complies with the requirements of subparagraph (i),. (ii) or (iii) of paragraph (1) of the definition of marketing contained in 45 CFR § 164.501, and (2) complies with the requirements of subparagraphs (A), (B) or (C) of Section 13406(a)(2) of the HITECH Act, and implementing regulations or guidance that may be issued or amended from time to time. Covered Entity agrees to assist Business Associate in determining if the foregoing requirements are met with respect to any such marketing communication. 7. Governmental Access to Records. Business Associate,shall make its internal practices, books and records relating to the Use and Disclosure of PHI available to the Secretary for purposes of determining Covered Entity's compliance with the HIPAA Regulations and the HITECH Act. Except to the extent prohibited by law, Business Associate agrees to notify Covered Entity of all requests served upon Business Associate for information or documentation by or on behalf of the Secretary. Business Associate shall provide to Covered Entity a 'copy of any PHI that Business Associate provides to the Secretary concurrently with providing such PHI to the Secretary. • 8. Minimum Necessary. To the extent required by the HITECH Act, Business Associate shall limit its Use, Disclosure or request of PHI to the Limited Data Set or, if needed, to the minimum necessary to accomplish the intended Use, Disclosure or request, respectively. Effective on the date the Secretary issues guidance on what constitutes "minimum necessary" for purposes of the HIPAA Regulations, Business'Associate shall limit its Use, Disclosure or request of PHI to only the minimum necessary as set forth in such guidance. 9. State Privacy Laws. Business Associate shall comply with state laws to extent that such state privacy laws are not preempted by HIPAA or the HITECH Act. 10. Termination. a. Breach by Business Associate. If Covered Entity knows of a pattern of activity or. practice of Business Associate that constitutes a material breach .or violation of Business Associate's obligations under this Agreement, then Covered Entity shall promptly notify Business Associate. With respect to such breach or violation, Business. Associate shall take reasonable steps to cure such breach or end such violation, if possible. If such steps are either not possible or are unsuccessful, upon written notice to Business Associate, Covered Entity may terminate its relationship with Business Associate. b. Breach by Covered Entity. If Business Associate knows of a pattern of activity or practice of Covered Entity that constitutes a material breach or violation of Covered Entity's obligations under this.Agreement, then Business Associate shall promptly notify Covered Entity. With respect to such breach or violation, Covered Entity shall :take'reasonable steps to cure such breach or end such violation, if possible. If such steps are either not possible or are unsuccessful, upon written notice to Covered Entity, Business Entity may terminate its relationship with Covered Entity. c. Effect of Termination. Upon termination of this Agreement for any reason, Business Associate shall either return or destroy all PHI, as requested by Covered Entity, that Business Associate or its agents or subcontractors still maintain in any form, and shall retain no copies of such PHI. If Covered Entity requests that Business Associate return PHI, such PHI shall be returned in a mutually agreed upon format and timeframe. If Business Associate reasonably determines that return or destruction is not feasible, Business Associate shall continue to extend the protections of this Agreement to such PHI, and limit further uses and disclosures of such PHI to those purposes that make the return or destruction of such PHI not feasible. If Business Associate is asked to destroy the PHI, Business Associate shall destroy PHI in a manner that renders the PHI unusable, unreadable or indecipherable to unauthorized persons as specified in the HITECH Act. 11. Amendment. The parties acknowledge that state and federal laws relating)to data security and privacy are rapidly evolving and that amendment of this Agreement may be required to ensure compliance with such developments. The parties specifically agree to take such action as is necessary to implement any new or modified standards or requirements of HIPAA, the HIPAA Regulations, the HITECH Act and other applicable laws relating to the security or confidentiality of PHI. Upon the request of Covered Entity, Business Associate' agrees to promptly enter into negotiation concerning the terms of an amendment to this Agreement incorporating any such changes. 12. No Third Party Beneficiaries. Nothing express or implied in this Agreement is intended to confer, nor shall anything herein confer, upon any person other than Covered Entity, Business Associate and their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever. 13. Effect on Underlying Agreement. In the event of any conflict between this Agreement and the Underlying Agreement, the terms of this Agreement shall control. 15. Survival. The provisions of this Agreement shall survive the termination or expiration of the Underlying Agreement. 16. Interpretation. This Agreement shall be interpreted as broadly as necessary to implement and comply with HIPAA, the HIPAA Regulations and the HITECH Act. The parties agree that any ambiguity in this Agreement shall be resolved(in favor of a meaning that complies and is consistent with such laws. 17. Governing Law. This Agreement shall be construed in accordance with the laws of the State of Florida. 18. Notices. All notices required or permitted under this Agreement shall be in writing and sent to the other party as directed below or as otherwise directed by either party, from time to time, by written notice to the other. All such notices shall be deemed validly given upon receipt of such notice by certified mail, postage prepaid, or personal or courier delivery: If to Covered Entity: Attn: Telephone no: Facsimile,no: If to Business Associate: Advanced Data Processing, Inc. c/o R1 RCM Inc. 401 N. Michigan Avenue, Suite 2700 Chicago, IL 60611 Attn: Chief Privacy Officer • • MASTER SUBSCRIPTION AND LICENSE AGREEMENT This Master Subscription and License Agreement(the"Agreement")is entered into as of 6/11/19 - ("Effective Date"), by and between ESO Solutions,Inc.,a Texas corporation having its principal place of business at 11500 Aliens Parkway,Suite 100 Austin,TX 78758("ESO")and City of Miami Beach("Customer")having its principal place of business at 1700 Convention Center Drive,Miami Beach, • FL,33139.This Agreement consists of the General Terms&Conditions below and any Addenda(as defined below)executed by the parties, including any attachments to such Addenda. ' The parties have agreed that ESO will provide Customer with certain technology products and/or services and that Customer will pay to ESO certain fees.Therefore,in consideration of the covenants,agreements and promises set forth below,and for other good and valuable consideration,the receipt and sufficiency of which is hereby acknowledged,the parties,intending to be legally bound,hereby agree as set forth in the pages that follow. GENERAL TERMS AND CONDITIONS 1. DEFINITIONS.Capitalized terms not otherwise defined in this 1.11. "Protected Health Information"or"PHI"shall have the Agreement shall have the meanings below: meaning set forth in HIPAA.All references herein to PHI shall be construed to include electronic PHI,or ePHI,as 1.1. "Add-On Software"means any complementary software that term is defined by HIPAA. components or reporting service(s)that ESO makes available to customer through its Licensed Software, 1.12. "Reporting Services"means collectively the different Interoperability Software or SaaS. programs or tools ESO provides for Customer to generate compilations of data,including but not limited to ad-hoc ' 1.2. "Addendum"or"Addenda"means a writing addressing an reports,analytics,benchmarking or any other reporting tool order of a specific set of products or services executed by provided through the Software. authorized representatives of each party.An Addendum may be(a)aSoftware Schedule(see Exhibit Al—A4),(b)a 1.13. "SaaS"means software-as-a-service that ESO hosts Statement of Work,or(c)another writing the parties intend (directly or indirectly)for Customer's use.For the to be incorporated by reference into this Agreement. avoidance of doubt,SaaS does not include Licensed Software,but does include Add-on Software and 1.3. "Customer Data"means data in electronic form managed or Interoperability Software. stored by ESO,which is entered into or transmitted through - the Software. 1.14. "Software"means any computer program,programming or • modules specified in each Software Schedule or SOW.For 1.4. "Deliverable"means software,report,or other work product the avoidance of doubt,Add-on Software,SaaS; created pursuant to a Statement of Work. Interoperability Software;and Licensed Software shall collectively be referred to as Software. 1.5. "Documentation"means user guides,operating manuals, and specifications regarding the Software covered by this 1.15. "Software Schedule"refers to an Addendum in which Agreement. Customer has ordered either Add-on Software,Licensed Software,Interoperability Software or SaaS,collectively 1.6. "Feedback"refersto any suggestion or idea for improving Software.See Exhibits Al—A4. or otherwise modifying ESO's products or services. - 1.16. "Statement of Work"or"SOW"refers to an Addendum in 1.7. "Intellectual Property"means trade secrets,copyrightable which Customer has ordered Professional Services or a Deliverable from ESO. • subject matter,patents,and patent applications and other proprietary information,activities,and any ideas,concepts,. innovations,inventions and designs. '1.17. "Support Services"means those services described in Exhibit B: • 1.8. "Interoperability Software"means software-as-a-service that ESO hosts(directly or indirectly)for Customer to 1.18. "User"means any individual who uses the Software on exchange healthcare data with others.Some of ESO's Customer's behalf or through Customer's account or Reporting Services may be made available to Customer via passwords,whether authorized or not. the Interoperability Software.For the avoidance of doubt, I • Interoperability Software does not include Add-on 2. SOFTWARE SCHEDULES.During the Term of this Software,Licensed Software or SaaS. Agreement,Customer may order Software from ESO by signing a Software Schedule. Customer's license to Licensed Software 1.9. "Licensed Software"means on premise software that ESO and its subscription to SaaS are set forth below.Each such provides to Customer for its reproduction and use.For the Software Schedule,Exhibits A-1,A-2,A-3,and A-4,are avoidance of doubt,Licensed Software does not include incorporated herein by reference. Add-on Software,Interoperability Software or SaaS. 3. LICENSEJSUBSCRIPTION TO SOFTWARE 1.10. "Professional Services"means professional services that a Statement of Work calls on ESO to provide. 3.1. Grant of License.In the case of Licensed Software,during the Term of this Agreement ESO hereby grants Customer a limited,non-exclusive,non-transferable,non-assignable, 5 revocable license to copy and use the Licensed Software,in 4.2. Service Level Agreement.No credits shall be given in the such quantities as are set forth on the applicable Software event Customer's access to SaaS is.delayed,impaired or Schedule and as necessary for Customer's internal business otherwise disrupted(collectively,an"Outage").If such purposes;provided that,Customer complies with the Outage,excluding Scheduled Downtime(as defined below), Restrictions on Use(Section 3.3)and other limitations and results in the service level uptime falling below 99%for obligations contained in this Agreement.Such internal three consecutive months or three months in any rolling business purposes do not include reproduction or use by any twelve-month period(collectively,"Uptime Commitment"), parent,subsidiary,or affiliate of Customer,or any other then Customer shall have the option to immediately third party,and Customer shall not permit any such use. terminate this Agreement;and ESO will refund any prepaid, unearned Fees to Customer.This is Customer's sole remedy 3.2. Grant of Subscription.In the case of SaaS,during the term for ESO's breach of the Uptime Commitment. of this Agreement Customer may access and use the SaaS, in such quantities as are set forth on the applicable Software 4.3. Scheduled Downtime. In the event ESO determines that it Schedule;provided that,Customer complies with the is necessary to intentionally interrupt the SaaS or that there Restrictions on Use(Section 3.3)and other limitations is a potential for the SaaS to be interrupted for the contained in this Agreement. performance of system maintenance(collectively, "Scheduled Downtime"),ESO will use good-faith efforts to 3.3. Restrictions on Use.Except as provided in this Agreement notify Customer of such Scheduled Downtime at least 72 or as otherwise authorized by ESO,Customer has no right hours in advance and will ensure Scheduled Downtime to:(a)decompile,reverse engineer,disassemble,print,copy occurs during non-peak hours(midnight to 6 a.m.Central or display the Software orotherwise reduce the Software to Time). In no event shall Scheduled Downtime constitute a a human perceivable form in whole or in part;(b)publish, failure of performance by ESO. release,rent,lease,loan,sell,distribute or transfer the Software to another person or entity;(c)reproduce the 4.4. Support and Updates. During the Term of this Agreement, Software for the use or benefit of anyone other than ESO shall provide to Customer the Support Services,in Customer,(d)alter,modify or create derivative works accordance with Exhibit B.Exhibit B is incorporated herein based upon the Software either in whole or in part;or(e) by reference. use or permit the use of the Software for commercial time- sharing arrangements or providing service bureau,data 5. FEES processing,rental,or other services to any third party.The rights granted under the provisions of this Agreement do not constitute a sale of the Software.ESO retains all right, 5.1. E .In consideration of the rights granted and except in title,and interest in and to the Software,including without the event there is a Third-Party Payer(as defined below), limitation all software used to provide the Software and all Customer agrees to pay ESO the fees for the Software graphics,user interfaces,logos and trademarks reproduced and/or Professional Services asset forth in the Software through the Software,except to the limited extent set forth Schedule(s)or SOW(s)(collectively,"Fees").The Fees are in this Agreement.This Agreement does not grant non-cancelable and non-refundable.Customer shall pay all Customer any intellectual property rights in the Software or invoices within thirty(30)days of receipt.In the event a any of its components,except to the limited extent that this third-party is paying some or all of the Fees on behalf of Agreement specifically sets forth Customer's rights to Customer("Third-Party Payer"),the Software Schedule access,use,or copy the Software during the Term of this will state that payment obligation.The parties agree that Agreement.Customer recognizes that the Software and its Customer may replace the Third-Party Payer by submitting components are protected by copyright and other laws. to ESO written notice memorialising the change.However, no such change shall be made until the then-current Term's renewal.Moreover,Customer is responsible for payment in 3.4. Delivery.In the case of Licensed Software,ESO shall the event the Third-Party Payer does not pay the Fees and provide the Licensed Software to Customer through a Customer continues using the Software.For the avoidance • reasonable system of electronic download.In the case of of doubt,any such Addenda will become part of this SaaS,ESO shall grant Customer access to SaaS promptly Agreement. after the Effective Date. • 5.2. Uplift on Renewal.Except in the instance of Overages(as 3.5. Third-Party Software.Software may incorporate software defined below),Fees for Software,which recur annually, and other technology owned and controlled by third parties shall increase by three percent(3%)each year this ("Third-Party Software"). ESO is licensed to sublicense Agreement is in effect. and distribute Third-Party Software.All Third-Party Software falls under the scope of this Agreement. Moreover,ESO neither accepts liability,nor warrants the 5.3. Taxes and Fees. This Agreement is exclusive of all taxes functionality,reliability or accuracy of Third-Party and credit card processing fees,if applicable.Customer is Software,including but not limited to third-party mapping responsible for and will remit(or will reimburse ESO upon applications. ESO's request)all taxes of any kind,including sales,use, duty,customs,withholding,property,value-added,and 4. HOSTING,SLA&SUPPORT SERVICES other similar federal,state or local taxes(other than taxes based on ESO's income)related to this Agreement. 4.1. Hosting&Management.Customer shall be solely 5.4. Appropriation of Funds.If Customer is a city,county or responsible for hosting and managing the Licensed other government entity,the parties accept and agree that Software.ESO shall be responsible for hosting and Customer has the right to terminate the Agreement at the managing the SaaS. end of the Customer's fiscal term for a failure by Customer's governing body to appropriate sufficient funds for the next fiscal year.Notwithstanding the foregoing,this • provision shall not excuse Customer from past payment of the Documentation and Licensed Software in its obligations or other Fees earned and unpaid.Moreover, possession or control,except as required by law. Customer agrees to provide ESO reasonable documentation evidencing such non-appropriation of funds. 6.4.4. Termination of this Agreement is without prejudice to any other right or remedy of the parties,and shall 5.5. Audit Rights.ESO may regularly audit Customer's use of not release either party from any liability(a)which the Software and charge Customer a higher annual Fee if at the time of termination,has already accrued to Customer's usage has increased beyond the tier contracted the other party,(b)which may accrue in respect of for in the current Software Schedule or otherwise assess any act or omission prior to termination,or(c)from additional fees(for example,Customer is uploading more any obligation which is intended to survive records into the Software than it has previously contracted termination. for)(collectively,"Overages").ESO may invoice for Overages immediately.Notwithstanding the foregoing,it is 6.5. Delivery of Data. If Customer requests its data within sixty solely Customer's responsibility to report Overages to ESO (60)days of expiration or termination of this Agreement, in a timely manner. ESO will provide Customer access to Customer Data in a searchable.pdf format within a reasonable time frame 6. TERM AND TERMINATION thereafter.ESO is under no obligation to retain Customer Data more than sixty(60)days after expiration or 6.1. Term.The term,of this Agreement(the"Term")shall termination of this Agreement. commence on the Effective Date and continue for the period set forth in the applicable Software Schedule or,if none,for 7. REPRESENTATIONS AND WARRANTIES one year.Thereafter,the Term will renew for successive one-year periods,unless either party opts out of such 7.1. Material Performance of Software.ESO warrants and renewal by providing at least sixty days'written notice represents that the Software will materially perform in before the scheduled renewal date.The license period or accordance with the Documentation provided by ESO,if subscription period shall begin on the date specified in the • any. applicable Software Schedule,and this Agreement shall automatically be extended to ensure that the contract Term is coterminous with the subscription period or license - 7.2. Warranty of Services.ESO warrants that its personnel are period,as applicable. adequately trained and competent to perform Professional Services and/or Support Services and that each will be performed in a professional and workmanlike manner. 6.2. Termination for Cause.Either party may terminate this Agreement or any individual Software Schedule for the other party's material breach by providing written notice. 7.3. Due Authority.Each party's execution,delivery and The breaching party shall have thirty days from receipt to performance of this Agreement and each agreement or cure such breach to the reasonable satisfaction of the non- instrument contemplated by this Agreement has been duly breaching party. authorized by all necessary corporate or government action. 6.3. Bankruptcy/Insolvency.This Agreement and any applicable 7.4. Customer Cooperation.Customer agrees to reasonably and Software Schedule may be terminated immediately upon timely cooperate with ESO,including but not limited to the following:(a)the institution of insolvency,receivership providing ESO with reasonable access to its equipment, or bankruptcy proceedings or any other proceedings for the software,data and using current operating system(s). settlement of debts of the other party;(b)the making of an assignment for the benefit of creditors by the other party;or 8. DISCLAIMER OF WARRANTIES.EXCEPT AS (c)the dissolution of the other patty. OTHERWISE PROVIDED IN SECTION 7,ESO HEREBY DISCLAIMS ALL WARRANTIES,EXPRESS OR IMPLIED, 6.4. Effect of Termination. INCLUDING,WITHOUT LIMITATION,ALL IMPLIED WARRANTIES OF MERCHANTABILITY,FITNESS FOR A PARTICULAR PURPOSE,PERFORMANCE,SUITABILITY, 6.4.1. If this Agreement or any Software Schedule is TITLE,NON-INFRINGEMENT,OR ANY IMPLIED terminated by Customer prior to the expiration of its WARRANTY ARISING FROM STATUTE,COURSE OF then-current term,for any reason other than ESO's DEALING,COURSE OF PERFORMANCE,OR USAGE OF • breach,Customer agrees to immediately remit all TRADE.WITHOUT LIMITING THE GENERALITY OF THE unpaid Fees as set forth on the applicable Software FOREGOING:(a)ESO DOES NOT REPRESENT OR Schedule equal to the Fees that will become due WARRANT THAT THE SOFTWARE WILL PERFORM during the remaining Term. WITHOUT INTERRUPTION OR ERROR;AND(b)ESO' DOES NOT REPRESENT OR WARRANT THAT THE 6.4.2. If Customer terminates this Agreement or any SOFTWARE IS SECURE FROM HACKING OR OTHER Software Schedule as a result of ESO's breach,then UNAUTHORIZED INTRUSION OR THAT CUSTOMER to the extent that Customer has prepaid any Fees, DATA WILL REMAIN PRIVATE OR SECURE.CUSTOMER ESO shall refund to Customer any prepaid Fees on a THEREFORE ACCEPTS THE SOFTWARE"AS-IS"AND"AS pro-rata basis to the extent such Fees are AVAILABLE." attributable to the period after the termination date. 9. CONFIDENTIALITY 6.4.3. Upon termination of this Agreement or any Software Schedule,Customer shall cease all use of 9.1. "Confidential Information"refers to the following items:(a) the Software and delete,destroy or return all copies any document marked"Confidential";(b)any information orally designated as"Confidential"at the time of • disclosure,provided the disclosing party confirms such disclosed by law,a lawful public records request,or judicial designation in writing within five(5)business days;(c)the order,provided that prior to such disclosure,written notice Software and Documentation,whether or not designated of such required disclosure shall be given promptly and confidential;and(d)any other nonpublic,sensitive without unreasonable delay by the receiving party in order information reasonably considered a trade secret or to give the disclosing party the opportunity to object to the otherwise confidential.Notwithstanding the foregoing, disclosure and/or to seek a protective order.The receiving Confidential Information does not include information that: party shall reasonably cooperate in this effort.In addition, (i)is in the other party's possession at the time of Customer may disclose the contents of this Agreement disclosure;(ii)is independently developed without use of or solely for the purpose of completing its review and approval reference to Confidential Information;(iii)becomes known processes under its local rules,if applicable. • publicly,before or after disclosure,other than as a result of a party's improper action or inaction;(iv)is approved for 10. INSURANCE.Throughout the term of this Agreement,and for a release in writing by the disclosing party;(v)is required to period of at least three(3)years thereafter for any insurance be disclosed by law;or(vi)PHI,which shall be governed written on a claims-made form,ESO shall maintain in effect the by the Business Associate Agreement rather than this insurance coverage described below: Section. 10.1. Commercial general liability insurance with a minimum of 9.2. Nondisclosure.The parties shall not use Confidential $I million per occurrence and SI million aggregate; Information for any purpose other than to fulfill the terms of this Agreement(the"Purpose").Each party:(a)shall ensure 10.2. Commercial automobile liability insurance covering use of that its employees or contractors are bound by confidentiality obligations no less restrictive than those all non-owned and hired automobiles with a minimum limit contained herein and(b)shall not disclose Confidential of$1 million for bodily injury and property damage Information to any other third party without prior written liability; consent from the disclosing party.Without limiting the generality of the foregoing,the receiving party shall protect 10.3. Worker's compensation insurance and employer's liability Confidential Information with the same degree of care it insurance or any alternative plan or coverage as permitted uses to protect its own confidential information of similar or required by applicable law,with a minimum employer's nature and importance,but with no less than reasonable liability limit of$1 million each accident or disease;and care.A receiving party shall promptly notify the disclosing party of any misuse or misappropriation of Confidential 10.4. Computer processor/computer professional liability Information of which it is aware. insurance("Technology Errors and Omissions")covering the liability for financial loss due to error,omission or 9.3. Disclosure of ESO's Security Policies.Customer negligence of ESO,and Privacy and Network Security acknowledges that any information provided by ESO insurance("Cyber")covering losses arising from a pertaining to ESO's security controls,policies,procedures, disclosure of confidential information,with a combined audits,or other infonnation concerning ESO's internal aggregate amount of$3 million. security posture are considered Confidential Information and shall be treated by Customer in accordance with the 11. INDEMNIFICATION • terms and conditions of this Agreement. 11.1. IP Infringement.ESO shall defend and indemnify Customer 9.4. Injunction.Customer agrees that breach of this Section from any damages,costs,liabilities,expenses(including would cause ESO irreparable injury,for which monetary reasonable and actual attorney's fees)("Damages")actually damages would not provide adequate compensation,and incurred or finally adjudicated as to any third-party claim or that in addition to any other remedy,ESO will be entitled to action alleging that the Software delivered pursuant to this injunctive relief against such breach or threatened breach, Agreement infringe or misappropriate any third party's without ESO proving actual damage or posting a bond or patent,copyright,trade secret,or other intellectual property other security. rights enforceable in the applicable jurisdiction(each an "Indemnified Claim").If an Indemnified Claim under this 9.5. Termination&Return.With respect to each item of Section occurs or if ESO determines that an Indemnified Confidential Information,the obligations of nondisclosure Claim is likely to occur,ESO shall at its option:(a)obtain a will terminate three(3)years after the date of disclosure; right for Customer to continue using such Software;(b) provided that,such obligations related to Confidential modify such Software to make it a non-infringing Information constituting ESO's trade secrets shall continue equivalent or(c)replace such Software with a non- so long as such information remains subject to trade.secret infringing equivalent.If(a),(b),or(c)above are not protection pursuant to applicable law.Upon termination of reasonably available,either party may,at its option, this Agreement,a party shall return all copies of terminate this Agreement and/or relevant Software Confidential Information to the other or certify,in writing, Schedule.ESO will refund any pre-paid Fees on a pro-rata the destruction thereof. basis for the allegedly infringing Software provided. Notwithstanding the foregoing,ESO shall have no 9.6. Retention of Rights.This Agreement does not transfer obligation hereunder for any claim resulting or arising from ownership of Confidential Information or grant a license (x)Customer's breach of this Agreement;(y)modifications thereto. made to the Software that were not performed or provided by or on behalf of ESO or(z)the combination,operation or use by Customer or anyone acting on Customer's behalf of 9.7. Open Records and Other Laws.Notwithstanding anything the Software in connection with a third-party product or in this Section to the contrary,the parties expressly service(the combination of which causes the infringement). acknowledge that Confidential Information may be This Section 11 states ESO's sole obligation and liability, disclosed if such Confidential Information is required to be 35 and Customer's sole remedy,for potential or actual INSOFAR AS APPLICABLE LAW PROHIBITS ANY intellectual property infringement by the Software. LIMITATION HEREIN,THE PARTIES AGREE THAT • SUCH LIMITATION SHALL BE AUTOMATICALLY 11.2. Indemnification Procedures. Upon becoming aware of any MODIFIED,BUT ONLY TO THE EXTENT SO AS TO matter which is subject to the provisions of Sections 11.1(a MAKE THE LIMITATION PERMITTED TO THE "Claim"),the party seeking indemnification(the FULLEST EXTENT POSSIBLE UNDER SUCH LAW. "indemnified Party")must give prompt written notice of THE PARTIES AGREE THAT THE LIMITATIONS SET such Claim to the other party(the"Indemnifying Party"), FORTH HEREIN ARE AGREED ALLOCATIONS OF accompanied by copies of any written documentation RISK CONSTITUTING IN PART THE regarding the Claim received by the Indemnified Party. The CONSIDERATION FOR ESO'S SOFTWARE AND Indemnifying Party shall compromise or defend,at its own SERVICES TO CUSTOMER,AND SUCH expense and withits own counsel,any?such Claim. The LIMITATIONS WILL APPLY NOTWITHSTANDING Indemnified Party will have the right,at its option,to THE FAILURE OF THE ESSENTIAL PURPOSES OF participate in the settlement or defense of any such Claim, ANY LIMITED REMEDY AND EVEN IF A PARTY with its own counsel and at its own expense;provided, HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH however,that the Indemnifying Party will have the right to LIABILITIES. control such settlement or defense. The Indemnifying Party will not enter into any settlement that imposes any liability [2.5. THIS SECTION 12 SHALL SURVIVE EXPIRATION OR or obligation on the Indemnified Party without the TERMINATION OF THE AGREEMENT. Indemnified Party's prior written consent. The parties will cooperate in any such settlement or defense and give each 13. CUSTOMER DATA&PRIVACY other full access to all relevant information,at the Indemnifying Party's expense. 13.1. Ownership of Data&Reports.As between ESO and • Customer,all Customer Data shall be owned by Customer. 12. LIMITATION OF LIABILITY Without limiting the foregoing,ESO will own all right,title and interest in all Intellectual Property in any aggregated 12.1. LIMITATION OF DAMAGES.UNDER NO and de-identified reports,summaries,compilations,analysis CIRCUMSTANCES SHALL ESO OR CUSTOMER BE or other information made available through ESO's LIABLE FOR ANY CONSEQUENTIAL,INDIRECT, Reporting Services.If subscribed to by Customer,ESO SPECIAL,PUNITIVE OR INCIDENTAL DAMAGES, grants to Customer a limited,non-exclusive license to use INCLUDING CLAIMS FOR DAMAGES FOR LOST its Reporting Services for Customer's internal purposes PROFITS,GOODWILL,USE OF MONEY, only during the Term of this Agreement.No other third INTERRUPTED OR IMPAIRED USE OF THE party shall rely on ESO's Reporting Services or the contents SOFTWARE,AVAILABILITY OF DATA,STOPPAGE thereof.ESO disclaims all liability for any damages related OF WORK OR IMPAIRMENT OF OTHER ASSETS. thereto.Customer aclmowledges and agrees that any such license expires upon the expiration or termination of the 12.2. LIMITATION OF LIABILITY.WITH THE applicable Software Schedule granting a license to ESO's EXCEPTION OF SECTION 12.3(EXCEPTIONS TO THE Reporting Services. • LIMITATION OF LIABILITY),ESO'S MAXIMUM AGGREGATE LIABILITY FOR ALL CLAIMS OF L3.2. Use of Customer Data.Unless it receives Customer's prior LIABILITY ARISING OUT OF OR IN CONNECTION written consent,ESO:(a)shall not access,process,or WITH THIS AGREEMENT,SHALL NOT EXCEED,THE otherwise use Customer Data;and(b)shall not intentionally FEES PAID BY CUSTOMER OR ON BEHALF OF grant any third-party access to Customer Data,including CUSTOMER IN THE CASE OF A THIRD-PARTY without limitation ESO's other customers,except PAYER UNDER THE APPLICABLE SOFTWARE subcontractors that are subject to a reasonable SCHEDULE OR SOW GIVING RISE TO THE CLAIM nondisclosure agreement or authorized participants in the WITHIN THE PRECEDING 12-MONTH PERIOD. case of Interoperability Software.Notwithstanding the foregoing,ESO may use and disclose Customer Data to 12.3. EXCEPTIONS TO LIMITATION OF LIABILITY. fulfill its obligations under this Agreement or as required by NOTWITHSTANDING SECTION 12.2,A PARTY'S applicable law or by proper legal or governmental authority. LIABILITY FOR CLAIMS INVOLVING A PARTY'S ESO shall give Customer prompt notice of any such legal or INDEMNIFICATION OBLIGATIONS UNDER SECTION governmental demand and reasonably cooperate with 11,SHALL BE LIMITED TO$250,000.IN ADDITION, Customer in any effort to seek a protective order or AND NOTWITHSTANDING SECTION 12.2,A otherwise to contest such required disclosure,at Customer's PARTY'S LIABILITY SHALL BE LIMITED TO THE - expense. AMOUNT OF INSURANCE COVERAGE REQUIRED BY SECTION 10 FOR THE FOLLOWING TYPES OF 13.3. Anonvmized Data.Notwithstanding any provision herein, CLAIMS:(I)CLAIMS ARISING FROM A PARTY'S ESO may use,reproduce,license,or otherwise exploit GROSS NEGLIGENCE OR WILLFUL MISCONDUCT; Anonymized Data;provided that Anonymized Data does- AND oesAND(II)CLAIMS ARISING FROM A BREACH OF not contain and is not PHI.("Anonymized Data"refers to CONFIDENTIAL INFORMATION,INCLUDING A Customer Data with the following removed:personally BREACH OF PROTECTED HEALTH INFORMATION. identifiable information and the names and addresses of Customer and any of its Users and/or Customer's clients.) 12.4. THE FOREGOING LIMITATIONS,EXCLUSIONS, DISCLAIMERS SHALL APPLY REGARDLESS OF 13.4. Risk of Exposure.Customer recognizes and agrees that WHETHER THE CLAIM FOR SUCH DAMAGES IS hosting data online involves risks of unauthorized BASED IN CONTRACT,WARRANTY,STRICT disclosure and that,in accessing and using the SaaS, LIABILITY,NEGLIGENCE,TORT OR OTHERWISE. Customer assumes such risks.Customer has sole • responsibility for obtaining,maintaining,and securing its whether those decisions or actions were made or taken connections to the Internet.ESO makes no representations using information received through the Software. to Customer regarding the reliability,performance or • security of any network or provider. 17. MISCELLANEOUS 14. FEEDBACK RIGHTS&WORK PRODUCT 17.1. Independent Contractors.The parties are independent contractors.Neither party is the agent of the other,and 14.1. Feedback Rights.ESO does not agree to treat as neither may make commitments on the other's behalf.The confidential any Feedback that Customer provides to ESO. parties agree that no ESO employee or contractor is or will Nothing in this Agreement will restrict ESO's right to use, be considered an employee of Customer. profit from,disclose,publish,keep secret,or otherwise exploit Feedback,without compensation or crediting 17.2. Notices.Notices provided under this Agreement must be in Customer.Feedback will not constitute Confidential writing and delivered by(a)certified mail,return receipt Information,even if it would otherwise qualify as such requested to a party's principal place of business as forth in pursuant to Section 9(Confidential Information). the recitals on page 1 of this Agreement,(b)hand delivered, (c)facsimile with receipt of a"Transmission Confirmed" 14.2. Work Product OwnershiR.In the event Customer hires ESO acknowledgment,(d)e-mail,or(e)delivery by a reputable to perform Professional Services,ESO alone shall hold all overnight carrier service.In the case of delivery by right,title,and interest to all proprietary and intellectual facsimile or e-mail,the notice must be followed by a copy property rights of the Deliverables(including,without, of the notice being delivered by a means provided in(a),(b) limitation,patents,trade secrets,copyrights,and or(e). The notice will be deemed given on the day the trademarks),as well as title to any copy of software made notice is received. by or for Customer(if applicable).Customer hereby explicitly acknowledges and agrees that nothing in this 17.3. Merger Clause. In entering into this Agreement,neither Agreement or a separate SOW gives the Customer any party is relying upon any representations or statements of right,title,or interest to the intellectual property or the other that are not fully expressed in this Agreement; proprietary know-how of the Deliverables. rather each party is relying on its own judgment and due diligence and expressly disclaims reliance upon any 15. GOVERNMENT PROVISIONS representations or statement not expressly set forth in this Agreement.In the event the Customer issues a purchase 15.1. Compliance with Laws. Both parties shall comply with and order,letter or any other documentaddressing the Software give all notices required by all applicable federal,state and or Services to be provided and performed pursuant to this local laws,ordinances,rules,regulations and lawful orders Agreement,it is hereby specifically agreed and understood • of any public authority bearing on the performance of this that any such writing is for the Customer's internal Agreement. purposes only,and that any terms,provisions,and conditions contained therein shall in no way modify this • 15.2. Business Associate Addendum.The parties agree to the Agreement. terms of the Business Associate Addendum attached hereto as Exhibit C and incorporated herein by reference. 17.4. Severability.To the extent permitted by applicable law,the parties hereby waive any provision of law that would render 15.3. Equal Opportunity.The parties shall abide by the any clause of this Agreement invalid or otherwise requirements of 41 CFR 60-1.4(a),60-300.5(a)and 60- unenforceable el any respect.If a provision of this • Agreement is held to be invalid or otherwise unenforceable, 741.5(a),and the posting requirements of 29 CFR Part 471, appendix A to subpart A,if applicable.These regulations purposuch se to tprovision will be interpretedextent to pefurmitted its intended le prohibit discrimination against qualified individuals based law,and to thehe maximum vio s ofthisd gy eemappent will on their status as protected veterans or individuals with law, remaining provisions of Agreement will continue in full force and effect. disabilities,and prohibit discrimination against all individuals based on their race,color,religion,sex,sexual orientation,gender identity or national origin. 17.5. Assignment&Successors.Neither party may assign, subcontract,delegate or otherwise transfer this Agreement or any of its rights or obligations hereunder,nor may it 15.4. Excluded Parties List.ESO agrees to immediately report to Customer if an employee or contractor is listed by a federal hereunderceuact withexcept td partiestto perform any oAgfre obligations ment, agency as debarred,excluded or otherwise ineligible for wihotthothas party's prior written in this consent. Except participation in federally funded health care programs. without partyy may, phot rio�c n so the er that either may,without the prior consent of other, assign all its rights under this Agreement to(i)a purchaser 16. PHI ACCURACY&COMPLETENESS of all or substantially all assets related to this Agreement,or (ii)a third party participating in a merger,acquisition,sale 16.1. ESO provides the Software to allow Customer(and its of assets or other corporate reorganization in which either respective Users)to enter,document,and disclose party is participating(collectively,a"Change in Control"); Customer Data,and as such,ESO gives no representations provided however,that the non-assigning party is given or guaranteesabout the accuracy or completeness of notice of the Change in Control. Customer Data(including PHI)entered,uploaded or disclosed through the Software. 17.6. Modifications and Amendments.This Agreement may not be amended except through a written agreement signed by 16.2. Customer is solely responsible for any decisions or actions authorized representatives of each party. taken involving patient care or patient care management, 17.7. Force Maieure.No delay,failure,or default,other than a brought exclusively in the state or federal courts located in failure to pay Fees when due,will constitute a breach of this • the county where Customer is located. Agreement to the extent caused by acts of war,terrorism, hurricanes,earthquakes,other acts of God or of nature, 17.14. Bench Trial.The parties agree to waive,to the maximum strikes or other labor disputes,riots or other acts of civil extent permitted by law,any right to a jury trial with respect disorder,embargoes,or other causes beyond the performing to any Dispute. party's reasonable control(collectively,"Force Majeure"). In such event,however,the delayed party must promptly provide the other party notice of the Force Majeure.The 17.15. No Class Actions.NEITHER PARTY SHALL BE delayed party's time for performance will be excused for ENTITLED TO JOIN OR CONSOLIDATE CLAIMS BY the duration of the Force Majeure,but if the event last OR AGAINST THE OTHER CUSTOMERS,OR PURSUE longer than thirty(30)days,the other party may ANY CLAIM AS A REPRESENTATIVE OR CLASS immediately terminate the applicable Software Schedule. ACTION OR IN A PRIVATE ATTORNEY GENERAL CAPACITY. 17.8. Marketing.Customer hereby grants ESO a license to include Customer's primary logo in any customer list or 17.16. Limitation Period.NEITHER PARTY,shall be liable for press release announcing this Agreement;provided ESO any claim brought more than 2 years after the cause of first submits each such press release or customer list to action for such claim first arose. Customer and receives written approval,which approval shall not be unreasonably withheld.Goodwill associated 17.17. Dispute Resolution.Customer and ESO will attempt to with the logo inures solely to Customer,and ESO shall take resolve any Dispute through negotiation or by utilizing a no action to damage the goodwill associated with the logo mediator agreed to by the parties,rather than through or with Customer. litigation.Negotiations and mediations will be treated as confidential.If the parties are unable to reach a resolution 17.9. Waiver&Breach.Neither party will be deemed to have within thirty(30)days of notice of the Dispute to the other waived any of its rights under this Agreement unless it is an party,the parties may pursue all other courses of action - explicit written waiver made by an authorized available at law or in equity. representative.No waiver of a breach of this Agreement will constitute a waiver of any other breach of this 17.18. Technology Export.Customer shall not:(a)permit any third Agreement. party to access or use the Software in violation of any U.S. law or regulation;or(b)export any software provided by 17.10. Survival of Terms.Unless otherwise stated,all of ESO's ESO or otherwise remove it from the United States except in compliance with all applicable U.S.laws and regulations. and Customer's respective obligations,representations and Without limiting the generality of the foregoing,Customer warranties under this Agreement which are not,by the expressed terms of this Agreement,fully to be performed shall not permit any third party to access or use the while this Agreement is in effect shall survive the Software in,or export such software to,a country subject to termination of this Agreement. a United States embargo(as of the Effective Date-Cuba, Iran,North Korea,Sudan,and Syria). 17.11. Ambiguous Terms.This Agreement will not be construed against any party by reason of its preparation. 17.19. Order of Precedence.In the event of any conflict between this Agreement,Addenda or other attachments incorporated herein,the following order of precedence will govern:(1) 17.12. Governing Law.This Agreement,any related Addenda,and the General Terms and Conditions;(2)any Business any CLAIM,DISPUTE,OR CONTROVERSY Associate Agreement;(3)the applicable Software Schedule (WHETHER IN CONTRACT,TORT,OR OTHERWISE, or SOW,with most recent Software Schedule or SOW INCLUDING STATUTORY,CONSUMER taking precedence over earlier ones;and(3)any ESO policy PROTECTION,COMMON LAW,INTENTIONAL TORT posted online,including without limitation its privacy AND EQUITABLE CLAIMS)BETWEEN CUSTOMER policy.No amendments incorporated into this Agreement AND ESO,including their affiliates,contractors,and after execution of the General Terms and Conditions will agents,and each of their respective employees,directors, amend such General Terns and Conditions unless it and officers(a"Dispute")will be governed by the laws of specifically states its intent to do so and cites the section or the State of Texas,without regard to conflicts of law. sections amended. Notwithstanding the foregoing,in the event Customer is a U.S.city,county,municipality or other U.S.governmental entity,then any Dispute will be governed by the law of state 17.20. Counterparts.This Agreement may be executed in one or where Customer is located,without regard to its conflicts of more counterparts.Each counterpart will be an original,and law.The UN Convention for the International Sale of all such counterparts will constitute a single instrument. Goods and the Uniform Computer Information Transactions Act will not apply.In any Dispute,each party will bear its 17.21. Signatures.Electronic signatures on this Agreement or on own attorneys'fees and costs and expressly waives any any Addendum(or copies of signatures sent via electronic statutory right to attorneys'fees under§38.001 of the means)are the equivalent of handwritten signatures. Texas Civil Practices and Remedies Code. 17.13. Venue.The parties agree that any Dispute shall be brought exclusively in the state or federal courts located in Travis County,Texas.The parties agree to submit to the personal jurisdiction of such courts.Notwithstanding the foregoing, in the event Customer is a U.S.city,county,municipality or other U.S.governmental entity,then any Dispute shall be 38 IN WITNESS WHEREOF,the parties have executed this Agreement as of the Effective D. e. • [Signature] [Signatlij ] 1 { Chris I7i11ie J I k rAt e S [Printed Name] [Printed Name] CEO&President s c.4-N``5e [Title] [Tide] APPROVED AS TO FORM&LANGUAGE &FOR EXECUTION . i rtAiDisA' t)..- ( -i City Attorney 67Data ATTEST: .721 Rafael E. Granado,.City Clerk q ••=1:24�B „�.'S'•'•S� INCORPiORATEDI s • • • EXHIBIT A-1 • SAAS SOFTWARE SCHEDULE (Applications-ESO EHR.ESO Fire,ESO PM) 1. The General Terms&Conditions are incorporated herein by reference.The SaaS subscription term shall begin fifteen(1 S)calendar days after the Effective Date("SaaS Subscription Start Date").Customer shall be deemed to have accepted the SaaS on the SaaS Subscription Start Date.The parties will make reasonable efforts to ensure that Customer is live on the SaaS as quickly as possible,and in no event will the SaaS Subscription Start Date be modified for implementation delays. 2. The following SaaS may be ordered under this Exhibit: 2.1. ESO Electronic Health Record("EHR")is a SaaS software application for prehospital patient documentation (http://www.esosolutions.comlsoftwardehr). 2.2. ESO Personnel Management("PM")is'a SaaS software application for tracking personnel records,training courses and education history(http://www.esosolutions.com/softwarepersonnel-manazement). 2.3. ESO Fire is a SaaS software application for NFIRS reporting(http:!/www.esosolutions.com/software/tire). 3. Third-Party Payer is responsible for the following products and Fees: • • • • • QroducL Fume FroduDescngtia i , + Total E'rscel ' - -' }. r:fl-.� ....,.�.-,rr ..,. _:x _4'.� � k t ..z•17, Rate'-:',n .. A:11=0=ft EHR Suite wI QM&Mobile Includes Quality Ma agement Ad Hoc Reports,Analytes,Patient 18000/Calls 525,220.00 Tracker.Allows for unlimited users,unlimited mobile applications,live support,state and federal data reporting,ongoing weekly web training, software updates and upgrades. Fee Type:Recurring EHR Suite w/QM&Mobile ($3,287.70) Discount Fee Type:Recurring CAD Integration Allows for integration of CAD data into EHR mobile and web 18000/incidents $2,995.00 application-Ongoing maintenance included.Additional fees from your CAD vendor may apply. Fee Type:Recurring CAD Integration Discount (S 389.35) Fee Type:Recurring - Cardiac Monitor Unlimited cardiac monitors,allows for import of cardiac monitor data 18000/Incidents $1,295.00 via local or cloud integration.Ongoing maintenance included. Fee Type:Recurring Cardiac Monitor Discount ($168.35) Fee Type:Recurring EHR Billing Standard Allows for integration of discrete ePCR data into third-party billing 18000/Incidents S 795.00 Interface software.Ongoing maintenance included. Fee Type:Recurring EHR Billing Standard (S 795.00) Interface Discount Fee Type:Recurring EHR Training Daily Rate 3/Day $2,985.00 Fee Type:One-Time EHR Training Travel Costs One-lime fee-covers all travel costs associated with on-site training 1500/Travel Cost S1,500.00 option. Fee Type:One-Time HDE-ESO EHR Bi-directional connection for an ESO EHR customer for HOE 1/incidents $495.00 Connection - Fee Type:Recurring List Price: $35,355.00 Discounts: ($4,540.40) Tax: S0.00 Total: $30,714.60 4. Customer hereby agrees to timely pay for the following products according to the schedule below: N/A { 5. All the Fees above will be invoiced by ESO as follows: 5.1. Training and Training Travel Fees shall be invoiced on the Effective Date. 5,2. During the first year,100%of the recurring Fees shall be invoiced on the Subscription Start Date. 5.3. During the second year and any renewal years thereafter.100%of the Fees shall due on the anniversary of the SaaS Subscription Start Date. { 1 EXHIBIT B SUPPORT SERVICES ADDENDUM 1. DEFINITIONS.Capitalized terms not defined below shall have the same meaning as in the General Terms&Conditions. 1.1. "Enhancement"means a modification,addition or new release of the Software that when added to the Software,materially changes its utility,efficiency,functional capability or application. 1.2. "E-mail Support"means ability to make requests for technical support assistance by e-mail at any time concerning the use of the then- current release of Software. 1.3. "Error"means an error in the Software,which significantly degrades performance of such Software as compared to ESO's then- published Documentation. 1.4. "Error Correction"means the use of reasonable commercial efforts to correct Errors. 1.5. "Fix"means the repair or replacement of object code for the Software or Documentation to remedy an Error. 1.6. "Initial Response"means the first contact by a Support Representative after the incident has been logged and a ticket generated.This may include an automated email response depending on when the incident is first communicated. • 1.7. "Management Escalation"means,if the initial Workaround or Fix does not resolve the Error,notification of management that such Error(s)have been reported and of steps being taken to correct such Error(s). 1.8. "Severity 1 Error"means an Error which renders the Software completely inoperative(e.g.a User cannot access the Software due to unscheduled downtime or an Outage). 1.9. "Severity 2 Error"means an Error in which Software is still operable;however,one or more significant features or functionality are unavailable(e.g.a User cannot access a core component of the Software). 1.1. "Severity 3 Error"means any other error that does not prevent a User from accessing a significant feature of the Software(e.g.User is experiencing latency in reports). 1.2. "Severity 4 Error"means any error related to Documentation ora Customer Enhancement request. 1.3. "Status Update'means if the initial Workaround or Fix cannot resolve the Error,notification of the Customer regarding the progress of the Workaround or Fix. 1.4. "Online Support"means information available through ESO's website(www.esosolutions.com),including frequently asked questions and bug reporting via Live Chat. 1.5. "Support Representative"shall be ESO employee(s)or agent(s)designated to receive Error notifications from Customer,which Customer's Administrator has been unable to resolve. 1.6. "Update"means an update or revision to Software,typically for Error Correction. 1.7.',"Upgrade"means a new version or release of Software or a particular component of Software,which improves the functionality or which adds functional capabilities to the Software and is not included in an Update.Upgrades may include Enhancements. 1.8. "Workaround"means a change in the procedures followed or data supplied by Customer to avoid an Error without substantially impairing Customer's use of the Software. 2. SUPPORT SERVICES. 2.1. Customer will provide at least one administrative employee(the"Administrator"or"Administrators")who will handle all requests for first-level support from Customer's employees with respect to the Software.Such support is intended to be the"front line"for support and information about the Software to Customer's Users. ESO will provide training,documentation,and materials to the Administrator to enable the Administrator to provide technical support to Customer's Users.'The Administrator will notify a Support Representative of any Errors that the Administrator cannot resolve and assist ESO in information gathering. 2.2. ESO will provide Support Services consisting of(a)Error Correction(s);Enhancements,Updates and Upgrades that ESO,in its discretion,makes generally available to its customers without additional charge;and(c)E-mail Support,telephone support,and l , • Online Support.ESO may use multiple forms of communication for purposes of submitting periodic status reports to Customer, including but not limited to,messages in the Software,messages appearing upon login to the Software or other means of broadcasting Status Update(s)to multiple customers affected by the same Error,such as a customer portal. 2.3. ESO's support desk will be staffed with competent technical consultants who are trained in and thoroughly familiar with the Software and with Customer's applicable configuration.Telephone support and all communications will be delivered in intelligible English. 2.4. Nonnal business hours for ESO's support desk are Monday through Friday 7:00 am to 7:00 pm CT.Customer will receive a call back from a'Support Representative after-hours for a Severity 1 Error. 3. ERROR PRIORITY LEVELS.Customer will report all Errors to ESO via e-mail(support@esosolutions.coml or by telephone(866-766- 9471,option#3).ESO shall exercise commercially reasonable efforts to correct any Error reported by Customer in accordance with the priority level reasonably assigned to such Error by ESO. 3.1. Severity 1 Error.ESO shall(i)commence Error Correction promptly;(ii)provide an Initial Response within four hours;(iii)initiate Management Escalation promptly;and(iv)provide Customer with a Status Update within four hours if ESO cannot resolve the Error within four hours. 3.2. Severity 2 Error.ESO shall(i)commence Error Correction promptly;(ii)provide an Initial Response within eight hours;(iii)initiate Management Escalation within forty-eight hours if unresolved;and(iv)provide Customer with a Status Update within forty-eight hours if ESO cannot resolve the Error within forty-eight hours. 3.3. Severity 3 Error.ESO shall(i)commence Error Correction promptly;(ii)provide an Initial Response within three business days;and (iii)provide Customer with a Status Update within seven calendar days if ESO cannot resolve the Error within seven calendar days. • 3.4. Severity 4 Error.ESO shall(i)provide an Initial Response within seven calendar days. 4. CONSULTING SERVICES.If ESO reasonably believes that a problem reported by Customer is not due to an Error in the Software,ESO will so notify Customer.At that time,Customer may request ESO to proceed with a root cause analysis at Customer's expense as set forth herein or in a separate SOW.If ESO agrees to perform the investigation on behalf of Customer,then ESO's then-current and standard consulting rates will apply for all work performed in connection with such analysis,plus reasonable related expenses incurred.For the avoidance of doubt,Consulting Services will include customized report writing by ESO on behalf of Customer. 5. EXCLUSIONS. • 5.1. ESO shall have no obligation to perform Error Corrections or otherwise provide support for:(i)Customer's repairs,maintenance or 'modifications to the Software(if permitted);(ii)Customer's misapplication or unauthorized use of the Software;(iii)altered or damaged Software not caused by ESO;(iv)any third-party software;(v)hardware issues;(vi)Customer's breach of the Agreement; and(vii)any other causes beyond the ESO's reasonable control. • 5.2. ESO shall have no liability for any changes in Customer's hardware or software systems that may be necessary to use the Software due to a Workaround or Fix. 5.3. ESO is not responsible for any Error Correction unless ESO can replicate such Error on its own software and hardware or through remote access to Customer's software and hardware. 5.4. Customer is solely responsible for its selection of hardware,and ESO shall not be responsible the performance of such hardware even if ESO makes recommendations regarding the same. 6. MISCELLANEOUS.The parties acknowledge that from time-to-time ESO may update its support processes specifically addressed in this Exhibit and may do so by posting such updates to ESO's website or otherwise notifying Customer of such updates.Customer will accept updates to ESO's support procedures and any other terms in this Exhibit;provided however,that they do not materially decrease the level of Support Services that Customer will receive from ESO.THESE TERMS AND CONDITIONS DO NOT CONSTITUTE A PRODUCT WARRANTY.THIS EXHIBIT IS AN ADDITIONAL PART OF THE AGREEMENT AND DOES NOT,CHANGE OR SUPERSEDE ANY TERM OF THE AGREEMENT EXCEPT TO THE EXTENT UNAMBIGUOUSLY CONTRARY THERETO. • • EXHIBIT C HIPAA BUSINESS ASSOCIATE ADDENDUM Customer and ESO Solutions,Inc.("Business Associate")agree that(1)this HIPAA Business Associate Addendum is entered into for the benefit of Customer,which is a covered entity under the Privacy Standards("Covered Entity"). - Pursuant to the Agreement,Business Associate may perform functions or activities involving the use and/or disclosure of PHI on behalf of the Covered Entity,and therefore,Business Associate may function as a business associate.Business Associate,therefore,agrees to the following terms and conditions set forth in this HIPAA Business Associate Addendum("Addendum"). 1. Scope. This Addendum applies to and is hereby automatically incorporated into all present and future agreements and relationships, whether written,oral or implied,between Covered Entity and Business Associate,pursuant to which PHI is created,maintained,received or transmitted by Business Associate from or on behalf of Covered Entity in any form or medium whatsoever. 2. Definitions.For purposes of this Addendum,the terms used herein,unless otherwise defined,shall have the same meanings as used in the Health Insurance Portability and Accountability Act of 1996("HIPAA"),or the Health Information Technology for Economic and Clinical Health Act("HITECH"),and any amendments or implementing regulations,(collectively"HIPAA Rules"). 3. Compliance with Applicable Law.The parties acknowledge and agree that,beginning with the relevant effective date,\Business Associate shall comply with its obligations under this Addendum and with all obligations of a business associate under HIPAA,HITECH,the HIPAA Rules,and other applicable laws and regulations,as they exist at the time this Addendum is executed and as they are amended,for so long as this Addendum is in place. 4. Permissible Use and Disclosure of PHI.Business Associate may use and disclose PHI as necessary to carry out its duties to a Covered Entity pursuant to the terms of the Agreement and as required by law.Business Associate may also use and disclose PHI(i)for its own proper management and administration,and(ii)to carry out its legal responsibilities.If Business Associate discloses Protected Health Information to a third party for either above reason,prior to making any such disclosure,Business Associate must obtain:(i)reasonable assurances from the receiving party that such PHI will be held confidential and be disclosed only as required by law or for the purposes for • which it was disclosed to such receiving party;and(ii)an agreement from such receiving party to immediately notify Business Associate of any known breaches of the confidentiality of the PHI. 5. Limitations on Use and Disclosure of PHI.Business Associate shall not,and shall ensure that its directors,officers,employees, subcontractors,and agents do not,use or disclose PHI in any manner that is not permitted by the Agreement or that would violate Subpart E of 45 C.F.R. 164("Privacy Rule")if done by a Covered Entity.MI uses and disclosures of,and requests by,Business Associate for PHI are subject to the minimum necessary rule of the Privacy Rule. 6. • Required Safeguards to Protect PHI.Business Associate shall use appropriate safeguards,and comply with Subpart C of 45 C.F.R.Part 164 ("Security Rule")with respect to electronic PHI,to prevent the use or disclosure of PHI other than pursuant to the terms and conditions of this Addendum. 7. Reporting to Covered Entity.Business Associate shall report to the affected Covered Entity without unreasonable delay:(a)any use or disclosure of PHI not provided for by the Agreement of which it becomes aware;(b)any breach of unsecured PHI in accordance with 45 C.F.R.Subpart D of 45 C.F.R.164("Breach Notification Rule");and(c)any security incident of which it becomes aware. With regard to Security Incidents caused by or occurring to Business Associate,Business Associate shall cooperate with the Covered Entity's investigation, analysis,notification and mitigation activities,and except for Security Incidents caused by Covered Entity,shall be responsible for reasonable costs incurred by the Covered Entity for those activities.Notwithstanding the foregoing,Covered Entity acknowledges and shall be deemed to have received advanced notice from Business Associate that there are routine occurrences of:(i)unsuccessful attempts to penetrate computer networks or services maintained by Business Associate;and(ii)immaterial incidents such as"pinging"or"denial of services"attacks. 8. Mitigation of Harmful Effects.Business Associate agrees to mitigate,to the extent practicable,any harmful-effect of a use or disclosure of PHI by Business Associate in violation of the requirements of the Agreement,including,but not limited to,compliance with any state law or contractual data breach requirements. 9. Agreements by Third Parties.Business Associate shall enter into an agreement with any subcontractor of Business Associate that creates, receives,maintains or transmits PHI on behalf of Business Associate.Pursuant to such agreement,the subcontractor shall agree to be bound by the same or greater restrictions,conditions,and requirements that apply to Business Associate under this Addendum with respect to such PHI. 10. Access to PHI.Within five(5)business days of a request by a Covered Entity for access to PHI about an individual contained in a Designated Record Set,Business Associate shall make available to the Covered Entity such PHI for so long as such information is maintained by Business Associate in the Designated Record Set,as required by 45 C.F.R. 164.524.In the event any individual delivers directly to Business Associate a request for access to PHI,Business Associate shall within five(5)•business days forward such request to the Covered Entity. - 11. Amendment of PHI.Within five(5)business days of receipt of a request from a Covered Entity for the amendment of an individual's PHI or a record regarding an individual contained in a Designated Record Set(for so long as the PHI is maintained in the Designated Record Set), Business Associate shall provide such information to the Covered Entity for amendment and incorporate any such amendments in the PHI as required by 45 C.F.R.164.526.In the event any individual delivers directly to Business Associate a request for amendment to PHI, Business Associate shall within five(5)business days forward such request to the Covered Entity. 12. Documentation of Disclosures.Business Associate agrees to document disclosures of PHI and information related to such disclosures as would be required for a Covered Entity to respond to a request by an individual for an accounting of disclosures of PHI in accordance with 45 C.F.R.164.528 and HITECH. 13. Accounting of Disclosures.Within five(5)business days of notice by a Covered Entity to Business Associate that it has received a request for an accounting of disclosures of PHI,Business Associate shall make available to a Covered Entity information to permit the Covered Entity to respond to the request for an accounting of disclosures of PHI,as required by 45 C.F.R.164.528 and HITECH. 14. Other Obligations.To the extent that Business Associate is to carry out one or more of a Covered Entity's obligations under the Privacy Rule,Business Associate shall comply with such requirements that apply to the Covered Entity in the performance of such obligations. 15. Judicial and Administrative Proceedings.In the event Business Associate receives a subpoena,court or administrative order or other discovery request or mandate for release of PHI,the affected Covered Entity shall have the right to control Business Associate's response to such request,provided that,such control does not have an adverse impact on Business Associate's compliance with existing laws.Business Associate shall notify the Covered Entity of the request as soon as reasonably practicable,but in any event within seven(7)business days of receipt of such request. • 16. Availability of Books and Records.Business Associate hereby agrees to make its internal practices,books,and records available to the Secretary of the Department of Health and Human Services for purposes of determining compliance with the HIPAA Rules. 17. Breach of Contract by Business Associate.In addition to any other rights a party may have in the Agreement,this Addendum or by operation of law or in equity,either party may:i)immediately terminate the Agreement if the other party has violated a material term of this Addendum;or ii)at the non-breaching party's option,permit the breaching party to cure or end any such violation within the time specified by the non-breaching party.The non-breaching party's option to have cured a breach of this Addendum shall not be construed as a waiver of any other rights the non-breaching party has in the Agreement,this Addendum or by operation of law or in equity. 18. Effect of Termination of Agreement.Upon the termination of the Agreement or this Addendum for any reason,Business Associate shall return to a Covered Entity or,at the Covered Entity's direction,destroy all PHI received from the Covered Entity that Business Associate maintains in any form,recorded on any medium,or stored in any storage system.This provision shall apply to PHI that is in the possession of Business Associate,subcontractors,and agents of Business Associate.Business Associate shall retain no copies of the PHI.Business Associate shall remain bound by the provisions of this Addendum,even after termination of the Agreement or Addendum,until such time as all PHI has been returned or otherwise destroyed as provided in this Section.For the avoidance of doubt,de-identified Customer Data shall not be subject to this provision. 2 19. Injunctive Relief.Business Associate stipulates that its unauthorized use or disclosure of PHI while performing services pursuant to this Addendum would cause irreparable harm to a Covered Entity,and in such event,the Covered Entity shall be entitled to institute proceedings in any court of competent jurisdiction to obtain damages and injunctive relief. 20. Owner of PHI.Under no circumstances shall Business Associate be deemed in any respect to be the owner of any PHI created or received by Business Associate on behalf of a Covered Entity. 21. Data Usage Provision.Business Associate may aggregate and de-identify PHI andior create limited data sets for use in research,evaluation and for publication or presentation of patient care quality improvement practices and outcomes.The Parties understand and agree that such aggregated and de-identified data is no longer PHI subject to the provisions of HIPAA and agree that Business Associate may retain such limited data sets indefinitely thereafter.Business Associate agrees that it will comply with all terms of this Agreement with respect to the limited data sets and that it shall not re-identify or attempt to re-identify the information contained in the limited data set,nor contact any of the individuals whose information is contained in the limited data set. 22. Safeguards and Appropriate Use of Protected Health Information.Covered Entity is responsible for implementing appropriate privacy and security safeguards to protect its PHI in compliance with HIPAA.Without limitation,it is Covered Entity's obligation to: 22.1.Not include PHI in information Covered Entity submits to technical support personnel through a technical support request or to community support forums.In addition,Business Associate does not act as,or have the obligations of a Business Associate under the HIPAA Rules with respect to Customer Data once it is sent to or from Covered Entity outside ESO's Software over the public - Internet;and • 22.2.Implement privacy and security safeguards in the systems,applications,and software Covered Entity controls,configures and connects to ESO's Software. • • i EXHIBIT A-1 SAAS SOFTWARE SCHEDULE (Applications-ESO ERR ESO Fire,ESO PM) 1. The General Terms&Conditions are incorporated herein by reference.The SaaS subscription term shall begin fifteen(15)calendar days after the Effective Date("SaaS Subscription Start Date").Customer shall be deemed to have accepted the SaaS on the SaaS Subscription Start Date.The parties will make reasonable efforts to ensure that Customer is live on the SaaS as quickly as possible,and in no event will the SaaS Subscription Start Date be modified for implementation delays. ( , 2. The following SaaS may be ordered under this Exhibit: _ 2.1. ESO Electronic Health Record("EHR")is a SaaS software application for prehospital patient documentation (http://www.esosolutions.comisoftwareiehr). 2.2. ESO Personnel Management("PM")is a SaaS software application for tracking personnel records,training courses and education history(http:/./w\vw.esosolutions.comisoftware/personnel-management). 2.3. ESO Fire is a SaaS software application for NFIRS reporting(http://www.esosoliitions.com/software/tire). 3. Third-Party Payer is responsible for the following products and Fees: , i-- • c • 0i-,4i4i4ri ti ..- product .. A!,,...:',.. Toal Pry/:; . 'Totaasks.,•;z:.-:.-. EHR EHR Suite wl QM&Mobile Includes Quaky Management,Ad Hoc Reports.Anatytrcs,Patient 18000/Calls 525290.00 Tracker.Allows for unlimited users,unlimited mobile applications,live support,state and federal data reporting,ongoing weekly web training, software updates and upgrades. Fee Type:Recurring EHR Suite w/QM&Mobile ($3,287.70) Discount Fee Type:Recurring CAD Integration Allows for integration of CAD data into EHR mobile and web 18000/Incidents $2,995.00 application.Ongoing maintenance included.Additional fees from your CAD vendor may apply. Fee Type:Recurring CAD Integration Discount ($389.35) Fee Type:Recurring Cardiac Monitor Unlimited cardiac monitors,allows for import of cardiac monitor data 18000/Incidents $1295.00 via local or cloud integration.Ongoing maintenance included. Fee Type:Recurring Cardiac Monitor Discount (5168.35) Fee Type:Recurring EHR Billing Standard Allows for Integration of discrete ePCR data into third-party billing 18000/Incidents S 795.00 Interface software.Ongoing maintenance included. Fee Type:Recurring EHR Billing Standard / ($795.00) Interface Discount Fee Type:Recurring EHR Training Daily Rate 3/Day $2,985.00 Fee Type:‘One-Time EHR Training Travel Costs One-time fee-covers all travel costs associated with on-site training 1500/Travel Cost S1,500.00 option. Fee Type:One-Time HDE-ESO EHR Bi-directional connection for an ESO EHR customer for HDE 1/Incidents $495.00 Connection Fee Type:Recurring List Price: $35,355.00 Discounts: ($4:640.40) Tax: $0.00 - Total: $30,714.60 4. . Customer hereby agrees to timely pay for the following products according to the schedule below: N/A 5. All the Fees above will be invoiced by ESO as follows: 5.1. Training and Training Travel Fees shall be invoiced on the Effective Date. 5.2. During the first year,100%of the recurring Fees shall be invoiced on the Subscription Start Date. 5.3. During the second year and any renewal years thereafter,100%of the Fees shall due on the anniversary of the SaaS Subscription Start Date. EXHIBIT B SUPPORT SERVICES ADDENDUM 1. DEFINITIONS.Capitalized terms not defined below shall have the same meaning as in the General Terms&Conditions. 1.1. "Enhancement"means a modification,addition or new release of the Software that when added to the Software,materially changes its utility,efficiency,functional capability or application. 1.2. "E-mail Support"means ability to make requests for technical support assistance by e-mail at any time concerning the use of the then- current release of Software. 13. "Error"means an error in the Software,which significantly degrades performance of such Software as compared to ESO's then- published Documentation. 1.4. "Error Correction"means the use of reasonable commercial efforts to correct Errors. I.5. "Fix"means the repair or replacement of object code for the Software or Documentation to remedy an Error. 1.6. "Initial Response"means the first contact by a Support Representative after the incident has been logged and a ticket generated.This may include an automated email response depending on when the incident is first communicated. . 1.7. "Management Escalation"means,if the initial Workaround or Fix does not resolve the Error,notification of management that such Enor(s)have been reported and of steps being taken to correct such Error(s). 1.8. "Severity 1 Error"means an Error which renders the Software completely inoperative(e.g.a User cannot access the Software due to unscheduled downtime or an Outage). 1.9. "Severity 2 Error"means an Error in which Software is still operable;however,one or more significant features or functionality are unavailable(e.g.a User cannot access a core component of the Software). 1.L. "Severity 3 Error"means any other error that does not prevent a User from accessing a significant feature of the Software(e.g.User is experiencing latency in reports). 12. "Severity 4 Error"means any error related to Documentation or a Customer Enhancement request. 1.3. "Status Update"means if the initial Workaround or Fix cannot resolve the Error,notification of the Customer regarding the progress of the Workaround or Fix. 1.4. "Online Support"means information available through ESO's website(www.esosolutions.com),including frequently asked questions and bug reporting via Live Chat. 1.5. "Support Representative"shall be ESO employee(s)or agent(s)designated to receive Error notifications from Customer,which Customer's Administrator has been unable to resolve. 1.6. "Update"means an update or revision to Software,typically for Error Correction. 1.7. "Upgrade"means a new version or release of Software or a particular component of Software,which improves the functionality or which adds functional capabilities to the Software and is not included in an Update.Upgrades may include Enhancements. 1.8. "Workaround"means a change in the procedures followed or data supplied by Customer to avoid an Error without substantially impairing Customer's use of the Software. 2. SUPPORT SERVICES. 2.1. Customer will provide at least one administrative employee(the"Administrator"or"Administrators")who will handle all requests for first-level support from Customer's employees with respect to the Software.Such support is intended to be the"front line"for support and information about the Softwarelto Customer's Users. ESO will provide training,documentation,and materials to the Administrator to enable the Administrator to provide technical support to Customer's Users. The Administrator will notify a Support Representative of any Errors that the Administrator cannot resolve and assist ESO in information gathering. 2.2. ESO will provide Support Services consisting of(a)Error Correction(s);Enhancements,Updates and Upgrades that ESO,in its discretion,makes generally available to its customers without additional charge;and(c)E-mail Support,telephone support,and Online Support.ESO may use multiple forms of communication for purposes of submitting periodic status reports to Customer, including but not limited to,messages in the Software,messages appearing upon login to the Software or other means of broadcasting Status Update(s)to multiple customers affected by the same Error,such as a customer portal., - 2.3. ESO's support desk will be staffed with competent technical consultants who are trained in and thoroughly familiar with the Software and with Customer's applicable configuration.Telephone support and all communications will be delivered in intelligible English. 2.4. Normal business hours for ESO's support desk are Monday through Friday 7:00 ant to 7:00 pm CT.Customer will receive a call back from a Support Representative after-hours for a Severity 1 Error. 3. ERROR PRIORITY LEVELS.Customer will report all Errors to ESO via e-mail(supnort(uesosolutions.com)or by telephone(866-766- 9471,option#3).ESO shall exercise commercially reasonable efforts to correct any Error reported by Customer in accordance with the priority level reasonably assigned to such Error by ESO. 3.1. Severity I Error.ESO shall(i)commence Error Correction promptly;(ii)provide an Initial Response within four hours;(iii)initiate Management Escalation promptly;and(iv)provide Customer with a Status Update within four hours if ESO cannot resolve the Error within four hours. 3.2. Severity 2.Error.ESO shall(i)commence Error Correction promptly;(ii)provide an Initial Response within eight hours;(iii)initiate Management Escalation within forty-eight hours if unresolved;and(iv)provide Customer with a Status Update within forty-eight hours if ESO cannot resolve the Error within forty-eight hours. 3.3. Severity 3 Error.ESO shall(i)commence Error Correction promptly;(ii)provide an Initial Response within three business days;and (iii)provide Customer with a Status Update within seven calendar days if ESO cannot resolve the Error within seven calendar days. 3.4. Severity 4 Error.ESO shall(i)provide an Initial Response within seven calendar days. 4. CONSULTING SERVICES.If ESO reasonably believes that a problem reported by Customer is not due to an Error in the Software,ESO will so notify Customer.At that time,Customer may request ESO to proceed with a root cause analysis at Customer's expense as set forth herein or in a separate SOW.If ESO agrees to perform the investigation on behalf of Customer,then ESO's then-current and standard consulting rates will apply for all work performed in connection with such analysis,plus reasonable related expenses incurred.For the avoidance of doubt,Consulting Services will include customized report writing by ESO on behalf of Customer. 5. .EXCLUSIONS. • 5.1. ESO shall have no obligation to perform Error Corrections or otherwise provide support for:(i)Customer's repairs,maintenance or modifications to the Software(if permitted);(ii)Customer's misapplication or unauthorized use of the Software;(iii)altered or damaged Software not caused by ESO;(iv)any third-party software;(v)hardware issues;(vi)Customer's breach of the Agreement; and(vii)any other causes beyond the ESO's reasonable control. • 5.2. ESO shall have no liability for any changes in Customer's hardware or software systems that may be necessary to use the Software due to a Workaround or Fix. 5.3. ESO is not responsible for any Error Correction unless ESO can replicate such Error on its own software and hardware or through remote access to Customer's software and hardware. '5.4. Customer is solely responsible for its selection of hardware,and ESO,shall not be responsible the performance of such hardware even if ESO makes recommendations regarding the same. 6. MISCELLANEOUS.The parties acknowledge that from time-to-time ESO may update its support processes specifically addressed in this Exhibit and may do so by posting such updates to ESO's website or otherwise notifying Customer of such updates.Customer will accept updates to ESO's support procedures and any other terms in this Exhibit;provided however,that they do not materially decrease the level of Support Services that Customer will receive from ESO.THESE TERMS AND CONDITIONS DO NOT CONSTITUTE A PRODUCT WARRANTY.THIS EXHIBIT IS AN ADDITIONAL PART OF THE AGREEMENT AND DOES NOT CHANGE OR SUPERSEDE ANY TERM OF THE AGREEMENT EXCEPT TO THE EXTENT UNAMBIGUOUSLY CONTRARY THERETO. • • EXHIBIT C HIPAA BUSINESS ASSOCIATE ADDENDUM Customer and ESO Solutions,Inc.("Business Associate")agree that(1)this HIPAA Business Associate Addendum is entered into for the benefit of Customer,which is a covered entity under the Privacy Standards("Covered Entity"). Pursuant to the Agreement,Business Associate may perform functions or activities involving the use and/or disclosure of PHI on behalf of the Covered Entity,and therefore,Business Associate may function as a business associate.Business Associate,therefore,agrees to the following terms and conditions set forth in this HIPAA Business Associate Addendum("Addendum"). 1. Scope. This Addendum applies to and is hereby automatically incorporated into all present and future agreements and relationships, whether written,oral or implied,between Covered Entity and Business Associate,pursuant to which PHI is created,maintained,received or transmitted by Business Associate from or on behalf of Covered Entity in any form or medium whatsoever. 2. Definitions.For purposes of this Addendum,the terms used herein,unless otherwise defined,shall have the same meanings as used in the Health Insurance Portability and Accountability Act of 1996("HIPAA"),or the Health Information Technology for Economic and Clinical Health Act("HITECH"),and any amendments or implementing regulations,(collectively"HIPAA Rules"). 3. Compliance with Applicable Law.The parties acknowledge and agree that,beginning with the relevant effective date,Business Associate shall comply with its obligations under this Addendum and with all obligations of a business associate under HIPAA,HITECH,the HIPAA Rules,and other applicable laws and regulations,as they exist at the time this Addendum is executed and as they are amended,for so long as this Addendum is in place. 4. Permissible Use and Disclosure of PHI.Business Associate may use and disclose PHI as necessary to carry out its duties to a Covered Entity pursuant to the terms of the Agreement and as required by law.Business Associate may also use and disclose PHI(i)for its own proper management and administration,and(ii)to carry out its legal.responsibilities.If Business Associate discloses Protected Health Information to a third party for either above reason,prior to making any such disclosure,Business Associate must obtain:(i)reasonable assurances from the receiving party that such PHI will be held confidential and be disclosed only as required by law or for the purposes for which it was disclosed to such receiving party;and(ii)an agreement from such receiving party to immediately notify Business Associate of any known breaches of the confidentiality of the PHI. 5. Limitations on Use and Disclosure of PHI.Business Associate shall not,and shall ensure that its directors,officers,employees, subcontractors,and agents do not,use or disclose PHI in any manner that is not permitted by the Agreement or that would violate Subpart E of 45 C.F.R. 164("Privacy Rule")if done by a Covered Entity.All uses and disclosures of,and requests by,Business Associate for PHI are subject to the minimum necessary rule of the Privacy Rule. 6. Required Safeguards to Protect PHI.Business Associate shall use appropriate safeguards,and comply with Subpart C of 45 C.F.R.Part 164 ("Security Rule")with respect to electronic PHI,to prevent the use or disclosure of PHI other than pursuant to the terms and conditions of this Addendum. 7. Reporting to Covered Entity.Business Associate shall report to the affected Covered Entity without unreasonable delay:(a)any use or disclosure of PHI not provided for by the Agreement of which it becomes aware;(b)any breach of unsecured PHI in accordance with 45 C.F.R.Subpart D of 45 C.F.R.164("Breach Notification Rule");and(c)any security incident of which it becomes aware. With regard to Security Incidents caused by or occurring to Business Associate,Business Associate shall cooperate with the Covered Entity's investigation, analysis,notification and mitigation activities,and except for Security Incidents caused by Covered Entity,shall be responsible for reasonable costs incurred by the Covered Entity for those activities.Notwithstanding the foregoing,Covered Entity acknowledges and shall be deemed to have received advanced notice from Business Associate that there are routine occurrences of:(i)unsuccessful attempts to penetrate computer networks or services maintained by Business Associate;and(ii)immaterial incidents such as"pinging"or"denial of services"attacks. 8. Mitigation of Harmful Effects.Business Associate agrees to mitigate,to the extent practicable,any harmful effect of a use or disclosure of PHI by Business Associate in violation of the requirements of the Agreement,including,but not limited to,compliance with any state law or contractual data breach requirements. 9. Agreements by Third Parties.Business Associate shall enter into an agreement with any subcontractor of Business Associate that creates, receives,maintains or transmits PHI on behalf of Business Associate.Pursuant to such agreement,the subcontractor shall agree to be bound by the same or greater restrictions,conditions,and requirements that apply to Business Associate under this Addendum with respect to such PHI. 10. Access to PHI.Within five(5)business days of a request by a Covered Entity for access to PHI about an individual contained in a Designated Record Set,Business Associate shall make available to the Covered Entity such PHI for so long as such information is maintained by Business Associate in the Designated Record Set,as required by 45 C.F.R.164.524.In the event any individual delivers directly to Business Associate a request for access to PHI,Business Associate shall within five(5)business days forward such request to the Covered Entity. 1 11. Amendment of PHI.Within five(5)business days of receipt of a request from a Covered Entity for the amendment of an individual's PHI or a record regarding an individual contained in a Designated Record Set(for so long as the PHI is maintained in the Designated Record Set), Business Associate shall provide such information to the Covered Entity for amendment and incorporate any such amendments in the PHI as required by 45 C.F.R. 164.526.In the event any individual delivers directly to Business Associate a request for amendment to PHI, Business Associate shall within five(5)business days forward such request to the Covered Entity. l2. Documentation of Disclosures.Business Associate agrees to document disclosures of PHI and information related to such disclosures as would be required for a Covered Entity to respond to a request by an individual for an accounting of disclosures of PHI in accordance with 45 C.F.R.164.528 and HITECH. 13. Accounting of Disclosures.Within five(5)business days of notice by a Covered Entity to Business Associate that it has received a request for an accounting of disclosures of PHI,Business Associate shall make available to a Covered Entity information to permit the Covered Entity to respond to the request for an accounting of disclosures of PHI,as required by-45 C.F.R.164.528 and HITECH. 14. Other Obligations.To the extent that Business Associate is to carry out one or more of a Covered Entity's obligations under the Privacy Rule,Business Associate shall comply with such requirements that apply to the Covered Entity in the performance of such obligations. 15. Judicial and Administrative Proceedings.In the event Business Associate receives a subpoena,court or administrative order or other discovery request or mandate for release of PHI,the affected Covered Entity shall have the right to control Business Associate's response to such request,provided that,such control does not have an adverse impact on Business Associate's compliance with existing laws.Business Associate shall notify the Covered Entity of the request as soon as reasonably practicable,but in any event within seven(7)business days of receipt of such request. 16. Availability of Books and Records.Business Associate hereby agrees to make its internal practices,books,and records available to the Secretary of the Department of Health and Human Services for purposes of determining compliance with the HIPAA Rules. 17. Breach of Contract by Business Associate.In addition to any other rights a party may have in the Agreement,this Addendum or by operation of law or in equity,either party may:i)immediately terminate the Agreement if the other party has violated a material term of this Addendum;or ii)at the non-breaching party's option,permit the breaching party to cure or end any such violation within the time specified by the non-breaching party.The non-breaching party's option to have cured a breach of this Addendum shall not be construed as a waiver of any other rights the non-breaching party ha's in the Agreement,this Addendum or by operation of law or in equity. 18. Effect of Termination of Agreement.Upon the termination of the Agreement or this Addendum for any reason,Business Associate shall return to a Covered Entity or,at the Covered Entity's direction,destroy all PHI received from the Covered Entity that Business Associate maintains in any form,recorded on any medium,or stored in any storage system.This provision shall apply to PHI that is in the possession of Business Associate,subcontractors,and agents of Business Associate.Business Associate shall retain no copies of the PHI.Business Associate shall remain bound by the provisions of this Addendum,even after termination of the Agreement or Addendum,until such time as all PHI has been returned or otherwise destroyed as provided in this Section.For the avoidance of doubt,de-identified Customer Data shall not be subject to this provision. 19. Injunctive Relief.Business Associate stipulates that its unauthorized use or disclosure of PHI while performing services pursuant to this Addendum would cause irreparable harm to a Covered Entity,and in such event,the Covered Entity shall be entitled to institute • proceedings in any court of competent jurisdiction to obtain damages and injunctive relief. 20. Owner of PHI.Under no circumstances shall Business Associate be deemed in any respect to be the owner of any PHI created or received by Business Associate on behalf of a Covered Entity. 21. Data Usage Provision.Business Associate may aggregate and de-identify PHI and/or create limited data sets for use in research,evaluation and for publication or presentation of patient care quality improvement practices and outcomes.The Parties understand and agree that such aggregated and de-identified data is no longer PHI subject to the provisions of HIPAA and agree that Business Associate may retain such limited data sets indefinitely thereafter.Business Associate agrees that it will comply with all terms of this Agreement with respect to the limited data sets and that it shall not re-identify or attempt to re-identify the information contained in the limited data set,nor contact any of the individuals whose information is contained in the limited data set. 22. Safeguards and Appropriate Use of Protected Health Information.Covered Entity is responsible for implementing appropriate privacy and security safeguards to protect its PHI in compliance with HIPAA.Without limitation,it is Covered Entity's obligation'to: 22.1.Not include PHI in information Covered Entity submits to technical support personnel through a technical support request or to community support forums.In addition,Business Associate does not act as,or have the obligations of a Business Associate under the HIPAA Rules with respect to Customer Data once it is sent to or from Covered Entity outside ESO's Software over the public Internet;and 22.2.Implement privacy and security safeguards in the systems,applications,and software Covered Entity controls,configures and connects to ESO's Software. • r ATTACHMENT A RESOLUTION COMMISSION ITEMS AND COMMISSION MEMORANDUM Resolutions-C7 AN MIAMI BEACH COMMISSION MEMORANDUM TO: Honorable Mayor and Members of the City Commission FROM: Jimmy.L. Morales, City Manager DATE: September 12, 2018 SUBJECT: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE RECOMMENDATION OF THE CITY MANAGER, PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO. 2017-002-JC, FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES. RECOMMENDATION Adopt the Resolution. ANALYSIS Emergency medical transport billing and collection services are essential to the Administration's ability to provide the City's residents and visitors with comprehensive medical transport services, and with efficient, reliable billing and collection services thereafter. The services assists Fire Department staff in obtaining patient and insurance information for emergency medical transport services provided, verifying patient insurance and patient demographic information, filing claims and sending invoices to self-pay accounts,submitting claims to Medicare, Medicaid,insurance companies,processing third-party reimbursements,and providing specific management and financial reports on a monthly basis,as specified by the City. Currently, Advanced Data Processing, Inc. (ADP), a subsidiary of Intermedix Corporation is providing emergency medical transport billing and collection services to the City. The agreement expires on September 30, 2018. On October 18, 2017, the City Manager recommended, as being in the City's best interest,the waiver of the formal competitive bidding requirements with respect to the procurement of emergency medical transport billing and collections services, and recommended that the City Commission authorize the Administration to enter into simultaneous negotiations with PST Services and ADP, the two service providers with the strongest local presence. PST Services, Inc., a subsidiary of McKesson Corporation, has over 25 years of EMS billing experience, including a strong presence in Florida, with an EMS client base generating approximately one million billable EMS transports annually.As such, PST Services is one of the largest EMS revenue recovery companies in America.As a subsidiary of McKesson Corporation, PST Services benefits from the global pharmaceutical and medical products technology network, medical supplies, distribution management, business services, financial capacity, and care management tools, strengthened by over 68,000 dedicated employees. Advanced Data Processing, Inc. (ADP), a subsidiary of Intermedix Corporation, the City's incumbent contractor, has been a leader in the EMS billing industry for 38 years.ADP processes more than 15 million patient encounters annually,collecting more than $3 billion in revenue for clients and connecting more than 95% of the United States population through emergency preparedness and response technologies. Of their 675 EMS billing operations personnel, approximately 250 are based in Florida.ADP has a Florida client base of 55 customers,representing over 60 municipalities and equaling nearly 900,000 billable accounts annually. On November 6, 2017, the Administration initiated the negotiations process with ADP and PST Services. Thereafter, on November 20,2017, the Fire Department determined,that in the City's best interests,a related field demonstration of Electronic Patient Care Reporting (ePCR) software system was required in order to proceed to the Best and Final Offer ("BAFO"). Electronic Patient Care Reporting (ePCR) software.is critical to the overall billing and collections solution. The awarded billing and collections contractor will partner with a single ePCR vendor to provide the City with the requirements of the RFP. Therefore, on December 19, 2017, the Fire Department received a software demonstration from vendors, ESO Solutions and ImageTrend software systems. The Fire Department further determined that additional hardware, including laptops, would be required to properly conduct the field testing portion of the proposed ePCR software. The Fire Department placed an order for several"Toughbook"laptops and related hardware on February 5, 2018. Soon thereafter, the device and hardware supplier advised the Fire Department of a three (3) month leadtime due to manufacturing issues internationally. The laptops and related hardware were delivered to the City on June 4,2018.Actual testing could not begin until these items were received by the City. The Fire Department beaan conducting a field testing oroaram utiliana the Touahbook laptops. loaded with ESO Solutions. Inc. and ImageTrend software systems, in various emergency vehicles citywide. On August 9, 2018, the Fire Department completed the field testing and recommended the preferred ePCR software vendor as ESO Solutions, Inc. On August 12,2018, the Fire Department advised both ADP and PST Services that ESO, Inc.is the preferred software,and requested that ADP and PST Services include the ESO Solutions, Inc. ePCR option in their Best and Final Offer("BAFO"). On August 24, 2018, the Fire Department requested both ADP and PST Services submit a BAFO with a proposal deadline established of August 28, 2018 by 3:00 PM EST. On August 28,2018 the City received a sealed BAFO from both ADP and PST Services. The Administration conducted its due diligence on the BAFOs received,which resulted in the following financial analysis: • ADP's BAFO Annual Cost to the City:$200,800 • PST's BAFO Annual Cost to the City:$273,570 • Annual Cost Difference Between ADP and PST:$72,770 • 3-Year Cost Difference Between ADP and PST:$218,310 Additionally, the ADP offer also includes the required eighteen (18) laptops for daily vehicle use, and fifteen (15) as-needed, special events laptops,at no additional cost to the City. Whereas,the offer submitted by PST would cost the City approximately $128,370 for annual hardware requirements. This alone is a significant, cost prohibitive consideration when comparing both offers. Notwithstanding the financial benefits that ADP's proposal represents over PST's,the Fire Department has determined the that following operational and logistics concerns also favor ADP over PST.These items are noted below: • Since ADP is the City's incumbent vendor for emergency medical transport billing and collection services, operations will remain seamless during the contract transition,without unwanted disruption to the City's EMS billing services. • PST did not offer direct personnel or facilities to manage and support required laptops,which demand routine maintenance and repair. • ADP offers a local storefront and plant accessibility, which will deliver a better, more reliable daily account support mechanism to the City's needs. • ADP has developed a long-term, and overall positive standing, with the Fire Department which is expected to continue in future contract years. Therefore, having taken all of the preceding items into careful consideration,on August 29, 2018, the Administration determined that ADP provides the best combination of services and cost benefit for emergency medical transport billing and collection services to the City of Miami Beach. CONCLUSION After reviewing best and final offers from both firms, and conducting a significant level of due diligence with regard to the field testing and software demonstration process, I concur with the Fire Department's recommendation to award a contract for emergency medical transport billing and collection services to ADP, a subsidiary of Intermedix Corporation. While the primary services and cost negotiations have been finalized, minor negotiations relative to the terms of the Agreement must still be completed. Therefore, I recommend that the Mayor and City Commission approve the award of a contract to Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation; and, authorize the City Manager and City Attorney to finalize the agreement with Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation; and, further authorizing the Mayor and City Clerk to execute the final negotiated agreement with Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation, upon approval of the City Manager and City Attorney; and, further, approve extension of the current month-to-month agreement with Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation, for a term not to exceed ninety (90) days, for the continuation of current services,or until such time as a new agreement is executed. KEY INTENDED OUTCOMES SUPPORTED Enhance Public Safety and Emergency Preparedness FINANCIAL INFORMATION Grant funding will not be utilized for this project. Legislative Tracking Fire Procurement ATTACHMENTS: Descri tion ❑ Attachment A-Draft Agreement 1 RESOLUTION NO. 2017-30034 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE WRITTEN RECOMMENDATION OF THE CITY MANAGER (AS FURTHER SET FORTH IN THE CITY COMMISSION MEMORANDUM ACCOMPANYING THIS RESOLUTION), AND WAIVING, BY 5/7THS VOTE, • THE FORMAL COMPETITIVE BIDDING REQUIREMENT, FINDING SUCH WAIVER TO BE IN THE CITY'S BEST INTEREST; AND, WITH RESPECT TO THE PROCUREMENT OF EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTIONS SERVICES, AUTHORIZING THE ADMINISTRATION TO ENTER INTO SIMULTANEOUS NEGOTIATIONS WITH ADVANCED DATA PROCESSING, INC., A SUBSIDIARY OF INTERMEDIX CORPORATION, AND PST SERVICES, INC., A SUBSIDIARY OF MCKESSON CORPORATION, RESPECTIVELY; AND FURTHER PROVIDING THAT FOLLOWING THE CONCLUSION OF NEGOTIATIONS BY THE ADMINISTRATION, THE FINAL SELECTION OF THE VENDOR AND AWARD OF THE CONTRACT SHALL BE SUBJECT TO THE PRIOR APPROVAL OF THE MAYOR AND CITY COMMISSION. WHEREAS, on January 11, 2017 the Mayor and City Commission approved the issuance of Request for Proposals (RFP) No. 2017-002-JC, for Emergency Medical Transport Billing and Collection Services; and WHEREAS, although the Evaluation Committee for the above-referenced RFP ranked PST Services, Inc., a subsidiary of McKesson Corporation ("PST Services"), and Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation ("ADP"), as the two top-ranked proposers, on July 26, 2017, the Mayor and City Commission rejected all proposals received, pursuant to Request for Proposals No. 2017-002-JC (the RFP), Emergency Medical Transport Billing and Collection Services; and WHEREAS, the Mayor and City Commission authorized the City Manager to negotiate and approve the terms of a month-to-month agreement with ADP, commencing on September 16, 2017, for a term not to exceed one (1) year, for the continuation of current services, or until such time as a new agreement is executed, whichever occurs first; and WHEREAS, as more fully set forth in the City Commission Memorandum accompanying this Resolution, the City Manager has recommended, as being in the City's best interest, the waiver of the formal competitive bidding requirements with respect to the procurement of emergency medical transport billing and collections services, and recommends that the City Commission authorize the Administration to enter into simultaneous negotiations with PST Services and ADP, based on each firm's industry experience, including strong Florida public sector agency experience, and each firm's local access to a dedicated team of Florida-based account representatives;and WHEREAS, at the conclusion of the simultaneous negotiations by the Administration, the final selection of the vendor, and award of the contract, shall be subject to the prior approval of the Mayor and City Commission. NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and City Commission hereby accept the written recommendation of the City Manager(as further set forth in the City Commission memorandum accompanying this resolution), and waive, by 5/7ths vote, the formal competitive bidding requirement, finding such waiver to be in the City's best interest; and, with respect to the procurement of emergency medical transport billing and collections services, authorize the Administration to enter into simultaneous negotiations with Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation, and PST Services, Inc., a subsidiary of McKesson Corporation, respectively; and further provide that following the conclusion of negotiations by the Administration, the final selection of the vendor and award of the contract shall be subject to the prior approval of the Mayor and City Commission. PASSED AND ADOPTED this (P day of D(XD /.V7 2017. ATTEST: J'. to l3 c RA AEL E. RANADO, CI EFS E C X �!PH IP LEV AYOR :\ jam;, c>-:.•'. APPROVED AS TO FORM&LANGUAGE • &FOR EXECUTION jt 4 City*amy it,Af. Date Resolutions - C7 G MIAMIBEACH . COMMISSION MEMORANDUM TO: Honorable Mayor and Members of the City Commission FROM: Jimmy L. Morales, City Manager DATE: October 18, 2017 SUBJECT A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE WRITTEN RECOMMENDATION OF THE CITY MANAGER (AS FURTHER SET FORTH IN THE CITY COMMISSION MEMORANDUM ACCOMPANYING THIS RESOLUTION), AND WAIVING, BY 5/7THS VOTE, THE FORMAL COMPETITIVE BIDDING REQUIREMENT, FINDING SUCH WAIVER TO BE IN THE CITY'S BEST INTEREST; AND, WITH RESPECT TO THE PROCUREMENT OF EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTIONS SERVICES, AUTHORIZING THE ADMINISTRATION TO ENTER INTO SIMULTANEOUS NEGOTIATIONS WITH ADVANCED DATA PROCESSING, INC.,A SUBSIDIARY OF INTERMEDIX CORPORATION,AND PST SERVICES, INC., A SUBSIDIARY OF MCKESSON CORPORATION, RESPECTIVELY; AND FURTHER PROVIDING THAT FOLLOWING THE CONCLUSION OF NEGOTIATIONS BY THE ADMINISTRATION, THE FINAL SELECTION OF THE VENDOR AND AWARD OF THE CONTRACT SHALL BE SUBJECT TO THE PRIOR APPROVAL OF THE MAYOR AND CITY COMMISSION. RECOMMENDATION Approve the Resolution. ANALYSIS Emergency medical transport billing and collection services are essential to the Administration's ability to provide the City's residents and visitors with comprehensive medical transport services, and with efficient, reliable billing and collection services thereafter. On January 11, 2017 the Mayor and City Commission approved the issuance of Request for Proposals (RFP) No. 2017-002-JC, for Emergency Medical Transport Billing and Collection Services. Subsequently, the Evaluation Committee convened, pursuant to the RFP, ranking PST Services, Inc., a subsidiary of McKesson Corporation ("PST Services"), and Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation ("ADP"), as the two top-ranked proposers. On July 26, 2017, the Mayor and City Commission approved Resolution No. 2017-29914, rejecting all proposals received, pursuant to the RFP, and simultaneously approved negotiating a month-to-month agreement, not to exceed one (1) year, with ADP,for the continuation of current services. The Administration was authorized, by way of Resolution No. 2017-29914, to refine the technical specifications, software requirements, and contract terms and conditions, in order to ensure the City's , Fire Department obtains the most advantageous billing and collection services, and• system implementation, without negatively impacting current or future patient care reporting, data analytics or revenue collections. Considering the time-sensitive and critical nature of the City's emergency Page 277 of 1633 medical billing and collection services, it is not in the City's best interest to re-bid the RFP. Instead, given the substantial market proficiency of both ADP and PST Services, who together represent over seventy (70) Florida public sector agencies, with over fifty (50) years of billing and collections industry experience, and combined with each firm's evaluation committee ranking, it is in the City's best interest to waive the competitive bidding requirement and enter into simultaneous negotiations with ADP and PST Services. CONCLUSION In evaluating the immediate needs of the City's Fire Department, I find it being in the City's best interest, the waiver of the formal competitive bidding requirements with respect to the procurement of emergency medical transport billing and collections services, and recommends that the City Commission authorize the Administration to enter into simultaneous negotiations with PST Services and ADP, based on each firm's industry experience, including strong Florida public sector agency experience, and each firm's local access to a dedicated team of Florida-based account representatives; and Therefore, the City Manager recommends that the Mayor and City Commission waive, by 5/7ths vote, the formal competitive bidding requirement, finding such waiver to be in the City's best interest; and, with respect to the procurement of emergency medical transport billing and collections services, authorize the Administration to enter into simultaneous negotiations with Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation, and PST Services, Inc., a subsidiary of McKesson Corporation, respectively; and further provide that following the conclusion of negotiations by the Administration, the final selection of the vendor and award of the contract shall be subject to the prior approval of the Mayor and City Commission. KEY INTENDED OUTCOMES SUPPORTED Enhance Public Safety and Emergency Preparedness FINANCIAL INFORMATION Grant funding will nbt be utilized for this project. Legislative Tracking ' Fire/Procurement ATTACHMENTS: Description ❑ Resolution , Page 278 of 1633 ATTACHMENT B INVITATION TO BID (RFP) AND ADDENDUMS IMI BEACH City of Miami Beach, 1755 Meridian Avenue, 3rd Floor, Miami Beach, Florida 33139,www.miamibeachfl.ciov PROCUREMENT DEPARTMENT Tel: 305-673-7490. • --- --- - - --- -ADDENDUM-NO:2- --- ------ RFP 2017-002-AK EMERGENCY MEDICAL TRANSPORTATION BILLING AND COLLECTION SERVICES February 24, 2017 This Addendum to the above-referenced RFP is Issued in response to questions from prospective proposers, or other clarifications and revisions issued by the City. The RFP is amended in the following particulars only(deletions are shown by strikethrough and additions are underlined). I. MODIFICATIONS: RFP DUE DATE AND TIME. The deadline for the receipt of proposals is extended until 3:00 p.m., on Wednesday, MARCH 8, 2017, at the following location: City of Miami Beach Procurement Department 1755 Meridian Avenue, 3rd Floor Miami Beach, Florida 33139 Late proposals will not be accepted. Proposers are cautioned to plan sufficient time to allow for traffic or other delays for which the Proposer is solely responsible. II. ANSWERS TO QUESTIONS RECEIVED VIA PublicPurchase. Q1: Does the City need a potential 4G LTE data signal (Verizon, AT&T, Sprint, Etc.) and GPS signal to follow the vehicle around or to also follow the device if/when it leaves the vehicle? Al: The City does not need a data signal or GPS signal to follow the vehicle. However, per item #1 of the Technical Specifications, on page 29 of the RFP, the mobile tablets and/or laptops are required to have cellular connectivity. _.._.-Q2: Does the__City envision- needing to boost-or arriplify_the 4G-_LTE.and/or,.G.PS.signals to external antennas on top of the vehicle to ensure a strong connection and up time? A2: No. Q3: Will the vendor be responsible for providing vehicle mounts for whichever hardware the City chooses? A3: The City does not have a need for vehicle mounts. Q4: Item 11 on page 29 of the RFP states: Establish a two-way data exchange system with billing hospitals with the ability to electronically transfer (e-Transfer) all ePCRs to the hospital and receive patient and related billing information back from the hospitals. This two-way exchange will increase the total cost significantly'of the ePCR software we are proposing. Would it be acceptable to obtain face sheets without the two-way data exchange system? How is the City currently receiving information/face sheets from the transporting hospitals? A4: Face sheets will not meet this requirement alone. The 2-way data exchange is needed and will be an interface between our ePCR software and the hospital ePCR software. The City currently does not have this capability, but seeks it by way of this RFP. This will provide a true 2-way data exchange where the City can receive clinical patient outcomes from hospital system. Q5: Can you please clarify thenumber of full time, spare and temporary laptops required by the City? - — A5:Pursuariit to the RFP-Technical-Specifications,item i,-Page 29-the CityTequires--- a total eighteen (18) rugged and mobile tablets and/or laptops, thirteen (13) of which will serve as primary devices, and five (5)will serve as spare devices. Q6: Will the City accept hardware pricing (Appendix E, Item 3) proposed as a percentage of net billing collections, rather than a dollar per unit cost? • A6: Please provide per unit pricing as requested in Appendix E, Item 3. Any questions regarding this Addendum should be submitted in writing to the Procurement Management • Department to the attention of the individual named below, with a copy to the City Clerk's Office at RafaelGranadona miamibeachfl.gov. • Procurement Contact: Telephone: Email: EE Jason Crouch 305-673-7000, ext. 6694 JasonCrouchr7a,miamibeachfl.gov Proposers are reminded to acknowledge receipt of this addendum as part of your RFP submission. Si erely, A- penis Pro.urement Director . . MIAMIBEACH 1 City of Miami Beach, 1755 Meridian Avenue, 3`d Floor, Miami Beach, Florida 33139,www.miamibeachfl.gov PROCUREMENT DEPARTMENT Tel: 305-673-7490. ADDENDUM NO. 1 REQUEST FOR PROPOSALS (RFP) 2017-002-JC EMS TRANSPORT BILLING AND COLLECTION SERVICES FEBRUARY 7, 2017 This Addendum to the above-referenced RFP is issued in response to questions from prospective proposers, or other clarifications and revisions issued by the City. I. ANSWERS TO QUESTIONS RECEIVED VIA EMAIL. Q1: Are you interested in different ePCR options; ESO, Imagetrend, emsCharts, Documed? If so,who is your preference? Al: There is no ePCR preference stated in the RFP. The Evaluation Committee will consider all proposed ePCR options as part of the RFP evaluation process. Q2: Will the vendor be financially responsible for the cost of your ePCR hardware? A2: Yes. Q3: Please provide the net charges for fiscal 2015. A3: $5,354,186 Q4: Please provide the total collections for 2015. A4: $2,302,239 Q5: Please provide the average revenue collected per transport for fiscal year 2015.. A5: $277 Q6: Please provide a breakdown of FY 2015 transports by primary payor for the following categories: a) Medicare; b) Medicaid; c)Commercial Insurance; d) Patient Pay A6: a)2,934 • b) 1,168 c) 1,604 d)2,612 Q7: Please provide the average loaded mileage per transport? A7: 3.24 average loaded miles per transport. 1 ADDENDUM NO.1 REQUEST FOR PROPOSALS(RFP)2017-002-JC EMS TRANSPORT BILLING AND COLLECTION SERVICES Q8: Please provide the number of transports for each call type for fiscal year 2015,for the following: a)ALS Emergency; b)ALS Non-Emergency; c) BLS Emergency; d) BLS Non-Emergency; e) ALS 2; f)SCT A8: a) 5,427 b)5 • • c) 2,791 d)4 e)91 f) 0 Q9: Please provide the current charges for each level of service below: a) ALS Emergency (A0427); b) ALS Non-Emergency (A0426); c) BLS Emergency (A0429); d) BLS Non-Emergency (A0428); e) ALS 2 (A0433); ' f) SCT (A0434); g) Mileage (A0425); h) Treatment No Transport.(A0998) A9: a) $800.00 b)$800.00 c)$800.00 d)$800.00 e)$800.00 f)N/A g)$15.00/mile h)N/A Q10: Please describe your current practice for managing Notice of Privacy Practice (NPP). Will the successful vendor be responsible for mailing NPP's? A10: NPP is currently mailed to all initial customers. Yes, the successful vendor will be responsible for mailing NPP's. Q11: Do you currently use a lockbox for all payments and correspondence? If so,who will be responsible for the cost of the lockbox? All: Yes. The City is responsible to bear the cost of any and all lockbox services. Q12: What is the reason for your RFP? Al2: The reason for the RFP is expiration of current contract. Q13:. We do not have a local office in Florida, however we service over 10 clients in the State. We are capable of meeting on site with Miami Beach as needed. Is item number 51 on page 28 a strict requirement or a preference? A13: A local office in Florida is not a minimum eligibility requirement as identified in Appendix C, section Cl, on page 27 of the RFP. Q14: Are you interested in considering bidders to provide delinquent account collection services? A14: No. 2 ADDENDUM NO,1 REQUEST FOR PROPOSALS(RFP)2017-002-JC EMS TRANSPORT BILLING AND COLLECTION SERVICES Q15: The RFP is requesting 13 laptops with 5 spares.What is your preferred model? A15: A particular model is not specified in the RFP. Per section C3, page 28 of the RFP, rugged mobile laptop devices are required. Q16: What is the anticipated start date for this contract? A16: We anticipate presenting this item to the April 26, 2017 City Commission meeting. The contract will commence upon award by the City Commission and successful contract execution.This information is tentative and may change. Q17: Will the successful vendor assume responsibility for any backlog of unbilled and/or previously billed accounts? A17: Yes. Q18: Would you like billing services for fire calls as well? A18: No. Q19: Does the Moratorium on the purchase of goods and services from North Carolina apply to the Miami Beach EMS billing RFP? A19: Yes. - Q20: Can you list out the hospitals that you transport to, that you would like to e-Transfer data to? A20: Below is a list in order of high frequency to low frequency of hospital transports. There is always the potential to transport to any hospital in Miami-Dade County, but the list below contains the most frequent transports: •• Mount Sinai Medical Center • Jackson Memorial Hospital • North Shore Medical Center • Aventura Hospital • Nicklaus Children's Hospital Q21: Do you currently document a patient's MRN /Encounter / Account / Visit Number when you hand over patient care to the hospital? A21: The account number currently displays on the ePCR, but is not documented by the report writer. This number is generated by the ePCR system and does not serve a purpose for field crews. 3 : ADDENDUM NO. 1 REQUEST FOR PROPOSALS(RFP)2017-002-JC EMS TRANSPORT BILLING AND COLLECTION SERVICES Any questions regarding this Addendum should be submitted in writing to the Procurement Management Department to the attention of the individual named below, with a copy to the City Clerk's Office at RafaelGranadoaa,miamibeachfl.cov. Procurement Contact: Telephone: Email: Jason Crouch 305-673-7000, ext. 6694 JasonCrouch@miamibeachfl.gov Proposers are reminded to acknowledge receipt of this addendum as part of your RFP submission. grit ' - is Proc rement Director f � • • voselaWManes 4 ADDENDUM NO.1 REQUEST FOR PROPOSALS(RFP)2017-002-JC EMS TRANSPORT BILLING AND COLLECTION SERVICES• f. REQUEST FOR. PROPOSALS (RFP) EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES 2017-002-JC RFP ISSUANCE DATE: JANUARY 13, 2017 PROPOSALS DUE: MARCH 1, 2017 @ 3:00 PM MIAMIBEACH Jason Crouch, Procurement Contracting Officer II DEPARTMENT OF.PROCUREMENT MANAGEMENT 1755 Meridian Ave, 3rd Floor, Miami Beach, FL 33139 305.673.7000 x6694 I Iasoncrouch@miamibeachfl.gov I www.miamibeachfl.gov RFP 2017-002-JC 1 MIAMI BEACH - TABLE OF CONTENTS SOLICITATION SECTIONS: PAGE 0100 NOT UTILIZED N/A 0200 INSTRUCTIONS TO PROPOSERS & GENERAL CONDITIONS 3 0300 PROPOSAL SUBMITTAL INSTRUCTIONS & FORMAT 13 0400 PROPOSAL EVALUATION 15 APPENDICES: PAGE APPENDIX A PROPOSAL CERTIFICATON, QUESTIONNAIRE AND AFFIDAVITS 17 APPENDIX B "NO PROPOSAL" FORM 24 APPENDIX C MINIMUM REQUIREMENTS.&SPECIFICATIONS 26 APPENDIX D SPECIAL CONDITIONS 44 APPENDIX E COST PROPOSAL FORM 47 APPENDIX F INSURANCE REQUIREMENTS 50 • RFP 2017-002-JC 2 ® MIAMIBEACH SECTION 0200 INSTRUCTIONS TO RESPONDENTS&GENERAL CONDITIONS 1. GENERAL. This Request for Proposals (RFP) is issued by the City of Miami Beach, Florida (the "City"), as the means for prospective Proposers to submit their qualifications, proposed scopes of work and cost proposals (the "proposal") to the City for the City's consideration as an option in achieving the required scope of services and requirements as noted herein. All documents released in connection wiT this solicitation, including all appendixes and addenda, whether included herein or released under separate cover, comprise the solicitation, and are complementary to one another and together establish the complete terms, conditions and obligations of the Proposers and, subsequently, the successful Proposer(s) (the"contractor[ ]") if this RFP results in an award. The City utilizes PublicPurchase (www.publicpurchase.com) for automatic notification of competitive solicitation opportunities and document fulfillment, including the issuance of any addendum to this RFP. Any prospective Proposer who has received this RFP by any means other than through PublicPurchase must register immediately with PublicPurchase to assure it receives any addendum issued to this RFP. Failure to receive an addendum may result in disqualification of proposal submitted. 2. PURPOSE. The City's FIRE-RESCUE DEPARTMENT provides medical transportation for the residents and visitors transported from incident scenes to health care facilities in EMS transport vehicles requiring Basic Life Support (BLS) or Advanced Life Support(ALS).The individuals are charged a BLS or ALS transportation fee, a mileage fee,and other charges including, but not limited to, oxygen administration, cardi' c monitoring, intubation and/or spinal immobilization fees. The services to be provided include, but are not limited to, obtaini g patient and insurance information for emergency medical transport services provided, verifying patient insurace and patient demographic information, filing claims and sending invoices to self-pay accounts, submitting claims to Medicare, Medicaid, and insurance companies, processing third party reimbursements, and providing specific management and financial reports on a monthly basis,as specified by the City. The City of Miami Beach is seeking qualified firm(s) to provide Emergency Medical Services (EMS) ambulance billing and Electronic Patient Care Reporting (EPCR) services for the City's FIRE-RESCUE DEPARTMENT, in accordance with the terms, conditions and specifications contained in this Request for Proposals (RFP). Proposers shall demonstrate their experience in the area of Medicare and Medicaid billing, and propose to perform the work in a manner which shall meet or exceed the technical specifications herein contained. On September 27, 2012 the City Commission passed Resolution No. 201?-28023 authorizing the billing of$800 for Basic Life support, Advanced Life Support 1, or Advanced Life Support emergent medical transports to assist in cost recovery. Transport fees are established by Miami Dade County/Code Section 4-7. Additional charges in varying amounts are based on miles transported to the hospital and the need for supplemental medical services such as cardiac monitoring, intravenous/intraosseous therapy, airway intuipation, and oxygen delivery. Despite these associated costs for medical transportation of a patient no individuals are deprived of fire-rescue transport services due to their inability to pay for services. The following table lists the relevant FIRE-RESCUE DEPARTMENT data regarding medical calls and transports for Fiscal Year 2013/2014 and Fiscal Year 2014/2015 as compiled from the IRE-RESCUE DEPARTMENT'S computer aided Dispatch (CAD)and report management software(RMS)databases. RFP 2017-002-JC 3 CA MIAMI BEACH FY 13/14 FY 14/15 EMS Calls 17,058 18,050 EMS Transports 7,955 7,956 The City collected the following revenues fees during the past two (2)fiscal years: FY 13/14 FY 14/15 TOTAL Gross Collection $1,967,207.75 $2,356, 9.32 $4,323,237.07 ADPI Fee (11.7%) $232,134.36 $277,72t58 $509,855.94 Net Collection $1,508,586.69 $1,836,052.59 $3,344,639.28 In the current professional services agreement the City of Miami each pays fees for services at a rate of six and one-half percent(6.5%) of all monies collected by ADPI, excluding Medicaid accounts.ADPI includes in the same invoice an amount of$10.00 per Medicaid account for providing all billing services related to such accounts. 3.ANTICIPATED RFP TIMETABLE.The tentative schedule for this solicitation is as follows: RFP Issued January 13,2017 Pre-Proposal Meeting February 1,2017 11:09 AM Deadline for Receipt of Questions February 9,2017 5:00 0 Responses Due March 1,2017 3:00 PM Evaluation Committee Review TBD Proposer Presentations TBD Tentative Commission Approval Authorizing Negotiations TBD Contract Negotiations Following Commission Approval 4. PROCUREMENT CONTACT.Any questions or clarifications concemin this solicitation shall be submitted to the Procurement Contact noted below: Procurement Contact: Telephone: Email: Jason Crouch 305-673-7000 ext.:6694 asoncrouch • miamibeachfl.'ov Additionally, the City Clerk is to be copied on all communications via e-mail at:.Rafael.G'ranado`@riliamibeachl.gov; or via facsimile: 786-394-4188. The Proposal title/number shall be referenced on all correspondence. All questions or requests for clarification must be received no later than seven (7) calendar days prior.to the date proposals are due as scheduled in Section 0200, page3. All responses to questions/clarifications will be sent to all prospective Proposers in the form of an addendum. RFP 2017-002-IC 4 IAMI BEACH 5. PRE-PROPOSAL MEETING OR SITE VISIT(S). Only if deemed necessary by the City, a pre-proposal meeting or site visit(s)may be scheduled. A Pre-PROPOSAL conference will be held as scheduled in Anticipated RFP Timetable section above at the following address: City of Miami Beach Procurement Department Conference Room 1755 Meridian Ave,3b Floor Miami Beach, Florida 33139 Attendance (in person or via telephone) is encouraged and recommended as a source of information, but is not mandatory. Proposers interested in participating in the Pre-Proposal Submission Meeting via telephone must follow these steps: (1) Dial the TELEPHONE NUMBER: 1-888-270-9936(Toll-free North America) (2) Enter the MEETING NUMBER: 9415468 Proposers who are interested in participating via telephone should send an e-mail to the contact person listed in this RFP expressing their intent to participate via telephone. 6. PRE-PROPOSAL INTERPRETATIONS. Oral information or responses to questions received by prospective Proposers are not binding on the City and will be without legal effect, including any information received at pre- submittal meeting or site visit(s). The City by means of Addenda will issue interpretations or written addenda clarifications considered necessary by the City in response to questions. Only questions answered by written addenda will be binding-and may supersede terms noted in this solicitation. Addendum will be released through PublicPurchase. Any prospective proposer who has received this RFP by any means other than through PublicPurchase must register immediately with PublicPurchase to assure it receives any addendum issued to this RFP. Failure to receive an addendum may result in disqualification of proposal.Written questions should be received no later than the date outlined in the Anticipated RFP Timetable section. 7. CONE OF SILENCE. This RFP is subject to, and all proposers are expected to be or become familiar with, the City's Cone of Silence Requirements, as codified in Section 2-486 of the City Code. Proposers shall be solely responsible for ensuring that all applicable provisions of the City's Cone of Silence are complied with, and shall be subject to any and all sanctions, as prescribed therein, including rendering their response voidable, in the event of such non-compliance. Communications regarding this solicitation are to be submitted in writing to the Procurement Contact named herein with a copy to the City Clerk at rafaelgranado@miamibeachfl.gov 8. SPECIAL NOTICES. You arehereby advised that this solicitation is subject to the following ordinances/resolutions, which may be found ) on the City Of Miami Beach website: http://web.miamibeachfl.qov/procurement/scroll.aspx?id=23510 • CONE OF SILENCE CITY CODE SECTION 2-486 • PROTEST PROCEDURES CITY CODE SECTION 2-371 • DEBARMENT PROCEEDINGS CITY CODE SECTIONS 2-397 THROUGH 2-485.3 • LOBBYIST REGISTRATION AND DISCLOSURE OF FEES CITY CODE SECTIONS 2-481 THROUGH 2-406 • CAMPAIGN CONTRIBUTIONS BY VENDORS CITY CODE SECTION 2-487 • CAMPAIGN CONTRIBUTIONS BY LOBBYISTS ON PROCUREMENT ISSUES CITY CODE SECTION 2-488 RFP 2017-002-JC 5 ® MIAMIBEACH • REQUIREMENT FOR CITY CONTRACTORS TO PROVIDE EQUAL BENEFITS FOR DOMESTIC PARTNERSCITY CODE SECTION 2-373 • LIVING WAGE REQUIREMENT CITY CODE SECTIONS 2 407 THROUGH 2 410 • PREFERENCE FOR FLORIDA SMALL BUSINESSES OWNED AND CONTROLLED BY VETERANS AND TO STATE-CERTIFIED SERVICE- DISABLED VETERAN BUSINESS ENTERPRISES CITY CODE SECTION 2-374 • FALSE CLAIMS ORDINANCE CITY CODE SECTION 70-300 • ACCEPTANCE OF GIFTS,FAVORS&SERVICES CITY CODE SECTION 2-449 9. PUBLIC ENTITY CRIME. A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crimes may not submit a Proposal on a'contract to provide any goods or services to a public entity, may not submit a Proposal on a contract with a public entity for the construction or repair of a public building or public work, may not submit Proposals on leases of real property to public entity, may not be awarded or perform work as a contractor, supplier, sub-contractor, or consultant under a contract with a public entity, and may not transact business with any public entity in excess of the threshold amount provided in Sec. 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. 10. COMPLAINCE WITH THE CITY'S LOBBYIST LAWS. This RFP is subject to, and all Proposers are expected to be or become familiar with, all City lobbyist laws. Proposers shall be solely responsible for ensuring that all City lobbyist laws are complied with, and shall be subject to any and all sanctions, as prescribed therein, including, without limitation,disqualification of their responses, in the event of such non-compliance. 11. DEBARMENT ORDINANCE: This RFP is subject to, and all proposers are expected to be or become familiar with, the City's Debarment Ordinance as codified in Sections 2-397 through 2-406 of the City Code. 12. WITH THE CITY'S CAMPAIGN FINANCE REFORM LAWS. This RFP is subject to, and all Proposers are expected to be or become familiar with, the City's Campaign Finance Reform laws, as codified in Sections 2-487 through 2-490 of the City Code. Proposers shall be solely responsible for ensuring that all applicable provisions of the City's Campaign Finance Reform laws are complied with, and shall be subject to any and all sanctions, as prescribed therein, including disqualification of their responses, in the event of such non-compliance. 13. CODE OF BUSINESS ETHICS. Pursuant to City Resolution No.2000-23879, the Proposer shall adopt a Code of Business Ethics("Code")and submit that Code to the Procurement Division with its response or within five (5) days upon receipt of request. The Code shall, at a minimum, require the Proposer, to comply with all applicable governmental rules and regulations including, among others, the conflict of interest, lobbying and ethics provision of the City of Miami Beach and Miami Dade County. 14.AMERICAN WITH DISABILITIES ACT(ADA). Call 305-673-7490 to request material in accessible format; sign language interpreters(five(5)days in advance when possible),or information on access for persons with disabilities. For more information on ADA compliance, please call the Public Works Department, at 305-673- 7000, Extension 2984. 15. POSTPONEMENT OF DUE DATE FOR RECEIPT OF PROPOSALS. The City reserves the right to postpone the deadline for submittal of proposals and will make a reasonable effort to give at least three (3) calendar days written notice of any such postponement to all prospective Proposers through PublicPurchase. 16. PROTESTS. Proposers that are not selected may protest any recommendation for selection of award in accordance with the proceedings established pursuant to the City's Proposal protest procedures, as codified in Sections 2-370 and 2-371 of the City Code (the City's Proposal Protest Ordinance). Protest not timely made pursuant to the requirements of the City's Proposal Protest Ordinance shall be barred. kiP 2017-002-JC 6 ® .MIAMI BEACH 17. NOT USED. 18.VETERAN BUSINESS ENTERPRISES PREFERENCE. Pursuant to City Code Section 2-374,the City shall give a preference to a responsive and responsible Proposer which is a small business concern owned and controlled by a veteran(s) or which is a service-disabled veteran business enterprise, and which is within five percent (5%) of the lowest responsive, responsible proposer, by providing such proposer an opportunity of providing said goods or contractual services for the lowest responsive proposal amount (or in this RFP, the highest proposal amount). Whenever, as a result of the foregoing preference, the adjusted prices of two (2) or more proposers which are a small business concern owned and controlled by a veteran(s) or a service-disabled veteran business enterprise constitute the lowest proposal pursuant to an RFP or oral or written request for quotation, and such proposals are responsive, responsible and otherwise equal with respect to quality and service, then the award shall be made to the service-disabled veteran business enterprise. 19. DETERMINATION OF AWARD. The final ranking results of Step 1 & 2 outlined in Section 0400, Evaluation of Proposals, will be considered by the City Manager who may recommend to the City Commission the Proposer(s) s/he deems to be in the best interest of the City or may recommend rejection of all proposals. The City Manager's recommendation need not be consistent with the scoring results identified herein and takes into consideration Miami Beach City Code Section 2-369, including the following considerations: (1)The ability, capacity and skill of the Proposer to perform the contract. (2)Whether the Proposer can perform the contract within the time specified,without delay or interference. (3)The character, integrity, reputation,judgment, experience and efficiency of the Proposer. (4)The quality of performance of previous contracts. (5)The previous and existing compliance by the Proposer with laws and ordinances relating to the contract. The City Commission shall consider the City Manager's recommendation and may approve such recommendation. The City Commission may also, at its option, reject the City Manager's recommendation and select another Proposal or Proposals which it deems to be in the best interest of the City,or it may also reject all Proposals. 20. NEGOTIATIONS. Following selection, the City reserves the right to enter into further negotiations with the selected Proposer. Notwithstanding the preceding, the City is in no way obligated to enter into a contract with the selected Proposer in the event the parties are unable to negotiate a contract. It is also understood and acknowledged by Proposers that no property, contract or legal rights of any kind shall be created at any time until and unless an Agreement has been agreed to;approved by the City; and executed by the parties. 21. POSTPONEMENT/CANCELLATION/ACCEPTANCE/REJECTION. The City may, at its sole and absolute discretion, reject any and all, or parts of any and all, responses; re-advertise this RFP; postpone or cancel, at any time, this RFP process; or waive any irregularities in this RFP, or in any responses received as a result of this RFP. Reasonable efforts will be made to either award the proposer the contract or reject all proposals within one-hundred twenty(120)calendar days after proposal opening date.A proposer may withdraw its proposal after expiration of one hundred twenty(120) calendar days from the date of proposal opening by delivering written notice of withdrawal to the Department of Procurement Management prior to award of the contract by the City Commission. 22. PROPOSER'S RESPONSIBILITY. Before submitting a response, each Proposer shall be solely responsible for making any and all investigations, evaluations, and examinations, as it deems necessary,to ascertain all conditions and requirements affecting the full performance of the contract. Ignorance of such conditions and requirements, and/or failure to make such evaluations, investigations, and examinations, will not relieve the Proposer from any RFP 2017-002-JC 7 MIAMI BEACH obligation to comply with every detail and with all provisions and requirements of the contract, and will not be accepted as a basis for any subsequent claim whatsoever for any monetary consideration on the part of the Proposer. 23. COSTS INCURRED BY PROPOSERS.All expenses involved with the preparation and submission of Proposals, or any work performed in connection therewith, shall be the sole responsibility (and shall be at the sole cost and expense)of the Proposer,and shall not be reimbursed by the City. 24. RELATIONSHIP TO THE CITY. It is the intent of the City, and Proposers hereby acknowledge and agree, that the successful Proposer is considered to be an independent contractor, and that neither the Proposer, nor the Proposer's employees, agents, and/or contractors, shall, under any circumstances, be considered employees or agents of the City. 24. OCCUPATIONAL HEALTH AND SAFETY. In compliance with Chapter 442, Florida Statutes, any toxic substance listed in Section 38F-41.03 of the Florida Administrative Code delivered as a result of this proposal must be accompanied by a Material Safety Data Sheet(MSDS)which may be obtained from the manufacturer. 25. ENVIRONMENTAL REGULATIONS. The City reserves the right to consider a proposer's history of citations and/or violations of environmental regulations in investigating a proposer's responsibility, and further reserves the right to declare a proposer not responsible if the history of violations warrant such determination in the opinion of the City. Proposer shall submit with its proposal, a complete history of all citations and/or violations, notices and dispositions thereof. The non-submission of any such documentation shall be deemed to be an affirmation by the Proposer that there are no citations or violations. Proposer shall notify the City immediately of notice of any citation or violation which proposer may receive after the proposal opening date and during the time of performance of any contract awarded to it. 26.TAXES.The City of Miami Beach is exempt from all Federal Excise and State taxes. 27. MISTAKES. Proposers are expected to examine the terms, conditions, specifications, delivery schedules, proposed pricing, and all instructions pertaining to the goods and services relative to this RFP. Failure to do so will be at the Proposer's risk and may result in the Proposal being non-responsive. 28. PAYMENT. Payment will be made by the City after the goods or services have been received, inspected, and found to comply with contract, specifications, free of damage or defect, and are properly invoiced. Invoices must be consistent with Purchase Order format. 29. COPYRIGHT, PATENTS & ROYALTIES. Proposer shall indemnify and save harmless the City of Miami Beach, Florida, and its officers, employees, contractors, and/or agents, from liability of any nature or kind, including cost and expenses for, or on account of, any copyrighted, patented, or unpatented invention, process,or article manufactured or used in the performance of the contract, including its use by the City of Miami Beach, Florida. If the Proposer uses any design, device or materials covered by letters, patent, or copyright, it is mutually understood and agreed, without exception, that the proposal prices shall include all royalties or cost arising from the use of such design, device,or materials in any way involved in the work. 30. DEFAULT. Failure or refusal of the selected Proposer to execute a contract following approval of such contract by the City Commission, or untimely withdrawal of a response before such award is made and approved, may result in a claim for damages by the City and may be grounds for removing the Proposer from the City's vendor list. 31. MANNER OF PERFORMANCE. Proposer agrees to perform its duties and obligations in a professional manner RFP 2017-002-JC 8 MIAMI BEACH and in accordance with all applicable Local, State, County, and Federal laws, rules, regulations and codes. Lack of knowledge or ignorance by the Proposer with/of applicable laws will in no way be a cause for relief from responsibility. Proposer agrees that the services provided shall be provided by employees that are educated,trained, experienced, certified, and licensed in all areas encompassed within their designated duties. Proposer agrees to furnish to the City any and all documentation, certification, authorization, license, permit, or registration currently required by applicable laws, rules, and regulations. Proposer further certifies that it and its employees will keep all licenses, permits, registrations, authorizations, or certifications required by applicable laws or regulations in full force and effect during the term of this contract. Failure of Proposer to comply with this paragraph shall constitute a material breach of this contract. Where contractor is required to enter or go on to City of Miami Beach property to deliver materials or perform work or services as a result of any contract resulting from this solicitation, the contractor will assume the full duty, obligation and expense of obtaining all necessary licenses, permits, and insurance, and assure all work complies with all applicable laws. The contractor shall be liable for any damages or loss to the City occasioned by negligence of the Proposer,or its officers,employees,contractors, and/or agents,for failure to comply with applicable laws. 32. SPECIAL CONDITIONS. Any and all Special Conditions that may vary from these General Terms and Conditions shall have precedence. 33. NON-DISCRIMINATION. The Proposer certifies that it is in compliance with the non-discrimination clause contained in Section 202, Executive Order 11246, as amended by Executive Order 11375, relative to equal employment opportunity for all persons without regard to race, color, religion, sex or national origin. In accordance with.the City's Human Rights Ordinance, codified in Chapter 62 of the City Code, Proposer shall prohibit(and cause hotel operator to prohibit) discrimination by reason of race, color, national origin, religion, sex, intersexuality, gender identity, sexual orientation, marital and familial status, and age or disability in the sale, lease, use or occupancy of the Hotel Project or any portion thereof. 34. DEMONSTRATION OF COMPETENCY. The City may consider any evidence available regarding the financial, technical, and other qualifications and abilities of a Proposer, including past performance (experience) in making an award that is in the best interest of the City; including: A. Pre-award inspection of the Proposer's facility may be made prior to the award of contract. B. Proposals will only be'considered from firms which are regularly engaged in the business of providing the goods and/or services as described in this solicitation. C. Proposers must be able to demonstrate a good record of performance for a reasonable period of time, and have sufficient financial capacity, equipment, and organization to ensure that they can satisfactorily perform the services if awarded a contract under the terms and conditions of this solicitation. D. The terms "equipment and organization", as used herein shall, be construed to mean a fully equipped and well established company in line with the best business practices in the industry, and as determined by the City of Miami Beach. E. The City may consider any evidence available regarding the financial, technical, and otherqualifications and abilities of a Proposer,including past performance(experience), in making an award that is in the best interest of the City. F.The City may require Proposer s to show proof that they have been designated as authorized representatives of a manufacturer or supplier, which is the actual source of supply. In these instances,the City may also require material information from the source of supply regarding the quality, packaging, and characteristics of the products to be supply to the City. 35. ASSIGNMENT. The successful Proposer shall not assign, transfer, convey, sublet or otherwise dispose of the contract, including any or all of its right, title or interest therein, or his/her or its power to execute such contract, to 'RFP 2017-002-JC 9 MIAMI BEACH any person,company or corporation,without the prior written consent of the City. 36. LAWS, PERMITS AND REGULATIONS. The Proposer shall obtain and pay for all licenses, permits, and inspection fees required to complete the work and shall comply with all applicable laws. 37. OPTIONAL CONTRACT USAGE.When the successful Proposer(s) is in agreement, other units of government or non-profit agencies may participate in purchases pursuant to the award of this contract at the option of the unit of government or non-profit agency. 38. VOLUME OF WORK TO BE RECEIVED BY CONTRACTOR. It is the intent of the City to purchase the goods and services specifically listed in this solicitation from the contractor. However, the City reserves the right to purchase any goods or services awarded from state or other governmental contract, or on an as-needed basis through the City's spot market purchase provisions. 39. DISPUTES. In the event of a conflict between the documents, the order of priority of the documents shall be as follows: A. Any contract or agreement resulting from the award of this solicitation;then B. Addendum issued for this solicitation,with the latest Addendum taking precedence;then C. The solicitation; then D. The Proposer's proposal in response to the solicitation. 40. INDEMNIFICATION. The Proposer shall indemnify and hold harmless the City and its officers, employees, agents and instrumentalities from any and all liability, losses or damages, including attorney's fees and costs of defense, which the City or its officers, employees, agents or instrumentalities may incur as a result of claims, demands, suits, causes of actions or proceedings of any kind or nature arising out of, relating to or resulting from the performance of the agreement by the contractor or its employees, agents, servants, partners, principals or subcontractors. The contractor shall pay all claims and losses in connection therewith, and shall investigate and defend all claims, suits or actions of any kind or nature in the name of the City,where applicable, including appellate proceedings, and shall pay all costs,judgments, and attorney's fees which may be incurred thereon. The Proposer expressly understands and agrees that any insurance protection required by this Agreement or otherwise provided by the contractor shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The above indemnification provisions shall survive the expiration or termination of this Agreement. 41. CONTRACT EXTENSION. The City reserves the right to require the Contractor to extend contract past the stated termination date for a period of up to 120 days in the event that a subsequent contract has not yet been awarded.Additional extensions past the 120 days may occur as needed by the City and as mutually agreed upon by the City and the contractor. 42. FLORIDA PUBLIC RECORDS LAW. Proposers are hereby notified that all Proposal including,without limitation, any and all information and documentation submitted therewith, are exempt from public records requirements under Section 119.07(1), Florida Statutes, and s. 24(a),Art. 1 of the State Constitution until such time as the City provides notice of an intended decision or until thirty (30) days after opening of the proposals, whichever is earlier. Additionally, Contractor agrees to be in full compliance with Florida Statute 119.0701 including, but not limited to, agreement to (a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the services; (b) provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law; (c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law; (d) Meet all. RFP 2017-0021C 10 MIAMIBEACH requirements for retaining public records and transfer, at no cost, to the public agency all public records in possession of the contractor upon termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the public agency in a format that is compatible with the information technology systems of the public agency. 43.OBSERVANCE OF LAWS. Proposers are expected to be familiar with, and comply with, all Federal, State, County, and City laws, ordinances, codes, rules and regulations, and all orders and decrees of bodies or tribunals having jurisdiction or authority which, in any manner, may affect the scope of services and/or project contemplated by this RFP (including, without limitation, the Americans with Disabilities Act, Title VII of the Civil Rights Act, the EEOC Uniform Guidelines, and all EEO regulations and guidelines). Ignorance of the law(s) on the part of the Proposer will in no way relieve it from responsibility for compliance. 44. CONFLICT OF INTEREST. All Proposers must disclose, in their Proposal, the name(s) of any officer, director, agent, or immediate family member(spouse, parent, sibling, and child)who is also an employee of the City of Miami Beach. Further, all Proposers must disclose the name of any City employee who owns, either directly or indirectly, an interest of ten (10%) percent or more in the Proposer entity or any of its affiliates. 45. MODIFICATION/WITHDRAWALS OF PROPOSALS.A Proposer may submit a modified Proposal to replace all or any portion of a previously submitted.Proposal up until the Proposal due date and time. Modifications received after the Proposal due date and time will not be considered. Proposals shall be irrevocable until contract award unless withdrawn in writing prior to the Proposal due date, or after expiration of 120 calendar days from the opening of Proposals without a contract award. Letters of withdrawal received after the Proposal due date and before said expiration date, and letters of withdrawal received after contract award will not be considered. 46. EXCEPTIONS TO RFP. Proposers must clearly indicate any exceptions they wish to take to any of the terms in this RFP, and outline what, if any, alternative is being offered. All exceptions and alternatives shall be included and clearly delineated, in writing, in the Proposal. The City, at its sole and absolute discretion, may acceptpr reject any or all exceptions and alternatives: In cases in which exceptions and alternatives are rejected, the City shall require the Proposer to comply with the particular term and/or condition of the RFP to which Proposer took exception to(as said term and/or condition was originally set forth on the RFP). 47.ACCEPTANCE OF GIFTS, FAVORS,SERVICES. Proposers shall not offer any gratuities,favors,or anything of monetary value to any official, employee, or agent of the City, for the purpose of influencing consideration of this Proposal. Pursuant to Sec. 2-449 of the City Code, no officer or employee of the City shall accept any gift, favor or service that might reasonably tend improperly to influence him in the discharge of his official duties. 48. SUPPLEMENTAL INFORMATION. City reserves the right to request supplemental information from Proposers at any time during the RFP solicitation process, unless otherwise noted herein. 49. ADDITIONAL SERVICES. Although this solicitation and resultant contract identifies specific goods, services or facilities ("items"), it is hereby agreed and understood that the City, through the approval of the Department and Procurement Directors (for additional items up to $50,000) or the City Manager (for additional items greater than $50,000), may require additional items to be added to the Contract which are required to complete the work. When additional items are required to be added to the Contract, awarded vendor(s), as applicable to the item being requested, under this contract may be invited to submit price quote(s) for these`additional requirements. If these quote(s) are determined to be fair and reasonable, then the additional work will be awarded to the current contract vendor(s)that offers the lowest acceptable pricing. The additional items shall be added to this contract by through a Purchase Order(or Change Order if Purchase Order already exists). In some cases, the City may deem it necessary kFP 2017-002-IC 11 MIAMIBEACH to add additional items through a formal amendment to the Contract,to be approved by the City Manager. The City may determine to obtain price quotes for the additional items from other vendors in the event that fair and reasonable pricing is not obtained from the current contract vendors, or for other reasons at the City's discretion. Balance of Page Intentionally Left Blank RFP 2017-002-JC 12 SECTION 0300 PROPOSAL SUBMITTAL INSTRUCTIONS AND FORMAT 1. SEALED RESPONSES. One original Proposal (preferably in 3-ring binder) must be submitted in an opaque, sealed envelope or container on or before the due date established for the receipt of proposals.Additionally,ten (10) bound copies and one (1) electronic format (CD or USB format) are to be submitted. The following information should be clearly marked on the face of the envelope or container in which the proposal is submitted: solicitation number, solicitation title, Proposer name, Proposer return address. Proposals received electronically, either through email or facsimile, are not acceptable and will be rejected. 2. LATE PROPOSALS. Proposals are to be received on or before the due date established herein for the receipt of Proposals. Any Proposal received after the deadline established for receipt of proposals will be considered late and not be accepted or will be returned to Proposer unopened. The City does not accept responsibility for anydelays, natural or otherwise. 3. PROPOSAL FORMAT. In order to maintain comparability, facilitate the review process and assist the Evaluation Committee in review of proposals, it is strongly recommended that proposals be organized and tabbed in accordance with the sections and manner specified below. Hard copy submittal should be tabbed as enumerated below and contain a table of contents with page references. Electronic copies should also be tabbed and contain a table of contents with page references. Proposals that do not include the required information will be deemed non- responsive and will not be considered. - TAB 1 Cover Letter&Minimum Qualifications Requirements 1.1 Cover Letter and Table of Contents.The cover letter must indicate Proposer and Proposer Primary Contact for the purposes of this solicitation. 1.2 Proposal Certification, Questionnaire & Requirements Affidavit (Appendix A). Attach Appendix A fully completed and executed. 1.3 Minimum Qualifications Requirements. Submit verifiable information documenting compliance with the minimum qualifications requirements established in Appendix C, Minimum Requirements and Specifications. TAB 2 Experience&Qualifications 2.1 Qualifications of Proposing Firm.Submit detailed information regarding the firm's history and relevant experience and proven track record of providing the scope of services similar as identified in this solicitation, including experience in providing similar scope of services to public sector agencies. For each project that the Proposer submits as evidence,.of similar experience, the following is required: project description, agency name, agency contact, contact telephone & email,and year(s)and term of engagement. 2.2 Qualifications of Proposer Team. Provide an organizational chart of all personnel and consultants to be used for this project if awarded,the role that each team member will play in providing the services detailed herein and each team members' qualifications. A resume of each individual, including education, experience, and any other pertinent information,shall be included for each Proposal team member to be assigned to this contract. 2.3 Disaster Recovery Compliance. Proposer shall provide a copy of its disaster and recovery policies and procedures. 2.4 Financial Capacity. At the request of the City each Proposer shall arrange for Dun & Bradstreet to submit a Supplier Qualification Report (SQR) directly to the Procurement Contact named herein. No proposal will be considered without receipt, by the City, of the SQR directly from Dun & Bradstreet. The cost of the preparation of the SQR shall be the responsibility of the Proposer.The Proposer shall request the SQR report from D&B at: httos://s upplierportal.dnb.com/webanp/wcs/stores/servlet/SupplierPortal?storeld=11696 Proposers are responsible for the accuracy of the information contained in its SQR. It is highly recommended that each Proposer review the information contained in its SQR for accuracy prior to submittal to the City and as early as possible in the solicitation process. For assistance with any portion of the SQR submittal process, contact Dun&Bradstreet at 800-424-2495. RFP 2017-002-JC 13 TAB 3 Scope of Services Proposed Submit detailed information addressing how Proposer will achieve each portion of the scope of services and technical requirements outlined in Appendix C, Minimum Requirements and Specifications. Responses shall be in sufficient detail and include supporting documentation, implementation plan, project timeline, phasing options, testing and risk mitigation options for assuring project is implemented on time and within budget, as applicable. . TAB,4 Cost Proposal Submit a completed Cost Proposal Form (Appendix E). Note: After proposal submittal, the City reserves the right to require additional information from Proposers (or Proposer team members or sub-consultants) to determine: qualifications (including, but not limited to, litigation history, regulatory action, or additional references); and financial capability (including, but not limited to, annual reviewed/audited financial statements with the auditors notes for each of their last two complete fiscal years). Balance of Page Intentionally Left Blank RFP 2017-002-JC 14 SECTION 0400 PROPOSAL EVALUATION 1. Evaluation Committee. An Evaluation Committee, appointed by the City Manager, shall meet to evaluate each Proposal in accordance with the requirements set forth in the solicitation. If further information is desired, Proposers may be requested to make additional written submissions of a clarifying nature or oral presentations to the Evaluation Committee. The evaluation of proposals will proceed in a two-step process as noted below. It is important to note that the Evaluation Committee will score the qualitative portions of the proposals only. The Evaluation Committee does not make an award recommendation to the City Manager. The results of Step 1 & Step 2 Evaluations will be forwarded to the City Manager who will utilize the results to make a recommendation to the City Commission. In the event that only one responsive proposal is received, the City Manager, after determination that the sole responsive proposal materially meets the requirements of the RFP, may, without an evaluation committee, recommend to the City Commission that the Administration enter into negotiations. The City, in its discretion, may utilize technical or other advisers to assist the evaluation committee in the evaluation of proposals. 2. Step 1 Evaluation. The first step will consist of the qualitative criteria listed below to be considered by the Evaluation Committee. The second step will consist of quantitative criteria established below to be added to the Evaluation Committee results by the Department of Procurement Management. An Evaluation Committee, appointed by the City Manager, shall meet to evaluate each Proposal in accordance with the qualifications criteria established below for Step 1, Qualitative Criteria. In doing so, the Evaluation Committee may review and score all proposals received,with or without conducting interview sessions. Step 1 -Qualitative Criteria , . • . . Maximum Points ., .r Experience and Qualifications 45 Scope of Services Proposed 30 - • TOTAL:__AVAILABLE STEP 1 POINTS 75 3. Step 2 Evaluation. Following the results of Step 1 Evaluation.of qualitative criteria, the Proposers may receive additional quantitative criteria points to be added by the Department of Procurement Management to those points earned in Step 1,as follows. Step 2-Quantitative Criteria; . ' Cost Proposal 25 Veterans Preference 5 .--:TOTAL AVAILABLE STEP 2 POINTS • V 30 • . 4. Cost Proposal Evaluation.The cost proposal points shall be developed in accordance with the following formula: Sample Objective Formula for Cost Vendor Vendor Example Maximum Formula for Calculating Points Total Cost Allowable Points (lowest cost 1 cost of proposal Points Proposal (Points noted are for being evaluated X maximum Awarded illustrative purposes only. allowable points=awarded Actual points are noted above.) points) Round to Vendor A $100.00 30 $1001$100 X30=30 30 Vendor B $150.00 30 $1001$150 X30=20 20 Vendor C $200.00 30 $100!$200X3015 l 15 RFP 2017-002-JC 15 5. Determination of Final Ranking. At the conclusion of the Evaluation Committee Step 1 scoring, Step 2 Points will be added to each Evaluation Committee member's scores by the Department of Procurement Management. Step 1 and 2 scores will be converted to rankings in accordance with the example below: Proposer A Proposer B. Proposer C. Step 1 Points 82 76 80 Step 2 Points 22 15 12 •=Committee Total 104 91 92 Mem eri;E...., 3 . 22. Step 1 Points 79 85 72 Step 2 Points 22 15 12 • Total 101 100 84 Member_2, Rangy!.. '. I AI• .i 2 - 3 ' Step1 Points 80 74 66 Step 2 Points 22 15 12 — - -eiTT Total 102 89 78 Membe[2 i RATE < , . _ 11 , .. 2 °. . . 3 Low Aggregate Score 3 7 a Final Ranking` i 2 3 *Final Ranking is presented to the City Manager for further due diligence and recommendation to the City Commission. Final Ranking does not constitute an award recommendation until such time as the City Manager has made his recommendation to the City Commission,which may be different than final ranking results. RFP 2017-0021C 16 APPENDIX A MIAMI BEACH Proposal Certification , Questionnaire & Requirements Affidavit 2017-002-JC Emergency Medical Transport Billing and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 REP 2017-002-JC 17 Solicitation No: Solicitation Title: 2017-002-JC Emergency Medical Transport Billing and Collection Services Procurement Contact Tel: Email: Jason Crouch 305-673-7000 ext.:6694 jasoncrouch@miamibeachfl.gov PROPOSAL CERTIFICATION,QUESTIONNAIRE&REQUIREMENTS AFFIDAVIT Purpose: The purpose of this Proposal Certification, Questionnaire and Requirements Affidavit Form is to inform prospective Proposers of certain solicitation and contractual requirements, and to collect necessary information from Proposers in order that certain portions of responsiveness, responsibility and other determining factors and compliance with requirements may be evaluated. This Proposal Certification, Questionnaire and Requirements Affidavit Form is a REQUIRED FORM that must be submitted fully completed and executed. 1. General Proposer Information. FIRM NAME: No.of Years in Business: No.of Years in Business Locally: No.of Employees: OTHER NAME(S)PROPOSER HAS OPERATED UNDER IN THE LAST 10 YEARS: FIRM PRIMARY ADDRESS(HEADQUARTERS): CITY: • STATE: ZIP CODE: TELEPHONE NO.: TOLL FREE NO.: FAX NO.: FIRM LOCAL ADDRESS: . CITY: STATE: ZIP CODE: PRIMARY ACCOUNT REPRESENTATIVE FOR THIS ENGAGEMENT: ACCOUNT REP TELEPHONE NO.: ACCOUNT REP TOLL FREE NO.: ACCOUNT REP EMAIL: FEDERAL TAX IDENTIFICATION NO.: The City reserves the right to seek additional information from Proposer or other source(s), including but not limited to:any firm or principal information,applicable licensure,resumes of relevant individuals,client information,financial information, or any information the City deems necessary to evaluate the capacity of the Proposer to perform in accordance with contract requirements. RFP 2017-002-JC 18 1. Veteran Owned Business.Is Proposer claiming a veteran owned business status? I I YES NO SUBMITTAL REQUIREMENT: Proposers claiming veteran owned business status shall submit a documentation proving that firm is certified as a veteran-owned business or a service-disabled veteran owned business by the State of Florida or United States federal government,as required pursuant to ordinance 2011-3748. 2. Conflict Of Interest.All Proposers must disclose,in their Proposal,the name(s)of any officer,director,agent,or immediate family member(spouse, parent, sibling, and child)who is also an employee of the City of Miami Beach. Further, all Proposers must disclose the name of any City employee who owns, either directly or indirectly, an interest of ten (10%) percent or more in the Proposer entity or any of its affiliates. SUBMITTAL REQUIREMENT: Proposers must disclose the name(s)of any officer, director, agent, or immediate family member (spouse,parent,sibling,and child)who is also an employee of the City of Miami Beach. Proposers must also disclose the name of any City employee who owns,either directly or indirectly,an interest of ten(10%)percent or more in the Proposer entity or any of its affiliates. 3. References&Past Performance.Proposer shall submit at least three(3)references for whom the Proposer has completed work similar in size and nature as the work referenced in solicitation. SUBMITTAL REQUIREMENT: For each reference submitted, the following information is required: 1) Firm Name, 2) Contact Individual Name&Title,3)Address,4)Telephone,5)Contact's Email and 6)Narrative on Scope of Services Provided. 4. Suspension,Debarment or Contract Cancellation.Has Proposer ever been debarred,suspended or other legal violation,or had a contract cancelled due to non- erfornance by an ublic sector agency? YES IINO SUBMITTAL REQUIREMENT: If answer to above is "YES," Proposer shall submit a statement detailing the reasons that led to action(s). 5. Vendor Campaign Contributions. Proposers are expected to be or become familiar with,the City's Campaign Finance Reform laws,.as codified in Sections 2-487 through 2-490 of the City Code. Proposers shall be solely responsible for ensuring that all applicable provisions of the City's Campaign Finance Reform laws are complied with,and shall be subject to any and all sanctions, as prescribed therein,including disqualification of their Proposals,in the event of such non-compliance. SUBMITTAL REQUIREMENT: Submit the names of all individuals or entities (including your sub-consultants)with a controlling financial interest as defined in solicitation. For each individual or entity with a controlling financial interest indicate whether or not each individual or entity has contributed to the campaign either directly or indirectly, of a candidate who has been elected to the office of Mayor or City Commissioner for the City of Miami Beach. 6. Code of Business Ethics.Pursuant to City Resolution No.2000-23879,each person or entity that seeks to do business with the City shall adopt a Code of Business Ethics("Code")and submit that Code to the Department of Procurement Management with its proposal/response or within five(5)days upon receipt of request.The Code shall,at a minimum,require the Proposer,to comply with all applicable governmental rules and regulations including, among others, the conflict of interest, lobbying and ethics provision of the City of Miami Beach and Miami Dade County. SUBMITTAL REQUIREMENT: Proposer shall submit firm's Code of Business Ethics. In lieu of submitting Code of Business Ethics,Proposer may submit a statement indicating that it will adopt,as required in the ordinance,the City of Miami Beach Code of Ethics,available at www.miamibeachfl.gov/procurement/. i RFP 2017-002-JC 19 7. ' ••,. , .,.. -. .... e ..:_;:.• •f: ! •:. ,:.••• !.....,..- _•• _:::, ... ../.: ... e.: .• _ . .e.• ...: e :••:,.' :::.- same(in rJ particular year) to the living wage requirement 8. Equal Benefits for Employees with Spouses and Employees with Domestic Partners. When awarding competitively solicited contracts valued at over$100,000 whose contractors maintain 51 or more full time employees on their payrolls during 20 or more calendar work weeks,the Equal Benefits for Domestic Partners Ordinance 2005-3494 requires certain contractors doing business with the City of Miami Beach,who are awarded a contract pursuant to competitive proposals, to provide"Equal Benefits"to their employees with domestic partners, as they provide to employees with spouses. The Ordinance applies to all employees of a Contractor who work within the City limits of the City of Miami Beach,Florida;and the Contractor's employees located in the United States, but outside of the City of Miami Beach limits, who are directly performing work on the contract within the City of Miami Beach. A. Does your company provide or offer access to any benefits to employees with spouses or to spouses of employees? YES NO B. Does your company provide or offer access to any benefits to employees with(same or opposite sex)domestic partners*or to domestic partners of employees? YES NO C. Please check all benefits that apply to your answers above and list in the "other" section any additional benefits not already specified. Note:some benefits are provided to employees because they have a spouse or domestic partner, such as bereavement leave;other benefits are provided directly to the spouse or domestic partner,such as medical insurance. BENEFIT Firm Provides for Firm Provides for Firm does not Employees with Employees with Provide Benefit Spouses Domestic Partners Health Sick Leave Family Medical Leave Bereavement Leave If Proposer cannot offer a benefit to domestic partners because of reasons outside your control, (e.g., there are no insurance providers in your area willing to offer domestic partner coverage)you may be eligible for Reasonable Measures compliance. To comply on this basis, you must agree to pay a cash equivalent and submit a completed Reasonable Measures Application (attached)with all necessary documentation.Your Reasonable Measures Application will be reviewed for consideration by the City Manager, or his designee.Approval is not guaranteed and the City Manager's decision is final. Further information on the Equal Benefits requirement is available at www.miamibeachfl.gov/procurement/. REP 2017-002-JC 20 9. Public Entity Crimes.Section 287.133(2)(a),Florida Statutes,as currently enacted or as amended from time to time,states that a person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a proposal, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a proposal, proposal,or reply on a contract with a public entity for the construction or repair of a public building or public work;may not submit proposals, proposals,or replies on leases of real property to a public entity;may not be awarded or perform work as a contractor, supplier,subcontractor,or consultant under a contract with any public entity;and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017 for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. SUBMITTAL REQUIREMENT: No additional submittal is required. By virtue of executing this affidavit document, Proposer agrees with the requirements of Section 287.133,Florida Statutes,and certifies it has not been placed on convicted vendor list. 10. Non-Discrimination.Pursuant to City Ordinance No.2016-3990,the City shall not enter into a contract with a business unless the business represents that it does not and will not engage in a boycott as defined in Section 2-375(a)of the City Code,including the blacklisting,divesting from,or otherwise refusing to deal with a person or entity when such action is based on race,color,national origin,religion,sex,intersexuality,gender identity,sexual orientation,marital or familial status,age or disability. SUBMITTAL REQUIREMENT: No additional submittal is required.By virtue of executing this affidavit document, Proposer agrees it is and shall remain in full compliance with Section 2-375 of the City of Miami Beach City Code. 11. Moratorium on Travel to and the Purchase of Goods or Services from North Carolina and Mississippi. Pursuant to Resolution 2016-29375, the City of Miami Beach, Florida, prohibits official City travel to the states of North Carolina and Mississippi,as well as the purchase of goods or services sourced in North Carolina and Mississippi. Proposer shall agree that no travel shall occur on behalf of the City to North Carolina or Mississippi,nor shall any product or services it provides to the City be sourced from these states. SUBMITTAL REQUIREMENT: No additional submittal is required.By virtue of executing this affidavit document,Proposer agrees it is and shall remain in full compliance with Resolution 2016-29375. 12. Acknowledgement of Addendum. After issuance of solicitation,the City may release one or more addendum to the solicitation which may provide additional information to Proposers or alter solicitation requirements. The City will strive to reach every . - Proposer having-received solicitation through the City's.e-procurement system, PublicPurchase.com. However, Proposers are solely responsible for assuring they have received any-and all addendum issued pursuant to-solicitation.This Acknowledgement of Addendum section certifies that the Proposer has received all addendum released by the City pursuant to this solicitation. Failure to obtain and acknowledge receipt of all addendum may result in proposal disqualification. Initial to Confirm Initial to Confirm Initial to Confirm Receipt Receipt Receipt Addendum 1 Addendum 6 Addendum 11 Addendum 2 Addendum 7 Addendum 12 Addendum 3 Addendum 8 Addendum 13 Addendum 4 Addendum 9 Addendum 14 Addendum 5 Addendum 10 Addendum 15 If additional confirmation of addendum is required,submit under separate cover. RFP 2017-0021C 21 DISCLOSURE AND DISCLAIMER SECTION The solicitation referenced herein is being furnished to the recipient by the City of Miami Beach (the"City")for the recipient's convenience. Any action taken by the City in response to Proposals made pursuant to this solicitation,or in making any award,or in failing or refusing to make any award pursuant to such Proposals, or in cancelling awards,or in withdrawing or cancelling this solicitation, either before or after issuance of an award,shall be without any liability or obligation on the part of the City. In its sole discretion, the City may withdraw the solicitation either before or after receiving proposals, may accept or reject proposals, and may accept proposals which deviate from the solicitation,as it deems appropriate and in its best interest. In its sole discretion,the City may determine the qualifications and acceptability of any party or parties submitting Proposals in response to this solicitation. Following submission of a Proposal or Proposal,the applicant agrees to deliver such further details, information and assurances, including financial and disclosure data, relating to the Proposal and the applicant including, without limitation, the applicant's affiliates, officers, directors,shareholders,partners and employees,as requested by the City in its discretion. The information contained herein is provided solely for the convenience of prospective Proposers. It is the responsibility of the recipient to assure itself that information contained herein is accurate and complete.The City does not provide any assurances as to the accuracy of any information in this solicitation. Any reliance on these contents,or on any permitted communications with City officials,shall be at the recipient's own risk. Proposers should rely exclusively on their own investigations,interpretations,and analyses.The solicitation is being provided by the City without any warranty or representation,express or implied,as to its content,its accuracy,or its completeness. No warranty or representation is made by the City or its agents that any Proposal conforming to these requirements will be selected for consideration,negotiation,or approval. The City shall have no obligation or liability with respect to this solicitation,the selection and the award process,or whether any award will be made.Any recipient of this solicitation who responds hereto fully acknowledges all the provisions of this Disclosure and Disclaimer,is totally relying on this Disclosure and Disclaimer,and agrees to be bound by the terms hereof.Any Proposals submitted to the City pursuant to this solicitation are submitted at the sole risk and responsibility of the party submitting such Proposal. This solicitation is made subject to correction of errors,omissions,or withdrawal from the market without notice. Information is for guidance only,and does not constitute all or any part of an agreement. The City and all Proposers will be bound only as, if and when a Proposal (or Proposals), as same may be modified, and the applicable definitive agreements pertaining thereto, are approved and executed by the parties, and then only pursuant to the terms of the definitive agreements executed among the parties.Any response to this solicitation may be accepted or rejected by the City for any reason,or for no reason,without any resultant liability to the City. The City is governed by the Government-in-the-Sunshine Law,and all Proposals and supporting documents shall be subject to disclosure as required by such law. All Proposals shall be submitted in sealed proposal form and shall remain confidential to the extent permitted by Florida Statutes, until the date and time selected for opening the responses.At that time, all documents received by the City shall become public records. Proposers are expected to make all disclosures and declarations as requested in this solicitation.By submission of a Proposal,the Proposer acknowledges and agrees that the City has the right to make any inquiry or investigation it deems appropriate to substantiate or supplement information contained in the Proposal,and authorizes the release to the City of any and all information sought in such inquiry or investigation. Each Proposer certifies that the information contained in the Proposal is true, accurate and complete, to the best of its knowledge, information,and belief. Notwithstanding the foregoing or anything contained in the solicitation,all Proposers agree that in the event of a final unappealable judgment by a court of competent jurisdiction which imposes on the City any liability arising out of this solicitation, or any response thereto, or any action or inaction by the City with respect thereto,such liability shall be limited to$10,000.00 as agreed-upon and liquidated damages.The previous sentence, however, shall not be construed to circumvent any of the other provisions of this Disclosure and Disclaimer which imposes no liability on the City. In the event of any differences in language between this Disclosure and Disclaimer and the balance of the solicitation, it is understood that the provisions of this Disclosure and Disclaimer shall always govern.The solicitation and any disputes arising from the solicitation shall be governed by and construed in accordance with the laws of the State of Florida. 'RFP 2017-002-JC 22 PROPOSER CERTIFICATION I hereby certify that: I,as an authorized agent of the Proposer,am submitting the following information as my firm's proposal; Proposer agrees to complete and unconditional acceptance of the terms and conditions of this document, inclusive of this solicitation, all attachments, exhibits and appendices and the contents of any Addenda released hereto, and the Disclosure and Disclaimer Statement; Proposer agrees to be bound to any and all specifications, terms and conditions contained in the solicitation, and any released Addenda and understand that the following are requirements of this solicitation and failure to comply will result in disqualification of proposal submitted; Proposer has not divulged, discussed, or compared the proposal with other Proposers and has not colluded with any other Proposer or party to any other proposal; Proposer acknowledges that all'information contained herein is part of the public domain as defined by the State of Florida Sunshine and Public Records Laws; all responses, data and information contained in this proposal, inclusive of the Proposal Certification, Questionnaire and Requirements Affidavit are true and accurate. Name of Proposer's Authorized Representative: Title of Proposer's Authorized Representative: Signature of Proposer's Authorized Representative: Date: State of FLORIDA ) On this day of ,20_,personally appeared before me •who County of ) stated that (s)he is the of , a corporation, and that the instrument was signed in behalf of the said corporation by authority of its board of directors and acknowledged said instrument to be its voluntary act and deed. Before me: Notary Public for the State of Florida My Commission Expires: RFP 2017-002-IC 23 APPENDIX B MIAMI BEACH " No Proposal " Form 2017-002-JC Emergency Medical Transport Billing and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 N5f�Gfrs irspar€anffor:those vendors vendUrTWNThave reeer ec ifc5iifiaafron 6tr i ns srl erfati5if; ilov dle idea naf:To respc r� to irOte aricf sO rf ; f e___.attadC ed Sfateefecifh RE! PrTir ikir..=T r `atite n o ta' iPr;e0-a i iVotW es i[ie C.kf itfrrr f©rEr a o-h oh how to improve_the Isbfr i diror-process Reit re icy subi it 0 "5faferi e ret-Nei Pro ©sat" ma Uresui it raof rgofiified offufufe dlrei dtiO s. i6 f , RFP 2017-002 JC 24 Statement of No. Proposal WE HAVE ELECTED NOT TO SUBMIT A PROPOSAL AT THIS TIME FOR REASON(S) CHECKED AND/OR INDICATED BELOW: Workload does not allow us to proposal _Insufficient time to respond Specifications unclear or too restrictive Unable to meet specifications _Unable to meet service requirements _Unable to meet insurance requirements _Do not offer this product/service _OTHER. (Please specify) We do_do not_want to be retained on your mailing list for future proposals of this type product and/or service. Signature: Title: Legal Company Name: Note: Failure to respond, either by submitting a proposal or this completed form, may result in your company being removed from our vendors list. PLEASE RETURN TO: CITY OF MIAMI BEACH PROCUREMENT DEPARTMENT ATTN: Jason Crouch PROPOSAL#2017-002-JC 1755 Meridian Ave, 3'd Floor MIAMI BEACH, FL 33139 RFP 2017-002-JC 25 APPENDIX C (-4- MIAMI B Minimum Requirements & Specifications 2017-002-JC Emergency Medical Transport Billing • and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 RFP 2017-002-JC 26 C1. Minimum Eligibility Requirements The Minimum Eligibility Requirements for this solicitation are listed below. Proposer shall submit, with its proposal, the required submittal(s) documenting compliance with each minimum requirement. Proposers that fail to include the required submittals with its proposal or fail to comply with minimum requirements shall be deemed non-responsive and shall not have its proposal considered. 1. Proposer shall have provided Emergency Medical Services (EMS) ambulance billing and Electronic Patient Care Reporting (EPCR) system installation, integration, and management for at least two (2) other governmental entities in the last five (5) years, performing at least 20,000 emergency transports per year. Submittal requirements: For each client reference submitted, the following information is required: 1) Client's Name and Year(s) Contracted; 2) Contact Individual Name&Title,3)Address,4)Telephone, 5)Contact's Email,6)Narrative on Scope of Services provided and final completion in total days, relative to project timeline. 2. Proposer must be enrolled in the Florida Emergency Medical Services Tracking and Reporting System (EMSTARS). 3. Proposer must be enrolled in the National Emergency Medical Services Information System (NEMSIS). C2.Statement of Work Required The City's FIRE-RESCUE DEPARTMENT provides medical transportation for the residents and visitors transported from incident scenes to health care facilities in EMS transport vehicles requiring Basic Life Support (BLS) or Advanced Life Support (ALS). The individuals are charged a BLS or ALS transportation fee, a mileage fee, and other charges including, but not limited to, oxygen administration,cardiac monitoring, intubation and/or spinal immobilization fees. - The services to be provided include, but are not limited to, obtaining patient and insurance information for emergency medical transport services provided, verifying patient insurance and patient demographic information, filing claims and sending invoices to self-pay accounts, submitting claims to Medicare, Medicaid, and insurance companies, processing third party reimbursements, and providing specific management and financial reports on a monthly basis, as specified by the City. The City of Miami Beach is seeking qualified firm(s)to provide Emergency Medical Services(EMS) ambulance billing and Electronic Patient Care Reporting (EPCR) services for the City's Fire- Rescue Department, in accordance with the terms, conditions and specifications contained in this Request for Proposals(RFP). Proposers shall demonstrate their experience in the area of RFP 2017-002-JC 27 Medicare and Medicaid billing, and propose to perform the work in a manner which shall meet or exceed the technical specifications herein contained. C3. Specifications General. The successful Proposer under this contract will provide all services necessary to report, bill and collect for services provided by the City's FIRE-RESCUE DEPARTMENT. Requirements include the acquisition, placement, support, maintenance and connectivity of rugged mobile computer laptop devices in fire rescue vehicle as well as desktop client software at all the City's Fire-Rescue Stations to capture,generate and modify patient care reports, gather and archive patient care data, gather and report performance statistics, generate and process insurance billing and payments, collect and remit funds to the City. The awarded Contractor shall set up, maintain and provide all comprehensive aspects of the EMS reporting, billing and collection services, as required by the scope of services herein contained. These services shall include but not necessarily be limited to: 1. Proposer shall provide sufficient staffing to ensure the smooth and efficient operation of Emergency Medical Transport Reporting, Billing and Collection Services contract. 2. Proposer shall provide full-time Project Manager and/or Customer Service Representatives.("CSR") assigned to the City's contract for EMS transportation billing and collection services, available during normal business hours, Eastern Standard Time (EST) five (5) days a week, Monday through Friday, that are able to communicate (read, write and speak) fluently in English, Spanish and Creole; however, it is not required that each CSR speaks in all the three (3) languages, but there must be available CSRs to conduct business in each language, as necessary. 3. Proposer's computer help desk support, or approved third-party support, must be available seven (7) days a week, twenty-four (24) hours a day, with the ability to provide technical assistance, trouble shooting, and correcting issues that may arise with the computer laptop systems hardware, software and connectivity and provide application support to users entering EPCR reports and accessing the quality control application from desktop platforms. 4. Proposer shall have a local office within Broward County, FL., Palm Beach County, FL., Monroe County, FL., Collier County, FL., Lee County, FL., or Miami- Dade County, FL., as of the date of the issuance of this Request for Proposal.The local office should have staff capable of meeting with City staff on an as-needed basis. RFP 2017-002-JC 28 Scope of Work. 1. A comprehensive electronic patient care report that captures necessary patient care information and computer aided dispatch data required to fulfill the requirements of, FIRE-RESCUE DEPARTMENT, the receiving hospitals, insurance, Medicare, and Medicaid billing,as well as capture the required data necessary to fulfill the State of Florida comprehensive EMS aggregate report requirements. 2. Access via the Internet a website that houses the FIRE-RESCUE DEPARTMENT's patient care procedures and protocols. 3. Connectivity via Bluetooth to Physio-Control's Lifepak 15 defibrillators. 4. Wireless connectivity between EPCR reports writing laptop computers, contractors servers, Physio Controls' LifeNet Internet gateway and FIRE-RESCUE DEPARTMENT patient care protocols. 5. In the event that the City requires additional laptops, any additional costs incurred, will be negotiated at time of necessity. 6. Perform invoicing, collection, and generation of any and all insurance forms and filings, record maintenance and preparation of standard and/or custom reports, as requested or required by FIRE-RESCUE DEPARTMENT. 7. Prepare quarterly State of Florida aggregate EMS reports. 8. Grant desktop computers at all FIRE-RESCUE DEPARTMENT fire stations access to patient care reports for statistical reporting and quality control processing. 9. Perform training for FIRE-RESCUE DEPARTMENT personnel on an as needed basis on desktop and laptop EPCR and quality control applications. 10. Maintain all thirteen (13) and five (5) spare rugged laptop computers in working condition. The contractor agrees to replace or correct any malfunctioning hardware or software within twenty-four hours of FIRE-RESCUE DEPARTMENT's written notification of failure or breakage. 11. Establish a two-way data exchange system with billing hospitals with the ability to electronically transfer (e-Transfer) all EPCRs to the hospital and receive patient and related billing information back from the hospitals. Technical Specifications. Computer / Hardware / Software/ Report Writing and Computer Aided Dispatch ("CAD")Requirements: 1. Awarded Proposer shall be required to supply and maintain thirteen (13) primary and five (5) spare (total of 18 units) rugged and mobile tablets and/or laptops with cellular connectivity, capable of generating and capturing real-time patient care and computer aided dispatch data for the formulation of a comprehensive patient care report and for reporting purposes. 2. Systems shall be configured as follows: Win7 (Win8.1 Pro COA), Intel Core i5-3610ME 2.7GHz, 10.1":XGA Multi Touch + Digitizer LCD, 128GB (or greater) Solid State Drive, 4GB, WiFi, Bluetooth, 4G LTE RFP 2017-002-IC 29 Multi Carrier, GPS Receiver, Dual Pass (Upper:WWAN/Lower:WLAN), TPM 1.2, 5MP or greater Camera, and Emissive Backlit Keyboard, or approved equal configurations. 3. Internet Explorer or equivalent with cellular connectivity to FIRE-RESCUE DEPARTMENT procedures and protocols site and any other websites requested by FIRE-RESCUE DEPARTMENT. 4. Connectivity via Bluetooth to EPCR client software and Physio Control's LifePak 15 manual cardiac defibrillators. 5. Device must have the ability to attach picture and documents to EPCR. 7. Contractor shall provide a stock of digitizer stylus/pens on a regular basis at no cost to the City. 8. Lifenet PC Gateway version-4.0 or 5.0 or current version for processing and transmission of code summary reports from Lifepak 15 defibrillators to receiving FIRE-RESCUE DEPARTMENT station computer(s). Prepare and process quarterly FIRE-RESCUE DEPARTMENT's State of Florida EMS pre-hospital data collection report, in a format designated by EMS Tracking and Reporting System (EMSTARS). 9. Process EPCR computer aided dispatch data generated from the current Miami Beach CAD by Tyler Technology(previously New World Systems)computer system using the current interface. 10. The ability to enter data on an EPCR while reviewing protocols, websites, etc., simultaneously on the tablet. 11. Contractor shall provide capabilities to change, modify, or add fields in underlying software. 12. Contractor shall provide the ability to add a field to document law enforcement case numbers on all motor vehicle accidents/incidents. Invoicing/Billing/Collections Requirements. 1. The Successful Contractor shall employ, maintain and assign an adequate number of competent and qualified professionals, as deemed necessary by the Department to meet the performance requirements. Contractor shall be responsible for the invoicing, collection, and generation of any and all insurance forms and filings, record maintenance and preparation of standard and/or custom reports,as requested or required by the FIRE-RESCUE DEPARTMENT. 2. The invoices for services rendered shall contain the following information: a.Account number of Patient. b. Invoice number. c. Invoice date. d. Name of Patient. e. Name of responsible person if different from patient. f. Complete address of Patient. g. Date of transport. h. Cost of transport including cost breakdown (mileage&oxygen). i. Incident number. j. Transport mileage from and to. RFP 2017-002-JC 30 k. Insurance coverage and instructions(if applicable). I. Billing inquiry telephone number, 800-phone number if not local for satisfaction of the receivable and customer satisfaction. 3. Contractor shall mail bills/invoice forms to patients within five (5) days of receipt of the patient information. This is to include return envelope and address specified by the City of Miami Beach. 4. Patient invoices:All invoices and reporting shall be automated. 5. Contractor shall be responsible for sending follow up bills at thirty-day(30),sixty- day(60), and ninety-day(90) intervals. 6. Contractor shall mail proper insurance forms or electronically process to third party payer as required or requested by the patient. (This is to include envelope and address specified by the City of Miami Beach). 7. Contractor shall post all payments as received directly or electronically within one (1)business day. 8. The Contractor shall agree to make every effort to locate and correct any incorrect billing address for billable patients. 9. Contractor shall agrees to include in the invoice mailing a citizen satisfaction survey and a return, self-addressed and postage paid envelope that will be provided by the City of Miami Beach. Said survey is expected to be no more than one page in,length and of a size not to exceed 81/2 x 11 inches. 10. Contractor will check hospital information twice per self-pay account(if necessary) to obtain/verify patient insurance and contact information. 11. Contractor shall conduct any follow-up required to obtain the necessary insurance information to process invoices for payment. Record of telephone calls and contact shall be maintained and any payment on an account shall be recorded per account. 12. Accept the hard copy or electronic information pertaining to patients' pay or billing documentation from FIRE-RESCUE DEPARTMENT for all patients transported by FIRE-RESCUE DEPARTMENT. 13. Patient invoices:All invoices and reporting systems shall be automated. 14. Contractor shall be responsible for all usual and customary costs incurred as a result of billing and collecting accounts, such as software, credit card processing fees, equipment and the installation of data and phone lines. 15. Contractor shall maintain and update all billings for ambulance services(accounts) to include update of address and telephone numbers obtained through billing and collection efforts. Report shall be provided as necessary. 16. In the event Contractor received payment for services which are later disallowed (such as bad checks paid directly to FIRE-RESCUE DEPARTMENT,or adjustments)by FIRE-RESCUE DEPARTMENT, FIRE-RESCUE DEPARTMENT may offset the amount disallowed from any payment due Contractor. 17. Contractor shall not add a charge of any kind to a billed account. 18. To the extent necessary to fulfill its billing and collection efforts under the awarded contract, Contractor is granted limited authority to sign in an administrative capacity on behalf of FIRE-RESCUE DEPARTMENT the following types of standard forms and correspondence: probate claim filings; letters to patients and their representatives verifying that an account is paid in full;form verifying FIRE- RESCUE DEPARTMENT tax exempt status; and insurance filings and related RFP 2017-002-JC 31 forms. Contractor has no authority to sign any document on behalf of FIRE- RESCUE DEPARTMENT,which imposes liability on FIRE-RESCUE DEPARTMENT. 19. All written billing and collection correspondence must be approved by an FIRE- RESCUE DEPARTMENT designee.All payments and correspondence shall be directed to the mailing address designated by FIRE-RESCUE DEPARTMENT. 20. Contractor agrees to negotiate and arrange modified payment schedules for those individuals unable to pay the full amount when billed. 21. Contractor agrees to refund patient or insurance company refunds within forty-five (45)days of receipt and agrees to all applicable Florida Statutes. 22. Contractor must provide the City of Miami Beach with a refund request including all pertinent information relating to refund payments to patients and/or insurance company. (Contractor to describe procedure in their proposal submittal). 23. Contractor will process all third party reimbursements within one(1)week after receipt of appropriate billing information from primary payer. 24. Contractor shall not settle any accounts for less than the amount indicated by FIRE-RESCUE DEPARTMENT without the prior written approval of the FIRE- RESCUE DEPARTMENT designee. 25. Contractor shall provide copies of remittance advice as required by FIRE- RESCUE DEPARTMENT. 26. Contractor shall post all payments received directly or electronically within one (1) business day and process refund requests with the month following an overpayment. 27. Contractor shall maintain proper insurance forms used by third party payers as required or requested by the patient in either the manual or electronic method. Either way, the contractor shall include information on where to send payments to FIRE-RESCUE DEPARTMENT. 28. Contractor shall expeditiously begin the billing and collection process for those Accounts provided to Contractor by FIRE-RESCUE DEPARTMENT based upon established rates. The method utilized by Contractor to'process the accounts shall be a means approved by FIRE-RESCUE DEPARTMENT Contract Administrator. 29. Contractor shall be responsible for contacting the sender of monies when there is insufficient information to identify which account the payment is being applied to. FIRE-RESCUE DEPARTMENT shall not be required to pay Contractor any collection fees on account until the corresponding account number can be identified. 30. Contractor shall reconcile the number of transports collected with those transmitted to Contractor and contact a FIRE-RESCUE DEPARTMENT designee to report any discrepancies. 31. If this Agreement is terminated, all accounts will be returned to FIRE-RESCUE DEPARTMENT regardless of payments made on account or arrangement made. Upon termination, Contractor will inform any billed account with whom they are dealing to make future payments directly to FIRE-RESCUE DEPARTMENT or other firm identified • by FIRE-RESCUE DEPARTMENT. 32. FIRE-RESCUE DEPARTMENT is the owner of all information submitted to the Contractor. If this Agreement is terminated, all accounts will be returned to FIRE- RFP 2017-0O2)C 32 RESCUE DEPARTMENT regardless of payments made on account or arrangement made. 33. If this Agreement is terminated contractor agrees to provide a raw flat file containing all relevant data that would be needed to re-create an EPCR for any purpose. The contractor agrees to provide the City a one-time column header file w/a brief description of each column's data and how it pertains to the formulation necessary to re-create the EPCR for the purposes mentioned above. 34. Contractor should include sample bill forms and the messages that will be used on each successive bill mailed, as part of the response. All text, format, and color of printing and stock are subject to approval by the City of Miami Beach. Billings should be at maximum intervals of thirty-five (35) days, except for the first invoice that should be rendered within ten (10)days of service. 35. Contractor shall be required to establish a method to accept and process credit card payments from patients through an online and a pay-by-phone solution. The City can be the merchant for the solution but the contractor shall be responsible for all fees associated with the credit card acceptance solution. 36. Contractor shall provide a process for collecting information from local law enforcement agencies and gross billable and payments on all incidents involving motor vehicles. 37. Contractor shall show the ability to increase collection rates annually. 38. Contractor shall have a mechanism in place to find a revenue source for all patients outside of contacting the hospitals. 39. Contractor shall be able to provide litigation services as it may relate to MVA (Motor Vehicle Accident/PIP Claims) incidents should the need arise. These services will only be executed based on direction from the City on an as-needed basis. Medicare and Medicaid Requirements. 1. Contractor shall provide prompt submission of Medicare, Medicaid and insurance claims within seventy-two (72) hours after receiving a completed EPCR, when all information necessary to file the claim is present. 2. Contractor will provide Medicare/Medicaid billings in accordance with all Federal, State and Local laws and Medicare/Medicaid rules and requirements. 3. Contractor shall provide Electronic Claims processing for Medicare and Medicaid and re-file Medicare, Medicaid or insurance claims, as necessary to obtain payment. 4. Contractor shall be prepared to assess service levels prior to billing and classify services into levels that meet Medicare and Medicaid transport criteria. These service levels may, in a limited number of cases, differ from what is indicated on internal documents based upon interpretation and must be brought to FIRE- RESCUE DEPARTMENT'S attention to determine if changes may be necessary. 5. Contractor will provide support for Medicaid or Medicare audits. 6. Contractor shall provide Electronic Claims Processing for Medicare and Medicaid to the City's lock box. • RFP 2017-002-IC 33 Compliance with Applicable Federal,State and Local Laws and Requirements. 1. Provide Health Insurance Portability and Accountability Act (HIPAA) privacy practice requirements to all patients transported in accordance with current regulatory requirements. 2. Comply with all applicable Federal, State, and local laws as they apply to the services being provided, such as but not limited to the Federal Debt Collection Practices Law. This further includes all requirements to maintain confidentiality for all medical and patient information as related in state and local laws or rules and regulations as well as HIPAA laws. 3. Contractor shall facilitate proper security of confidential information and proper shredding of all disposed materials containing such proprietary information in accordance with Florida Law regarding records retention privacy act. Customer Service. 1. Respond to all patients' requests and inquiries, either written or verbal, in a TIMELY manner not to exceed two(2) business days. 2. Agrees to provide and furnish all material and personnel required for the performance of the Agreement. 3. Contractor shall provide Customer Service Representative (CSRs), available during normal business hours, which are able to read, write and speak fluently in English, Spanish and Creole. These CSRs shall be able to assist patients and/or other third party payees in all billing inquiries in a timely and courteous manner. • Customer calls will be facilitated as local within the County or through a "toll free" exchange, which will be published on all invoices. Contractor shall respond within three (3) business days to FIRE-RESCUE DEPARTMENT and patients on requests for information or records. All scripts and protocol for answering and placing calls shall be agreed upon prior to the commencement of services between Contractor and FIRE-RESCUE DEPARTMENT. A record of telephone calls and contacts shall be maintained. 4. Contractor shall be responsible for the mailing of all forms, i.e., HIPAA, customer survey and related forms. Contractor shall be responsible for all associated costs. 5. Contractor shall respond promptly to all patient requests and inquires, either written or verbally in a timely and courteous manner. This and all communications should be in a format that can be tracked by both City and Contractor and shall comply with all applicable Federal, State and Local laws as such laws apply to the services being provided. 6. Contractor shall provide and furnish all materials and personnel required for the performance of the Agreement. 7. Contractor shall provide a designated liaison for patient/payer concerns. 8. Contractor shall provide a 1-800 number and 24/7 (365 days) computer help desk support for the EPCR report writing laptop and desktop hardware, software and its connectivity. RFP 2017-002-JC 34 Document Maintenance. 1. Contractor will maintain any and all documentation records and patient information in a safe and secure manner that will allow inspection and audit by the City of Miami Beach or its agents upon proper notification. 2. Any and all data created by FIRE-RESCUE DEPARTMENT and collected by the contractor is owned by the City of Miami Beach and shall be returned upon request in a format agreeable to City. 3. Contractor shall provide access to its database and a data dictionary for FIRE- RESCUE DEPARTMENT to use for report writing capabilities. Communications with City of Miami Beach Staff. 1. Contractor shall attend meetings with the FIRE-RESCUE DEPARTMENT staff when requested to review contract operations. 2. Contractor shall participate in a yearly audit conducted by FIRE-RESCUE DEPARTMENT consistent with Generally Accepted Accounting Principles- GAAP. This audit will cover the common set of accounting principles, standards and procedures used to compile annual financial statements. 3. Contractor will notify FIRE-RESCUE DEPARTMENT of any changes in federal, state or local laws, rules, regulations and codes that affect this subsequent agreement. 4. Contractor shall designate a Program Manager responsible for all matters related to the Contract, including performance. A toll free number and the name of the Project Manager shall be provided upon commencement of this Agreement The Project Manager shall be available during FIRE-RESCUE DEPARTMENT business hours of 8:30 am to 5:00 pm, Monday through Friday, and shall respond to FIRE-RESCUE DEPARTMENT within one(1)hour. 5. Upon request by FIRE-RESCUE DEPARTMENT, a written response shall be provided to all complaints received by FIRE-RESCUE DEPARTMENT of any alleged actions taken by Contractor and/or its agents. The response shall be provided by Contactor's Project Manager and shall be received by FIRE-RESCUE DEPARTMENT within thirteen (13) days from the date the request is sent to Contractor. The response shall address all questions and statements made by FIRE-RESCUE DEPARTMENT concerning the alleged actions. 6. Contractor shall provide FIRE-RESCUE DEPARTMENT with a read-only access to accounts at locations determined by FIRE-RESCUE DEPARTMENT. 7. Contractor shall provide all necessary developing, copying, faxing, mailings, and all other such related services at no additional cost to FIRE-RESCUE DEPARTMENT. 8. Contractor shall maintain and inform FIRE-RESCUE DEPARTMENT regarding the following: • 1. Records of current fees. 2. Industry approved billing codes. 3. Description files. 4. Current laws applicable to billing of patients for transports. RFP 2017-0O21C 35 5. Records of nation-wide and local trends in transport fee schedule and inform FIRE-RESCUE DEPARTMENT of any changes. 9. FIRE-RESCUE DEPARTMENT; its staff, consultant, and/or contractors shall have the right to visit the offices of Contractor and/or its agents periodically for inspection of the facilities and operations used in the performance of any resultant agreement. 10. For record keeping purposes (not related to billing/collection cycle), Contractor shall retain all account information for a minimum of three(3)years. Training for City of Miami Beach Staff. 1. Contractor shall provide training to appropriate FIRE-RESCUE DEPARTMENT personnel regarding the gathering of necessary information and proper completion of its EPCR laptop and desktop software. 2. Contractor shall provide minimum annual basic and on-going training to appropriate FIRE-RESCUE DEPARTMENT personnel regarding HIPAA compliance. Training may be in the classroom or electronically so long as it is consistent.Certificate must be supplied to employee upon completion of training. 3. Contractor shall provide a series of training programs at locations designated by the City to educate field personnel on the proper utilization of its quality control software application as well as other features available within the reporting software. 4. All training shall be at no charge to the City. Communications with Miami Beach Serviced Hospitals. 1. Contractor shall agree to maintain a working arrangement with all FIRE-RESCUE DEPARTMENT-serviced hospitals including Business Associates Agreement/Electronic Access with hospitals. 2. Contractor shall provide FIRE-RESCUE DEPARTMENT with a copy of all letters of complaint within ten (10) days of receipt, and indicate what action was taken to achieve an acceptable resolution. 3. Contractor shall maintain a working arrangement with all of the FIRE-RESCUE DEPARTMENT serviced hospitals and requests that hospitals provide a copy of patient fact sheets or be provided with demographic and insurance information. Electronic Data Transfer. 1. Electronic Data Transfer: Contractor shall be able to receive and send data electronically. All data being sent to FIRE-RESCUE DEPARTMENT should be transmitted electronically and shall ensure that such transmissions are in compliance with HIPAA and other federal, state and local laws, rules, regulations and codes. 2. Contractor will provide rugged mobile computer laptop specified EPCR units as field computer devices, perform all requisite software installation on such units, as well as facilitate web browser access from desktop units supplied by FIRE- RESCUE DEPARTMENT. Installation, access and units will be provided by RFP 2017-002-JC 36 qualified company representatives. 3. Contractor will provide support for additional modules that could be added to the system already installed without significant disruption to service. Should FIRE- RESCUE DEPARTMENT desire to modify hardware quantities, such changes will require written notification. 4. Server maintenance, upgrades and software changes should all be administered automatically from Contractor's development facility (or alternate location at Contractor's discretion) and downloaded to field tablets during power up/down sequencing. 5. The Contractor must be able to provide up to fifteen (15) temporary laptop or similar devices upon request. The temporary units will be utilized for large events or during periods of peak staffing. 6. The PCR software must be able to verify and capture patient address from a driver's license or social security number via the cell connection. 7. The Successful Proposer will be required to update all hardware equipment provided to the City every three(3)years. EPCR Software and Patient Reporting Capabilities. Information to be gathered by EPCR software should include the following patient information, but not be limited to: 1. Incident Address with Zip Code. 2. Social Security Number. 3. Address. 4. Telephone Number. 5. Date of Birth,Weight,Age, Gender and Race. 6. Family Physician. 7. Medicaid State. 8. Medicaid Number. 9. Medicare Number. 10. Medicare Plus Plan Name. 11. Insurance Number. 12. Group Number. 13. Secondary Insurance Number. 14. Secondary Group Number. 15. Guarantor Information. 16. Documentation of patient or guardian release of patient information for billing, including a digitized patient or guardian signature captured in multiple languages, and supports hand writing recognition. 17. Supports additional billing inputs (i.e., additional supplies such as foam usage or additional medications). 18. Information about the medical condition and complaints of the patient including, but not limited to: a. Cause of injury. b. Trauma triage. c. Patient position information. d. Medical condition(s)and systems details. REP 2017-002-JC 37 e. Narratives by the care providers regarding the incident. f. Ability to enter multiplies patients. 19. Unlimited primary and secondary assessment information including, but not limited to: a. Glasgow Coma Scale (GCS) scoring automatically calculates a total. b. Revised trauma score, scoring automatically calculates a total. c. Pupil size and reaction. d. Capillary refill. e. Respiratory assessment. f. ECG. g. Ectopy. h. Blood glucose level. Skin color. j. Temperature. k. Moisture. Lung sounds. m. Times of vital signs. n. Appearance Pulse Grimace Activity Reparations(APGAR)scores (if applicable). o. Neurological assessment information. p. Medical history including, but not limited to: Prescription medications—with Pick List input. ii. Allergies. iii. Pre-existing conditions. iv. Current conditions. q. Blood pressure; be able to indicate Palp and Mast. r. SPA02. s. LOC. t. Pulse Rate; strength and regularity. u. Allow the user to set either the `within normal limits" or "not assessed"value to each defined assessment area (body part) by click of a single button. 20. All examination of and treatment provided to the patient including, but not limited to: a. Medical control contact name and time of contact physician. b. Patient protocol. c. Method of contact. d. Airway intervention. e. Breathing intervention. f. Circulatory intervention. g. Intravenous intervention. h. Input/output therapy. , i. Provides patient weight conversion to metric for medications. j. Call summary information, including all patient information entered. 21. Data about the care providers including, but not limited to: RFP 2017-002JC 38 a. Vehicle number. b. Primary attendant's(Attendant No. 1) name and license number. c. Attendant No.2's name and license number. d. Attendant No. 3's name and license number. e. Attendant No.4's name and license number. f. Exposure information, including medic name,time,exposure type, description, supervisor notified, exposure report completed, loss of work. 22. Prehospital information including, but not limited to: . a. Call times. b. Scene location information, including County, zip code, response and scene. c. Response districts. d. Special scene conditions. 23. Patient destination information including,but not limited to: a. Receiving hospital with State of Florida four-digit identifier code. b. Reason for selecting a destination selected from pick list. c. Transport urgency(lights and siren, routine, etc.). d. Call disposition BLS,ALSI,ALSII. e. Refusal of care by patient. 24. Odometer readings to determine distances including, but not limited to: a. From ambulance starting point to incident scene. b. From incident scene to patient destination. 25. Desk top software: a. Provide the exact same interface and functionality as the mobile software with the exception of any pen-based, character recognition functionality that cannot be supported on desktop computers. b. Software should provide for monitoring of all supplies utilized and give administration users.the ability to access the data through report writing tools. Security Controls-User Access Control and Security. The software should allow for an array of user access control and security that can vary by module and security level from no access to complete insert/delete/edit capability anywhere in the software system. In addition, the system should: 1. Have a hierarchy of security (logon, record, field, function, object, and user- group)to allow or prevent specified users(or groups of users)to access specified programs at specified levels of data entry, editing, updating, deleting, and reporting functions. RFP 2017-002-JC 39 \ 2. The software should require a valid logon ID and possess two levels of security with different password levels. One is to be used for system administration and configuration and the other for field personnel. 3. The system should also provide a complete audit trail of every transaction or modification executed by each user. 4. System locks, which allow user to "lock" terminal without shutting system down and "unlock" terminal with password, allowing users to step away from the terminal temporarily and prevent unauthorized use. 5. Restrict download of confidential data to high-level-security-authorized users to prevent loss/misuse of confidential data and information. 6. Provide a means to print transaction error/alteration 'logs as needed and specified,depending on application. 7. Automatic timeout or keyboard lock after a defined period of inactivity. 8. List all users logged on to the system at any time, and track this usage by user, date, time, and station. 9. Log off users after specified number of unsuccessful log on attempts and display message for user to contact the system administrator. 10. Allow specified intervals for mandatory password changes. 11. Automatically log off users who have logged off improperly. 12. Revoke a user's access upon too many unauthorized logon attempts. 13. Validity test: critical fields can be checked against a format, a formula, or a table to see that data contained in a field is admissible. Examples: System requires all Advanced Life Support Calls have two vital signs. 14. Range checks: critical fields can be checked against a table or formula to determine if the data entered is within a given range of values. Examples:vehicle mileage not to exceed four digits. 15. Completeness check: critical fields can be checked for a non-empty range and processing action determined according to a specified table. Example: system will not allow the call to be closed without the patient name first and last being entered. 16. Real time error checking: error checking described above is done at the time of input and errors are flagged:to operator either by a user understandable message or operation halt as specified. 17. Time Stamping:All transactions shall be time stamped by the internal clock of the system and this may be modified in the field and exists for all interventions. Reports. Pursuant to the Scope of Services, the Successful Proposer shall perform all services and/or work necessary to complete the following tasks and/or provide the following items: 1. Contractor to provide the City with monthly reports reflecting all new placements from the City, all accounts that are currently active with the contractor, the contractor's collection results, and aging reports reflecting the City's receivable in an aged format. 2. Records/Reports: Contractor will keep full and accurate accounts of services performed by FIRE-RESCUE DEPARTMENT, billing and collections received and RFP 2017-002-JC 40 other records related to the Emergency Medical Transport Billing and Collection Services. 3. Contractor will prepare and provide FIRE-RESCUE DEPARTMENT Administration monthly reports as required by FIRE-RESCUE DEPARTMENT. 4. Contractor shall provide, on a monthly basis, a copy of all monthly financial activity, billing and receivable reports, consistent with GAAP on the account. Reports Compilation and Listing. The Successful Proposer shall maintain a computerized.database of all accounts and shall provide the Department with reports to show management and financial information. The Successful Proposer at a minimum will provide all reports provided to the Department by the incumbent. The Department will provide samples of all current reports to the Successful Proposer. The format of reports required under this contract will be determined by the Department. In addition to the reports described below, the Successful Proposer shall provide any custom reports at the request of the Department in a mutually agreeable timeframe at no additional cost to the City. Monthly reporting is produced after month closing and provided to FIRE-RESCUE DEPARTMENT no later than the 21st of each month. Contractor will generate reports within twenty-four (24) business hours of receiving and posting the last day of the month's receivables from the bank. All reporting will be in the manner as requested by FIRE-RESCUE DEPARTMENT. The following are major reports that Contractor shall produce for FIRE-RESCUE DEPARTMENT: 1. Collection Statistics—GrosslNet Consumption Shows overall monthly computation of gross collection percentages providing number of accounts billed and accounts not billable. The total amounts are summarized. 2. Billing and Collection Statistics—Monthly Summary Provides a running month summary of charge, aggregate transports by unit, aggregate percentage collection by unit, adjustments and payments for the closing month period showing gross and net collection percentagesfor each period. Summarizes totals for each type activity and computes average collections for both gross and net. Note: All payment activity is reflected against the original month billed in order to reflect true collection percentages. 3. Insurance Report—#of Bills with Outstanding Balance by Class Provides summary showing by running (billed) month the number of patient bills having an outstanding balance. Shows balance and number of bills outstanding by class. 4. Collections—by Payer Class,Unit and Geographic Area Provides a running month summary for the closing month period of collections by Payer Class (Self-Pay, Medicare, Medicaid and Private insurance), by Unit and by geographic area. The report also shows for each running month the mix or, percentage (%) of total collected against that month's billing for each class. Also shows number of accounts collected by class and percentage(%)of total. 5. Ambulance Unit Report—Gross Billings this Month by Ambulance Unit RFP 2017-002-IC 41 Shows all billing (new charges) processed and summarized total billing for period by transport unit. 6. Accounts Receivable—Summary Provides summary for period ending of Accounts Receivable showing gross billing, payments received/processed, reflected write-offs and adjustments, reversals and ending balance. 7. Account Activity—Monthly Billing Report(Charges) Shows all billing (new charges) processed alpha sorted by Last Name and summarized total billing for period. 8. Account Activity—Monthly Payment Report(Receivables) Provides a batch oriented listing of all payments processed including check number and type of payment (self-pay, Medicare, Medicaid, private insurance). Report reconciles against bank deposit and ties back to EOB detail for secondary filing, refund processing and adjustments. 9. Collections—Summary to Date, Monthly Running Shows receivables as applied to"original billed month." 10. Monthly Refund Schedule Report provided by account detail of associated payments reflecting an overpayment and necessary refund to be processed. 11. Refund Request Provides for previous billing month,with a separate sheet per account, requesting refund on overpayment accounts. This includes all information pertinent to determining refund. 12. Distribution of Charges and Collections This report will track the charges. payments and financial class mix of all patients fora given month. 13. Aged Receivable Report This report will have outstanding invoices sorted by date for current, thirty, sixty, ninety and over ninety days.This report will provide totals for these categories. 14. Patient Alpha Listing This report lists all invoices alphabetically by patient name. 15. Monthly Payment Listing This report lists payments, bad checks, required charge offs, and refunds posted to each patient's account. 16. Overpayment Reports This report lists all patients due refunds as a result of overpayment of account. 17. Additional Information Reports may include any statistical information pertaining to medical calls including but not limited to-intubation analysis, IV success rates, chief complaint call volumes and number of.cardiac arrests and trauma calls. Responsibilities of the City of Miami Beach. 1. The City of Miami Beach will comply with all Federal, State and Local laws, rules and regulations as applicable to the services being contracted. 2. The City of Miami Beach will agree to use the successful firm for all medical REP 2017-002-IC 42 billings exclusively for the service specified herein as long as the contract agreement is in force. 3. The City of Miami Beach will make every effort to obtain the proper billing address for all billable patients prior to forwarding to the Contractor. 4. The City will pay the Contractor additional fees for any postage increases that may occur during the contract period. However, this fee will only be the actual cost of increase. Service Fees. The Selected Proposer shall perform EMS Billing and collection services on behalf of the FIRE-RESCUE DEPARTMENT, and shall conform to the following: 1. All monies collected by the Selected Proposer shall be deposited in the designated lockbox. 2. At the end of each calendar month Selected Proposer shall send an invoice to the Department with collection details of all Department transports entered in the Selected Proposer's billing system from the preceding month. 3. The fees shall be based upon contractor performance and expressed as a percentage of actual collections remitted to the City of Miami Beach. This fee shall be all-inclusive. No additional payments shall fall due under this contract except for any refunds due contractor due to patient overpayment refunds. 4. The Successful Proposer shall be entitled to fees on all collections for billings during Contract term, up to six (6) months after expiration or termination of Contract. The Department will be entitledto a refund of fees due to refunds on collections for billings during Contract term, up to one (1) year after expiration or termination of Contract. c Florida Certified Public Expenditure(CPE) Program. 1. At the request of the City, the Selected Proposer shall provide ongoing consulting/costing services to enroll and/or maintain the City of Miami Beach in the Florida Certified Public Expenditure (CPE) Program for Emergency Medical Transportation (PEMT) and the Intergovernmental Transfer (IGT) PEMT which includes Medicaid managed care transports revenue programs. Balance of Page Intentionally Left Blank RFP 2017-002-IC 43 APPENDIX D P- MIAMI BEACH Special Conditions 2017-002-JC Emergency Medical Transport Billing and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 RFP 2017-002-JC 44 1. TERM OF CONTRACT. The contract(s) entered into with the successful proposer(s) shall have an initial term of three(3)years. 2. OPTIONS TO RENEW. The City, through its City Manager, will have the option to extend for two (2) additional one (1) year periods subject to the availability of funds for succeeding fiscal years. 3. PRICES SHALL BE FIXED AND FIRM. All prices quoted in the awardee's Proposal submittal shall remain firm and fixed, unless amended in writing by the City. 3.1 COST ESCALATION. Prices must be held firm during the initial term of the agreement. During the renewal term, the City may consider prices increases not to increase the applicable Bureau of Labor Statistics (www.bls.gov) CPI-U index or 3%,whichever is less. The City may also consider increases based on mandated Living Wage increases. In considering cost escalation due to Living Wage increases, the City will only consider the direct costs related to Living Wage increases, exclusive of overhead, profit or any other related cost. 4. EQUITABLE ADJUSTMENT. The City, through its City Manager, may, in its sole discretion, make an equitable adjustment in the contract terms and/or pricing or availability of supply is affected by extreme or unforeseen volatility in the marketplace, that is, by circumstances that satisfy all the following criteria: (1) the volatility is due to circumstances beyond the successful Proposer(s) control, (2) the volatility affects the marketplace or industry, not just the particular contract source of supply, (3) the effect on pricing or availability of supply is substantial, and (4) the volatility so affects the successful Proposer(s)that continued performance of the contract would result in a substantial loss. Successful Proposer(s) might have to supply documentation to justify any requested percentage increase in cost to the City of Miami Beach. 5. ADDITION/DELETION OF FACILITIES/SERVICE/PRODUCTS. Although this solicitation identifies specific items/products, it is hereby agreed and understood that any related item/products may be added to, and any awarded items/products may be deleted from, this contract at the option of the City. When an addition to the contract is required, the Successful Proposer(s) under this contract and other suppliers, as deemed necessary shall be invited to submit price quotes for these new items/products. If these quotes are comparable with market prices offered for similar items/products, the supplier(s)and item(s) shall be added to the contract, if it is in the best interest of the City and an addendum and a separate purchase order or change order shall be issued by the City. 6. INDEMNIFICATION. Provider shall indemnify and hold harmless the City and its officers, employees, agents and instrumentalities from any and all liability, losses or damages, including attorneys' fees and costs of defense, which the City or its officers, employees, agents or instrumentalities may incur as a result of claims, demands, suits, causes of actions or proceedings of any kind or nature arising out of, relating to or resulting from the performance of this Agreement by the Provider or its employees, agents, servants, partners principals or subcontractors. Provider shall pay all claims and losses in connection therewith and shall investigate and defend all claims, suits or actions of any,kind or nature in the name of the City, where applicable, including appellate proceedings, and shall pay all costs, judgments, and attorney's fees which may issue thereon. Provider expressly understands and agrees that any insurance protection required by this RFP 2017-002-JC 45 Agreement or otherwise provided by Provider shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. 7. COMPETITIVE SPECIFICATIONS. It is the goal of the City to maximize competition for the project among suppliers & contractors. Consultant shall endeavor to prepare all documents, plans & specifications that are in accordance with this goal. Under no condition shall Consultant include means & methods or product specifications that are considered "sole source" or restricted without prior written approval of the City. 8. NEGOTIATIONS. Upon approval of selection by the City Commission, negotiations between the City and the selected Proposer (s) will take place to arrive at a mutually acceptable Agreement, including final scope of services, deliverables and cost of services. RFP 2017-002-JC 46 APPENDIX E • MIAMI BEACH Cost Proposal Form 2017-002-JC Emergency Medical Transport Billing and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 RFP 2017-002-JC 47 APPENDIX E PROPOSAL TENDER FORM Failure to submit,Proposal Tender Form, in its entirety and fully executed,by the deadline established for the receipt of proposals will result in Proposal being deemed non-responsive and being rejected. Proposer affirms that the prices stated on the cost proposal form below represents the entire cost of the items in full accordance with the requirements of this RFP, inclusive of its terms, conditions, specifications and other requirements stated herein, and that no claim will be made on account of any increase in wage scales, material prices, delivery delays, taxes, insurance, cost indexes or any other unless a cost escalation provision is allowed herein and has been exercised by the City Manager in advance. The Cost Proposal Form shall be completed mechanically or, if manually, in ink. Proposal Tender Forms completed in pencil shall be deemed non-responsive.All corrections on the Cost Proposal Form shall be initialed. The numbers are provided based on the City's current contract and last fiscal year performance.The City does not guarantee the same amount for future contract years. Proposer must calculate and state the extended total amount for each line, Items 1-4, culminating in a Grand Total Price to be entered below. Item Description Estimated amount , %q Discount ExtendedTotal •t' - (;a) - , 0 b) (a X ti=c) 1 Cost for Billing Services $2,000,000.00 % $ , - SUB-TOTAL Extended Total ,Description . EstimatedQtiarrtityq = Uni#COSI ."-- (ouantiry`_X_unit'costy 2 Medicaid Account Billin• Service 2,200 $ $ : _ SUB-TOTAL. Item! Description • Q ntit Ezti x total It p y ' _ Ur�d Cast: ' (Quntity:X Unit_Cost) Lease of Computers: Proposer must state an additional fee,if any 3 for the lease of the 18th ruggedized field 18 $ $ com•uters as re•uested in Ap•endix C. ' • SUB-TOTAL ' ` ` ' ' EidenaedTotal • Descnptiorr • . Estimated Quantity Un-it-.Coit' (Quantity-x-.unit_cost) 4 Privac Notices 7500 $ $ '•- ,., • ' SUB-TOTAL+ GRANDMOTALOTEMSTAI $ RFP 2017-002-JC 48 Proposer's Affirmation Company: Authorized Representative: Address: Telephone: Email: Authorized Representative's Signature: Balance of Page Intentionally Left Blank RFP 2017-002-IC 49 APPENDIX F Insurance Requirements - 2017-002-JC Emergency MedicalTransport Billing and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 RFP 2017-002-JC 50 MIAMIBEACH INSURANCE REQUIREMENTS This document sets forth the minimum levels of insurance that the contractor is required to maintain throughout the term of the contract and any renewal periods. XXX 1. Workers'Compensation and Employer's Liability per the Statutory limits of the state of Florida. XXX 2. Comprehensive General Liability (occurrence form), limits of liability $ 1,000,000.00 per occurrence for bodily injury property damage to include Premises/ Operations; Products, Completed Operations and Contractual Liability. Contractual Liability and Contractual Indemnity (Hold harmless endorsement exactly as written in"insurance requirements"of specifications). XXX 3. Automobile Liability-$1,000,000 each occurrence-owned/non-owned/hired automobiles included. 4. Excess Liability-$ .00 per occurrence to follow the primary coverages. XXX 5. The City must be named as and additional insured on the liability policies; and it must be stated on the certificate. 6. Other Insurance as indicated: _Builders Risk completed value $ .00 Liquor Liability $ .00 Fire Legal Liability $ .00 _Protection and Indemnity $ .00 Employee Dishonesty Bond $ .00 Other $ .00 XXX 7. Thirty(30)days written cancellation notice required. .XXX 8. Best's guide rating B+:VI or better, latest edition. XXX 9. The certificate must state the proposal number and title The City of Miami Beach is self-insured. Any and all claim payments made from self-insurance are subject to the limits and provisions of Florida Statute 76828, the Florida Constitution, and any other applicable Statutes. RFP 2017-002-JC 51 ATTACHMENT C CONSULTANTS RESPONSE TO THE (RFP) sunbiz.org - Florida Department of State Page 1 of 1 Florida Department of State DIVISION OF CORPORATIONS If JI'IL;!Vs r 1j 5ui .org Lit;file•'i Ff.0 ebt .1 I,. Previous on List Next on List Return to List Filing History Fictitious Name Detail Fictitious Name INTERMEDIX Filing Information Registration Number G11000025470 Status ACTIVE Filed Date 03/10/2011 Expiration Date 12/31/2021 Current Owners 1 County BROWARD Total Pages 2 Events Filed 1 FEI/EIN Number 22-3875190 Mailing Address 6451 N.FEDERAL HIGHWAY,SUITE 1000 FT.LAUDERDALE,FL 33308 Owner Information ADVANCED DATA PROCESSING,INC. 6451 N.FEDERAL HIGHWAY,SUITE 1000 FT.LAUDERDALE,FL 33308 FEI/EIN Number:22-3875190 Document Number:F02000005151 Document Images 03/10/2011—Fictitious Name Filing View image in PDF format 07/07/2016—Fictitious Name Renewal Filing View image in PDF format Previous on List Next on List Return to List Filing History Fonda Department of State.Division of Corporations http://dos.sunbiz.org/scripts/ficidet.exe?action=DETFEI&docnum=G 11000... 11/1/2018 Detail by FEI/EIN Number Page 3 of 3 401 N. MICHIGAN AVENUE, SUITE 2700 CHICAGO, IL 60611 Title Director ZIMMERLI, BERT 401 N. MICHIGAN AVENUE, SUITE 2700 CHICAGO, IL 60611 Annual Reports Report Year Filed Date 2017 05/18/2017 2018 04/13/2018 2018 10/28/2018 Document Images 10/28/2018—AMENDED ANNUAL REPORT View image in PDF format 04/13/2018—ANNUAL REPORT View image in PDF format 05/18/2017—ANNUAL REPORT View image in PDF format 04/14/2016—ANNUAL REPORT View image in PDF format 05/01/2015—ANNUAL REPORT View image in PDF format 04/27/2014—ANNUAL REPORT View image in PDF format 04/18/2013—ANNUAL REPORT View image in PDF format 03/27'2012—ANNUAL REPORT View image in PDF format 09/26/2011—Req.Agent Change View image in PDF format 01/14/2011—ANNUAL REPORT View image in PDF format 01/28/2010—ANNUAL REPORT View image in PDF format 01/21/2009—ANNUAL REPORT View image in PDF format 04/28/2008—ANNUAL REPORT View image in PDF format 04/23/2007—ANNUAL REPORT View image in PDF format 03/03/2006—ANNUAL REPORT View image in PDF format 04/18/2005—ANNUAL REPORT View image in PDF format 03/19/2004—ANNUAL REPORT View image in PDF format 04/04/2003—ANNUAL REPORT View image in PDF format 10/11/2002—Foreign Profit View image in PDF format Ciorida Department of State,Division of Corporations http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inq... 11/1/2018 intermedix Response to Request for Proposals ( RFP) for Emergency Medical Transport Billing and Collection Services • 2017-002-JC V1-arch 8, 2017 @ 3:00 PM Local Time Darryl Hartung Jason Crouch Vice President, Business Development Procurement Contracting Officer H Intermedix Corporation Miami Beach Department of Procurement 6451 N.Federal Highway Management Suite 1000 1755 Meridian Avenue,3rd Floor Fort Lauderdale,FL 33308 Miami Beach,FL 33139 305.459.0653', Darryl.Hartuneintermedix.com 305.673.7000 x6694 jasoncrouch@miamibeachfl.gov • b ' : .' I. p ' . 4 • . , --r • • ,.. • . I„ • • . . . . , • , . .: .., .... 4. RFP 2017-002-JC . • � '' Tab 1 : Cover Letter & Vinimum Qualifications Requirements .. ,_ x aiii: _ u, u, __ , 7 3,, 3,, _ 3‘ , .c,2016 I ntermedix Corporation I ww.v.intermedix.com M . S intermedia TAB 1: COVER LETTER & MINIMUM QUALIFICATIONS REQUIREMENTS 1.1 Cover Letter & Table of Contents Cover Letter March 7,2017 Jason Crouch,Procurement Officer II Miami Beach Department of Procurement Management 1755 Meridian Avenue,3'd Floor Miami Beach,FL 33139 Dear Mr.Crouch and the Evaluation Committee: Attached is the Intermedix proposal for Emergency Medical Transport Billing and Collection Services in response to RFP 2017-002-JC for the City of Miami Beach.We are proud to have served the City for over 22 years providing best-in-class billing and collection services. During our longstanding partnership we have collected nearly$33 million and have employed dozens of Miami Beach residents along with hundreds of Miami-Dade County residents.These results are a direct outcome of the City's efforts and our experience,people,processes,and technology. Our collaborative approach to providing billing and collection services throughout the years has resulted in consistent revenue collection and compliance with local,state and federal policies and controls. Jack Donahue and his team are committed to continuing to work closely with the City and our physical proximity to Miami Beach allows us to provide you with personal,local attention that no other vendor can provide. Other vendors do not provide the level of client service that Intermedix provides by having employees in place that have been intimately involved with the City's account for nearly 17 years.Throughout our relationship, we have often attended on-site meetings, provided fee schedule increase projections, industry and compliance guidance and have customized our services to ensure the satisfaction of Miami Beach. We have worked together to integrate and customize our processes to optimize collections for the City through significant effort on both our parts.This includes significant Intermedix efforts over the years to electronically integrate with City transport hospitals.This mutual investment has resulted in consistent collections,regular communication and quick resolution of issues that do surface.To confirm the accuracy of our billing processes,the Miami Beach Internal Audit Department has conducted regular audits resulting in consistent and compliant billing and collections processes. 1 ©2017 Intermedix Corporation www.intermedix.com X intermedix Our technical and cost proposal provides several different technology options and ensures that Intermedix can continue to meet the high expectations and deliver customized processes that the City relies upon for its EMS billing program.In the case of Miami Beach,our detailed understanding of the resources and processes required to meet your consistency and quality expectations have been factored into our overall proposal in a way that other vendors are likely to overlook. Intermedix is committed to continuing the close-working relationship with the City and to move forward in our mutual journey to upgrade and improve our collective processes with this contract. Darryl Hartung and Rebeca Botero will also provide a continuity of support and responsiveness to focus on EMS billing results. We are confident that our knowledge,technology and customer service model continues to make us the right partner for Miami Beach.We are dedicated to providing superior service and are committed to your success. Please reach out to your primary contact for this proposal,Darryl Hartung,Vice President at (305)459-0653 or via email at Darryl.Hartungaintermedix.com should you need any further information. Respectfully submitted, -----:7;..--, ,-1 in Cooke,Chief Operating icer Intermedix Corporation 2 C 2017 Intermedix Corporation www.intermedix.com X intermedix Table of Contents TAB 1:COVER LETTER&MINIMUM QUALIFICATIONS REQUIREMENTS 1 1.1 Cover Letter&Table of Contents 1 1.2 Proposal Certification, Questionnaire&Requirements Affidavit(Appendix A) 4 1.3 Minimum Qualifications Requirements 7 TAB 2: EXPERIENCE&QUALIFICATIONS 8 2.1 Qualifications of Proposing Firm 8 2.2 Qualifications of Proposer Team 8 2.3 Disaster Recovery Compliance 13 2.4 Financial Capacity 17 TAB 3:SCOPE OF SERVICES PROPOSED 18 TAB 4:COST PROPOSAL 88 3 ©2017 Intermedix Corporation www.intermedix.com �►i intermedix 1.2 Proposal Certification, Questionnaire & Requirements Affidavit (Appendix A) Please see our completed and executed Appendix A within the following pages. Additional Detail 2. Conflict Of Interest.All Proposers must disclose, in their Proposal,the name(s) of any officer,director, agent,or immediate family member(spouse, parent,sibling,and child) who is also an employee of the City of Miami Beach. Further,all Proposers must disclose the name of any City employee who owns,either directly or indirectly, an interest of ten (10%) percent or more in the Proposer entity or any of its affiliates. SUBMITTAL REQUIREMENT: Proposers must disclose the name(s) of any officer, director, agent,or immediate family member(spouse, parent,sibling,and child) who is also an employee of the City of Miami Beach. Proposers must also disclose the name of any City employee who owns,either directly or indirectly,an interest of ten (10%) percent or more in the Proposer entity or any of its affiliates. Intermedix does not have any conflicts of interest to report. 3. References& Past Performance. Proposer shall submit at least three (3) references for whom the Proposer has completed work similar in size and nature as the work referenced in solicitation. SUBMITTAL REQUIREMENT: For each reference submitted,the following information is required: 1) Firm Name,2) Contact Individual Name&Title, 3)Address,4) Telephone, 5) Contact's Email and 6) Narrative on Scope of Services Provided. Reference 1 Reference 2 Reference 3 1)Miami Dade County Fire Rescue City of Fort Lauderdale Fire City of Hialeah Fire Rescue Department 2)Scott Mendelsberg,Assistant Daniel Oatmeyer,Batallion Chief Michael Anchia,Fire Chief Director/CFO 3)9300 NW 41 St.,Miami,FL 528 NW 2"d Street,Fort 501 Palm Avenue,Hialeah,FL Lauderdale,FL 4)786-331-4902 954-828-6800 305-883-6909 5) doatmeyerCafortlauderdale.gov manchiaOhialeahfl.gov scoff.m endelsberagm iamidade.gov 6)EMS Billing and Collection EMS Billing and Collection EMS Billing and Collection Services Services and ePCR Services software/hardware 4 ©2017 Intermedix Corporation www.intermedix.com intermedia 5. Vendor Campaign Contributions. Proposers are expected to be or become familiar with,the City's Campaign Finance Reform laws,as codified in Sections 2-487 through 2-490 of the City Code. Proposers shall be solely responsible for ensuring that all applicable provisions of the City's Campaign Finance Reform laws are complied with, and shall be subject to any and all sanctions, as prescribed therein, including disqualification of their Proposals, in the event of such non-compliance. SUBMITTAL REQUIREMENT: Submit the names of all individuals or entities(including your sub-consultants) with a controlling financial interest as defined in solicitation. For each individual or entity with a controlling financial interest indicate whether or not each individual or entity has contributed to the campaign either directly or indirectly,of a candidate who has been elected to the office of Mayor or City Commissioner for the City of Miami Beach. Intermedix does not have any campaign contributions to report. 5 2017 Intermedix Corporation www.intermedix.com APPENDIX A (-P—. MIAMIBEAC Proposal Certification , Questionnaire & Requirements Affidavit 2017-002-JC Emergency Medical Transport Billing and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 'EP 01 •02-1 17 . Solicitation No: Solicitation Title: 2017-002-JC Emergency Medical Transport Billing and Collection Services Procurement Contact Tel: Emat Jason Crouch 305-673-7000 ext.:6694 jasoncrouch@miamibeachfl.gov PROPOSAL CERTIFICATION, QUESTIONNAIRE&REQUIREMENTS AFFIDAVIT Purpose: The purpose of this Proposal Certification, Questionnaire and Requirements Affidavit Form is to inform prospective Proposers of certain solicitation and contractual requirements, and to collect necessary information from Proposers in order that certain portions of responsiveness, responsibility and other determining factors and compliance with requirements may be evaluated. This Proposal Certification, Questionnaire and Requirements Affidavit Form is a REQUIRED FORM that must be submitted fully completed and executed. 1. General Proposer Information. FIRM NAME: Advanced Data Processing,Inc.,a subsidiary of Intermedix Corporation No.of Years in Business: No.of Years in Business Locally: No.of Employees: 38 years 38 years 2400+- OTHER NAME(S)PROPOSER HAS OPERATED UNDER IN THE LAST 10 YEARS: Intermedix FIRM PRIMARY ADDRESS(HEADQUARTERS): 6431 North Federal Highway.Suite 1000 CITY: Fort Lauderdale STATE: ZIP CODE: 33308 FL TELEPHONE NO.: 954-308-8700 TOLL FREE NO.: FAX NO.: 954-308-8723 FIRM LOCAL ADDRESS: 6451 North Federal Highway,Suite 1000 CITY: Fort Lauderdale STATE: ZIP CODE: FL 33303 PRIMARY ACCOUNT REPRESENTATIVE FOR THIS ENGAGEMENT: Darryl Hartung,Vice President of Client Relations ACCOUNT REP TELEPHONE NO.: 305459-0633 ACCOUNT REP TOLL FREE NO.: ACCOUNT REP EMAIL Darryl.Hartungaintermedix.com FEDERAL TAX IDENTIFICATION NO.: 22-3875190 The City reserves the right to seek additional information from Proposer or other source(s),including but not limited to:any firm or principal information, applicable licensure,resumes of relevant individuals,client information,financial information,or any information the City deems necessary to evaluate the capacity of the Proposer to perform in accordance with contract requirements. RFP 2017-002-JC 1 8 1. Veteran Owned Business.Is Pro oser claiming a veteran owned business status? YES x NO SUBMITTAL REQUIREMENT: Proposers claiming veteran owned business status shall submit a documentation proving that firm is certified as a veteran-owned business or a service-disabled veteran owned business by the State of Florida or United States federal government,as required pursuant to ordinance 2011-3748. 2. Conflict Of Interest All Proposers must disclose,in their Proposal,the name(s)of any officer,director,agent,or immediate family member (spouse, parent, sibling, and child) who is also an employee of the City of Miami Beach. Further, all Proposers must disclose the name of any City employee who owns, either directly or indirectly, an interest of ten (10%) percent or more in the Proposer entity or any of its affiliates. SUBMITTAL REQUIREMENT: Proposers must disclose the name(s)of any officer, director, agent,or immediate family member (spouse,parent,sibling,and child)who is also an employee of the City of Miami Beach. Proposers must also disclose the name of any City employee who owns, either directly or indirectly,an interest of ten(10%)percent or more in the Proposer entity or any of its affiliates. 3. References&Past Performance.Proposer shall submit at least three(3)references for whom the Proposer has completed work similar in size and nature as the work referenced in solicitation. SUBMITTAL REQUIREMENT: For each reference submitted, the following information is required: 1) Firm Name, 2) Contact Individual Name&Title,3)Address,4)Telephone,5)Contact's Email and 6)Narrative on Scope of Services Provided. 4. Suspension,Debarment or Contract Cancellation.Has Proposer ever been debarred,suspended or other legal violation,or had a contract cancelled due topfzpirformance by an • blic sector agency? YES x NO SUBMITTAL REQUIREMENT: If answer to above is°YES,' Proposer shall submit a statement detailing the reasons that led to action(s). 5. Vendor Campaign Contributions. Proposers are expected to be or become familiar with, the City's Campaign Finance Reform laws, as codified in Sections 2-487 through 2-490 of the City Code. Proposers shall be solely responsible for ensuring that all applicable provisions of the City's Campaign Finance Reform laws are complied with,and shall be subject to any and all sanctions, as prescribed therein,including disqualification of their Proposals,in the event of such non-compliance. SUBMITTAL REQUIREMENT: Submit the names of all individuals or entities(including your sub-consultants) with a controlling financial interest as defined in solicitation. For each individual or entity with a controlling financial interest indicate whether or not each individual or entity has contributed to the campaign either directly or indirectly, of a candidate who has been elected to the office of Mayor or City Commissioner for the City of Miami Beach. 6. Code of Business Ethics. Pursuant to City Resolution No.2000-23879,each person or entity that seeks to do business with the City shall adopt a Code of Business Ethics('Code°)and submit that Code to the Department of Procurement Management with its proposal/response or within five(5)days upon receipt of request The Code shall,at a minimum,require the Proposer,to comply with all applicable governmental rules and regulations including, among others, the conflict of interest, lobbying and ethics provision of the City of Miami Beach and Miami Dade County. SUBMITTAL REQUIREMENT: Proposer shall submit firm's Code of Business Ethics. In lieu of submitting Code of Business Ethics,Proposer may submit a statement indicating that it will adopt,as required in the ordinance,the City of Miami Beach Code of Ethics,available at www.miamibeachfl.govlprocurement/. RFP 2017-002-(C 19 • • • 7. ..• e _-. .e• •et e • - - _- - _et - -- - e e see - benefits,and$12.92/hr without benefits. using the Consumer Price Index for all Urban Consumero(CPI U)Miami/Ft.Lauderdale,issued by the U.S. Department of Labcr's e -es - • e • . . . .- . . •. . .. .• . . - • -• .. :• •- - - , same(in a particular year). at its colo option, immediately deem said Proposer as non responsive, and may further subject Proposer to additional penalties - .- . . ... . e e ' e •- . , . .•••: - ' - SUBMITTAL ECUIIRE _ .ee . ... . _ ___ . _ _ _ .. ...e. • -_.. r 8. Equal Benefits for Employees with Spouses and Employees with Domestic Partners. When awarding competitively solicited contracts valued at over$100,000 whose contractors maintain 51 or more full time employees on their payrolls during 20 or more calendar work weeks, the Equal Benefits for Domestic Partners Ordinance 2005-3494 requires certain contractors doing business with the City of Miami Beach, who are awarded a contract pursuant to competitive proposals, to provide"Equal Benefits"to their employees with domestic partners, as they provide to employees with spouses. The Ordinance applies to all employees of a Contractor who work within the City limits of the City of Miami Beach,Florida;and the Contractor's employees located in the United States, but outside of the City of Miami Beach limits, who are directly performing work on the contract within the City of Miami Beach. A. Does your company provide or offer access to any benefits to employees with spouses or to spouses of employees? x YES NO B. Does your company provide or offer access to any benefits to employees with(same or opposite sex)domestic partners*or to domestic partners of employees? x YES NO C. Please check all benefits that apply to your answers above and list in the "others section any additional benefits not already specified. Note: some benefits are provided to employees because they have a spouse or domestic partner, such as bereavement leave;other benefits are provided directly to the spouse or domestic partner.such as medical insurance. 'Please see our provided BENEFIT Firm Provides for Firm Provides for Firm does not certificate of insurance Employees with Employees with Provide Benefit for more nformation. Spouses Domestic Partners Health Sick Leave Family Medical Leave Bereavement Leave If Proposer cannot offer a benefit to domestic partners because of reasons outside your control, (e.g., there are no insurance providers in your area willing to offer domestic partner coverage) you may be eligible for Reasonable Measures compliance. To comply on this basis, you must agree to pay a cash equivalent and submit a completed Reasonable Measures Application (attached)with all necessary documentation.Your Reasonable Measures Application will be reviewed for consideration by the City Manager, or his designee. Approval is not guaranteed and the City Manager's decision is final. Further information on the Equal Benefits requirement is available at www.miamibeachfl.gov/procurement/. RFP 2017-002-JC 20 9. Public Entity Crimes.Section 287.133(2)(a),Florida Statutes,as currently enacted or as amended from time to lime,states that a person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a proposal, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a proposal, proposal,or reply on a contract with a public entity for the construction or repair of a public building or public work;may not submit proposals, proposals,or replies on leases of real property to a public entity;may not be awarded or perform work as a contractor, supplier,subcontractor,or consultant under a contract with any public entity;and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017 for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. SUBMITTAL REQUIREMENT: No additional submittal is required.By virtue of executing this affidavit document, Proposer agrees with the requirements of Section 287.133,Florida Statutes,and certifies it has not been placed on convicted vendor list 10. Non-Discrimination.Pursuant to City Ordinance No.2016-3990,the City shall not enter into a contract with a business unless the business represents that it does not and will not engage in a boycott as defined in Section 2-375(a)of the City Code,including the blacklisting, divesting from,or otherwise refusing to deal with a person or entity when such action is based on race,color,national origin,religion,sex,intersexuality,gender identity,sexual orientation,marital or familial status,age or disability. SUBMITTAL REQUIREMENT: No additional submittal is required.By virtue of executing this affidavit document, Proposer agrees it is and shall remain in full compliance with Section 2-375 of the City of Miami Beach City Code. 11. Moratorium on Travel to and the Purchase of Goods or Services from North Carolina and Mississippi. Pursuant to Resolution 2016-29375, the City of Miami Beach, Florida, prohibits official City travel to the states of North Carolina and Mississippi, as well as the purchase of goods or services sourced in North Carolina and Mississippi. Proposer shall agree that no travel shall occur on behalf of the City to North Carolina or Mississippi,nor shall any product or services it provides to the City be sourced from these states. SUBMITTAL REQUIREMENT: No additional submittal is required.By virtue of executing this affidavit document, Proposer agrees it is and shall remain in full compliance with Resolution 2016-29375. 12. Acknowledgement of Addendum. After issuance of solicitation, the City may release one or more addendum to the solicitation which may provide additional information to Proposers or alter solicitation requirements. The City will strive to reach every Proposer having received solicitation through the City's e-procurement system, PublicPurchase.com. However, Proposers are solely responsible for assuring they have received any and all addendum issued pursuant to solicitation.This Acknowledgement of Addendum section certifies that the Proposer has received all addendum released by the City pursuant to this solicitation. Failure to obtain and acknowledge receipt of all addendum may result in proposal disqualification. Initial to Confirm Initial to Confirm Initial to Confirm Receipt Receipt Receipt KC Addendum 1 Addendum 6 Addendum 11 (;C Addendum 2 Addendum 7 Addendum 12 Addendum 3 Addendum 8 Addendum 13 Addendum 4 Addendum 9 Addendum 14 Addendum 5 Addendum 10 Addendum 15 If additional confirmation of addendum is required,submit under separate cover. RFP 2017-002-JC 21 DISCLOSURE AND DISCLAIMER SECTION The solicitation referenced herein is being furnished to the recipient by the City of Miami Beach (the'City")for the recipient's convenience. Any action taken by the City in response to Proposals made pursuant to this solicitation, or in making any award,or in failing or refusing to make any award pursuant to such Proposals, or in cancelling awards, or in withdrawing or cancelling this solicitation, either before or after issuance of an award,shall be without any liability or obligation on the part of the City. In its sole discretion, the City may withdraw the solicitation either before or after receiving proposals, may accept or reject proposals, and may accept proposals which deviate from the solicitation,as it deems appropriate and in its best interest. In its sole discretion,the City may determine the qualifications and acceptability of any party or parties submitting Proposals in response to this solicitation. Following submission of a Proposal or Proposal, the applicant agrees to deliver such further details, information and assurances, including financial and disclosure data, relating to the Proposal and the applicant including, without limitation, the applicant's affiliates, officers, directors,shareholders, partners and employees,as requested by the City in its discretion. The information contained herein is provided solely for the convenience of prospective Proposers. It is the responsibility of the recipient to assure itself that information contained herein is accurate and complete.The City does not provide any assurances as to the accuracy of any information in this solicitation. Any reliance on these contents,or on any permitted communications with City officials, shall be at the recipient's own risk. Proposers should rely exclusively on their own investigations,interpretations,and analyses.The solicitation is being provided by the City without any warranty or representation,express or implied, as to its content,its accuracy,or its completeness. No warranty or representation is made by the City or its agents that any Proposal conforming to these requirements will be selected for consideration,negotiation,or approval. The City shall have no obligation or liability with respect to this solicitation,the selection and the award process,or whether any award will be made. Any recipient of this solicitation who responds hereto fully acknowledges all the provisions of this Disclosure and Disclaimer,is totally relying on this Disclosure and Disclaimer,and agrees to be bound by the terms hereof. Any Proposals submitted to the City pursuant to this solicitation are submitted at the sole risk and responsibility of the party submitting such Proposal. This solicitation is made subject to correction of errors, omissions,or withdrawal from the market without notice. Information is for guidance only, and does not constitute all or any part of an agreement. The City and all Proposers will be bound only as, if and when a Proposal (or Proposals), as same may be modified, and the applicable definitive agreements pertaining thereto, are approved and executed by the parties, and then only pursuant to the terms of the definitive agreements executed among the parties.Any response to this solicitation may be accepted or rejected by the City for any reason,or for no reason,without any resultant liability to the City. The City is governed by the Government-in-the-Sunshine Law,and all Proposals and supporting documents shall be subject to disclosure as required by such law. All Proposals shall be submitted in sealed proposal form and shall remain confidential to the extent permitted by Florida Statutes, until the date and time selected for opening the responses. At that time, all documents received by the City shall become public records. Proposers are expected to make all disclosures and declarations as requested in this solicitation. By submission of a Proposal,the Proposer acknowledges and agrees that the City has the right to make any inquiry or investigation it deems appropriate to substantiate or supplement information contained in the Proposal,and authorizes the release to the City of any and all information sought in such inquiry or investigation. Each Proposer certifies that the information contained in the Proposal is true, accurate and complete, to the best of its knowledge, information,and belief. Notwithstanding the foregoing or anything contained in the solicitation,all Proposers agree that in the event of a final unappealable judgment by a court of competent jurisdiction which imposes on the City any liability arising out of this solicitation, or any response thereto, or any action or inaction by the City with respect thereto, such liability shall be limited to$10,000.00 as agreed-upon and liquidated damages.The previous sentence, however, shall not be construed to circumvent any of the other provisions of this Disclosure and Disclaimer which imposes no liability on the City. In the event of any differences in language between this Disclosure and Disclaimer and the balance of the solicitation, it is understood that the provisions of this Disclosure and Disclaimer shall always govern. The solicitation and any disputes arising from the solicitation shall be governed by and construed in accordance with the laws of the State of Florida. RFP 2017-002-JC 22 PROPOSER CERTIFICATION I hereby certify that: I,as an authorized agent of the Proposer,am submitting the following information as my firm's proposal; Proposer agrees to complete and unconditional acceptance of the terms and conditions of this document, inclusive of this solicitation, all attachments, exhibits and appendices and the contents of any Addenda released hereto, and the Disclosure and Disclaimer Statement; Proposer agrees to be bound to any and all specifications,terms and conditions contained in the solicitation, and any released Addenda and understand that the following are requirements of this solicitation and failure to comply will result in disqualification of proposal submitted; Proposer has not divulged, discussed, or compared the proposal with other Proposers and has not colluded with any other Proposer or party to any other proposal; Proposer acknowledges that all information contained herein is part of the public domain as defined by the State of Florida Sunshine and Public Records Laws; all responses, data and information contained in this proposal, inclusive of the Proposal Certification, Questionnaire and Requirements Affidavit are true and accurate. Name of Proposers Authorized Representative: Title of Proposers Authorized Representative: Ken Cooke \ t1 Chief Operating Officer Signature of Pro el'sAutthhorrizzed Representative: Date: March 7.2017 State of TENNESSEE ) On this 7th day of March .2017 personally appeared before me Ken Cooke who County of DAVIDSON ) stated that (s)he is the Chief Operating Officer of Intermedix , a corporation, and that the instrument was signed in behalf of the said corporation by authority of its board of di rs and acknowledged said instrument to be its voluntary act and deed. Before e: c).7y7 %.0‘,161*W S,pyT.,� _ ry Public for the State of TENNESSEE 'f' - December 10,2019 My Commission Expires: SOf E . = C • ‘ WOW RFP 2017-0021C 23 X intermedix 1.3 Minimum Qualifications Requirements 1. Proposer shall have provided Emergency Medical Services(EMS) ambulance billing and Electronic Patient Care Reporting(EPCR)system installation,integration,and management for at least two(2) other governmental entities in the last five (5) years, performing at least 20,000 emergency transports per year. Submittal requirements: For each client reference submitted,the following information is required: 1)Client's Name and Year(s) Contracted;2) Contact Individual Name&Title,3)Address,4)Telephone,5)Contact's Email,6) Narrative on Scope of Services provided and final completion in total days,relative to project timeline. Reference 1 Reference 2 1)Broward Sheriff's Fire Rescue Dept.,14 years City of Fort Lauderdale Fire Rescue,18 years contracted contracted 2)Tammy Nugent,Division Chief of EMS Daniel Oatmeyer,Battalion Chief/EMS Bureau 3)2601 W Broward Blvd.,Ft.Lauderdale,FL 528 NW 2"d Street,Fort Lauderdale,FL 4)954-831-8254 954-828-3609 5)tammy.nugent sherriff.org danieloVortlauderdale.gov 6)EMS billing and collection services and ePCR EMS billing and collection services and ePCR implementation,60-day implementation implementation,60-day implementation 2. Proposer must be enrolled in the Florida Emergency Medical Services Tracking and Reporting System (EMSTARS). Intermedix is enrolled in EMSTARS.Additionally,we are contracted directly with the State of Florida to manage the EMSTARS database.This ensures that the City will always be in compliance with state requirements. 3. Proposer must be enrolled in the National Emergency Medical Services Information System(NEMSIS). We maintain our NEMSIS relationship and offer only NEMSIS-approved patient care reporting software to the City. 7 ©2017 Intermedix Corporation www.intermedix.com 1' RFP 2017-002-JC Tab 2 : Experience & Qualifications t. 2016Intermedix Corporation I www.intermedi tom �► intermedix TAB 2: EXPERIENCE & QUALIFICATIONS 2.1 Qualifications of Proposing Firm Submit detailed information regarding the firm's history and relevant experience and proven track record of providing the scope of services similar as identified in this solicitation, including experience in providing similar scope of services to public sector agencies. For each project that the Proposer submits as evidence of similar experience, the following is required: project description,agency name,agency contact,contact telephone&email,and year(s) and term of engagement. Intermedix has been a leader in the EMS billing industry for 38 years,which includes all of these years in Florida.We process more than 15 million patient encounters annually,collect more than $3 billion in revenue for clients and connect more than 95%of the United States population through our emergency preparedness and response technologies. Intermedix is the leading provider of EMS revenue cycle management services and serves 50%of the nation's largest cities by population. ;`.L-7,<E S-I =tE O=TOD 50 C T EMS MARKET LEADERSHIP I n.-errnedix is a leading provider of EMS revenue cycle management services and serves 50°c of the nation's largest cities by population. Inver medix 12 Vendcrs MUNICIPAL MARKET LEADERSHIP Intermedix is committed to serving municipal clients. 95%Municipal EMS Operations ■ Intermedix 5%Commercial EMS Operations ■ Other Vendors Unmatched Florida Experience Of the 675 EMS billing operations resources on staff, approximately 250 are based in Florida. Our Florida footprint includes a client base of 55 customers, representing over 60 municipalities and equaling nearly 900,000 billable accounts each year. More specifically,Intermedix billing services covers over 20 municipalities in Bra ward County alone. This unrivaled experience leads to a more comprehensive database of patient insurance information shared amongst our client base. 8 ©2017 Intermedix Corporation www.intermedix.com �► intermedix Intermedix is heavily involved with organizations in the State of Florida and south Florida that directly benefits the City.Our ongoing sponsorships, memberships,and associations with the Florida Fire Chief's Association, Broward County Fire Chief's, Florida Ambulance Association (FAA),and the Florida Association of Counties(FAC) allows us to bring large issues to the forefront with the Florida legislation and have a direct,positive impact to client revenues. Over the years we have fought for our clients to increase their revenue through assisting the FAC and FAA with the passing of the direct pay legislation that prohibited insurance companies from paying their patients directly and instead in forced payers to pay providers directly. In addition,we took direct action against the Medicare carrier in Florida when they overpaid on thousands of accounts and tried to recoup the money,but we got this money back for our clients. Experience in similar work As the Selection Committee evaluates the proposals submitted,one of the key tasks it will undertake will be to determine which company is best able to produce the kind of results projected within their proposal. Intermedix submits that our references will attest to our excellence in terms of client services, industry expertise and customer service focus,and to our ability to drive significant revenue performance. .. later nredix ,` .s ser.ed pr r:ne'r ifeliwring e.cceptiorrul customer service and cortsistent j`irra'rcraf results . The t. termedix diem service representath,e5 and exet ttt r.e n ana ers keep me intA med f ct mpliance changes in the industry and I retrtain confident the Intermedix team offers a compliance program that clearly protects • out i rganizatir?n and patients.... Inter riled ix fetuses on collecting maximum compliant reimbursements for the Atiarni trade County Fire Rescue Department and I heli=ve they will produce the same results for any client that selects this superior team " „ASSISTANT DIRECTOR MIAM. DADE FIRE RESCUE `,IENT Intermedix has clients of varying demographic make-up and size. Some have high percentages of Medicare and Medicaid patients,while others have younger populations.We serve municipalities that are wealthy,others that are socioeconomically depressed,and those with large urban populations,as well as small rural area populations. Our clients range in size from less than 600(Lighthouse Point, FL) to more than 600,000(FDNY) annual transports. To meet the needs of this broad cross-section of clients,we have established highly flexible processes and technology that are used by seasoned professionals focused on the unique needs of each agency we serve.Our professionals are regionally aligned to help ensure that local knowledge is incorporated into our daily operational processes and client service delivery. 9 ©2017 Intermedix Corporation www.intermedix.com X intermedix Menu of Services Intermedix is dedicated to supporting the full continuum of care represented in the emergency healthcare system.Those services listed in bold type below,identify revenue cycle management services currently provided to pre-hospital and hospital emergency professionals. • Emergency Medical Services Ground and Air Billing and Collection • TripTix MOBILE Pre-Hospital Electronic Patient Care Reporting System • Fleeteyes Common Operating Picture Technology • Emergency Department Billing and Collection Emergency Response Billing for Fire, Hazmat,and MVA • Enterprise Analytics that uncovers meaningful data for strategic and operational decision making Additionally,through our Technology and Systems Division,Intermedix EMSystems provides comprehensive web-based solutions that deliver integrated components of emergency management preparedness.The following services that are noted in `bold,'are already statewide implementations for the State of Florida: • Hospital Bed, Dialysis, Mental Health, Shelter and Emergency Resource Management • Health Alert Notification and Response • Hospital Incident Command • Patient, Evacuee and Event Management Tracking • Volunteer and At-Risk Registry • Contract services for Program and Training Outreach Specialists Evidence of Similar Experience Below,we have listed several of our existing clients as examples of comparable agencies where we perform similar services. Intermedix has over 300 EMS billing clients nationwide and can provide further reference information at the City's request. 10 ©2017 Intermedix Corporation www.intermedix.com �► intermedix Agency Name Broward Sheriff's Fire Rescue City of Fort Lauderdale Fire Department Rescue Years Contracted 16 20 Annual Transports 20,000+ 20,000+ Contact Name Tammy Nugent Daniel Oatmeyer Title Division Chief of EMS Battalion Chief/EMS Bureau Address 2601 W.Broward Blvd.,Fort 528 NW 2nd St.,Fort Lauderdale, Lauderdale,FL 33312 FL 33311 Telephone 954.831.8254 954.828.3609 Email Tammy nug_entr@sheriff.org danieloCEfortlauderdale,gov Project Description EMS billing and collection services EMS billing and collection and ePCR implementation services and ePCR implementation 11 ©2017 Intermedix Corporation www.intermedix.com X intermedix 2.2 Qualifications of Proposer Team Provide an organizational chart of all personnel and consultants to be used for this project if awarded,the role that each team member will play in providing the services detailed herein and each team members'qualifications.A resume of each individual, including education,experience,and any other pertinent information,shall be included for each Proposal team member to be assigned to this contract. Please see the proposed team organizational chart below. Jack Donahue Executive Vice President. EMS RCM Andy Shells Darryl Hartung Omar Perez Senior Vice President, Vice President.Client Vice President,EMS Client Relations Relations Operations L Burelt Rebeca Patens ll Shy •lent Relations Manager Director,Patient Research Myra Bell om Coding Director Fauvette Cameus,Sr. tanager.Credit ealanr: Vanessa Elias Payment Posting Manager Mls ak.Tedla Gathering&Data Entry Manager Although we are the largest provider of EMS billing and collection services in the industry,we are dedicated to maintaining our local touch with our local client base.This is accomplished through our account management teams whereby clients are assigned a dedicated Client Relations Team.This team includes Rebeca Botero,Manager, Darryl Hartung,Vice President, and Andy Sheils Senior Vice President.Jack Donahue, Executive Vice President, leads the EMS division for Intermedix and is located in our Fort Lauderdale office.All of these leaders are available to meet on short notice due to the proximity to the City of Miami Beach. 12 ©2017 I ntermedix Corporation www.intermedix.com )► intermedix Key functions of the Client Relations Team include: End of Month Reporting Policy and Services Implementation Education and Training Coordination Performance Management Reporting Special Projects to include Reporting,Auditing Support,etc. Miami Beach Fire Rescue will continue to be served by the Client Relations Team of Darryl Hartung and Rebeca Botero, both of whom are well known to the City. Information on our key team members is provided below. The Intermedix Team Name Experience/Bio Darryl Hartung,Vice Mr.Hartung has been with Intermedix for nearly 17 years,having filled various President of Client company roles.As the Vice President of Client Relations for the Miami Lakes Relations office,Mr.Hartung works directly with our customers in Florida,including but not limited to Miami Beach,Broward Sheriff's Office,City of Fort Lauderdale,Palm Beach County,Brevard City,Miami Dade County,and others.Mr.Hartung graduated from Florida Atlantic University with a bachelor's of Business Administration degree. He has developed a specialized client understanding,as well as a reputation of excellence and reliability among his customer base.Mr.Hartung will ensure that your interaction with our firm will be handled professionally and as contractually agreed.He has an experienced client services team who will provide quality service to the City. Rebeca Botero,Manager Rebeca has been with the company since 2016.Prior to joining Intermedix Mrs. Client Relations Botero worked in revenue cycle management and technology for over 10 years. Rebeca has significant client relations experience through working with hospitals and physician offices during this same time.Mrs.Botero has already worked significantly with the City and other clients such as City of Hialeah,Broward Sheriff's Office,and the City of Hollywood. Andy Shells,Sr.Vice Mr.Sheils has led the Intermedix client relations team since 2014.He has more President,Client Relations than 10 years of experience in government finance and operations roles.Prior to joining Intermedix,he held the position of first deputy comptroller for the City of Chicago.Mr.Sheils earned his bachelor's and master's degrees from the University of Illinois at Chicago.EMS billing project experience includes Leon County,Sarasota County and City of Jacksonville. Jack Donahue,Executive Mr.Donahue leads EMS billing and collection services at Intermedix.He has more Vice President than 10 years of experience with Intermedix,managing strategic technology, operations and client service solutions.Prior to joining Intermedix,Mr.Donahue spent 10 years as a consultant,working with clients to implement complex technology and process changes.His last position was Senior Manager at Arthur Andersen.Donahue earned his bachelor's degree in business administration- 13 ©2017 Intermedix Corporation www.intermedix.com ,o; intermedix Name Experience/Bio finance from the University of Notre Dame.He holds a master's degree in business administration with a concentration in global management and decision information sciences,and an executive master's degree in healthcare administration from the University of Florida.ERMS billing project experience includes Leon County,Miami-Dade County and Collier County. Omar Perez,Sr.Vice Mr.Perez has been with Intermedix for nearly 10 years.He oversees the day-to- President of Operations day workflow activities and management of the resources that process your accounts.He has nearly 15 years'experience in EMS billing and collections. Steven Burch,Director Mr.Burch leads the Intermedix Patient Research team.He has over 9 years of Patient Research experience in operations management,including almost three years with Intermedix.Before Directing Patient Research in the Miami Lakes office,he was the RCM Manager for the City of Los Angeles and the State of Hawaii based out of Denver.Steven earned his bachelor's degree in International Business at the University of Colorado.EMS billing project experience includes Leon County, Orange County,Miami-Dade County and Collier County. Kyra Bell,Coding Director Mrs.Bell is the Director of EMS Coding at Intermedix.She has been in EMS coding/billing for four years and medical coding and billing for more than 20 years.Kyra has served as a Certified Paramedic since 1995.EMS billing project experience includes Leon County,Miami-Dade County,Brevard County and Collier County. Fauvette Cameus,Sr. Ms.Cameus leads our Credit Balances and Refunds department.She has more Manager,Credit Balances than eight years of experience with Intermedix with more than three years of in operations management.Prior to Intermedix,Fauvette worked in other areas in the medical industry such as Pharmaceuticals and Physician Practices.Fauvette holds Associates in Physician Assistant Studies and in December 2016,is earning a Bachelor's in Health Service Administration from Florida International University. EMS billing project experience includes Leon County,Orange County,Miami-Dade County and Collier County. Misrak Tedla,Gathering Ms.Telda has been with Intermedix for eight years and has focused on all areas and Data Entry Manager related to the billing and collection process.Her prior experience was with service related organizations.Misrak's education includes an Associate of Arts degree from National School of Technology in Medical Billing and coding specialist certifications from Keiser College.She will manage the day to day operations of your account to ensure that daily transactions associated with our data gathering and data entry processes are being handled correctly,efficiently,and in a manner that will maximize compliant revenue collection. Vanessa Elias,Payment Ms.Elias has been with Intermedix for about six years,and in the medical field for Posting Manager over 15 years.Her main focus is to ensure that all payments are entered into the system correctly in a timely and efficient manner.Her prior experience includes locating revenue on a daily basis,monitoring postings for accuracy,and assigning necessary projects to employees in order to close all accounts in a timely manner. Ms.Elias holds an associate's Degree in Medical Administration from Kaiser 14 ©2017 Intermedix Corporation www.intermedix.com X intermedix Name Experience/Bio ■ University.EMS billing project experience includes Leon County,Orange County, Miami-Dade County and Collier County. 15 ©2017 Intermedix Corporation www.intermedix.com Darryl Hartung Vice President, Client Services Darryl.Hartung@intermedix.com I EDUCATION 1995-1993 B.A.in Business Management,Florida Atlantic University 1990-1993 A.A. in Business Management,Broward Community College I EXPERIENCE _ - _ - Intermedix, Miami Lakes,FL Vice President, Client Services Responsible for the overall management of the client services for the southeast United States.Specific responsibilities include client management and account services. _:: Mortgage.com Mortgage Consultant/Manager Responsible for selling various custom loan programs for residential properties. Worked with executive management to establish goals and objectives for the sales department. American General Finance Lending and Collections Administrator SIRS, Inc. Proposal Coordinator Acosta Sales Co., Inc. Assistant Network Administrator X intermedix Rebecca M. Botero Client Services Manager Rebecca.Botero@intermedix.com Education: Coleman Senior High-Academic Miami Dade Communications-Business Administration (UC) Experience: 2016-Present Intermedix, Miami, FL Client Services Manager 2012-2016 CareCloud Account Manage 2012 Collections Lead 2004-2010 Avisena,Inc. Senior Collector Andy Sheits Senior Vice President, Client Relations Andy.Sheils@intermedix.com EDUCATION 2000-2002 Master of Public Administration Degree,University of Illinois at Chicago 1992-1996 Bachelor's Degree,English,University of Illinois at Chicago I PROFESSIONAL EXPERIENCE 2013-Present Inten iedix,Fort Lauderdale,FL Senior Vice President,Client Relations As national leader of client services for our EMS RCM division,works with the largest municipal clients to find the right solutions to their business problems.Works with clients as partners, listening to their problems and using his extensive experience in government to determine the right solution.Understands that each agency is different,and while Intermedix uses the best- of-breed industry standards,every problem has a unique solution. 2010-2013 City of Chicago,Chicago,IL First Deputy Comptroller Externally,a member of the City's executive financial management team(with Mayor's Office and Office of Budget and Management)charged with leadership and decision-making responsibility on City-wide financial strategies such as revenue enhancement and expenditure reduction scenario planning;re-financing of debt;budget development;and legislative strategies.Internally,functioned as chief executive for the 550-employee Department of Finance,a client-service department responsible for citywide financial policies and management,as well as for the transactional needs of 37 other city departments. 200.7-2010 Deloitte Consulting,Chicago,IL Manager 2001-2'007 City of Chicago,Chicago,IL Budget Analyst,Assistant Budget Director,Deputy Director Office of Budget and Management(OBM) Office of Emergency Management and Communications(OEMC) Jack Donahue Executive Vice President, EMS Revenue Cycle Management Jack.Donahue@intermedix.com I EDUCATION 2002-2004 E.H.M.A.,University of Florida 1993-1995 M.B.A.,University of Florida 1988-1992 B.A.in Business Administration,University of Notre Dame 1 EXPERIENCE 2004-Present Intermedix,Fort Lauderdale,FL Executive Vice President,EMS Revenue Cycle Management Responsible for managing all aspects related to EMS revenue cycle management operations for Intermedix. 2002-2004 BearingPoint,Inc.,Miami,FL Senior Manager Provided technology solutions to fortune 500 companies in a variety of industries that enabled the optimization of business processes and revenue. 1995-2002 Arthur Andersen,LLP,Miami,FL Senior Manager Provided technology solutions to mid-market clients in a variety of industries that enabled the optimization of business processes and revenue. Omar Perez Senior Vice President, EMS Operations Omar.Perez@intermedix.com I EDUCATION 1993-1996 A.A.in Business Administration,Miami Dade Community College I EXPERIENCE 2015-Present Intermedix,Miami Lakes,FL Senior Vice President of Operations Responsible for EMS billing and collection operations across the United States,which includes client communications,revenue generation and process management. 2004-2015 Intermedix,Miami Lakes,FL Vice President of Southeast Operations Responsible for operations associated with the Southeastern United States,which includes client communications,revenue generation and process management. 1996-2004 Per-Se Technologies,Miami,FL Manager,Hospital Liaison Established and maintained hospital connections for Per-Se Technologies'Miami office, a national healthcare services company that provides third party billing for EMS and physician services. I CERTIFICATIONS & INDUSTRY INVOLVEMENT Six Sigma Green Belt Member-Healthcare Billing and Management Association X intermedix Steven Burch Patient Research Director Steven.Burch@intermedix.com Education: B.S.-International Business, University of Colorado-2013 Experience: 2013-Present Intermedix,Miami Lakes, FL 2015-Present-Director, Patient Research 2013-2015-Manager,Operations-Denver,CO 2006-2012 Waterway Gas&Wash,Denver,CO 2009-2012 General Manager 2008-2009 Facilities Manager 2007-2008 Manager 2006-2007-Team Leader 2006-Line Specialist • intermedia Kyra Bell Director, EMS Coding kyra.bell@intermedix.com Education: Pursuing B.A. Healthcare Management,Southern New Hampshire University Paramedic Certification,Community College of Allegheny County EMT-Basic Certification,Community College of Allegheny County Experience: 2015-Present Intermedix,Columbus,OH Director, EMS Coding 2012-2015 University of Vermont Medical Center,S. Burlington,VT Revenue Integrity Analyst 2001-2004 The Ohio State University Medical Center Dublin,OH Manager,Coding&Coding Compliance 1998-2000 University Physicians, Inc., Denver,CO,Chart Abstractor 1997- 1998 Western Cardiology,Thornton CO,Account Service Manager 1994-1997 U.S. Heart&Vascular, Pittsburgh, PA,Assistant Manager 1991-1993 Paul. H. Resnick, M.D., Pittsburgh, PA, Billing Clerk/Clinical Assistant Certifications Certified Professional Coder(CPC),AAPC Certified Professional Coder, Instructor(CPC-I),AAPC Certified Ambulance Compliance Officer(CACO), NAAC Certified Professional Compliance Officer(CPCO),AAPC Paramedic Certification Fauvette Cameus Credit Balances Assistant Manager Fauvette.Cameus@intermedix.com I EDUCATION 2012-Present Bachelors of Arts,Health Services Administration(BHSA), Florida International University 2010-2012 Associates of Arts,Physician Assistance Studies,Miami Dade College 2004-2005 Certificate,Pharmaceutical Studies,ATI College of Health I EXPERIENCE 2008-Present intermedix,Miami Lakes,FL 2012-Present Credit Balances Assistant Manager 2030-2012 Refund Department Team Lead 2008-2010 Refunds Specialist 2006-2008 Turnberry Associates Headquarters Aventura Mall Management Concierge/Guest Services Associate Associate of property Management Company,assisted with marketing services and brands,along with providing guest accommodations and concierge services. 2004-2006 Palm Springs General Hospital Pharmacy Technician Technician of hospital pharmacy,pharmaceutical preparations of drug/IV according to patient charts and prescriptions,along with maintaining healthcare products and pharmaceutical services. I CERTIFICATIONS & INDUSTRY INVOLVEMENT Certified Pharmacy Technician '►' intermedix Misrak Tedla Gathering and Data Entry Manager Misrak.TedlaPintermedix.com Education: Associates Degree- Health Service Administration-National School of Technology Business Associates Degree-University of Addis Ababa, Ethiopia Experience: 1989- Present Intermedix, Miami Lakes, FL Gathering and Data Entry Manager Certifications NHA Certified Coding and Billing Vanessa Elias Payment Posting Manager Vanessa.Elias@intermedix.com I EDUCATION Associate in Medical Office Administration,Keiser College,Fort Lauderdale,FL I PROFESSIONAL EXPERIENCE 2010-Present Interniedix,Fort Lauderdale,FL Payment Posting Manager 2008- Family Practice Medical,Psychiatric,Personal Injury&Massage Therapy Administrative Assistant 2007-2008 Delray Advanced Medical,Inc. Office Manager/Administration 2003-2007 Medical Associates of Tamarac,Inc. Administrative Assistant 2001-2003 Neuro Science and Spine Administrative Assistant '► intermedix 2.3 Disaster Recovery Compliance Proposer shall provide a copy of its disaster and recovery policies and procedures. For security reasons,we do not share our full disaster recovery policies and procedures in RFP responses.With that said,we ensure business resilience through multiple redundant data centers that are compliant with HIPAA HITECH and SSAE-16. In summary, Intermedix uses a documented Adverse Event Planning and Management Procedure to maintain operations during an emergency that outlines planning, management responsibilities,and actions that should be taken to prepare for,respond during and recover following an adverse event.Our highest priority is always the safety of our people. Pre-Event planning includes (i.e.: a hurricane or pandemic that allow assessment prior to the occurrence of the actual event) bringing together the pre-event team to reiterate prearranged plans for maintaining communication and safety throughout the event.The Event Response Team will be immediately engaged and provide guidance prior to and during the event according to documented procedures. Post-event response includes assessment and status updates from the Event Response Team and invocation of the Disaster Recovery Plan, if deemed necessary. A post-event action list is maintained to ensure that successes and opportunities are documented,policies are updated and any used supplies are re-stocked and ready for the next event. 2.4 Financial Capacity At the request of the City each Proposer shall arrange for Dun&Bradstreet to submit a Supplier Qualification Report(SQR) directly to the Procurement Contact named herein. No proposal will be considered without receipt,by the City,of the SQR directly from Dun &Bradstreet.The cost of the preparation of the SQR shall be the responsibility of the Proposer. Intermedix has submitted our Supplier Qualification Report(SQR)directly to the Jason Crouch.Our SQR was delivered and received on February 15th,2017. 17 ©2017 Intermedix Corporation www.intermedix.com • 4 w ' p Y r • RFP 2017-002-JC , Tab 3 : Scope of Services Proposed , .. • • - • 4 r w . ; • • • I N c • t 4 t 0 ut . 1 i O ac z, 4t.- _ a‘ '3‘) --. 31b x 2016Intermedix Corporation 1 www.intermedix.com rmedix TAB 3: SCOPE OF SERVICES PROPOSED General. The successful Proposer under this contract will provide all services necessary to report, bill and collect for services provided by the City's FIRE-RESCUE DEPARTMENT. Requirements include the acquisition,placement,support,maintenance and connectivity of rugged mobile computer laptop devices in fire rescue vehicle as well as desktop client software at all the City's Fire-Rescue Stations to capture,generate and modify patient care reports,gather and archive patient care data,gather and report performance statistics,generate and process insurance billing and payments,collect and remit funds to the City.The awarded Contractor shall set up,maintain and provide all comprehensive aspects of the EMS reporting,billing and collection services,as required by the scope of services herein contained. Our approach for the City includes the continued use of proven tools and processes already in place today.This significantly decreases any risk of a decline in collections during a transition to a different vendor. Some of the key areas already in place have been mentioned above but are critical to the billing collection process, include: Intermedix TripTix ePCR,which includes monitor integration. Integration with City billing policies and procedures. Mature revenue stream.As indicated in the graph below, Intermedix has continued an upward collection trend despite negative economic and industry pressures.With that said,the most recently completed fiscal year 2016 has resulted in a record collection year of over$2.4 million. I $2,400,000 $2,200,000 - $2,000,000 $1,800,000 3 $1,600,000 $1,400,000 $1,200,000 $1,000,000 FY2013 FY2014 FY2015 FY2016 To drive revenue for the City,we have worked closely with all of the hospitals, in which the City provides transports to establish electronic connections.This allows us to obtain patient insurance information and add it to patient accounts to expedite the billing 18 ©2017 Intermedix Corporation www.intermedix.com U. intermedix process.The following provides our current connection method(s)with each of the City's hospitals. %of Transport Hospital Name Volume Access Method MOUNT SINAI MEDICAL CENTER 95% Electronic JACKSON MEMORIAL HOSPITAL TRAUMA 3% Electronic JACKSON MEMORIAL HOSPITAL 1% Electronic JACKSON MEMORIAL HOSPITAL Pediatric ED 1% Electronic MISC. 0% Various • Improved charge mix.The above connections and patient insurance database leads us to be able to reduce the City's self-pay/uninsured mix to the lowest possible levels.The following graph represents the most mature charge mix achieved for the City. 'Medicare - ■Medicaid 19.2% _ 4.1/0 ii Insurance ■Self Pay • Financial stability combined with a focus on EMS revenue cycle management(RCM)from locally based executive leadership. • Intense focus on compliance,including third-party systems and process audits,resulting in efficiency and effectiveness. EMS Compliance Officer located in Fort Lauderdale. • Multiple geographically-dispersed EMS dedicated RCM offices and employees around the country ensure continued account processing in the case of an outage to the City's primary operations facility. • Weekly EMS RCM and division leadership meetings.Collection opportunities identified in one area of the company are rapidly communicated and implemented in others. 19 0 2017 Intermedix Corporation 1 www.intermedix.com X intermedix • Regionally-focused client relations team with extensive knowledge of the City's policies and procedures,payer community,and state regulations.This includes understanding of the City's fee schedule,Florida Medicaid regulations and auto insurance PIP laws. • Consistent communication with City stakeholders for the identification of revenue opportunities,performance evaluation and initiative accountability.This includes regularly scheduled onsite meetings with City staff. • Proprietary IMX billing platform and dedicated IT resources allows for rapid change to take advantage of opportunities as they arise. • Proprietary linkage database with 30+million records against which the City's accounts are bounced nightly for potential capture of patient insurance and demographic information. • Expedited billing efforts through accessing 100%of the City's transport hospitals either through electronic or fax-back arrangements. • Application of City-defined policies and adjustments allowing us to focus on collectable accounts receivable. • Extensive reporting capabilities via our CDX and Business Objects solution allowing us to easily identify trends and opportunities down to the medic level. • Extremely flexible patient invoice cycle and wording,facilitating patient account resolution. • Technologically advanced Patient Contact Center.This includes skills-based call routing that directs patients to a representative trained to address their specific need,call recording capabilities,and a vast ability to handle foreign languages facilitating patient account resolution.Including Spanish and Creole languages. • Flexible outbound phone call campaigns for receipt of patient payment,insurance, signature,etc. • Claim follow-up based on defined payer and expected payment timing rules to ensure timely accounts receivable follow-up. • Denial management based on payer and denial code rules to provide timely and accurate denial processing. • Medicare signature solutions including complex linking options,letter requests,phone calls,Social Security Administration deceased file look-up,and exception processing to allow claim filing. • Deposit reconciliation process ensuring no payments are missed. • Proprietary medical necessity codes providing audit support as well as coder and crew member trending for training opportunities. 20 ®2017 Intermedix Corporation I www.intermedix.com �► intermedix ■ Iterative budgeting process completed in partnership with the City,resulting in common collection goals. We continuously enhance our billing processes and billing platform to ultimately drive compliant collections for our clients.In addition,we have worked with the City and other Miami Dade County-based clients to implement customized procedures within our billing platform.The following outlines our billing processes and procedures. Invoicing/Billing The Intermedix EMS billing process is technologically advanced,customer-centric and supported by industry best practices. • PCR Import-This stage includes a full National ✓ 80%Clean claim EMS Information System (NEMSIS) import from the adjudication rate City to bring all field data directly into the reflecting accounts paid Intermedix billing system. after the first invoice . • Coding-Our compliant coding process begins ,/ 8%Denial rate,including immediately upon import and includes medical deductibles necessity determination,signature verification, 100%Electronic claims confirmation of submitted mileage calculation,and filing where accepted a level of service determination facilitated by professional coders. • Patient Research-After coding,the patient record will undergo data verification and authentication,electronic and manual eligibility verification,and outbound phone calls to self-pay patients for possible payers. • Billing-Next,we will submit claims to third-party payers and invoice patients,if necessary. Because billing follows our extensive patient research phase,our system reliably files clean claims. We track our adjudication success and denial rates to ensure that performance follows expectations. • Payer Response-When a response is received-electronically or on paper-we will post and reconcile payments and support follow-up with payers and patients.We accept payment from patients in several mediums,including credit cards on the phone or online. • Account Resolution-During account resolution,we will process refunds,apply your policies for setting-up payment arrangements and identifying accounts for write-off or advanced collections. • Unpaid Account Strategies-Our goal is to bring accounts to a zero balance.We have dedicated this phase of the process to contact non-responsive,uninsured patients and insurers,to facilitate alternate payment sources and payment plans(e.g.,credit card 21 ©2017 Intermedix Corporation I www.intermedix.com intermedix payoffs)to satisfy deductibles and outstanding charges prior to any third-party collections activity. Third Party Collections-Finally,we will submit secure electronic files to your chosen vendor with the information required for delinquent account collections.The patient record will reflect collections status at this phase.We also have the ability to receive data files from third-party collections vendors into our billing system,so that the City can see collections activity within the patient record. Throughout the billing process,Intermedix focuses on supporting you with a dedicated compliance program and experienced client service representatives. In-depth reporting makes both clinical and financial data available to you at any point in the revenue cycle. Now fur Imo woo � O %No two EXTERNAL • , DEMOGRAPHIC DATA PRO'IDER .y 25 a 2 bi 4.I, • RUING DATA ra PATIENTACCC(:"i' _P'+EE`iT4'P;Fc Figure 1:Intermedix Billing Process allows daims with accurate information move quickly through the billing cycle.We leverage all possible sources for verifying insurance and demographic data,including access to hospital data.Our workflow results in cleaner first pass daims and maximized client revenue. PCR IMPORT&CODING Our relationship with PCR vendors is unprecedented.Our proprietary TripTix ePCR solution, currently used by the City is NEMSIS Gold certified and EMSTARS compliant. Data transfer to the billing system is accomplished via secured VPN from the City or via direct data entry if through our TripTix ePCR Solution,as we have already done with the City. Data transfer between the ePCR field tablets and the TripTix host system is via cellular wireless technology. After opening a new PCR,a medic can look up patient demographics electronically by entering the patient's Social Security Number or Driver License number.The system then locates the patient's information in a comprehensive database to quickly and accurately fill 22 ©201T Intermedix Corporation I www.intermedix.com )► intermedix out their demographics and medical history on your run record.You can also use devices with built-in scanners to scan a patient's driver license barcode directly. The system also provides workflow controls that ensure faster"clean"claim generation, resulting in fewer denials. Ensuring that the account is coded at the proper level when the claim is submitted avoids negative revenue events like audits and "take backs"that could occur later on in the process.Once the system has created the account and runs through the initial automated coding process described above,our coding staff accesses the IMX system. Incident information is captured directly into the IMX billing system, regardless of whether initiation is through a paper PCR or an electronic data import.Trip reports created with our TripTix ePCR Solution are automatically available in the billing system as soon as the run is submitted.Since the billing system and TripTix use the same platform,the City and our billing specialists have nearly real-time access to your transport data. CODING Our coding application automatically performs data quality and integrity checks on all incoming data.When the system finds inconsistencies, it alerts our coders. In compliance with proprietary rules-based algorithms, a coder cannot save the claim until the issues are addressed. For example,we verify that demographic data contains patient address,social security number and date of birth,etc. We code the trip based on dispatch,assessment,and crew member narrative,and treatment data.The initial coding is done through our automated systems.A coder then manually reviews each account for accuracy and completeness.The coder also verifies insurance information is consistent with payer specific requirements. Intermedix coders are required to maintain a greater than 95%accuracy rating.We use the Medicare Level of Service Coding Guidelines(unless they conflict with a local ordinance)with coding completed within one business day of receipt. Coding every trip at the highest,compliant level of service for the care provided ensures the City is able to recover the cost of providing the service while remaining compliant with all of the rules and statutes that govern ambulance billing. MEDICAL NECESSITY REVIEW The Intermedix billing system automatically performs data quality and integrity checks on incoming patient records.As an added layer of compliance verification prior to invoicing, Intermedix will run all patient records received through our automated platform. For example,we verify that demographic data contains patient address,social security number and date of birth,etc.This automated platform is a proprietary system that uses algorithms and key data points to suggest medical necessity and diagnosis codes. It uses the Medicare Level of Service Coding Guidelines (unless in conflict with a local ordinance).We also review 23 0 2017 Intermedix Corporation www.intermedix.com �► intermedix the account for medical necessity documentation using our proprietary contraindication codes and review required patient and crew credentials. If we identify a discrepancy based on element of medical necessity,we send the patient record for internal review. In compliance with our proprietary algorithms,the reviewer must resolve the issue before continuing to the next patient record. If the discrepancy is valid,we send the patient record to a research request queue inside the billing system. The reviewer has a variety of options to respond to the issue with next steps and can forward it to the appropriate parties for resolution.This process allows for continuous dialogue on patient records within the system,ensuring that the process is logged in the patient record. MEDICARE SIGNATURE RECEIPT AND VERIFICATION We receive an electronic image of signatures from the field-generated City PCR,directly into our billing system to support documentation compliance. To successfully document signatures,we implement a number of solutions by: Linking accounts without a valid signature to accounts for the same patient where we have a lifetime signature on file,or where there is an indication that the patient is deceased. Linking Patient Unable to Sign (PUTS) and Representative Unable to Sign (RUTS) accounts to electronic medical records for the same incident received from the hospitals. Running accounts against the SSAs"deceased"file to identify deceased patients. Sending letters to patients with specifically targeted language requesting signature. Working with hospitals to obtain a proxy signature per the Medicare regulation exception, which allows certain other signatures to satisfy the signature rule. Once the coder has manually reviewed the account, it is released to enter the Patient Research phase. PATIENT RESEARCH We place intense operational efforts on our front-end processes.The primary goal is to obtain a patient combination of technology, personnel and processes to locate patient information from receiving facilities,insurance data bases,transport records,skip-tracing resources and patient phone calls. To identify any additional information that may have become available, all returned mail is researched and sent through the same processes and sweeps performed on the initial transport. ELIGIBILITY VERIFICATION We execute a series of insurance eligibility transactions to help retrieve appropriate insurance information. 24 ©2017 Intermedix Corporation www.intermedix.com �► intermedix To ensure the information is complete,we interface with external sources such as Medicare HIPAA Eligibility Transaction System (NETS)and various commercial partners.To augment the data in our database,our Hospital Liaison Program supplements this information by connecting with your receiving facilities to gather demographic and insurance information from your onsite registration staff. MASTERBANK PATIENT DATA REPOSITORY We have developed a master database application within our proprietary billing system for internal eligibility sweeps.Our database runs each account against: • Every EMS patient in our database • All hospital data • All prior patient linkage • All patient information maintained by our Emergency Department billing database—more than 30 million records nationwide Our database combined with local hospital data means that each City account will be run against our nationwide database.This action ensures access to local patient data in real-time yielding accurate patient data to bill claims accurately the first time. Our system will search all historical transports for patient information in case demographics and insurance information exist from a previous transport-wherever it occurred throughout the country. PATIENT OUTBOUND PHONE CALLS When insurance information is still missing after the eligibility verification,Patient Account Representatives(PARs) contact the patient.We use advanced technology to call patients with a valid phone number and then automatically transfer connected calls to a PAR.If the patient is uninsured,the PAR requests payment or attempts to initiate a payment plan for the patient. These call campaigns are customizable based on account attributes,patient demographics, number of attempts,days and times to call and more. SKIP-TRACING There are times when the patient demographics are also incomplete. If the demographic information is not found during the initial database search,we use Accurint to perform skip tracing. Eligibility and skip tracing activities are completed with quantitatively defined metrics that reveal the returned data belongs to the patient in our system.Our billing specialists review all records for accuracy. With valid information,we are able to bill the patient's insurance without ever having to contact the patient.Optimal patient customer service is achieved when we can recover the information without having to contact the patient. 25 ®2017 Intermedix Corporation I www.intermedix.com �► intermedix 61%of invoices paid and resolved without direct patient interaction >30 million patient records in Masterbank 35%outbound patient call connection rate BILLING As soon as the necessary patient demographic and insurance information is obtained and the account updated,a claim will be sent out.Accounts can often be sent within 24 hours of PCR receipt with correct patient demographic and insurance information. For accounts that do not contain the necessary information to file a claim to a third-party payer,the duration may be longer in locating and confirming valid payer information.Any claim that has not been identified to have a third-party payer is sent out on a self-pay bill schedule within the time limits o required by the City. , MIwo CLP.& ELL We use a combination of automated technology and billing specialist monitoring to ensure clean 0 claims.We make it possible to communicate electronically with a large number of payers.Our customizable patient billing rules ensure a patient-centric billing process that follows the 1 process shown In Figure 3 to the right. Prior to submission,we automatically review PATIENT MAIL claims against our proprietary rules-based 1 engine.Claims not passing the review are placed a into a work queue and are processed by team members.Our clearinghouse provides a second level of review for electronic claims. �. Inconsistencies caught by our clearinghouse are also reviewed by a billing specialist and updated in the Intermedix system. Claims to Medicare,Medicaid and most commercial payers are transmitted electronically.We print and mail paper claims if electronic delivery is not available or when the payer requires hard copies of PCRs or explanation of benefits. PATIENT BILLING Intermedix performs extra work behind the scenes to ensure we have gathered accurate patient contact information.We identify accounts with invalid addresses as well as other data elements.We automatically apply our skip tracing process and implement manual research tools to find updated mailing addresses from our external demographic data provider, previous transports and hospital files. 26 0 2017 Intermedix Corporation 1 www.intermedix.com �► intermedix Patient billing follows the specific process designated by the City. If insurance information has not yet been captured on the account,the statement includes language requesting the patient provide payment or insurance information. It also instructs them on how to do so. Insurance information can be provided by the patient using the following methods: ■ Returning the payment invoice with completed information via regular mail • Calling our toll-free customer service line • Logging on to the patient portal on our website Today,the City's patients are presented with a"Make Payment"button.This option seamlessly redirects the patient to the online payment site to update insurance and/or pay by credit card or electronic check. Statement activity is automatically generated by the billing system,although authorized users can access and print statements or-demand. For example,if a patient visits or calls your office requesting a copy of their statement,you can access the account,print and send the information for your patients.The patient statement wording is fully customizable to meet the needs of the City. Intermedix has a flexible patient mail application that ensures clear and specific communication;we: ■ Include account charge,payment and insurance information on invoices. • Supply virtually unlimited patient statement wording variations. ■ Generate mail automatically from the billing system. ■ Allow authorized users to access and print statements on demand. 94%average clean claim rate 80%first invoice payment rate 100%electronic claims submittal(for those that accept electronic claims) PAYER RESPONSE Payer responses can vary significantly between the different pay classes. Medicare will typically respond within one to two weeks from claims filing,with Medicaid typically responding between two to three weeks from initial filing.Commercial insurance normally responds anywhere from two to five weeks from claims filing. We understand that the majority of patient self-pay accounts are often difficult to collect.Self- pay accounts that do get paid in full are typically paid between one to seven months from PCR receipt. 27 ®2017 Intermedix Corporation 1 www.intermedix.com Intermedix AIL rn AL. PAYER ENGAGEMENT rn 0 co * AUTOMATED MONITORING m 8 PAYMENT DATA I a. Lock Box Figure 2:Payer Response—for payment receipt,posting and follow-up,Intermedix follows the process shown here. PAYMENT POSTING Upon receipt of payment documentation,our Payment Posters apply payments to the account within one business day.We provide the tools necessary to receive payments through several methods, including electronic fund transfers(EFTs),checks and credit cards.We receive electronic payment from Medicare, Medicaid and most commercial payers and our Electronic Remittance Advice(ERA) browser allows the Payment Poster to access and verify these responses. When we receive hardcopy EOB documents instead of ERAs,a Payment Poster manually applies the payment with our web-based system. Credit card information received through the contact center or patient correspondence is processed online by a Payment Poster through Virtual Merchant. We review every data element for accuracy before committing transactions to our database. To ensure the best quality assurance processes,we maintain an audit trail with the User ID. If payments are received without identifying information,they appear in our Check Reconciliation Queue for follow-up.We research the payment with both the client and the entity that provided the payment,then post to the proper payment account.We can provide daily,weekly, monthly reconciliation with your bank account. 28 ©2017 Intermedix Corporation www.intermedix.com �► intermedin SUPPLEMENTAL PAYER CLAIM FILING Claims that contain supplemental payer information are submitted according to the established procedures,after the initial payment is received.When dealing with Medicare crossover claims;we: Send claims to the supplemental insurer automatically. File a claim automatically with the corresponding EOBs to the secondary payer on file if a secondary payment is not received in a predefined number of days. Handle exceptions automatically and adjust the remaining balance when Medicaid does not cover the remaining 20%responsibility. File a claim with the supplemental insurer immediately upon receipt of Medicare's Electronic Remittance Advice(when we have supplemental insurance(MediGap) on file, and Medicare has not crossed over the information to the payer). File Medicare secondary claims electronically with all required information. DENIAL MANAGEMENT Our goal is to file a clean claim the first time. However,denials do occur.With denials,we initiate a series of actions specific to the reason. For example: If a claim is denied due to a policy number issue,we check a number of insurance eligibility sources and may contact the patient to obtain the correct insurance information. If a claim is denied for medical necessity reasons,we review the PCR to verify the original medical necessity determination. Our denial rate is 6.4%-including denials for any reason. Approximately 80%of denials are related to coverage issues and approximately 15% are related to short pay appeals to commercial payers. We are committed to timely and accurate processing to improve cash flow,and automatically address many denials upon receipt.We are continuously expanding the payer and denial code combinations that can be automatically handled. Denials that are not processed automatically are addressed by Accounts Receivable resources through our Manual Denial Management Queue. We engage in a number of activities to resolve accounts such as researching accounts, verifying electronic claim status,accessing payer websites and making payer phone calls. Once the problem has been identified,we update accounts and re-file claims when appropriate.The queue allows sorting by payer,so that our representatives can quickly resolve multiple claim issues for a single payer at the same time. 29 ©2017Intermedix Corporation www.intermedix.com ntermedix Intermedix is successful on short pays approximately 35%of the time and we have seen a marked increase in commercial short pays over the last 24 months as payers are shifting more responsibility to the patient. We are confident that when we submit a transport for payment to governmental payer,we have determined it meets the rules for Medical Necessity, Level of Service, Medicare Signature Requirements,and any remaining submittal requirements.Therefore,any account that would subsequently be denied is appealed.This is not typically a large volume and usually only requires a trip report being sent to the payer. Credit card or e-check payment success rate=$80 per uninsured account(compared to $18 for clients who do not offer online payment options) 55,000/week-primary claims filed 55,600 monthly inbound calls 17 second average speed to answer calls PATIENT RESPONSE We offer a number of methods for the patient or patient representative to respond to requests for insurance or payment. For example,they can contact us by mail,through a customer service toll-free phone line or on our secure patient website.We recommend that clients use an online payment solution to significantly increase collections. Our professionally staffed Patient Contact Center is focused solely on interacting with EMS transport patients.Our representatives handle both insurance and self-pay arrangements. Patients can use a toll-free number to access the Contact Center,which takes calls between 8:00 a.m. and 5:00 p.m.Central Time.The Contact Center uses the latest telephony technology,including skills-based routing by call type and language preferences. We have a number of bilingual Contact Center representatives for foreign language calls with fluency in many languages including Spanish,Chinese Dialects, French,Creole and more. Translation services are also available where patient account representatives can dial in the vendor for a live conference with a translator for one of the 200+supported languages. RECONCILIATION We provide detailed month-end reports that include all payments,write-offs and adjustments.We reconcile with the date of transport, monthly bank deposits,credit card payments and the month end total.Checks and balances occur at numerous levels throughout the payment posting process to ensure that all money has posted balances at the 30 d 2017 Intermedix Corporation www.intermedix.com intermedix end of each day.The daily"batch" reporting is reviewed to verify the total amount of money posted each day. REFUNDS When a credit balance occurs, Payment Posters provide the payment record to a Refund Processor for follow-up.The Refund Processor then researches the claim,gathering supporting documentation from our billing system,which may include the EOB and copies of the original check from the payer. After the credit balance is confirmed as a legitimate over payment or duplicate payment,the Refund Processor completes the necessary refund request documentation. UNPAID ACCOUNT STRATEGIES We continuously look for new ways to leverage technology and processes that will help us increase our ability to collect on unpaid accounts before considering third party collections. APPEALS Intermedix offers several important advantages surrounding appeals;we: Review each payment received from a third party to ensure accurate reimbursement. Identify problematic patterns and proactively involve our EMS Compliance Officer to work directly with the carrier to get them resolved. When we receive no payment;we: Appeal any timely filing denials immediately with proof showing when we received the insurance information and filed the claim. Submit a new claim with the proof of eligibility for patients who receive retroactive Medicaid coverage. AGED ACCOUNTS RECEIVABLE We have developed monitoring tools that allow us to follow-up on claims that have not been paid within an expected timeframe.When claims are submitted without a payer response,our staff is assigned in the Claims Status Monitor queue.Accurate data mining of denials is the most critical element of our denial management process. This Claims Status Monitor queue watches activity on accounts with primary and secondary insurance,an open status, and a balance that is not equal to zero. It recognizes the insurance process date and searches for a response from the payer. 31 9 2017 Intermedix Corporation www.intermedix.com 3i intermedix PROTOCOLS FOR ACCOUNT ADJUSTMENTS We work with each client to define and implement a core set of reasons for adjustments and write offs.As reasons are identified during the contract review,we can implement additional reasons that better fit your reporting operations. THIRD-PARTY DEBT COLLECTIONS After exhausting all efforts,including applying payments,adjustments and write-offs, accounts with open balances may become eligible for advanced collections.After a final review to ensure no recent account activity,we send the patient invoice that has language warning the account may be sent to collections if left unpaid.Upon written direction by the City,we will release the account to your designated collections vendor.This is done by electronically providing the necessary data to perform collection services. We also have the ability to receive export files into our billing system so that even delinquent account payment activity is reflected in the patient record. Medicare and Medicaid requirements HIPAA requirements Timely filing and compliance Our billing process has distinct steps filing for primary insurance and secondary insurance across all payer categories to ensure that collection efforts are documented appropriately and adhere to timely filing guidelines.We understand that these criteria differ based on payer type,and our billing specialists are well-versed in the nuances across all categories. Intermedix uses the Medicare Level of Service Coding Guidelines unless they conflict with a local ordinance.We have experience receiving payment from all payer categories,including Medicare, Medicaid,commercial insurers,liability carriers,worker's compensation and other governmental and commercial guarantors. Most often,we are able to arrange electronic remittances where the payer sends electronic funds directly into your bank account and an electronic remittance advice file is submitted electronically into our billing system and automatically posts payments to each patient account. This type of arrangement includes 100%of Medicare and Medicare payments and roughly 85%of commercial insurer payments.The remaining payments are handled manually according to strict policies and procedures that ensure the integrity of the transaction. Intermedix and its systems are certified compliant with CMS rules and regulations,including HIPAA and HITECH requirements.Our compliance program is dedicated to HIPAA HITECH compliance,which encompasses HIPAA privacy and security rules,HITECH and the Omnibus Rule.Our program also addresses PCI (Payment Card Industry) Data Security Standards and applicable State Information Security and Privacy controls. Audit Intermedix is able to commit to providing the City with regular updates on all audit findings, according to your specified schedule and format. 32 ©2017 Intermedix Corporation I www.intermedix.com )► intermedix Service Levels Service levels have been defined through our current contract with the City.We are amiable to review these service levels,should the City wish to amend. Compliance with other applicable Federal, State and Local laws and Requirements Intermedix has a keen focus on the many laws and regulations that impact the industry, including interpretation changes communicated by CMS.We have a dedicated EMS Compliance Officer who ensures our compliance, monitors audits and findings and is proactively engaged in helping to shape the future of the industry.All Intermedix employees go through HIPAA and compliance training upon hire and then annually thereafter.The use and release of patient information is front and center of our Compliance Program. As stated above, Intermedix and its systems are certified compliant with CMS rules and regulations, including HIPAA and HITECH requirements.Our compliance program is dedicated to HIPAA compliance,encompassing HIPAA privacy and security rules, HITECH and the Omnibus Rule.Our program also addresses PCI (Payment Card Industry) Data Security Standards and applicable State Information Security and Privacy controls. Customer Service We serve your patients with professional courtesy and compassion.We have a dedicated patient contact center that is staffed with experienced patient account representatives who are available via a toll free number from 8:00 am to 8:00 pm EST every weekday. The goal is to resolve patient inquiries within the first call.When that isn't possible,our patient account representatives seek to provide resolution back to the patient within two business days.This allows time for research or follow up that needs to occur to resolve the request. Patients can also leave a voice mail message that will be returned within one (1) business day. All patient inquiries will be handled according to the guidelines provided by the client,with you providing the final determination on any escalated issues. Documentation Maintenance Intermedix will maintain any and all documentation records and patient information in a secure environment.The City may request information at any time. Our quality assurance plan includes consistent monitoring,documentation and review of the processes we employ to accurately and compliantly bill for EMS transports.In addition,the City has access to reporting tools and information you need 24/7/265,via secured servers.Accounts collected, individual patient accounts, medic statistics,call statistics and financial statistics are available in a dynamic, real-time format. PCR, patient account,call statistic,demographic resource, and financial information is available via any internet capable computer.The City 33 ©2017 Intermedix Corporation www.intermedix.com �► intermedix also has secured online access to clinical documentation related to patient transports as well as any additional supporting data scanned and indexed for each individual encounter. Communications with City staff We build customer relationships with a focus on communication and transparency.The client team that works with the City today brings the benefit of already knowing your business operations,our longevity in the industry and regional experience to this relationship.One of the city's key points of contact,Darryl Hartung has worked with the City for nearly 17 years and has attended multiple City commission meetings.Patrick McKeon,your daily point of contact,is available during regular business hours for standard inquiries and contact management. Communications with your serviced hospitals As we do today,Intermedix will continue to maintain solid working relationships with all of your serviced hospitals.To support this claim,our Hospital Liaison Program has helped your Client Services Team establish relationships with all of the facilities you transport to for the purpose of obtaining patient insurance,demographic and Medicare signature documentation. This is a valuable asset we currently offer to the City that would be difficult and time- consuming to replicate with a different vendor.We currently have relationships established to receive patient demographic and insurance information,when available,from 100%of the hospitals to which the City transports patients. Training As part of the implementation process,we provide training on billing system set-up, procedures for navigating and using the system and steps to receiving customer support. Initial training is focused around ensuring that you are able to easily view account activity on a real-time basis.Additionally,we provide training for field personnel on the essential elements of clinical,patient demographic and insurance information that helps maximize reimbursements when properly collected.We also offer the Intermedix Training Center,an online,virtual classroom where our clients and their staff can access many topics designed to help improve the patient care reports for 911 providers.The training center is accessible 24/7/365 via the web. Surveys Intermedix will provide surveys to City's patients according to provided protocols. Electronic Data Transfer Data transfer to the billing system is accomplished via secured VPN from the City or via direct data entry if through our TripTix ePCR Solution. Data transfer between the ePCR field tablets and the TripTix host system is via cellular wireless technology. PCR records completed either on the tablet or on TripTix Web become immediately available to the billing system as TripTix and the IMX billing system reside on the same platform.Incident information is captured directly into the IMX billing system,regardless of initiation through a paper PCR or an 34 ®2017 Intermedia Corporation I www.intermedix.com �► intermedix electronic data import.Trip reports are automatically available in the billing system as soon as the run is submitted or uploaded.Intermedix hosts both a secure website and Secure File Transfer Protocol(SFTP)server that is capable of uploading and downloading files of any format.Security on both the secure website and SFTP server are in compliance with HIPAA security and encryption regulations ensuring protection from casual interception and inspection by unauthorized persons. Like we do today,our professional services team works to establish connections with various departments within your receiving facilities,including Information management and medical records,to gather demographic and insurance information to further augment this data.Our preferred method is an electronic file.We also pursue fax requests and VPN access into the hospital system to obtain necessary information.This team is staffed by experienced IT and administrative professionals who work with the City's hospitals on a daily basis to establish electronic and fax-back connections with our clients'receiving facilities. We will continue to mobilize our team to receive electronic data files for your patients.These interfaces provide access to critical patient demographic and insurance eligibility information provided through the intake process in the emergency room.When an electronic interface is active,it allows data to directly link to the patient account in our billing system. Computer Hardware,Software, Report Writing and Computer Aided Dispatch Requirements Since we are already providing the services outlined in the request for proposal,all computer and hardware specifications have been addressed.This includes the TripTix ePCR software the City uses today. Having all of these items already in place provides for uninterrupted cash flow for the City. The unique call flow design of TripTix allows your field user to enter data into the medical record as they would normally progress through a call. Each screen is designed for ease of use to maximize data capture while minimizing the effort.This allows the report writer the flexibility of real-time data entry or documentation at call conclusion. Report Writing The Intermedix Business Objects reporting interface contains easy to use template reports that are highly configurable using basic drag-and-drop skills.Users can add filter logic and manipulate the output layout and export to various formats throughout the contract.Our reporting tool is user friendly.When we encounter more complicated reporting requests,we have a team of reporting specialist that can either be consulted or used to create the reports. It does not require a programmer to formulate a query or format a report.Additionally,the client receives training from its client services team on the Business Objects reporting tools 35 C 2017 Intermedix Corporation 1 www.intermedix.com U intermedix and your client services team is always available to run specialized reports for you—a programmer is never needed. Our connection to the City dispatch information is accomplished through your TripTix ePCR. Our records management uses industry best practices with billing documents scanned and embedded into the patient account.This information is easily accessed through a hyperlink. In addition to the TripTix ePCR software being proposed,we have also provided two additional ePCR software options ESO Solutions and SafetyPad for the Committee's consideration.Separate pricing sheets and further information about each firm have also been included as well. These services shall include but not necessarily be limited to: 1. Proposer shall provide sufficient staffing to ensure the smooth and efficient operation of Emergency Medical Transport Reporting, Billing and Collection Services contract. We build customer relationships with a focus on communication and transparency.The client team that works with the City today brings the benefit of already knowing your business operations,our longevity in the industry and regional experience to this relationship.One of the city's key points of contact, Darryl Hartung has worked with the City for nearly 17 years and has attended multiple meetings with City staff and has worked with the City's internal auditing department to coordinate several routine audits of our services. Rebeca Botero,your daily point of contact,is available during regular business hours for standard inquiries and contact management. In addition to the people outlined above who will work with the City directly,we process Miami Beach billings in Miami Lakes.Our Miami Lakes office is staffed with over 100 local Miami Dade employees who are thoroughly experienced with Miami Beach billing processes and most importantly,the City's residents and community. Employees are continuously monitored to ensure effective and compliant billing of the City's accounts. 2. Proposer shall provide full-time Project Manager and/or Customer Service Representatives("CSR") assigned to the City's contract for EMS transportation billing and collection services,available during normal business hours, Eastern Standard Time(EST)five (5) days a week,Monday through Friday,that are able to communicate(read,write and speak)fluently in English,Spanish and Creole; however,it is not required that each CSR speaks in all the three (3) languages,but there must be available CSRs to conduct business in each language,as necessary. Our professionally staffed Patient Contact Center is focused solely on interacting with EMS transport patients.Our representatives handle both insurance and self-pay arrangements. Patients can use a toll-free number to access the Contact Center,which takes calls between 8:00 a.m.and 5:00 p.m.Central Time.The Contact Center uses the latest telephony technology,including skills-based routing by call type and language preferences. 36 C 2017 Intermedix Corporation www.intermedix.com �► interrnedix We have a number of bilingual Contact Center representatives for foreign language calls with fluency in many languages including Spanish,Chinese Dialects, French,Creole and more.Translation services are also available where patient account representatives can dial in a third party business associate for a live conference with a translator for one of the 200+supported languages. 3. Proposer's computer help desk support,or approved third-party support,must be available seven(7)days a week,twenty-four(24)hours a day,with the ability to provide technical assistance,trouble shooting,and correcting issues that may arise with the computer laptop systems hardware,software and connectivity and provide application support to users entering EPCR reports and accessing the quality control application from desktop platforms. The Intermedix Support Center is available 24 hours per day,7 days per week and 365 days per year. The Intermedix Support Center is available 24/7 to receive evening and weekend support calls.During periods of heavy call volume callers may be prompted to leave their telephone number,preserving their queue order for the next available technician. Email requests can be submitted for issues not requiring immediate resolution. The Intermedix Multi-Tier Support Model provides well-defined tier 1 through tier 3 severity level- driven escalation pathways: Tier 1—Support Center Technicians(SCTs)gather and document the customer's information and resolve simple issues,when possible.Typically straightforward issues will be resolved through utilization of the company knowledge management tool,or in collaboration with personnel at the same level or Tier 2.If the issue is more complex,they will escalate to the next level of support-Tier 2. Tier 2—SCT-II's are responsible for triaging complex technical issues by confirming the validity of the problem and seeking known solutions related to complex issues.If a problem is new and/or this group cannot determine a solution,they are responsible for collaborating with or raising the issue to a Tier 3 resource. Dependent on the nature and impact of the reported issue,escalations to teams outside the Support Center occur at this level. Tier 3&Above—SCT-Ill's,as well Product Support Specialists(PSS'),are responsible for handling the most difficult and advanced problems.They are experts in their fields and are responsible for identification of new and previously unknown issues,completing research,and collaborating across the organization.This is the highest level of technician within the Support Center. Escalations above this level occur when developing and deploying solutions to new and previously unknown issues. 4. Proposer shall have a local office within Broward County,FL,Palm Beach County,FL, Monroe County,FL,Collier County,FL,Lee County,FL,or Miami-Dade County,FL,as 37 ®2017 Intermedix Corporation I www.intermedix.com intermedix of the date of the issuance of this Request for Proposal.The local office should have staff capable of meeting with City staff on an as-needed basis. Intermedix has local offices in both Miami Dade and Broward counties. Each office provides for key staff that is capable and willing to provide support to City staff on a regular and ongoing basis just as we have provided for over 20 years. Miami Dade County Broward County EMS Billing Operations Center Florida Corporate Headquarters 7900 NW 154th Street,Suite 201 6451 N. Federal Highway,#1000 Miami Lakes, FL 33016 Fort Lauderdale, FL 33308 Please note that the client service we provide is far superior to that of our competitors as competitors typically provide access to lower level employees incapable of handling higher level City needs in an expedited manner. Scope of Work. 1. A comprehensive electronic patient care report that captures necessary patient care information and computer aided dispatch data required to fulfill the requirements of, FIRE-RESCUE DEPARTMENT,the receiving hospitals,insurance, Medicare, and Medicaid billing as well as capture the required data necessary to fulfill the State of Florida comprehensive EMS aggregate report requirements. TripTix is a proprietary and NEMSIS 3.0 approved EPCR product of Intermedix. Due to our extensive billing and collections background we have ensured that TripTix allows the billing side to be compliant with the ever changing Medicare and Medicaid rules.Some of the TripTix features include automatically validating data before finalizing a patient care report by flagging specific fields with errors and warnings,automatic patient searching through a patient's social security number or driver's license number(even if the patient has never been seen before),compliant patient signature language,and seamless patient billing uploads into our IMX billing platform. Since Intermedix manages the State of Florida EMSTARS database,the City will always be in compliance. 2. Access via the Internet a website that houses the FIRE-RESCUE DEPARTMENT's patient care procedures and protocols. TripTix can be accessed as a software-as-a-service architecture that can be used and accessed on any PC with a modern web browser and Internet connectivity. 3. Connectivity via Bluetooth to Physio-Control's Lifepak 15 defibrillators. We support this functionality.You can transfer your patient's critical data into the run record using various technologies,including Bluetooth. 38 0 2017 Intermedix Corporation www.intermedix.com 34, intermedix 4. Wireless connectivity between EPCR reports writing laptop computers,contractor's servers, Physio Controls' LifeNet Internet gateway and FIRE-RESCUE DEPARTMENT patient care protocols. TripTix allows peer to peer capability allows you to wirelessly transfer data to your devices without manually duplicating the information. 5. In the event that the City requires additional laptops,any additional costs incurred, will be negotiated at time of necessity. As we have demonstrated in the past,we work with our clients during changes to the City environment and agree to work with the City to negotiate and provide anything that may be needed. 6. Perform invoicing,collection,and generation of any and all insurance forms and filings, record maintenance and preparation of standard and/or custom reports,as requested or required by FIRE-RESCUE DEPARTMENT. We will continue to provide comprehensive billing and collection services for the City of Miami Beach. Please see above for greater detail. 7. Prepare quarterly State of Florida aggregate EMS reports. We perform this service currently and will continue to do so.With that said,the City has consistently achieved complaint data submissions scores of 100%.The following supports this excellent achievement. ,aloe.. 0 .7 mart ten.6,1-464 star tneve History A 0.606•0440 K:rOa.c.On. o 060 u... 041..a0• 1114 Pl.ley A tq. IMO tom 64*101.14 lrwt•a .n. ,0/u/ 42-4'20* irvaaR 4 4..11A. .7 WV'*✓M— 23161 ,411,223 311 , 100%.', 09.33 7% ,.. �sw 440,000 ApO04011¢0010 ale..0420 0446,606043 400•4.00 300 6E6605 Ot,1•4'I tanner. Wm 04.6 F. O r.a'. .1— aSO 4,S,AQ311 A•. W. ry..r• 0,,O, 0sv7PO4.a 1r=las s 1446..S 20,73.. t.6.0 .2512• 0,.2320,) ar.�.te ...t•RO F.. a•1®,A,02003. 23ia• .4,4033, , 1011% t 4%.Ot 06.0, .SS %sum 030.10641 ,Th)46,6766101 ac.,4 6336 06'••30.0,3. 0000,0,47 134 61,413, 43A•7 MiNene 11 Yaw 0000 t.. ea..as ID„! ,40501../11 t ,31 0,603 0\A1 ,00% 4104 3e40Y001 010,JISIOVIMINCI.pet•00 04000,1601 OgONIIImi•D 3114 * 4'.04277! lastttaa 06663x.a.. 1,QV Mat a 1U• F.VSTM3:I PO "5. 0%,0) 04.01 ,00\ ae,tle JeOla+et 0164.1110111044..44tet 7360 oaf item 8. Grant desktop computers at all FIRE-RESCUE DEPARTMENT fire stations access to patient care reports for statistical reporting and quality control processing. Our ePCR solution supports this functionality. 39 0 2017 Intermedix Corporation www.intermedix.com intermedin 9. Perform training for FIRE-RESCUE DEPARTMENT personnel on an as needed basis on desktop and laptop EPCR and quality control applications. Intermedix provides any necessary training the City may need to help with documenting a patient run record in our TripTix system.We recognize the importance and the impact proper documentation has from both the clinical and billing standpoint and stand ready to continuing to provide the City with training support. 10. Maintain all thirteen (13) and five (5) spare rugged laptop computers in working condition.The contractor agrees to replace or correct any malfunctioning hardware or software within twenty-four hours of FIRE-RESCUE DEPARTMENT's written notification of failure or breakage. We agree to support this requirement as we have continued to do for the last several years. 11. Establish a two-way data exchange system with billing hospitals with the ability to electronically transfer(e-Transfer) all EPCRs to the hospital and receive patient and related billing information back from the hospitals. Intermedix already has electronic hospital connections with the hospitals the City transports to obtain patient insurance information. In addition,we have implemented an etransfer of patient EPCRs to hospitals who participate.We can setup an electronic file push (outgoing) of data to the receiving facility and incorporate the electronic receipt (incoming) of data from the facility into our billing and reporting solution.We look forward to working with the City's facilities to accomplish this task.Additionally, ESO and SafetyPad both support this solution. Technical Specifications. Computer / Hardware / Software/ Report Writing and Computer Aided Dispatch ("CAD") Requirements: 1. Awarded Proposer shall be required to supply and maintain thirteen (13) primary and five(5) spare (total of 18 units) rugged and mobile tablets and/or laptops with cellular connectivity,capable of generating and capturing real-time patient care and computer aided dispatch data for the formulation of a comprehensive patient care report and for reporting purposes. Confirmed. Intermedix will provide 18 Panasonic CF20 ruggedized laptop devices along with the use of either the TripTix or ESO software solutions.An Xplore tablet device would be provided with the selection of the SafetyPad software solution.All of the remaining areas above would be provided within the costs as proposed. 40 ©2017 Intermedix Corporation www.intermedix.com �► intermedix 2. Systems shall be configured as follows:Win7 (Win8.1 Pro COA), Intel Core i5-3610ME 2.7GHz,10.1":XGA Multi Touch+ Digitizer LCD,128GB(or greater) Solid State Drive, 4GB,WiFi, Bluetooth,4G LTE Multi Carrier,GPS Receiver,Dual Pass (Upper:WWAN/Lower:WLAN),TPM 1.2,5MP or greater Camera,and Emissive Backlit Keyboard,or approved equal configurations. Our solution is configured at or above the City's requirements outlined above. 3. Internet Explorer or equivalent with cellular connectivity to FIRE-RESCUE DEPARTMENT procedures and protocols site and any other websites requested by FIRE-RESCUE DEPARTMENT. Our solution supports this requirement. 4. Connectivity via Bluetooth to EPCR client software and Physio Control's LifePak 15 manual cardiac defibrillators. Our solution supports this requirement. 5. Device must have the ability to attach picture and documents to EPCR. Our ePCR solution has this functionality. 7. Contractor shall provide a stock of digitizer stylus/pens on a regular basis at no cost to the City. Our solution supports this requirement. 8. Lifenet PC Gateway version 4.0 or 5.0 or current version for processing and transmission of code summary reports from Lifepak 15 defibrillators to receiving FIRE-RESCUE DEPARTMENT station computer(s). Prepare and process quarterly FIRE-RESCUE DEPARTMENT's State of Florida EMS pre-hospital data collection report,in a format designated by EMS Tracking and Reporting System (EMSTARS). Intermedix will handle this requirement.We are the most qualified in this area since we are currently contracted with the State of Florida to manage the Florida EMSTARS database.This allows us the unique ability of ensuring the City remains in compliance with the State EMSTARS data requirements.Our proposal provides only NEMSIS/EMSTARS compliant ePCR software solutions in TripTix, ESO and SafetyPad. Again,to demonstrate compliance with EMSTARS monthly reporting requirements,the following is a screen shot from the last several monthly submissions for the City of Miami Beach Fire Rescue. 100%compliance! 41 ©2017 Intermedix Corporation www.intermedix.com 3110. intermedix Doe User Depament Fee NM tee Fee Noe Lee New Ree.anae Facture Accept rManie Rau "0'266 02-16-20': ,,reia,t Yom.Beam Fre e'41121/3064-7l en 239 tB '{LS.S I 3 s ny"II; 9%4CI 0%101 '00% ZeaTte 3epa9nee Trp1S Dewagaehes veer C lee =e.ncgtapnrs Depa 106 4022064 09-t 1417 =wean' lean Beam Fre 0'31.20' 7201 iw 4 1,0 411574150,a 97, .00%; 1%1 0%(9) 100% 0esc'na?mermen Sean Bean Fire Jimmy 20'7:ao Enna 9.7 .rvrl+ie MYn 9'i01 Fee 0'46::.5955554 Jn 23:KB .EK9$7(J • t00'A It 0%•0. 0%(0( '00% Rescue 3epslreni TWA.3enograpnce agent,6 086 :augments Decorerentl 306 609757 0120-2017 reenn+44 Ulan Bean Fee 0')649.7171991 as 297 em '('4353 1J100%(1) 0%(0? 0%(0) 100% Rescu:4av pent TryT40005 plecs agent)a 006 3e.-yarlecs , Dep nmenei'106 15)52.1 01-36.2017 ]rt,area anon*An Fee 0''1'..0' J 40) EUSTARS•4 971 '00% 0%x01 9%(0) 100% ;ex.Dep 1005 9a4n4 Ream r r e.-r4'23'6;Mtn E7aes 9. Process EPCR computer aided dispatch data generated from the current Miami Beach CAD by Tyler Technology(previously New World Systems) computer system using the current interface. We agree to this requirement as we are already integrated with the City's CAD. 10. The ability to enter data on an EPCR while reviewing protocols,websites,etc., simultaneously on the tablet. We agree to this requirement as we already provide this ability. 11. Contractor shall provide capabilities to change,modify,or add fields in underlying software. We agree to this requirement. 12. Contractor shall provide the ability to add a field to document law enforcement case numbers on all motor vehicle accidents/incidents. We agree to this requirement as we already provide this ability. Invoicing/ Billing/ Collections Requirements. 1. The Successful Contractor shall employ,maintain and assign an adequate number of competent and qualified professionals,as deemed necessary by the Department to meet the performance requirements. Contractor shall be responsible for the invoicing,collection, and generation of any and all insurance forms and filings, record maintenance and preparation of standard and/or custom reports,as requested or required by the FIRE-RESCUE DEPARTMENT. Intermedix takes great pride in the employees that have worked with the City of Miami Beach over the years in providing the highest level of compliant collections. Darryl Hartung will continue to work with Rebeca Botero and the operational staff in continuing this excellent trend.Omar Perez,Senior Vice President of Operations,will continue to oversee and ensure that the City's collections exceed your expectations. Omar's staff 42 O 2017 Intermedix Corporation www.intermedix.com 2140,- intermedix includes a deep knowledge of the City's billing policies and procedures as they have been involved with the City's accounts for many years and ensures that the City's insurance claims are filed to the proper payers.The Intermedix reporting department stands ready to meet the needs of any future reporting need the City requests. Jack Donahue will continue to oversee the entire EMS division and is located within in a short drive from Miami Beach.While the billing process is occurring,our compliance department constantly monitors operational staff to ensure proper compliance with all federal,state, and local laws.Additional staffing information is provided earlier in our proposal. 2. The invoices for services rendered shall contain the following information: a. Account number of Patient. b. Invoice number. c. Invoice date. d. Name of Patient. e. Name of responsible person if different from patient. f. Complete address of Patient. g. Date of transport. h. Cost of transport including cost breakdown (mileage&oxygen). i. Incident number. j. Transport mileage from and to. k. Insurance coverage and instructions(if applicable). I. Billing inquiry telephone number,800-phone number if not local for satisfaction of the receivable and customer satisfaction. We have provided this in a sample patient invoice for your reference in the following page. 43 0 2017 Intermedix Corporation www.intermedix.com John Doe City of Miami Beach EMS 1110 Ocean Drive Phone: 888-772-3199 Miami Fl 33110 Emergency Medical Services Bill Statement Date: 01/14/2017 Date of Service: 01/01/2017 Account Number: 0000000 Incident No. 2017-00000 This invoice is the result of a response for ambulance services on 01/01/2017. If you have insurance,please complete and sign the back of this form,and return to us. Please make sure your name is exactly as it appears on your insurance card.To update your insurance information online,go to www.intermedix.com/billpay.We will file a claim on your behalf. If you do not have insurance,this payment is your responsibility.Please see options below to submit payment. For information or assistance on this account,please call 888-772-3199. Statement of Account Emergency Medical Services $845.00 Amount Due: $845.00 **DETACH LOWER PORTIONS AND RETURN STUB WITH YOUR PAYMENT,THANK YOU** City of Miami Beach EMS INCIDENT NO. STATEMENT DATE PAY THIS AMOUNT ACCOUNT NO. P.O. BOX 116790 2017-00000 01/14/2017 $845.00 00000000 ATLANTA GA 30368 liii I liii II I liii I 11111 III Make checks payable to: City of Miami Beach EMS John Doe To view your account online, go to www.intermedix.com/billpay 1110 Ocean Drive Miami Fl City of Miami Beach EMS 33110 P.O. BOX 116790 ATLANTA GA 30368 1 In order to process your claim, please provide your insurance information below and mail the form to CITY OF MIAMI BEACH EMS, P.O. BOX 116790, ATLANTA GA 30368 or fax it to 305-428-5385. To view your account online,go to www.intermedix.com/billpay Do you have insurance? Yes❑No❑(If you do not have insurance,complete only the Patient Information section.) Patient Information(Required Information) Patient's First Name MI Patients Last Name Patient's Sex M ❑ F ❑ Patients Date of Birth(MM-DO-YYYY) Patient's Social Security Number Telephone Number(Include Area Code) I I I I - I - E-mail Address 111 1 1 I authorize any holder of medical or other information about me to release to Medicare.Medicaid or may other payer responsible for payment and any information needed for this related Medicare or other claim.now.in the future or in the pas.I permit a copy of this atmthoiition to be used in place of the original and request payment of medical insurance benefits to the service provider. Signature Date Signer's relationship to patient:Self❑ Parent❑ Other 0 If other,please explain: Signer's Address: City: State: Zip Code: Medicare Information Medicaid Information Medicare ID(Include letters and numbers) Railroad Medicaid ID(Include letters and numbers) State l ❑ I Patient Insurance Information Policy Holder's First Name MI Policy Holder's Last Name Patients Relationship to Insured . ❑ Serf❑Spouse❑Other❑ Insurance Company Name Primary 0 Secondary❑ Insurance Policy Number Insurance Group Number i I _ Insurance Company Address I I City State ZIP Code I I II Patient Accident/Injury Insurance Information If services were related to an accident or injury,please provide any additional in,vrance information,such as homeowners. automobile.workers'compensation.or liability. Policy Holder's First Name MI Policy Holder's Last Name Patient's Relationship to Insured ❑ 1 Serf❑ Spouse❑Other❑ Insurance Company Name Insurance Contact Phone Number Insurance Policy Number Claim Number 1 I1 Insurance Company Address City State ZIP Code III _ At-fault Party's Accident/Injury Insurance Information If services were related to an accident or injury,please provide any additional insurance information for the responsible parr-. such as homeowners,automobile,workers'compensation.or liability. Policy Holder's First Name MI Policy Holder's Last Name Patients Relationship to Insured I I ❑ I I J 1 �❑ Spouse ElOther CI Insurance Company Name Insurance Contact Phone Number I - I - Insurance Policy Number Claim Number Insurance tompany Address I City State ZIP Code I 1 I 2 For office use only-Patient Account Number:41400516 City of Miami Beach EMS P.O. BOX 116790 ATLANTA GA 30368 II Ill liii 11111111 liii! II RETURN SERVICE REQUESTED John Doe 1110 Ocean Drive Miami Fl 33110 Phone#: 888-772-3199 CITY OF MIAMI BEACH EMS THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. This Notice of Privacy Practices("Notice")describes the legal duties of City of Miami Beach EMS("Provider,""we,""us,"or"our")and your legal rights regarding your protected health information("PHI")in accordance with the Health Insurance Portability and Accountability Act of 1996,as amended("HIPAA"). provider Re;poncihilities. The Provider is required by law to: • Maintain the privacy of your PHI; • Provide you with certain rights with respect to your PHI; • Provide you with a copy of this Notice of our legal duties and privacy practices with respect to your PHI;and • Follow the terms of the Notice that is currently in effect. Uses and Disclosures of PHI. The Provider may use or disclose PHI for the purposes of treatment,payment,and health care operations without your written permission,in most cases. Examples of our use or disclosure of your PHI include the following: For Treatment. This includes such things as obtaining verbal and written information about your medical condition and treatment from you,as well as from others,such as doctors and nurses who give orders to allow us to provide treatment to you. We may give your PHI to other health care providers involved in your treatment,and may transfer your PHI via radio or telephone to the hospital or dispatch center. For Payment. This includes any activities we must undertake in order to get reimbursed for the services we provide to you,including such things as submitting bills to insurance companies,making medical necessity determinations,and collecting outstanding accounts. For Health Care Operations. This includes quality assurance activities,licensing,and training programs to ensure that our personnel meet our standards of care and follow established policies and procedures,as well as certain other management functions. t•ii'I. ,• , „ i I, S r' . We may also contact you to provide you with a reminder of any scheduled appointments for non-emergency ambulance and medical transportation,or to provide information about other services we provide. Use and Disclosure of PHI Without Your Authorization. The Provider is permitted to use or disclose PHI without your written authorization,or opportunity to object,in certain situations,and unless prohibited by a more stringent state law,including: • For the treatment,payment,or health care operations activities of another health care provider who treats you; • For health care and legal compliance activities; • To business associates that perform various functions on our behalf or to provide certain types of services; • To a family member,other relative,close personal friend,or other individual involved in your care if we obtain your verbal agreement to do so or if we give you an opportunity to object to such a disclosure and you do not raise an objection,and in certain other circumstances where we are unable to obtain your agreement and believe the disclosure is in your best interests; • To a public health authority in certain situations,as required by law(such as to report abuse,neglect,or domestic violence); • For health oversight activities,including audits or government investigations,inspections,disciplinary proceedings,and other administrative or judicial actions undertaken by the government(or its contractors)by law to oversee the health care system; • For judicial and administrative proceedings,as required by a court or administrative order,or in some cases in response to a subpoena or other legal process; • For law enforcement activities in limited situations,such as when responding to a warrant; • For military,national defense and security,and other special government functions; • To avert a serious threat to the health and safety of a person or the public at large; • For workers'compensation purposes,and in compliance with workers'compensation laws; • To coroners,medical examiners,and funeral directors for identifying a deceased person,determining cause of death,or as necessary to carry out their duties,as authorized by law; 3 • If you are an organ donor,to an organization that handles organ procurement or organ,eye,or tissue transplantation,or to an organ donation bank,as necessary to facilitate organ donation and transplantation; • For research projects,but this will be subject to strict oversight and approvals;and • In a manner that does not personally identify you or reveal who you are. I tse and Disclosure of PHI With Your Authorization. Other uses or disclosures of your PHI not described above will only be made with your written authorization. For example,in general and subject to specific conditions,we will not use or disclose your psychiatric notes;we will not use or disclose your PHI for marketing;and we will not sell your PHI,unless you give us a written authorization. You may revoke written authorizations at any time,so long as the revocation is in writing.Once we receive your written revocation,it will only be effective for future uses and disclosures. It will not be effective for any PHI that may have been used or disclosed in reliance upon the written authorization and prior to receiving your written revocation. Patient Rights. As a patient,you have a number of rights with respect to your PHI,including: The Right to Access,Copy,or Inspect Your PHL You have the right to inspect and copy certain types of your PHI. We will generally provide you with access to this PHI within 30 days of your request. If the PHI you request is maintained electronically,and you request an electronic copy,we will provide a copy in the electronic format you request if the PHI can be readily produced in that format. If the PHI cannot be readily produced in that format,we will work with you to come to an agreement on format. If we cannot agree on an electronic format,we will provide you with a paper copy. To inspect and copy your PHI,please contact our Privacy Officer(as set forth below). If you request a copy of the PHI,we may charge a reasonable fee for you to copy any PHI that you have the right to access. We may deny your request to inspect and copy your PHI in certain limited circumstances. If you are denied access to your PHI,we will provide a written denial,and you may request that the denial be reviewed by submitting a written request to our Privacy Officer. The Right to Receive Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example,you can ask that we only contact you at work or by mail. To request confidential communications,please contact our Privacy Officer. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests. The Right to Amend Your PHI. You have the right to ask us to amend PHI that we may have about you. We will generally amend your PHI within 60 days of your request and will notify you when we have amended the PHI. We are permitted by law to deny your request to amend your PHI only in certain circumstances,like when we believe the PHI you have asked us to amend is correct. If you wish to request that we amend the PHI that we have about you,please contact our Privacy Officer. The Right to Request an Accounting. You may request an accounting from us of certain disclosures of your PHI that we have made in the six years prior to the date of your request. We are not required to give you an accounting of uses or disclosures for purposes of treatment,payment,or health care operations,or when we share your PHI with our business associates,such as our billing company or a medical facility from/to which we have transported you. We are also not required to give you an accounting of our uses and disclosures of PHI for which you have given us written authorization. If you wish to request an accounting,please contact our Privacy Officer. The Right to Request that We Restrict the Uses and Disclosures of Your PHI. You have the right to request that we restrict how we use and disclose your PHI. Except as provided below,the Provider is not required to agree to any restrictions you request. However,any restrictions agreed to by the Provider in writing are binding on the Provider. We will comply with any restriction request if(1)except as otherwise required by law,the disclosure is to a health plan for purposes of carrying out payment or health care operations(and is not for purposes of carrying out treatment),and(2)the PHI pertains solely to a health care item or service for which the health care provider involved has been paid in full by you or another person. To request restrictions,please contact our Privacy Officer. The Right to Be Notified of a Breach. You have the right to be notified in the event that we(or a business associate)discover a breach of unsecured PHI. Other Appticabl laws. HIPAA generally does not preempt other laws that give individuals greater privacy protections. Therefore,if any state or federal privacy law requires us to provide you with more privacy protections,then we will also follow that law in addition to HIPAA. Internet Electronic Mail.and the Right to Obtain Copy of Paper Notice on Request. If we maintain a web site,we will prominently post a copy of this Notice on our web site. If you allow us,we will forward you this Notice by electronic mail instead of on paper and you may always request a paper copy of the Notice. Revisions to the Notice. The Provider reserves the right to change the terms of this Notice at any time,and the changes will be effective immediately and will apply to all PHI that we maintain. Any material changes to the Notice will be promptly posted in our facilities and posted to our web site,if we maintain one. You can get a copy of the latest version of this Notice by contacting our Privacy Officer. Your . gal Rights and Com las. You also have the right to complain to us or to the Secretary of the United States Department of Health and Human Services("Secretary") if you believe your privacy rights have been violated. You will not'be retaliated against in any way for filing a complaint with us or the Secretary. To file a complaint with the Provider,or if you have any questions or comments regarding this Notice,please contact our Privacy Officer. Please note that all complaints filed with the Provider must be submitted in writing. Privacy Officer Contact Information: Privacy Officer Francois Betancourt,EMS Division Chief 2300 Pinetree Dr.Miami Beach,FL 33140 Phone:305-673-7130 Fax:305-673-7257 Effective Date of the Notice:July 16,2013 COMPLIANCE WITH SECTION 119.071(5),FLORIDA STATUTES,REGARDING OUR COLLECTION AND USAGE OF YOUR SOCIAL SECURITY NUMBER Pursuant to requirements outlined in Section 119.071(5),Florida Statutes,OTHER PERSONAL INFORMATION,we are hereby advising you that the collection of your Social Security Number is imperative for the performance of our duties and responsibilities as prescribed by law. Your Social Security Number will be used for billing purposes and to enable other healthcare providers and/or insurers to identify your records. Such use is authorized under federal and state law. As such,we are in compliance with Section 119.071(5),Florida Statutes. 2 intermedix 3. Contractor shall mail bills/invoice forms to patients within five(5)days of receipt of the patient information.This is to include return envelope and address specified by the City of Miami Beach. We currently provide this process for the City,and will continue delivering this service. 4. Patient invoices:All invoices and reporting shall be automated. We will comply with this requirement. 5. Contractor shall be responsible for sending follow up bills at thirty-day(30),sixty- day(60),and ninety-day(90) intervals. We currently provide this process for the City and will continue to support your needs in this manner. 6. Contractor shall mail proper insurance forms or electronically process to third party payer as required or requested by the patient. (This is to include envelope and address specified by the City of Miami Beach). We will comply with this requirement. 7. Contractor shall post all payments as received directly or electronically within one (1) business day. We will comply with this requirement. Once payment information is received,the City's bank will post payments within one business day. 8. The Contractor shall agree to make every effort to locate and correct any incorrect billing address for billable patients. We will comply with this requirement.Our normal billing process includes skip tracing efforts utilizing one of the largest skip tracing companies in the country,Accurint.We have implemented automated lookup processes to capture and correct incorrect patient formation received on the run report. Please note that these are significantly reduced when clients are utilizing TripTix and the patient lookup feature. 9. Contractor shalt agrees to include in the invoice mailing a citizen satisfaction survey and a return,self- addressed and postage paid envelope that will be provided by the City of Miami Beach.Said survey is expected to be no more than one page in length and of a size not to exceed 8 1/2 x 11 inches. We currently provide this process for the City and will continue to support your needs in this manner. In addition, Intermedix can help with the creation of the City's survey by providing sample surveys of surrounding agencies. 45 ©2017 Intermedix Corporation www.intermedix.com �► intermedix 10. Contractor will check hospital information twice per self-pay account(if necessary) to obtain/verify patient insurance and contact information. We connect with 100%of the hospitals to which you transport and obtain files containing new information daily and weekly. 11. Contractor shall conduct any follow-up required to obtain the necessary insurance information to process invoices for payment. Record of telephone calls and contact shall be maintained and any payment on an account shall be recorded per account. Intermedix takes a number of steps to try and obtain patient insurance information other than hospital data,including our own internal patient insurance database that contains over 30 million records,effective patient statements with customized wording, and targeted patient calling campaigns to speak directly with patients and obtain the information we need.All of these efforts are documented on the patient accounts and is 100%visible to the City at any time through any web based computer. 12. Accept the hard copy or electronic information pertaining to patients'pay or billing documentation from FIRE-RESCUE DEPARTMENT for all patients transported by FIRE- RESCUE DEPARTMENT. We will comply with this requirement.All patient correspondence related to a patient is scanned and linked directly to the patient's account for future reference if needed. 13. Patient invoices:All invoices and reporting systems shall be automated. We will comply with this requirement. Patient statements are set on an automated scheduled as per the City's last contract guidelines.The City's statement profile can be altered on short notice but will only be altered at the direction of the City. 14. Contractor shall be responsible for all usual and customary costs incurred as a result of billing and collecting accounts,such as software,credit card processing fees, equipment and the installation of data and phone lines. We will comply with this requirement.All of our systems and processes are in place and collecting revenue at a high level for the City.Any change in vendors would disrupt this process and could have a significant impact to the City's collection levels. 15. Contractor shall maintain and update all billings for ambulance services(accounts) to include update of address and telephone numbers obtained through billing and collection efforts. Report shall be provided as necessary. We will comply with this requirement. Intermedix utilizes one of the largest skip tracing firms,Accurint,to provide updated patient demographic information.This process is automated and runs each night to check for updated information.Once updated information is received,the information is automatically updated to the patient's account and is ready for the next action,which includes rechecking for insurance information hits. 46 ©2017 Intermedix Corporation www.intermedix.com �► intermedix 16. In the event Contractor received payment for services which are later disallowed (such as bad checks paid directly to FIRE-RESCUE DEPARTMENT,or adjustments) by FIRE-RESCUE DEPARTMENT, FIRE-RESCUE DEPARTMENT may offset the amount disallowed from any payment due Contractor. Intermedix reconciles payments on a monthly basis.When our invoice is generated to the City we net out any amounts the City is not responsible for. In addition,if an account payment is ever refunded at a later date,our fee credits back the City in the next applicable invoice. 17. Contractor shall not add a charge of any kind to a billed account. We will not add a charge of any kind to a billed account.This has been demonstrated over the years and confirmed by the City's internal auditing department through regular audits throughout our relationship. 18. To the extent necessary to fulfill its billing and collection efforts under the awarded contract,Contractor is granted limited authority to sign in an administrative capacity on behalf of FIRE-RESCUE DEPARTMENT the following types of standard forms and correspondence: probate claim filings;letters to patients and their representatives verifying that an account is paid in full;form verifying FIRE-RESCUE DEPARTMENT tax exempt status;and insurance filings and related forms.Contractor has no authority to sign any document on behalf of FIRE-RESCUE DEPARTMENT, which imposes liability on FIRE-RESCUE DEPARTMENT. We will comply with this requirement.As we have demonstrated over the years,we work with the City and provide appropriate forms,when needed,to the City for any necessary signatures. 19. All written billing and collection correspondence must be approved by an FIRE- RESCUE DEPARTMENT designee.All payments and correspondence shall be directed to the mailing address designated by FIRE-RESCUE DEPARTMENT. Intermedix will review all writing billing and collection correspondence upon contract award,and on an as-needed basis during the term of our contract. 20. Contractor agrees to negotiate and arrange modified payment schedules for those individuals unable to pay the full amount when billed. We currently perform this service for the City.Over the years wehave established patient payment policies in collaboration with City staff. This has led to appreciative patients as it allows them the opportunity to pay their obligation in an economical way. 47 2017 Intermedix Corporation www.intermedix.com �► intermedix 21. Contractor agrees to refund patient or insurance company refunds within forty-five (45) days of receipt and agrees to all applicable Florida Statutes. We currently perform this service for the City.Once a refund is identified it is typically processed within 30 days. Our compliance department monitors all credit balance activity to ensure our compliance with all federal,state,and local laws.Additional information related to refunds is included in the next item. 22. Contractor must provide the City of Miami Beach with a refund request including all pertinent information relating to refund payments to patients and/or insurance company. (Contractor to describe procedure in their proposal submittal). Intermedix currently provides the City with a refund request including all pertinent backup information relating to refund payments to patients and/or insurance company. Intermedix has worked with City staff over the years to perfect this process and will continue to ensure the City receives the appropriate documents needed to process an accurate and timely refund. When a credit balance occurs, Payment Posters provide the payment record to a Refund Processor for follow up.The Refund Processor then researches the claim,gathering supporting documentation from our billing system,which may include the EOB and copies of the original check from the payer.After the credit balance is confirmed as a legitimate overpayment,the Refund Processor completes the necessary refund request documentation and forwards to the City for final check processing. 23. Contractor will process all third party reimbursements within one(1)week after receipt of appropriate billing information from primary payer. We will comply with this requirement.As soon as we receive a new transport for billing it is automatically imported into our system and the billing process begins.Our system is already checking for insurance information in our internal database and will load insurance to the patient's account when a direct match is identified.The account is coded during this time as well. Skip tracing is also occurring to try and update account with the most accurate demographic information.Our system is also checking with various insurance databases electronically to see if patients have insurance information for Medicare, Medicaid,or other commercial insurance companies.Within a few days we have typically received the hospital file and will update any remaining accounts. Patients statements will start to go out should no insurance information be discovered during all of these processes. 24. Contractor shall not settle any accounts for less than the amount indicated by FIRE- RESCUE DEPARTMENT without the prior written approval of the FIRE-RESCUE DEPARTMENT designee. We will comply with this requirement. Intermedix does try to setup affordable payment plans for the patients the City transports but at no time is the balance discounted. 48 9 2017 Intermedix Corporation www.intermedix.com intermedix 25. Contractor shall provide copies of remittance advice as required by FIRE- RESCUE DEPARTMENT. Upon receipt of payment documentation,our Payment Posters apply payments to the account within one business day.We provide the tools necessary to receive payments through several methods,including electronic fund transfers(EFTS),checks and credit cards.We receive electronic payment from Medicare, Medicaid and most commercial payers and our Electronic Remittance Advice (ERA) browser allows the Payment Poster to access and verify these responses.All remittance advice are scan to the patient account for future reference.All of these documents can be provided to the City on request. 26. Contractor shall post all payments received directly or electronically within one (1) business day and process refund requests with the month following an overpayment. We will comply with this requirement. 27. Contractor shall maintain proper insurance forms used by third party payers as required or requested by the patient in either the manual or electronic method. Either way,the contractor shall include information on where to send payments to FIRE-RESCUE DEPARTMENT. We will comply with this requirement. Intermedix generally files claims electronically but will also file claims to third parties that do not accept electronic filings.We maintain up to date insurance forms through our compliance department. 28. Contractor shall expeditiously begin the billing and collection process for those Accounts provided to Contractor by FIRE-RESCUE DEPARTMENT based upon established rates.The method utilized by Contractor to process the accounts shall be a means approved by FIRE-RESCUE DEPARTMENT Contract Administrator. We currently perform this service for the City. The City's fee schedule is already setup in our billing profile for the City and has also been mapped according to the level of service each transport in coded. 29. Contractor shall be responsible for contacting the sender of monies when there is insufficient information to identify which account the payment is being applied to. FIRE-RESCUE DEPARTMENT shall not be required to pay Contractor any collection fees on account until the corresponding account number can be identified. We will meet this requirement. Intermedix researches unidentified payments on a regular basis and once resolved,we try to resolve the root cause behind it so it does not occur in the future. 49 2017 Intermedix Corporation www.intermedix.com �► intermedix 30. Contractor shall reconcile the number of transports collected with those transmitted to Contractor and contact a FIRE-RESCUE DEPARTMENT designee to report any discrepancies. Your Client Relations Manager has the ability to check for,and resolve, import errors using an online utility. The reconciling is handled by your client relations manager; Rebeca Botero. Rebeca compares data from the ePCR system with that of our billing system.Any discrepancies are researched and corrected by working with City staff. 31. If this Agreement is terminated,all accounts will be returned to FIRE-RESCUE DEPARTMENT regardless of payments made on account or arrangement made. Upon termination,Contractor will inform any billed account with whom they are dealing to make future payments directly to FIRE-RESCUE DEPARTMENT or other firm identified by FIRE-RESCUE DEPARTMENT. We will meet this requirement. 32. FIRE-RESCUE DEPARTMENT is the owner of all information submitted to the Contractor. If this Agreement is terminated,all accounts will be returned to FIRE- RESCUE DEPARTMENT regardless of payments made on account or arrangement made. We will meet this requirement. 33. If this Agreement is terminated contractor agrees to provide a raw flat file containing all relevant data that would be needed to re-create an EPCR for any purpose.The contractor agrees to provide the City a one-time column header file w/a brief description of each column's data and how it pertains to the formulation necessary to re-create the EPCR for the purposes mentioned above. We will meet this requirement. 34. Contractor should include sample bill forms and the messages that will be used on each successive bill mailed,as part of the response.All text,format,and color of printing and stock are subject to approval by the City of Miami Beach. Billings should be at maximum intervals of thirty-five(35)days,except for the first invoice that should be rendered within ten (10)days of service. We have provided our sample bill form in the previous pages. If needed,we will work with the City to modify our current process for you. 50 ©2017 Intermedix Corporation www.intermedix.com Nt, intermedix 35. Contractor shall be required to establish a method to accept and process credit card payments from patients through an online and a pay-by-phone solution.The City can be the merchant for the solution but the contractor shall be responsible for all fees associated with the credit card acceptance solution. Intermedix will meet this requirement through our credit card partner,Zirmed.We will work with the City to complete the necessary forms to setup this convenient feature for patients.This tool,which is directly linked to our patient bill pay website,allows patients to pay both credit as well as echeck utilizing their banking account information. 36. Contractor shall provide a process for collecting information from local law enforcement agencies and gross billable and payments on all incidents involving motor vehicles. We will meet this requirement. 37. Contractor shall show the ability to increase collection rates annually. Intermedix prides itself on providing year over year compliant collection increases.We have partnered closely with the City to ensure consistent revenue collection and compliance with your policies and controls.We have maintained relationships with 100% of the hospitals to which you transport. Intermedix has worked together with you diligently to integrate and customize collections for the City through shared effort.We have increased the City's collections by 157%since we began providing billing services. As demonstrated in the following graph,collections have continued to increase in recent years despite tough economic times and industry and legislative changes. $2,400,000 $2,200,000 $2,000,000 $1,800,000 $1,600,000 $1,400,000 -H - $1,200,000 - $1,000,000 FY2013 FY2014 FY2015 FY2016 Intermedix is continuously researching and developing new methods to increase client collections in a compliant manner,which has been the case over the last 22 years.To this end,we recently implemented a deductible monitoring tool that allows us to track the status of a patient's deductible.This allows us to temporarily hold filing a claim until the patient has reached their deductible requirement. Once the deductible is reached,we will file the claim.This process is monitored very closely and at no time do we hold any claims 51 O 2017 Intermedix Corporation www.intermedix.com intermedix past timely filing limits.We are excited that this will lead to additional collections for the City. 38. Contractor shall have a mechanism in place to find a revenue source for all patients outside of contacting the hospitals. We comply with this requirement.This is where Intermedix separates itself from any competitors.We have developed the most extensive patient insurance database that includes not only patients previously transported by the City of Miami Beach Fire Rescue but also all of the clients we perform the billing services for.This database currently stands at over 30 million records and allows us the unique ability to link patient insurance information among all of our clients.This ultimately leads to expedited claims to payers and higher collections for our clients. 39. Contractor shall be able to provide litigation services as it may relate to MVA(Motor Vehicle Accident/PIP Claims) incidents should the need arise.These services will only be executed based on direction from the City on an as-needed basis. We comply with this requirement. Our billing specialists work with attorneys constantly to ultimately obtain payments related to Motor Vehicle Accidents(MVA). These efforts include initial claim filing,submitting appeals,and following up with adjusters. In the end, there are a remaining portion of MVA related accounts that require additional action due to incorrect payments from the auto insurance companies. Intermedix is able to take this further beyond our normal billing efforts and bring in a PIP attorney to submit demand letters and/or file suit against the auto insurance companies to recover appropriate payment for the City. Medicare and Medicaid Requirements. 1. Contractor shall provide prompt submission of Medicare, Medicaid and insurance claims within seventy-two(72) hours after receiving a completed EPCR,when all information necessary to file the claim is present. As soon as a new run report is received for billing the Intermedix billing begins.As soon as all information is received and updated to the patient account,it is typically filed the same night.This realistically means that a claim can be filed the same day in which we receive it from the City.The automated processes we have developed over the years with hospitals,ski tracing, insurance eligibility confirmations,etc. has led to highly efficient claim filing processes,which ultimately leads to a fast turnaround of the City's revenue. 2. Contractor will provide Medicare/Medicaid billings in accordance with all Federal, State and Local laws and Medicare/Medicaid rules and requirements. We will comply with this requirement. Intermedix is the leader in the State of Florida and across the country when it comes to compliance with state,federal, and local laws.We work with various associations and have had major impacts in the State of Florida on reimbursement and overall industry rulemaking. Intermedix goes further than any other 52 ©2017 Intermedix Corporation www.intermedix.com �► Intermedix vendor in Florida due to the number of clients we have in the state.Our most recent success came from assisting the Florida Fire Chief's Association with implementing the Florida Medicaid Certified Public Expenditure Program.No other billing vendor was involved with getting this legislation passed. Once the initial hurdle was passed,we partnered with PCG to allow our clients to capture maximum (new) revenue in FY 2017 and we expect the efforts from this program to pay off before the end of March 2017. Miami Beach is benefiting from these efforts. 3. Contractor shall provide Electronic Claims processing for Medicare and Medicaid and re-file Medicare,Medicaid or insurance claims,as necessary to obtain payment. We comply with this requirement. Please see our above response. 4. Contractor shall be prepared to assess service levels prior to billing and classify services into levels that meet Medicare and Medicaid transport criteria.These service levels may,in a limited number of cases,differ from what is indicated on internal documents based upon interpretation and must be brought to FIRE-RESCUE DEPARTMENT'S attention to determine if changes may be necessary. Intermedix takes great pride in coding compliance as we employee certified coding professionals to review the City's accounts. We work with the City when coding differences are identified and discuss any needed changes that ensures the City is compliant with applicable Medicare and Medicaid guidelines. 5. Contractor will provide support for Medicaid or Medicare audits. We comply with this requirement. Intermedix stands behind all billing and collection processes and will assist the City in event of a Medicaid or Medicare audit. Intermedix employs in-house counsel and an EMS compliance officer who is also an attorney and would assist should this ever occur. Further information about our compliance team is below. 6. Contractor shall provide Electronic Claims Processing for Medicare and Medicaid to the City's lock box. We agree to meet this requirement.This is how the process has been for many years.We work closely with City staff and,when necessary,bank staff to ensure payments are being received into the City's bank account.This includes both electronic EFT payments as well as physical check payment sent to the lockbox address. Compliance with Applicable Federal, State and Local Laws and Requirements. 1. Provide Health Insurance Portability and Accountability Act(HIPAA) privacy practice requirements to all patients transported in accordance with current regulatory requirements. 53 0 2017 Intermedix Corporation www.intermedix.com Vi intermedix We are a leader in our focus on compliance. One of the first executive hires made within our billing organization was a Compliance Officer. Today,we have a Corporate Compliance Officer in addition to an EMS Compliance Officer,and a full supporting information security and legal staff that includes in-house Counsel. These leaders are focused full-time on ensuring that we are addressing the strategic and tactical aspects of Compliance within organizations as well as across our clients and partners. We understand the trust that you and other clients place upon us in handling highly-regulated data and are committed adhering to laws and regulations,as well as shaping the future of our industry. Our compliance program is dedicated to HIPAA HITECH compliance,which encompasses HIPAA privacy and security rules,HITECH,the Omnibus Rule and State Information Security and Privacy controls.Intermedix and its systems are certified compliant with CMS rules and regulations,including HIPAA and HITECH requirements.Our compliance program is dedicated to HIPAA HITECH compliance,which encompasses HIPAA privacy and security rules,HITECH and the Omnibus Rule.Our program also addresses PCI (Payment Card Industry) Data Security Standards and applicable State Information Security and Privacy controls.Intermedix,though not a registered delinquent account collections agency,is compliant with the Fair Debt Collection Practices Act as it applies to the services we do provide. Intermedix has a comprehensive library of HIPAA and HITECH documented policies and procedures that are available to our team members via the corporate intranet.These policies include(but are not limited to): • Standards of Business Ethics and Conduct • Safeguarding Confidential Information • Compliance Training&Certification • HIPAA Affiliated Covered Entity • HIPAA Business Associates Agreements • PHI Breach Determination, Notification and Disclosure We ensure continued compliance with HIPAA and the many regulations that govern the treatment of healthcare information as patient care enters the digital age through our dedicated compliance department which is charged with continuously monitoring changes as regulations evolve. 54 0 2017 Intermedix Corporation I www.intermedix.com Intermedix I 1 Compliance Leadership at Intermedix ,1% Melissa Leigh served as the company's Associate General Counsel for ft, , three years before being appointed Chief Compliance Officer of Intermedix in 2015. In her role as CCO,she is responsible for the 41 enterprise-wide compliance program.As an attorney, Ms. Leigh brings a wealth of organizational knowledge and industry expertise to provide legal and regulatory guidance. Ms. Leigh holds a bachelor's degree from Colgate University, her masters from New York University and her Juris Doctorate from the Pace University School of Law. Leigh Anne Bedrich oversees Intermedix organizational compliance — • related to EMS. She has more than 30 years of experience in prehospital '.a and acute care,focusing most recently on systems development and compliance. Prior to joining Intermedix, Ms. Bedrich was the compliance ��^ :"'': officer for Emergicon and manager of emergency healthcare systems at -- ' . :.,: NCTTRAC. She earned her bachelor of fine arts degree from Baylor ; �►� intermedix Customer Service. 1. Respond to all patients'requests and inquiries,either written or verbal,in a TIMELY manner not to exceed two (2) business days. We serve your patients with professional courtesy and compassion.We have a dedicated patient contact center that is staffed with experienced patient account representatives who are available via a toll free number from 8:00 am to 8:00 pm EST every weekday. The goal is to resolve patient inquiries within the first call.When that isn't possible,our patient account representatives seek to provide resolution back to the patient within two business days.This allows time for research or follow up that needs to occur to resolve the request. Patients can also leave a voice mail message that will be returned within one (1) business day. All patient inquiries will be handled according to the guidelines provided by the client, with you providing the final determination on any escalated issues. 2. Agrees to provide and furnish all material and personnel required for the performance of the Agreement. We agree to provide and furnish all personnel required for the performance of this agreement. 3. Contractor shall provide Customer Service Representative(CSRs),available during normal business hours,which are able to read,write and speak fluently in English, Spanish and Creole.These CSRs shall be able to assist patients and/or other third party payees in all billing inquiries in a timely and courteous manner. Customer calls will be facilitated as local within the County or through a "toll free"exchange,which will be published on all invoices.Contractor shall respond within three (3) business days to FIRE-RESCUE DEPARTMENT and patients on requests for information or records.All scripts and protocol for answering and placing calls shall be agreed upon prior to the commencement of services between Contractor and FIRE-RESCUE DEPARTMENT.A record of telephone calls and contacts shall be maintained. As indicated earlier in our proposal,we have a full customer/patient service center that allows patients the ability to interact with a live voice, use automated menu selections if they prefer,and/or go to our secure billing website to review account information or provide insurance information. In the event they want to speak with a live representative we offer the following: Fully trained agents Integrated call prompting so the agent knows the patient account before actually speaking with the patient English,Spanish,Creole—we employ a language translation service which interprets over 200 languages while the caller is on the line. If a caller wishes to speak a language 56 0 2017 Intermedix Corporation www.intermedix.com )► intermedix other than English,we will initiate a three way call with an interpreter and assist the caller. We use a toll free number which is published on the statement Three day response rate for information or records—this would fall outside the call center in most situations. Please include Client Relations and/or Operations for specifics. We record and keep all phone calls for a period of 60 days. 4. Contractor shall be responsible for the mailing of all forms,i.e., HIPAA,customer survey and related forms. Contractor shall be responsible for all associated costs. We currently provide this service for the City and will continue to do so. Intermedix took the lead with ensuring client compliance when HIPAA was first implemented.We worked with the City Attorney's office to develop a standard HIPAA notice for patients and have used it,after minor updates over the years,ever since. 5. Contractor shall respond promptly to all patient requests and inquires,either written or verbally in a timely and courteous manner.This and all communications should be in a format that can be tracked by both City and Contractor and shall comply with all applicable Federal,State and Local laws as such laws apply to the services being provided. The goal is to resolve patient inquiries within the first call.When that isn't possible,our patient account representatives seek to provide resolution back to the patient within two business days.This allows time for research or follow up that needs to occur to resolve the request. Patients can also leave a voice mail message that will be returned within one (1) business day. All patient inquiries will be handled according to the guidelines provided by the client, with you providing the final determination on any escalated issues. 6. Contractor shall provide and furnish all materials and personnel required for the performance of the Agreement. We agree to provide all personnel required for the performance of the Agreement. 7. Contractor shall provide a designated liaison for patient/payer concerns. We agree to this requirement. 8. Contractor shall provide a 1-800 number and 24/7 (365 days)computer help desk support for the EPCR report writing laptop and desktop hardware,software and its connectivity. We agree to this requirement. 57 ©2017 Intermedix Corporation www.intermedix.com '► intermedix Document Maintenance. 1. Contractor will maintain any and ail documentation records and patient information in a safe and secure manner that will allow inspection and audit by the City of Miami Beach or its agents upon proper notification. Intermedix will maintain any and all documentation records and patient information in a secure environment. Intermedix offices and office buildings are secure with electronic ID scan cards and visitors must pass through a security area to acknowledge they are visiting someone in our office. Both elevators and stairwells can only be accessed through the use of employee ID scan cards. In addition, Intermedix offices can only be accessed using these same cards.City staff has visited our buildings on many occasions and can confirm our significant level of security. 2. Any and all data created by FIRE-RESCUE DEPARTMENT and collected by the contractor is owned by the City of Miami Beach and shall be returned upon request in a format agreeable to City. Please see our earlier response but we agree to this requirement. 3. Contractor shall provide access to its database and a data dictionary for FIRE- RESCUE DEPARTMENT to use for report writing capabilities. Please see our earlier response but we agree to this requirement Communications with City of Miami Beach Staff. 1. Contractor shall attend meetings with the FIRE-RESCUE DEPARTMENT staff when requested to review contract operations. We conduct regular meetings with the City on an as-needed basis,which is typically twice a year. Due to our proximity to your location,we can meet as often as needed with very short notice. 2. Contractor shall participate in a yearly audit conducted by FIRE-RESCUE DEPARTMENT consistent with Generally Accepted Accounting Principles-GAAP.This audit will cover the common set of accounting principles,standards and procedures used to compile annual financial statements. We undergo an annual SSAE-16 audit.We welcome the City to conduct audits as needed. We have welcomed the City's Internal Audit department many times and are very proud of the results. 3. Contractor will notify FIRE-RESCUE DEPARTMENT of any changes in federal,state or local laws,rules,regulations and codes that affect this subsequent agreement. Intermedix is the leader in keeping our clients apprised of industry and legislative changes.Through our normal onsite meetings with City staff or through special client webinars,we keep clients,including the City fully up to date. Last year was the last 58 ©2017 Intermedix Corporation www.intermedix.com intermedix example as there was pending legislation that would have prevented balance billing patients but through our efforts in working with various clients and Florida Association of Counties, it was defeated. Intermedix and our systems are certified compliant with CMS rules and regulations, including HIPAA and HITECH requirements.Our compliance program is dedicated to HIPAA HITECH compliance, which encompasses HIPAA privacy and security rules,HITECH,the Omnibus Rule,PCI (Payment Card Industry) Data Security Standards and State Information Security and Privacy controls. 4. Contractor shall designate a Program Manager responsible for all matters related to the Contract,including performance.A toll free number and the name of the Project Manager shall be provided upon commencement of this Agreement.The Project Manager shall be available during FIRE-RESCUE DEPARTMENT business hours of 8:30 am to 5:00 pm, Monday through Friday,and shall respond to FIRE-RESCUE DEPARTMENT within one(1) hour. Your Client Relations Manager, Rebeca Botero,will be responsible for all matters related to the contract.You may reach out to her directly,or contact our help desk in order to receive immediate assistance. 5. Upon request by FIRE-RESCUE DEPARTMENT,a written response shall be provided to all complaints received by FIRE-RESCUE DEPARTMENT of any alleged actions taken by Contractor and/or its agents.The response shall be provided by Contactor's Project Manager and shall be received by FIRE-RESCUE DEPARTMENT within thirteen (13) days from the date the request is sent to Contractor.The response shall address all questions and statements made by FIRE-RESCUE DEPARTMENT concerning the alleged actions. Our goal is to serve your patients with professional courtesy and compassion as we provide the avenue for them to satisfy their bill for the services provided by the County. We have a dedicated patient contact center that is staffed with experience patient account representatives who are available by toll free number from 8:00 am to 5:00 pm Pacific every weekday.Additionally,all patient inquiries will be handled according to the guidelines provided by the client,with you providing the final determination on any escalated issues.Our goal is to resolve patient inquiries within the first call;however, when that isn't possible,our Patient Account Representatives seek to provide resolution back to the patient within two business days to allow time for research or follow up that needs to occur to answer the question or handle the issue. Patient complaints usually come to our attention when a patient calls in to our call center and are addressed on a tiered basis,escalating through our Customer Service Department as needed.Supervisors are on duty at all times to be the first line for escalated calls. If the concern is unable to be resolved by our call center they will reach out to Megan Manweiler in Client Support Services or escalate it to Candiece Taylor for resolution.The few concerns that make it to this level usually get resolved without going further,but,if need be,we will engage the County and senior management at Intermedix until fully addressed. It is important to note that our EMS Compliance Officer is made aware of any 59 O 2017 Intermedix Corporation www.intermedix.com 21, intermedix and all compliance concerns immediately through an internal communication mechanism,which ensures that concerns are tracked for trending and analysis. 6. Contractor shall provide FIRE-RESCUE DEPARTMENT with a read-only access to accounts at locations determined by FIRE-RESCUE DEPARTMENT. We will comply with this requirement. 7. Contractor shall provide all necessary developing,copying,faxing, mailings, and all other such related services at no additional cost to FIRE-RESCUE DEPARTMENT. We will comply with this requirement. 8. Contractor shall maintain and inform FIRE-RESCUE DEPARTMENT regarding the following: 1. Records of current fees. 2. Industry approved billing codes. 3. Description files. 4. Current laws applicable to billing of patients for transports. 5. Records of nation-wide and local trends in transport fee schedule and inform FIRE-RESCUE DEPARTMENT of any changes. Generally,all of these areas are covered in our annual business review. In addition,we have worked with the City on fee schedules over the course of our relationship,including work with our client, Miami-Dade County,in setting the fees that other City follows. 9. FIRE-RESCUE DEPARTMENT, its staff,consultant,and/or contractors shall have the right to visit the offices of Contractor and/or its agents periodically for inspection of the facilities and operations used in the performance of any resultant agreement. We will comply with this requirement. 10. For record keeping purposes(not related to billing/collection cycle),Contractor shall retain all account information for a minimum of three(3)years. We will comply with this requirement. Training for City of Miami Beach Staff. 1. Contractor shall provide training to appropriate FIRE-RESCUE DEPARTMENT personnel regarding the gathering of necessary information and proper completion of its EPCR laptop and desktop software. Training will be provided by your chosen ePCR vendor. If choosing our Intermedix ePCR solution,TripTix, Intermedix will provide training.As part of the implementation process, 60 ©2017 Intermedix Corporation www.interrnedix.com U2 intermedix we provide training on billing system set-up, procedures for navigating and using the system and steps to receiving customer support. Initial training is focused around ensuring that you are able to easily view account activity on a real-time basis. Additionally,we provide training for field personnel on the essential elements of clinical, patient demographic and insurance information that helps maximize reimbursements when properly collected.We also offer the Intermedix Training Center,an online,virtual classroom where our clients and their staff can access many topics designed to help improve the patient care reports for 911 providers.The training center is accessible 24/7/365 via the web. We have included optional pricing sheets for both ESO and SafetyPAD ePCR solutions, including training. 2. Contractor shall provide minimum annual basic and on-going training to appropriate FIRE-RESCUE DEPARTMENT personnel regarding HIPAA compliance.Training may be in the classroom or electronically so long as it is consistent. Certificate must be supplied to employee upon completion of training. We comply with this requirement.We will work with the City to provide online HIPAA compliance training to Fire Rescue staff. 3. Contractor shall provide a series of training programs at locations designated by the City to educate field personnel on the proper utilization of its quality control software application as well as other features available within the reporting software. We can provide these training services.Training will be provided by the appropriate ePCR vendor. 4. All training shall be at no charge to the City. Online training and initial training is provided at no additional cost to the City.Additional training may be provided via an online training solution. Communications with Miami Beach Serviced Hospitals. 1. Contractor shall agree to maintain a working arrangement with all FIRE-RESCUE DEPARTMENT-serviced hospitals including Business Associates Agreement/Electronic Access with hospitals. Intermedix already has electronic access setup with all of the facilities the City transports to. of Transport Access Hospital Name Volume Method MOUNT SINAI MEDICAL CENTER 95% Electronic JACKSON MEMORIAL HOSPITAL TRAUMA 3% Electronic 61 ®2017 Intermedix Corporation 1www.intermedix.com intermedix JACKSON MEMORIAL HOSPITAL 1% Electronic JACKSON MEMORIAL HOSPITAL Pediatric ED 1% Electronic MISC. 0% Various 2. Contractor shall provide FIRE-RESCUE DEPARTMENT with a copy of all letters of complaint within ten (10)days of receipt,and indicate what action was taken to achieve an acceptable resolution. Our goal is to serve your patients with professional courtesy and compassion as we provide the avenue for them to satisfy their bill for the services provided by the City.We have a dedicated patient contact center that is staffed with experienced patient account representatives who are available by toll free number from 8:00 am to 8:00 pm every weekday. Patients can also leave a voice mail message that will be returned within 1 business day. As it relates to the complaint resolution and escalation process,we seek to resolve patient inquiries within the first call;however,when that isn't possible,our Patient Account Representatives seek to provide resolution back to the patient within two business days to allow time for research or follow up that needs to occur to answer the question or handle the issue. If resolution cannot be completed in a timely manner or if the patient is still not satisfied,a manager will engage with the patient to rectify the issue. In the end,if the patient continues to be unsatisfied the issue is then transferred to the Client Relations Director, Rebeca Botero,and Rebeca will report the issue to the City staff to develop a plan for final resolution. Fairly recently we have added an additional level of complaint resolution for the County with the use of a dedicated representative, Keisha Gerald,that focuses on working with patients,County staff, payers,and attorneys and ultimately resolving any issues they may have. 3. Contractor shall maintain a working arrangement with all of the FIRE-RESCUE DEPARTMENT serviced hospitals and requests that hospitals provide a copy of patient fact sheets or be provided with demographic and insurance information. We will comply with this requirement. Electronic Data Transfer 1. Electronic Data Transfer: Contractor shall be able to receive and send data electronically.All data being sent to FIRE-RESCUE DEPARTMENT should be transmitted electronically and shall ensure that such transmissions are in compliance with HIPAA and other federal,state and local laws,rules,regulations and codes. Data transfer to the billing system is accomplished via secured VPN from the City or via direct data entry if through our TripTix ePCR Solution. Data transfer between the ePCR field tablets and the TripTix host system is via cellular wireless technology. PCR records completed either on the tablet or on TripTix Web become immediately available to the billing system as TripTix and the IMX billing system reside on the same platform. Incident 62 8 2017 Intermedix Corporation www.intermedix.com Intermedix information is captured directly into the IMX billing system, regardless of initiation through a paper PCR or an electronic data import.Trip reports are automatically available in the billing system as soon as the run is submitted or uploaded. Intermedix hosts both a secure website and Secure File Transfer Protocol(SFTP) server that is capable of uploading and downloading files of any format.Security on both the secure website and SFTP server are in compliance with HIPAA security and encryption regulations ensuring protection from casual interception and inspection by unauthorized persons. Like we do today,our professional services team works to establish connections with various departments within your receiving facilities, including Information management and medical records,to gather demographic and insurance information to further augment this data. Our preferred method is an electronic file.We also pursue fax requests and VPN access into the hospital system to obtain necessary information.This team is staffed by experienced IT and administrative professionals who work with the City's hospitals on a daily basis to establish electronic and fax-back connections with our clients'receiving facilities. We will continue to mobilize our team to receive electronic data files for your patients. These interfaces provide access to critical patient demographic and insurance eligibility information provided through the intake process in the emergency room.When an electronic interface is active,it allows data to directly link to the patient account in our billing system. 2. Contractor will provide rugged mobile computer laptop specified EPCR units as field computer devices,perform all requisite software installation on such units,as well as facilitate web browser access from desktop units supplied by FIRE-RESCUE DEPARTMENT. Installation,access and units will be provided by qualified company representatives. Intermedix will support this requirement.Several hardware and ePCR options have been provided.We will ensure this item is met no matter the system selected. 3. Contractor will provide support for additional modules that could be added to the system already installed without significant disruption to service.Should FIRE- RESCUE DEPARTMENT desire to modify hardware quantities,such changes will require written notification. Intermedix will support this requirement. 4. Server maintenance,upgrades and software changes should all be administered automatically from Contractor's development facility(or alternate location at Contractor's discretion) and downloaded to field tablets during power up/down sequencing. Intermedix will support this requirement. 63 0 2017 Intermedix Corporation www.intermedix_com ntermedix 5. The Contractor must be able to provide up to fifteen (15)temporary laptop or similar devices upon request.The temporary units will be utilized for large events or during periods of peak staffing. Intermedix will support this requirement.As we have historically done for the City,we have provided additional units at generally no additional cost for large events.We will continue to support the City with meeting this requirement. 6. The PCR software must be able to verify and capture patient address from a driver's license or social security number via the cell connection. Intermedix supports this requirement.The TripTix software is the leader in the industry with this tool that not only looks up prior patients but also information on patients never seen by the City through the social security number and/or driver's license lookup feature. 7. The Successful Proposer will be required to update all hardware equipment provided to the City every three(3)years. Intermedix will continue to support this requirement as we currently do today. 64 ©2017 Intermedix Corporation www.intermedix.com ► intermedix EPCR Software and Patient Reporting Capabilities. Information to be gathered by EPCR software should include the following patient information,but not be limited to: 1. Incident Address with Zip Code. 2. Social Security Number. 3. Address. 4. Telephone Number. 5. Date of Birth,Weight,Age, Gender and Race. 6. Family Physician. 7. Medicaid State. 8. Medicaid Number. 9. Medicare Number. 10. Medicare Plus Plan Name. 11. Insurance Number. 12. Group Number. 13. Secondary Insurance Number. 14. Secondary Group Number. 15. Guarantor Information. 16. Documentation of patient or guardian release of patient information for billing, including a digitized patient or guardian signature captured in multiple languages, and supports hand writing recognition. 17. Supports additional billing inputs(i.e.,additional supplies such as foam usage or additional medications). 18. Information about the medical condition and complaints of the patient including,but not limited to: a. Cause of injury. b. Trauma triage. c. Patient position information. 65 9 2017 Intermedix Corporation www.intermedix.com intermedix d. Medical condition(s) and systems details. e. Narratives by the care providers regarding the incident. f. Ability to enter multiplies patients. 19. Unlimited primary and secondary assessment information including,but not limited to: a. Glasgow Coma Scale(GCS)scoring automatically calculates a total. b. Revised trauma score,scoring automatically calculates a total. c. Pupil size and reaction. d. Capillary refill. e. Respiratory assessment. f. ECG. g. Ectopy. h. Blood glucose level. i. Skin color. j. Temperature. k. Moisture. 1. Lung sounds. m. Times of vital signs. n. Appearance Pulse Grimace Activity Reparations(APGAR) scores(if applicable). o. Neurological assessment information. p. Medical history including,but not limited to: i. Prescription medications-with Pick List input. ii. Allergies. iii. Pre-existing conditions. iv. Current conditions. q. Blood pressure;be able to indicate Palp and Mast. r. SPA02. s. LOC. t. Pulse Rate;strength and regularity. 66 ©2017 Intermedix Corporation www.intermedix.com 3k0 intermedix u. Allow the user to set either the"within normal limits"or"not assessed"value to each defined assessment area (body part) by click of a single button. 20. All examination of and treatment provided to the patient including,but not limited to: a. Medical control contact name and time of contact physician. b. Patient protocol. c. Method of contact. d. Airway intervention. e. Breathing intervention. f. Circulatory intervention. g. Intravenous intervention. h. Input/output therapy. i. Provides patient weight conversion to metric for medications. j. Call summary information, including all patient information entered. 21. Data about the care providers including,but not limited to: a. Vehicle number. b. Primary attendant's(Attendant No. 1) name and license number. c. Attendant No.2's name and license number. d. Attendant No.3's name and license number. e. Attendant No.4's name and license number. f. Exposure information,including medic name,time,exposure type,description, supervisor notified,exposure report completed,loss of work. 22. Prehospital information including,but not limited to: a. Call times. b. Scene location information,including County,zip code,response and scene. c. Response districts. d. Special scene conditions. 23. Patient destination information including,but not limited to: a. Receiving hospital with State of Florida four-digit identifier code. b. Reason for selecting a destination selected from pick list. 67 ©2017 Intermedix Corporation www.intermedix.com ntermed ix c. Transport urgency(lights and siren, routine,etc.). d. Call disposition BLS,ALSI,ALSII. e. Refusal of care by patient. 24. Odometer readings to determine distances including,but not limited to: a. From ambulance starting point to incident scene. b. From incident scene to patient destination. 25. Desk top software: a. Provide the exact same interface and functionality as the mobile software with the exception of any pen-based,character recognition functionality that cannot be supported on desktop computers. b. Software should provide for monitoring of all supplies utilized and give administration users the ability to access the data through report writing tools. We comply with these requirements with our TripTix ePCR solution.We have also provided details on both ESO and SafetyPAD in the Attachments section of our response. Security Controls - User Access Control and Security. The software should allow for an array of user access control and security that can vary by module and security level from no access to complete insert/delete/edit capability anywhere in the software system. In addition,the system should: 1. Have a hierarchy of security(logon,record,field,function,object,and user-group) to allow or prevent specified users(or groups of users)to access specified programs at specified levels of data entry,editing,updating,deleting,and reporting functions. We will comply with this requirement. 2. The software should require a valid logon ID and possess two levels of security with different password levels.One is to be used for system administration and configuration and the other for field personnel. We will comply with this requirement. 3. The system should also provide a complete audit trail of every transaction or modification executed by each user. We will comply with this requirement. 68 ©2017 Intermedix Corporation www.intermedix.com �► intermedix 4. System locks,which allow user to"lock"terminal without shutting system down and "unlock"terminal with password,allowing users to step away from the terminal temporarily and prevent unauthorized use. We will comply with this requirement. 5. Restrict download of confidential data to high-level security-authorized users to prevent loss/misuse of confidential data and information. We will comply with this requirement. 6. Provide a means to print transaction error/alteration logs as needed and specified, depending on application. We will comply with this requirement. 7. Automatic timeout or keyboard lock after a defined period of inactivity. We will comply with this requirement. 8. List all users logged on to the system at any time,and track this usage by user,date, time,and station. We will comply with this requirement. 9. Log off users after specified number of unsuccessful log on attempts and display message for user to contact the system administrator. We will comply with this requirement. 10. Allow specified intervals for mandatory password changes. We will comply with this requirement. 11. Automatically log off users who have logged off improperly. We will comply with this requirement. 12. Revoke a user's access upon too many unauthorized logon attempts. We will comply with this requirement. 13. Validity test:critical fields can be checked against a format,a formula,or a table to see that data contained in a field is admissible. Examples:System requires all Advanced Life Support Calls have two vital signs. We will comply with this requirement. 14. Range checks:critical fields can be checked against a table or formula to determine if the data entered is within a given range of values. Examples:vehicle mileage not to exceed four digits. We will comply with this requirement. 69 0 2017 Intermedix Corporation www.intermedix.com intermedix 15. Completeness check:critical fields can be checked for a non-empty range and processing action determined according to a specified table. Example:system will not allow the call to be closed without the patient name first and last being entered. We will comply with this requirement. 16. Real time error checking:error checking described above is done at the time of input and errors are flagged to operator either by a user understandable message or operation halt as specified. We will comply with this requirement. 17. Time Stamping:AU transactions shall be time stamped by the internal clock of the system and this may be modified in the field and exists for all interventions. We will comply with this requirement. Reports Pursuant to the Scope of Services,the Successful Proposer shall perform all services and/or work necessary to complete the following tasks and/or provide the following items: 1. Contractor to provide the City with monthly reports reflecting all new placements from the City,all accounts that are currently active with the contractor,the contractor's collection results,and aging reports reflecting the City's receivable in an aged format. We comply with this requirement. Please see the following pages of sample reports. 2. Records/Reports: Contractor will keep full and accurate accounts of services performed by FIRE-RESCUE DEPARTMENT, billing and collections received and other records related to the Emergency Medical Transport Billing and Collection Services. We comply with this requirement. Please see the following pages of sample reports. 3. Contractorwill prepare and provide FIRE-RESCUE DEPARTMENT Administration monthly reports as required by FIRE-RESCUE DEPARTMENT. The IMX system provides the City with enhanced tools that enable you to be constantly informed about your financial status and operations.This system gives you access to the information you need 24 hours a day,7 days a week via the internet and our secured servers.Accounts collected, individual patient accounts, medic statistics,call statistics and financial statistics are available in a dynamic, real-time format. As soon as information is entered via a medic's patient care report or by our staff, it is available to authorized users. PCR, patient account,call statistic,demographic resource and financial information is available via any internet capable computer. In addition,you have secured online access to clinical documentation sent to Intermedix about to your 70 0 2017 Intermedix Corporation www.intermedix.com X intermedix patient transports as well as any additional supporting data scanned and indexed for each individual encounter. The Intermedix IMX Billing System reporting interface contains easy to use template reports that are highly configurable by using basic drag-and-drop skills. Users can add filter logic and configure the output layout and export to various formats throughout the contract. In addition,reports can be scheduled to run on demand and then distributed to resources as defined by the report creator.Of note,the City has received training from your dedicated client services team on the Business Objects reporting tools. The City will continue to receive a monthly reporting package typically within three business days following the end of the month.Lastly,we realize that some users will not want to create their own reports.Your client services team and IT staff are available to create ad-hoc reports at your request. The reports the City uses today include the following End of Month Financials: • Billing activity summary • Summary of new charges • Management summary • AR aging summary and detail • Signature and NMN by medic • Monthly cash log • Refunds and credit balances Please see the sample reports provided below. Sample Reports Our standard reports include a variety of financial data reports,medic statistics and key performance indicators to support operational efficiency.The types of reports available in the reports library allows the City to build a customized reporting package. End of Month Financial Data 1 .' "' TAM L a•S C* I LO Un. t•us Una. MTD&YTD Reports " - +'+a .2 • Charge Activity kiz ; . -Y— 17111 4•. � VCM a • Payments/Revenue 6.4 1 x 9 f.j2422•2/ ... .v, 0,,,ar. • Adjustments&Write-offs Miss•M • AR Aging by Payer Class NS SI IQ • Management Summary . ---,•• ;-- Ira- 71 C 2017 Intermedix Corporation I www.intermedix.com X intermedix Medic Statistics *Elm d AOe ICI Can••• Min= Minnow c,c.. Colwriona w Cana=Rem Data Capture by Medic&Trends .. j 1,1 tn , • s ■ Patient Demographics I Signatures a f J : I- 0111 • Insurance a . A i 2. ■ Dispatched Reasons a n — t 11, o. ■ Medications Administered . [ ,. Key Performance Indicators Data Trends ,_._ _.__.._...�._._..__ . .. • Charges .,. f,I - -Ai;,E ..� Payments/Revenue ' ""� ' • Denials _ IR .. •,:,:'',.: aft • Gross/Net Collections Percentage • Revenue Per Transport • Medical Necessity • Patient Deductibles fa M Ific:4 OA Volume Comparison 1 LI • Payer Mix —- �. __ • Level of Service • Date of Service 72 ©2017 intermedix Corporation I www.intermedix.com ,, , 34; intermedix End of Month -----I ....aa..»...d. Financial Close ....Y e Wt. -9 �- - - a =__ fa.. SS sass ms _ .- - ass .:_.: ..i..... w rrr L_ .,.. .a.. Report also Includes ..... •Collection by Financial Clam Detail ..a. ,tea ,, •Billing ACTriq Summary Detail •Management Summary Dead .' i..... •AR Aged Trial Balance Detail "'•• mei. •Unidentified Permian • • 73 C 2017 Intermedix Corporation www.intermedix.com intermedix �► Monthly Summary by Data of Service Monthly Summary by Date of Service Star!Date: 1/1/2015—End Date:3/31!2015 BIa<'.le :1hl.e C T h[Idant2 filaSS c1 r3oe MTjiiS'illaets Mal Charles C ih Cfl a Amt .tta4 im a O�n� Avg CAa/ge Avg IR 24,s.n, 167'3 5,5.827!52000 S98'5722.51 55-47,.79739 52,903,22806 532..'0464 53.945;357.60 51,03275 232 ,Sar *4395 514.729 39000 58 822 320 93 SR.59735907 52.511534 t9 5,1986!3 53252.'54552 51.022 231 A,S� 160.'1 515.500 88O 00 S9 808 540 56 55.592.29934 52.904,414 69 &'8.904 39 53.751,98026 51,02807 2 31 Total9: 48903 $4$057,9110.00 52H,J98.73&20 579.551,185. f$Sf8,174.34 590.3.97.99 51Q961.Sgl77 51,02152 231 Fiscal Year Summary Start Date:1/1!2015—End Date:3/312015 Bitable 4Vnt8 at Ondeet9 Co/ C1�aOe9 Adl89tment9 Net CEarOee 0000011 09 Amt Balance Coe A' Change Ar0 LYe9 MI6 15903 548.35'.,900.00 320.496,!}110 519,561,16`..80 56.509.174}, 590.397.59 510.951=93.77 51,02452 2.31 Ta' 46003 548.557.900.00 $28,4!6,754.20 515501.106.80 38,509.174.34 9!11.397.09 510.301.563J7 $1.024.52 2.31 Calendar Year Summary Start Date: 1/12015—End Date:3/31/2015 ®able :Vnte CR YKalaMs fimcc 7'a Adpalmmlx U.S Mama% ca..5oe And BnL,nrn Boa Avg Ch.lrga Avg I�Ar. 7815 3' 548.357.900.30 S28 00.73420 519.561.10E-.80 58.509.17434 590.39'Co 510.961.493.77 51.027.52 2.31 Taal 40403 548457900.00 528,496,73420 519551,16580 58,509.174.34 390,377.59 $10,961593.77 51.024,52 2.31 Report also includes Additional Summary Data Incidents by Level of Service Incidents by Financial Class • Average Adjustment • BLS-NE-*an) #and% • Medicare-x and?fo • Average Net Charge • BLS-E-#and% • Medicaid-*and% • Avenge Collection •ALS-NE-#and% • Commercial-#and% • Gross Collection% • ALS E-1 and% • Self-Pay-*and% • Net Collection ni • ALS2-s and% •Auto-e and?moi • Paid% • SCT-#and% • Workers Comp-#and% • Rotary-#and% • Contract-#and% • Fixed Wing-*and% • PIT-4 and*3 • Other-land% 74 ®2017 Intermedix Corporation www.intermedix.com �1► intermedix Monthly Summary by Pickup Zip Code Monthly Summary by Pickup Zip Code Start Date:1/1/2015-End Date:3/31/2015 Burx aa Write011 A g 210 Code Indrlb b Amt Croas C1wge9 AdiustnenNet Charges Collec8en, rt Balance Due Charge Avg Hits trio 58 SST 790.00 32627314 531,510.86 39480.58 $0.00 52203628 5396.38 124 19102 317 532588000 3171 76371 5153,91629 570.990 97 5100 20 582.625 12 31 077 35 1 50 11143 635 5x. 206000 5300.47909 535196191 3191,05123 5631.48 3160294.20 5102750 1.40 19164 1978 52,025.790 00 $1.153 599 30 5872.196 70 5401,86319 5150 00 5470,177 51 51.025 23 1 67 11144 4 5381000 31,68400 52.186.00 324600 50.00 5194000 496750 1.75 17104 403 5412.290.00 5185.720.00 52i'6.561.4o 3101.01226 43.07009 5122.479.06 31.223.05 1.34 11147 1206 57231,75006 $584,27173 $847,47827 5211,83767 52.33115 5433,30915 51.02133 115 11144 3 12.950 CO 5734 46 52105 54 51205.54 50 00 W0 CO 435333 200 moss 17 517.13000 56.76522 510.36475 52,51275 50.00 57.852.03 $100r65 2.35 11110 d 55593000 4223560 53,754.40 5764.40 80.00 5299000 4948.33 150 11111 1097 $1,121,000.00 5624.78430 5496,235.70 3217,61588 53.171.45 5275,44837 3102155 2.79 19112 21 521 480 40 56.648511 51479489 53.71738 S0 00 511 042 51 5107256 2.71 559 1:116 2 5.02000 31.43610 559390 090 50.00 4000 $107500 1.50 Report also includes Additional Summary Data Incidents by Level of Service Incidents by Financial Class • Average Adjustments • BLS-NE-rand% • Medicare-?1 and% • Average Net Charge • BLS-E-#and% • Medicaid-4 and% • Average Collection •ALS-NE-#and% • Commercial-r and% • Gross Collection% • ALS-E-+and% • Self-Pay-7t and% • Net Collection% • ALS2-*and% • Auto-*and i • Paid% • SCT-#and% • Worker;Comp-*and% • Rotary-rand% • Contract-4 and% • Fixed Wing-rand% • TNT-land 4o • Other-a and% 75 0 2017 Intermedix Corporation I www.intermedix.com U intermedix Payment Posting Payment Posting Summary Start Deposit Date: 1/1/2015—End Deposit Date:3/31/2015 Deposit ' Collections Month IMX Amount Amount CC Amount Total 2015-01 S2,578 592 41 S78,190 87 S2,655,383 28 2015-02 S2,830 366 33 S77,490 17 T2,907 856 50 2015-03 S3 050.882 27 S73,246.34 S3,124,128 61 Grand Total: 58.457,841.01 8229.527.38 $8,687,368.39 Payment Posting, by Payor Start Deposit Date: 1/1/2015—End Deposit Date:3/31/2015 .i r. H . Payor; I Amount Auto Insurance S410,163.84 4.72% Contract 514.201.15 0.16% Medicaid 51,989,458.29 22.90% Medicare 53,632,222.23 41.81% NA 526;664.04 0.31% Private Insurance 51,659,998.64 19.11% Self Pay S865,124.38 9.96% Worker Comp 589.535.77 1.03% Grand Total: $8,687,368.39 100.00% Report also includes • Payment Posting,by Date of Service • Batch Detail • Transaction Detail { 76 C 2017 Intermedix Corporation i www.intermedix.com U' '' intermedix Insurance Aged Receivables Insurance Aged Receivables Start Date: 1/1/2015—End Date:3/31/2015 Primary Insurance lime !insurance rice 11CCCeat'S c(.7.,."7::: I Mau31rrloma I I4r116On9 V3y11e11[3 ! Balance Gnash nash Fiesta reerance I 3980 SO 50 5500 SO 71st Orduh AVID A Iw rs:.tanee 4 53,190 51,363 50 31.417 500 21st Ornate"AetO I st,ran. sato Imam.* 1 3300 30 SO 30 35340 AAA Mau rs✓a1u 1 357: SS= SO St43 $0 ewe Mta.0sfnec es Croup Moe er++ante 3 5],070 S1,C3 50 35,437 50 MAP .n.ar_ranwc t 3479 5:71 31 Zee $0 Naomi Caroni MRO ela,W C. I 57290 32.611 5) 31.777 67.702 kettle 1.0t1R LON1011 6.8066C1 1 5960 5050 53 SO 55 ACCett hsuralw A440 Musses* 2 52,200 3702 so 5:63 SLIM A:nst'Muescw C0r414ny auto rs..l4rlee 1 $1,010 5812 53 5192 53 A.3 North Ararican Cairo Warr Cone I $1,1% 30 50 36 $1.100 414�.3cht.i.mret Rnraat rsu ansat 5580 30 50 30 3960 s.ae.*.Fneeebin ite^s:ae 114 5122,710 596067 5O ;:t0 419 5:6.:75 64156 rle-rose 58 330340 5"3.1.954 57 326206 3- &area omits rsuswo 733 S7S7.02O 344691' St`.0r 561333 T9394; 6093 64COr`it71 VOl636 I 3900 USA 53 S0 53 Sates 0664/750611.7.4 V.ad0.'sit 1.163 SI,130.910 3067.579 5562 5110.413 5212—'51 Seam Ycars NMC 5606*. 454 347.550 33'8,!06 55 t•0 S132.1141 579.:20 Arai 760 Scare Medicare 1 $1,020 5632 3) 3766 S0 bloc =tired"rsurence 1 SSW SO SO S0 3480 a.0 Auto rstanee 1 39'x I 5532 50 5103 SO 40 rev. Drano/sumacs 1 3970 SO 53 SO 5970 Mort 6men 500631 Cer'Y Pronto raursoOo 1 $1,130 so SJ s6 31.170 al Verson—cues LC MCCat I 59611 SO 53 SO 5050 Amid woc4rty sod Casuecr tum 06.1110* I 5960 30 SS 50 5060 altla:a tum rs,4alct I $1.010 $313 53 5031. 50 *Mae Atka I ,salsa 2 52.000 31203 SO 3527 5-5: &atom Awn rsursac, Mao ssalance 8 34000 WADS S) 54)131 3+90 Maturer* Aura75,rtnce 2 $1.960 Si ASS S3 0v0? 30 Report also includes Insurance Aged Receivables Detail by Account 77 ©2017 Intermedix Corporation www.intermedix.com xi, intermedix Call Statistics Response Times Transports by Facility Start Date:1/1/2015-End Date:3/312015 Start Date:1/12015-Eid Date:3/312015 unit 8t1144 Jan P O Mat Tctdti r171ny name ' .Ian Poo Mar TOtati Olcpat011- 741 771 644 703 534 33s 541.11 3 6 3 14 Location .1d Moso.Ln 9.0:m 0646 3291r, 1.0011 0 01% 004% 01t% 5.1% Location- 827.313 836 its 371 613 437 PM 1934 1757 310, 10 Pawns N.dtcil 1112 11 7235 1356. 14'435 13.11.1 Caner To taS nal• 9 17% 0.•.811 1028% 1.74% p 609 125 62`3 425 6'4 is 514431 At NOsptgl 1¢49 982 1001 3171 !O 14*, 10.See 1027^1 10.216 C.N.al81 491% 508% 517% 4171 Al 4015451• 1.298671 127141s 1 298 31s 1,21175 In s.r.ic. 750 553 7:70 2149 2.5435 21 19m 21 31 t1,4181 CC Hann 3.00% 352% 259% 3.40% L.Cat1On- •3e]141 1.300 751 I TM9m 1.31.11. -- AIMolptal76311 23.16M 3. 27.1111 FF Hcsaat ]23 234 2601t7 1.31% 123% 127% 1.337% O111pa10l- 1.003 Os 1.91`25o 1243 Rls 1.530.111 _- -- AtNosprul ..crlicr" 543 1.1.7 402 1400 37 3.'.35 32.42^. 323935 22.1861 4o,on, • 2 68% 2:2% 240% 211% Dnpatcn- 2 328 341 2831 GOe 2881 091 2131.149 In 5.rv,c. 47,135 47 Ism 47 sin 47jhn Calls by Time of Day Start Date:1/12015-End Date:3/312015 Patient Disposition Start Date: 1/1/2015-End Date:3/31/2015t,m. „n 7.b ,,,, Twat. OtspOs[bOn Jan Fab Mar Totals 0300.3103 -971 2070 3177 1374 Tool 11 0%73% 136 1531% 11.71% GrlOounl.rs 30110 11'11 20483 11477 OC17-1153 't70 431 0 15.01 13697 Transport and 163x^.2 14324 12443 41413 26/5% 26 21% 23 47% 33.50% troatrn.nt 73:.5% 7315% 7363% 78-17% 1:10.1759 =1, 5741 6361 11177 Treatment no 126 14.^, •T6 411 7,71% 31 36% 32 13% 31.71% 174413040I184E7 4907 5017 15411 0 89% 0 73% 77 31% 032% 1830-2281 NO troatmert,no 6E 572 640 1674 23 22% 21 711% 20 371 x53% transport —. 3 78% 3.12% 1121 2.14% CAP canc.iMd 1839 1650 11"3 1321 8.865 8.99% 5.90% 1.32% Report also includes 275 242 260 777 • Patient Age Dead 0n scone • Dispatched Call Types 1 .13 1. ` 1'� 1.30% • Call Locations PAIS.*Wm, vrtto0nd4037 1547 1401 esti 4150 • Unit Transport. NO P1 7 4271 714% 7 37% 7.44% 78 0 2017 Intermedix Corporation I www.intermedix.com ■ -0 q ? | m m R f $ [ { o_ + § $ ] § \ § ! % gg & / | \ n R I k. -C C3 § C2 - S % kN w Q °C 2 j �|- F E o n ! F 3cp .1 cm , 22 -k | d 2 t. ƒ m7 �R i",-;2: 0 NJ ( k B &7 1.. a2 12 �� 3 S. C ig/J ; « N E ■ v, 4 % . , 4 , '• 2 R § § \\ 2 ` A 2/ ! d6 9 v / ) Z.I. n ` ° ■ = d ° • « » : ; | (#) i 0 0 0 0 � e z e e ; , of - % $ ,3,-- a E # m § | E i ! § § $ § $ § § B B a 6 « a a § § / $ » , , r # / t r . 0 at CD g _. a ` 2 2 f n - ® 4 ■ ± ■ ■ k r ! k t . a $ S 2 § ( , ; _ 7 ¥ ! rafri . . CD 6 k § § i $ § / § $ § R § a § § -A 2 § R ) 3 „ . / » 0 # # e i f e e f_ 0 CD .1 i CL ) • ® 4 4 A \ § i 2 £ A K A § « a a e # 4 �• ) & 1 0 0 0 0 0 0 0 0 0 0 0 X intermedix Invalid Signatures and NMN Summary Medicare Summary—Invalid Signatures and'Not Medically Necessary' Start Date: 1/1/2015—End Date:3/31/2015 Total Medicare Countl%) Medica Invalid siinatdre Accounts Medicare Nail 11ed ca lyNecessar r_ Total Medicare Count of Month of 8:0at1e Bilintle invalid %Invalid of%Invalid of Count of %MIN of %NUN of Service Incidents Incidents t%of Total AR Signatures Medicare Total AR Nf4N Medicare Total AR 2015.01 16453 5,240 31 97% 133 3.10% 0 99% 263 500% 160% 2015.1)2 14.399 4,580 3181: 129 2.79: 089% 198 132% 138% 2015-03 16.051 5,012 31.23"i 14T 293%-. -0.92.1 200 199% 125% Totals: 4,903 11862 31.97% 438 296% 0.93% 841 446% 1-41% Medicaid Summar/—Invalid Signatures and'Not Medically Necessary' Start Date: 1/1/2015—End Date:331/2015 -- Total Medcaid(Caurltl%); Madlcald Not Medically Necessary_ Total Medicaid Month of; Billable liable %efTotal Count at %NUN of %NUN of service ' incident incidents AR .NUN .I _ . • Total AR 2015-01 16.453 6.775 41 18 2015-02 14 399 6 038 4192% 2015-03 16.951 6,97E 43-47% Totals: 46.903 19789 42.19% Commercial Summary—Invalid Signatures and'Not Medically Necessary' Start Date:1/1/2015—End Date:3/312015 Dial Commercial(Count%Commercial Invalid Signature Accounts To Cormeerclal • Count of Month of Billable Billable %of Total Invalid %invalid of %Invalid of Service Incidents Incidents . AR. Signatures Commercial Total AR 2015-01 16,453 1.919 11.66% 3 0 16% 0.02% 2015.02 14.399 1.701 11 81% 0 0 00% 0.00% 2015-03 16,051 1.845 11 49% 1 005% 0.01% Totals: 46.903 6466 11.66% 4 0.87% 0.01% Report also includes • Medicare Invalid Sirature Detail • Medicare NMN Detail 1[ • Medicaid NMN Detail •Commercial Invalid Signature Detail 80 0 2017 Intermedix Corporation I www.intermedix.com 114 intermedix 4. Contractor shall provide,on a monthly basis,a copy of all monthly financial activity, billing and receivable reports,consistent with GAAP on the account. We provide detailed month-end reports that include all payments,write-offs and adjustments.We reconcile with the date of transport,monthly bank deposits,credit card payments and the month end total.Checks and balances occur at numerous levels throughout the payment posting process to ensure that all money has posted balances at the end of each day.The daily"batch" reporting is reviewed to verify the total amount of money posted each day. Reports Compilation and Listing. The Successful Proposer shall maintain a computerized database of all accounts and shall provide the Department with reports to show management and financial information.The Successful Proposer at a minimum will provide all reports provided to the Department by the incumbent.The Department will provide samples of all current reports to the Successful Proposer.The format of reports required under this contract will be determined by the Department. In addition to the reports described below,the Successful Proposer shall provide any custom reports at the request of the Department in a mutually agreeable timeframe at no additional cost to the City. Monthly reporting is produced after month closing and provided to FIRE-RESCUE DEPARTMENT no later than the 21st of each month.Contractor will generate reports within twenty-four(24) business hours of receiving and posting the last day of the month's receivables from the bank.All reporting will be in the manner as requested by FIRE-RESCUE DEPARTMENT.The following are major reports that Contractor shall produce for FIRE-RESCUE DEPARTMENT: 1. Collection Statistics-Gross/Net Consumption Shows overall monthly computation of gross collection percentages providing number of accounts billed and accounts not billable.The total amounts are summarized. 2. Billing and Collection Statistics-Monthly Summary Provides a running month summary of charge,aggregate transports by unit, aggregate percentage collection by unit,adjustments and payments for the closing month period showing gross and net collection percentages for each period. Summarizes totals for each type activity and computes average collections for both gross and net. Note:All payment activity is reflected against the original month billed in order to reflect true collection percentages. 81 2017 Intermedix Corporation www.intermedix.com intermedix 3. Insurance Report-#of Bills with Outstanding Balance by Class Provides summary showing by running(billed) month the number of patient bills having an outstanding balance.Shows balance and number of bills outstanding by class. 4. Collections-by Payer Class,Unit and Geographic Area Provides a running month summary for the closing month period of collections by Payer Class(Self-Pay, Medicare,Medicaid and Private insurance),by Unit and by geographic area.The report also shows for each running month the mix or, percentage(%)of total collected against that month's billing for each class.Also shows number of accounts collected by class and percentage (0/0) of total. 5. Ambulance Unit Report-Gross Billings this Month by Ambulance Unit Shows all billing(new charges) processed and summarized total billing for period by transport unit. 6. Accounts Receivable-Summary Provides summary for period ending of Accounts Receivable showing gross billing, payments received/processed, reflected write-offs and adjustments,reversals and ending balance. 7. Account Activity-Monthly Billing Report(Charges) Shows all billing(new charges) processed alpha sorted by Last Name and summarized total billing for period. 8. Account Activity- Monthly Payment Report(Receivables) Provides a batch oriented listing of all payments processed including check number and type of payment(self-pay, Medicare,Medicaid,private insurance). Report reconciles against bank deposit and ties back to EOB detail for secondary filing, refund processing and adjustments. 9. Collections-Summary to Date, Monthly Running Shows receivables as applied to "original billed month." 10. Monthly Refund Schedule Report provided by account detail of associated payments reflecting an overpayment and necessary refund to be processed. 11. Refund Request Provides for previous billing month,with a separate sheet per account,requesting refund on overpayment accounts.This includes all information pertinent to determining refund. 82 ®2017 Intermedix Corporation www.intermedix.com intermedix 12. Distribution of Charges and Collections This report will track the charges,payments and financial class mix of all patients for a given month. 13. Aged Receivable Report This report will have outstanding invoices sorted by date for current,thirty,sixty, ninety and over ninety days.This report will provide totals for these categories. 14. Patient Alpha Listing This report lists all invoices alphabetically by patient name. 15. Monthly Payment Listing This report lists payments, bad checks,required charge offs,and refunds posted to each patient's account. 16. Overpayment Reports This report lists all patients due refunds as a result of overpayment of account. 17. Additional Information Reports may include any statistical information pertaining to medical calls including but not limited to-intubation analysis,IV success rates,chief complaint call volumes and number of cardiac arrests and trauma calls. Intermedix provides end-of-month reports to the City generally by the 10`h business day of the month currently.We have provided a sample of the City's monthly report package, followed by a sample of our standard reports in the following pages.All of these reports are already in place today.Any revised, ad-hoc,or additional reports are generally provided to the City within a few days of request depending on the complexity of the report request. 83 8 2017 Intermedix Corporation www.intermedix.com �► intermedix KPI Management Summary Reports FOR PERIOD ENDING: 2017-JANUARY Page Number. 1/6 intermedix City of Miami Beach EMS Charges (in thousands) $900 $800 $755 E, $706 $700 , Se37 saw .. 5515 -1.--Vikt, seo ,- •••• $616 $600 iwea 04 $574 ''4'•' — $500 : Fiscal Year Period Ending $400 2015 . 201-3 $300 $200 $100 ---------- - I $0 -- -- OCT NOV DEC JAN FEB MAP AEP. HAY J7/4 JUL AUG SEP ._.. ......] Month Period Ending Payments (in thousands) $300 -- - $280 $273 - $260 - :---- i $240 - 7.,f __We .04 9223 ."- 9220 , ir $220 $200 •u 79_ _ 111111In 178 $180 --A— Irrl .11Le2 $160 ---\ - — - Fiscal Year Period Ending $140 — --- — -- — 2015 $ $120 - ip 2015 $100 ---• _ -_-_ _--- — $80 _____ _ $60 --------- - $40 $20 - ----- — -- $0 -— OCT NOV LEC JAN FEB MAR APR MAY JUN JUL AUG SEP Month Period Ending This Report May Contain Confidential Information or ' - - : : :': -_ * '.*. ,., Protected Health Information.Please Treat Accordingly-Copyright©2013 Intermedix . . . Days in AR -n 8 8 g o 8 8 _ _ 1v 0 8_ P. 8 S § § S § § § S z C - 2015-01 i O 3 OD a Cji m - 2015-02 I I I I N .. 11112015-U3 I i I ; (WV11 N O) - 2015-04 !- W �- 2015-05 i f ; I cp ~V - - 2015-06 1 I I I i CO coDIM 4 • 2015-07 I , UD (n I 11111 2015-08 I ' i (VO A n 0 2015-05 i I O un 13 �j 2015-10 11,1 i -OD+ (� a+C+'. ID I I 0 Ip a v _ � - 1 3 2015-11 I j ..< In=ti Will I + I o _ - W - I gy 2015-12 ' I i I i I 1 W 7 -< I'2016-01 , A co D. CD �_ MEM N 4 I z tiWIll 3 2016-02 I ? O - N I I z O I -�- 2016-03 I I V 0 . . W. iiM 2016-04 ! VW CDN a (. , 111111111111111111111M111 2016-05 I . (1) Cita W 31 w o 2016-06 I ( I ! I i • cD 0 - co cD "►1 J m M A= 2016-07 i j �+ 01 w I+ c� R = 2016-U9 I I GNpJ 2016-04 W . o ■ ■ LI INtVp (7 2016-10 I I I A fl• 2016-11 ! Or Xi Ni ((00 `< -. -p: 2016-12 1I j I y 2017-0.1 j ! I i o Page Number:3/6 i ntermedix Charge Mix FY 2016 110% 100% I 111 , 90°6 80% -- -- -- - 0% 7 r 42°. 3. , 60% -- - ■ Medicare I Medicaid 50°� - . 2°� ° : :: zda I 30% - - -- - - 10% - II 0% - - - - - OCT NOV DEC JAN FEB MAR AER MAY JUN .JUL AU•J SEP Gross Collection Ratio 55% 50% as% - - -- — 45% __MS- 40% % a _ __ .. 3771 37% h 355% -V-- . H O c 30% -- , co Fiscal Year Period Ending 25% - -..-ry----J---- - ------ ;;l 2015 0 20% 1g% - -- - - ♦ 2016 V 15% 10% 5% % -- ----— - :)CT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SBP Month P.riod Ending This Report May Contain Confidential Information or Protected Health Information:Please Treat • 4 Accordingly-Copyright©2013 Intermedix Page Number:4/6 Intermedix Net Collection Ratio 80% - - _ -_ __ _ — 75% -73%— ---- -- 70°6 -- ------- -------- sox •x E 4� -- - � 2 45°k ----- - O 40% - - -- - Fiscal Year Period Ending gi 35% \ -. -- - •/ v 2015 ° Sox Z 30% --- -- - $ • 2016 V 25% 24 --- --- al 20% -------- - - --------.- 15% -------- 10% --- - ._ - 5% - ___._____________-- ----------_ % --- —.__. — OCT NOV DEC JAN FEB NAA ASP MAY PJN JUL AUG SSP Month Period Ending LOS Transports 900 - _________ 800 700 - in 600 - c O• 500 c.) Level Of Service v w400 BLS O it 300 1 22� III ALS1 ■ ALS2 200 100 I 20177 _ • 'i 1yei° �c�° 10'0' v` JH: ,,,�� "'plc �o�` aN.°oysc1O' te s �Y- 153 34‘c p-.. 0- Month-Year DOS This Report May Contain Confidential Information or '. .r- Proteded Health Information.Please Treat . Accordingly-Copyright©2013 Intermedix Page Number: 5/6 intermedix Revenue/Transport 350 ---- ------ 300 — 278 278 281\, 2 i ::: —_---.—_ 197 - 2 i- Fiscal Year DOS v c 150 — — -- -- ■ 2015 402018 tt CC 100 ----- 50 ---- --- 0 — -- -- -- OCT NOV DEC JAN FEB M.AP. APR MAY JUN JUL AUG SEP Month DOS o Self Pay Receipts Trended $18,000 -- $16,000 $15784 $14,000 $13,u654 5$1332255 $13,319 $12,527 51�$12.528 D $12181 $12,000 $11,716 U1 ; •193 G $10,000 - - F-- -- . ._-__—. ---- 59.584 a) • $o' ' 13e /1 S8n952Fiscal Year Period Ending ani 11 •'.•-• ---- ------- --- $8'� ,038 818-$7; .. 2015 $6,000 -- — — �— — — — ♦ 2016 $4,000 ----- — — ---- - $2,000 — — —— $0 ----------------— OCT NOV DEC JAN FEB MAR APP. MAY 213W JUL AUG SEP Month Period Ending This Report May Contain Confidential Information or . . , - Protected Health information.Please Treat • Accordingly-Copyright 0 2013 Intermedix intermedix Pagnmumm,r�0 Insurance Receipts Trended (in thousands) s280 ::: o261 $220 � �zno --'�--- -----'- - - /mr'-����w-- x�- a/� � 72 — ' ---11-7r `, — • -- --' k s160 1 1 , ^ � $|*o Fiscal Year Period Ending $120 -- sir—_-____--__--___________ - uns $100 - • 2016 $80 ---'-------------'------ --- $so '---------- '--'------- ---- s40 o20 ------------- --- — - ---- � $o — -- ---- --- ------ OCT NOV DEC JAN mm MAP um es ''JN JUL AUG SEP Month Period Ending This Report May Contain Confidential Information or ', . r .. ^ ProtwdadHoalth Information.Please Treat -' Accordingly-Copyright®2013 Intermedix Page Number:1/4 materteedix City of Miami Beach EMS Number of Transports Collections 10.000 $2.600.000 9.000 $2,400,000 8.000 $2,200,000 $2.000.000 7,000 -- - $1,800,000 -- - 6,000 $1,600.000 5,000 $1.400,000 -- $1,200,000 4.000 $1,000,000 3,000 $800.000 - - 2,000 $600,000 - 1.000 $400,000 $200,000 0 $0 Fiscal Year DOS Fiscal Year Period Ending This Report May Contain Confidential Information or Protected Health Information.Please Treat Accordingly-Copyright®2013 Intermedia Page Number:2/4 i nterm edix Transport Comparison by Month Monthly Collection Comparison 900 $300.000.00 800 7Q0 ` ♦j $250,000.00 600 $200,000.00 Soo 400 Fiscal Year DOS $150 app 00 Ending ■ 2015 300 g 2016 ■ 2015 $100,000.00 9 2016 200 100 111111 $50.000.00 111111111 Fiscal Year Period 0 $0.00 Month FY DOS Month FY Period Ending This Report May Contain Confidential Information or Protected Health Information.Please Treat Accordingly-Copynght©2013 Intermedia 0 a 4, N co 5 to m PA z j m Q J ■ n ■ ■ ............. ..... ... ,I07a11s lim ... A107-1-41V O 3m7''Mr 2 .... . 9102'N1ii' T At07-AVN 910 1-NAV O avN N ��� °t0?-MVC M to m...... .,,,„ , no,-. 5 .....m..... .... .... 910?-001 �.� 3T07-1..10 +a > ommaimm...•"a. .... 5t00-100 Of J J -+ ST07.-CNN �.�,�•- i 1107-90C +.... 0100-91lt -+.a ST07.1.11,1 c Slu)-eaV S(D X i ilu.'9 to cu'0i sa XST07-MVC • ator-71.1 �� s10,, p 0.r)StOZ_C:w vc C LIM .yam eee�1 ■ '+ ■ ■ ■ N S Z y c o 132 o 0 aP 0 O` V CC 11 Q N 0 b O O 1�0 N dac ' u) 0 (A a `o 2 o >. 10 -J u O W t� O Q E 7 Z 1P rn CO 00 N 03 CO K CO N0 a 0 0 0 0 0 0 0 0 Page Number:4/4 intermedix Charge Mix Payer Mix Medicare Medicare (35.91%) (55.14%) Medicaid (13.36%) Self Pay Private Insurance ar (5.22%) (16.08%) Medicaid Self Pay (7.46%) (34.65%) Private Insurance (32 19%) Financial Class Financial Class ■ Medicare .: Medicaid IN Private Insurance ■ Self Pay ■ Medicare a Medicaid ■ Private Insurance ■ Self Pay This Report May Contain Confidential Information or . Protected Health Information.Please Treat Accordingly-Copynght©2013)ntermedx AR DOS it termedix Page Number: 1/3 City of Miami Beach EMS I60hm Masi mra6 •06 C6ttq� Irll4atahe Coirtbn Catrctlm i T . tam Senior *cc. Ammo Amts Net Charges gbipd ar Gni% tet% I ym 2015 2014-10 684 $590,704.50 5157.480.68, 9433.22342' 5172.247.18 5260975.64. 29.16% 39.76% 252 2015 2014-11 708 $619,126.50 $170,403.68 $448,722.88 5185283.60. 5263.43922 29.93% 4129% 262 2015 2014.12 774 9666.003.00, 5174508.77 549648423! 9214,551.501 $278.932.731 3212% 43.46% 278 2015 2015-01 739 8643.741.00'. 9191.096.49. 9452,64451 8205,327.85. 8247,316.66 31.90% - 45.36% 278 2015 . 2015-02 674 • 9580.030.10 8156,816.78_- 8423.21322. 9204,801.94 $218,611.38; 3527% 4834% 304 2015 2015-03 794 9671.395.95. 2169,979.48; $50341647' 9205028.57` $297,387.90: 30.54% 40.81% 259_+ 2015 2015-04: 726 $619,298.80• $154,57562' 9484,72288: 8202,053.48 8262,889.46! 32.63% - 43.46% 279 2015 2015-05. 740 , 0333 193.00, 3177,831.49: $15838151 $196,334.30 $259.02721. 29.43% 40.92% 252 2015 2015435 646 5651.59825; 8142607.361 $409.386-89; $163,347.06; 8246,041831 29.81% 39.90% 253 2015 2015-07 681 9670.574.00' 9150221.43 9420.35257' $172,562.92.- 9247,789.651 30.24% 41.05% j 254 2015 ' 2015.05. 690 5594.940.601 $151,888261 9443,062.34. $170,921.33; $272.131,01, 28.73% 38.56% 246 2015 201509 859 $661,669.80 $152,863.26, $408,8pe54 $172583.40; 5236223.14; 30.73% 4222% 262 2015': Sun:, 9,521 - 27,304,273.50 21,948,873.60: 58,38439969! 92.254,14217. 93,100,56760 • • TMs Report May Contain Confidential Information or Protected Health Information.Please Treat Accordingly-Copyng1it J 20131ntermedix AR DOS intermedix Page Number:2/3 Year- ; I i Revs Month Fiscal Date of tot Chiirrie ' Met ammo Coliectkin i Conon Year Service Ato Amount A99-Dents Net Charges Recetcts Due Ge tess% I Not% pen 2015 1 2015'10 870 266843570 8156.23461. $410 089 6164.3011.94. 6245.2111151 26.91% 40.38% ! 246 i H--- - 1 2016 ' 2015.11 677 $572.848.40 $157,562.48; $415.285.92 2173.496.53 $241,719.39. 30.29% 41.78% 257 --1-- ; ,_ 2016 2015-12 703 2580,349.051, $1502,4.62 2429.805.43, 2195,665.71 1234140.72 3373% i 2016 2016-01 715 3603.826.65 $178274.00 2425.562.65 $188,164.25 8237.368.40' 31.16% : 44.22% 264 2018 2016-02 726 _._ $616412.25 $175289.36 S441.122.95. 51X14.69322 2237629.731 33.11% ' 4627% 261 2018 2016-03 842 3696.765.45 $164272.62 $532,492.82 $181,318.55. 2351.17427 26.02% 34.05% 216 ' . 2016 2016-04 741 5627,23435 $153.756.86. $476,477.47 5178,724.991 $297,75248 28.49% ' 3761% 242 2016 201605 726 2626246.20, $150,860.87 2460.884.33, $171.424.66 2289,459.65. 27.62% , 37.19% 237 2016_j, 906 649 2546301.26 $142231.40 $407,069.86 8148,746.111 2258.323.66 27.08% 1 36.54% : 230 2016 2016.07 666 $571,575.96. $126,065.42 $445,510.53 $146969.61._ 229662692, 26.07% 33.44% . 224 2018 '2016-08 , 629 .__' 1337,459.86 2125.907.24 8411,552.56: $133.980.42! 5277,572.14. 24.93% . 32.55% l_214 2016 2016-09 619 $536,519.46 $118,317.75 $418,201.70. $121,901.99. $296.299.71 22.72% i 29.15% . 157 i 2016' 8.mt 8,365 $7.061.17346 51,807.015.40 $6274.158.05, 12o1e.016.0e 51.263,343.05! E . : , . . Stun: 10.886 214.305.44225; 83.7ee08eoe. 610.42555796; 25266.65727' 65365100.02 men 40.13% ; .1 Unk1410111=1; WriftOff:, 12.098.11. This This Report May Contain Confidential Information or Protected Health Information.Please Treat Accordingly-Copynght C 2013 Intermedx AR DOS intermedix Page Number:3/3 Fiscal , charge Charge I Receipts Year IS at Accounts , Financial Class A17011 nt 11, Receipts 1 % 2015 2,948 Medicare $2,604,897.55, 35.66%i $1,142.678.27, 50.68%i 1 2015 I 1,172 Medicaid $1,024,777.80 14.03%. $160,384.46 7.11%, --t- r --, 2015 1 1,609 j.Private Insurance $1,398,441.60 19.15%, $851,270.861 37.75%1 2015 I 2.792 1 Self Pay 52276,156.55 31.16% $100,509.28 4.46% 2015! 8,521 17.304.273.501 $2,254,842.87 Fiscal Change Charge Receipts Year e of Accounts Financial Class Amount % Receipts % 2018 2.995 Medicare $2,628.567.80, 37.12% $1,158,557.98 57.82%1 2016 ' 990 Medicaid $863,092.35 12.19% $122,371.16 6.09% ,,- 2018 ' 1,413 'Private Insurance 51,224,993.251 17.30% $852,329.93 32.44%' 2016 2,967 Self Pay 12,364.520.05 33.39% $77,555.93 3.86% 2016, 8,365 $7,081,173.45 I 62,010,815.00' Sum: 16,866 $14,385,446.95 100.00%, $4,265,657.87 100.00%: . . This Report May Contain Confidential information or • Protected Health Information.Please Treat Accordingly-Copyright©2013 Intermech AR Period Ending intermedix Page Number: 1/3 City of Miami Beach EMS ! Period Ending I Net Festal Year- Cage Net Balance i Collection Collection Year Illonth Amount I Adjustments Charges Receipts Due I Gross% Net% 2015 2014-10 $577.936.50 $160,884.98 $417,051.52 5199,77227 $217,279.25 34.57% 47.90% 1 , 2015 2014.11 5815,048.00 5114,385.41, $500,082.591 $118,302.17 5382,200.42. 19.25% 23.85% y 2015 201412 $658,856.50_ $201,100.00• 9455,758.501 5200.945.12 $244811.30; 31.51% 45.41% 2015 _ 2015-01 $650,389.50 9212.109.89 $438,279.611 5251,629.931 $186,049.60' 38.69% 57.41% 2015 ff 2015-02 5589,283.00: ----5158,185.30 5411.117.701 $181,260.601 1229,857.101 31.64% 44.09%. 2015 2015-03 , $661,474.50{ $178,190.48 $483,284.021 $156,701.451 -_-- I $324,58257; 23.99% 32.84% 2015 2015-04 $595,128.001_ $143,802.49! 5 S451,325.511 $178.880.491 1272,445.02! 30.06% 639.83% 20132015.05 1i $759,357.043278.67 $616,000.33] $184,266.14:! $431,814.19r 0 $1 2427% i 29.91% 2015 2015-06 ! $568,038.50: $192,255.84, 5375,782.66 1225,443.004 $150,339.861 30.09% 59.90% — I 2015 , 2015-07 1 $566,616.50' $180.486.44 $388.130.001 5220,051.661 1186.078.401 38.84% 56.99% 201S i j 2015-08 $587,101.331 $188,194.48 1418,908.85 8213,331.741 5203,575.11 36.68% 51.40% 1 2015 I 2015-09 $566,182.40 $141,291.40 $424,871.001 $181,573.98: $263297.02; 28.54% 38.03% 2015 1 - - -- .-- 01 _ Sum: $7,373.301.73: 11.994,143.18 65,379,24455 52,302238.55: 83,077,010.00! This Report May Contain Confidential Information or Protected Health Information. Please Treat Accordingly-Copyright©2013 Intermedix AR Period Ending i nterni ed ix Page Number: 2/3 Period j • • EncOng l Net Fiscal Year- Charge I! Net Balance i Collection Collection Year Month Amount Adjustments ! Charges Receipts Due I, Gross% Net% 2018 201510 5567,874.55 ---- ---5193_89936, 5873,975.19 $273.453.62 $700.521.57 48.17% (f 73.12% 2016 2015-11 ---- $573,738.50 $170,03628 $403,702.22 5224,052.16 ---$179.850_06. 39.05% + 55.50%_`Y 2016 2015-12 $574.098.60 $202.152.78.. --- % . _.. _ __ 5371.915.82] 5776,988.95 -_519�2,978.8T` 3t-17% 48.12%- 2016 , 2016-01 5809.826.80 $129,043.70 $480,784.90 $151,070.371 $329,714.531 24.77% 31.42% - 2016 2016.02 5807.088.80, Sf68,858.9 4 �— -----__ - _ $438,20_7./6 t 5198,706.51 5241,501.361{ 3240% 44.89%_ 2016 2018-03 5708,121.10 ---- $176,024.81~ $530,096 .291 5222,817.731 5307278.56131.56% i 42.03% 2018 2016-04 5628,001.95; .._.._..—.! 52 ,784.99 _5386238:96 $7i2,0�23.52 51362t3.M1 3696% 63.01% 2016 ;._ -�-- -- - i —., 2016-05 5615,630.201 $147,456.08'. 5468,174.121 5173,437.80 5294,736.521 28.17% 37.05% 2016 2016-06 $550,91210] $148,080.77;,$402,831331 5197,029.15 $205,802.18 35.76% ' 48.91% ' — T 2016 1 C 201507 5574275.20; $152,445.58; $421,829.64 $178,056.391 5243,773.251 31.01% j 4221% 2016 2016- '-- 5537,410.20], $127288.59 5410,121.811 $155,887.11 5254,454.50; 28.9796 1 3746% ! 2018 --. —+-- _ 2018.09 5538,586.451 5210203.13 5326,383.32: 5236,148.09 3 5902352 44.01% ! 72.35% 1018 Sum: 57,081,344.25;' 52,065,054.99 54,996,289.26, 5$419,43110. — ----- -- -----— --- _52,578.658.06; ! ---—. Sum: $14,454,735.98 54,079.198.17 910,375,537.M ss rn,os.75:i 56,853,860.081 3267% i 45.51% write06: $2,887.00' Unidentified; _.------ Payments._.----- x.001 3 • . This Report May Contain Confidential Information or Protected Health Information.Please Treat Accordingly-Copyright- 2013 Intermedix AR Period Ending intermedix Page Number: 3/3 Fiscal Financial I Charge ` Charge 1 Receipts Year Class Amount % Receipts 1 % 2015 Medicare $2,622,657.00' 35.57% $1,168,107.10 50.74%; 2015 . Medicaid $1,030,701.50 13.98% $147,922.25; 6.43%` 2015 ,ivate Insure, $1,410,467.40 19.13% $851,835.20; 37.00%' 2015 Self Pay $2,309,565.83 31.32% $134,374.00 5.84% 2015 Sum: $7,373,391.73 i $2,302,238.55 Fiscal Financial Charge ` Charge Receipts Year Class Amount % ; Receipts 2016 Medicare $2,630,427.00 37.15% $1,252,075.38 51.75%1 2016 Medicaid $863,087.551 12.19% $154,252.07 6.38% 2016 ivate Insure $1,224,140.10, 17.29% $896,691.51 37.06%1 2016 Self Pay $2,363,689.601 33.38% $116,412.24 4.81%I 2016 Sum: $7,081,344.25; $2,419,431.20 $14,454,735.98; 100.00%; $4,721,669.75; 100.00% This Report May Contain Confidential Information or Protected Health Information.Please Treat Accordingly-Copyright©2013 Intermedix Medicare 1 intermedix Page Number: 1/2 I City of Miami Beach EMS . . ' Year- Month I • Met 1 Fiscal Period ; Charge Net Radar= Collection Collection Year Ending Amount Adjustments Charges Receipts Due Gross% Net% 1 i . . . 2015 2014-10 . $200,426.00! $107,778.32 $92.847 68 $108,842.00: 418,194.321 54.31% : 117.48% ______4 1 - 2015 2014-11 ' $221.405$0 $72,834.81: $148,570.80 $8$074.03 $83,498.88' 29.39% : 43.80% 1 i ! 2015 2014-12 I $245,704.00, $119113.57 i $12.1.590.4.3 $105.851.411 $20,739.02 f, 43.08% .1 I 2015 , 2015-01 $267,666.00 8133,107.821 8134,558.38; $120,728.181 813,83222: 45.10% 89.72% : , I 1---- 2015 2015-02 9220,982.00 8117,480.021 $103.521.981 8109,764.971 48,242.991 49.87% : 106.03% 2015 2015-03 ' $208,128.50 995.891.52' $110,234.98: i 1 $86465.57; $23,789.41 41.95% ; 78.44% i 2015 2015-04 i $193,0013.00 $87,90&34 $105,097.86,i $84,809.79! $20,287.87! 43.94% 80.70% -:--- ----+-- 1 i. 2015 2015-05 ! $258,491.50. S98,001.341 $160,490.16 $67,755.191 972.734.97 it 33.95% : 54.88% 1 , i --t-- 1 ' 2015 ; 2015-08 &..I $208,375.00, $108,918.821 sirtsse.18. $ioo,165461 42.ros.901 48.54% I 102.7S% 1 /, -- -- ;-- 2015 : 2015-07 i 8199,821.50• $91,401.58 $108,419.92 $112,285.26 '$3.865.34j 58.19% I 103.57%-t 1 , ' 2015 : 2015-08 ; $189,773.00 $69,396.44 $100,378.58 $97,808.04 $2,938.521 51.54% i 97.44% t--- I- ; 2015 , 2015-09 $212,880.00 995,810.97 $117,289.03 $88,559.60 $28,709.431 41.80% : 75.52% 2015' Sum:, $2,822,857.00; $1.217.421.151 $1405235.55 K168,107.10, $231,128.15! 1 I I 111111.11Mat: This Report May Contain Confidential Information or Protected Health Information.Please Treat Accordingly-Copyright©2013 Intermedix Medicare 1 intermedix Page Number: 2/2 Year. I 1 , I I Month , Net Fiscal Period Charge I I Net 1 Balance Collection Collection Year Ending Amount I Adjustments Charges 1 Receipts I Due ' Gross% i Net% I 2016 2015-10 $200,907.00, it $116,778.03 1914,126.97 51/2,846.31i 428.517.34 r 56.07% 133.90% 2016 2015-11 $233,114.50 $116,396.27 5116.718.23 $110,778.43; 55.939.80, 47.52% 94.91% ' f I I 2016 2015-12 , WM 920 05 6112,51229 $118,407.16 5107,596.04i 310,609.12 41.60% ; 90.67% . 2016 2016-01 5256,09925 388.848.58. $169,250.67 $91.472.55; $77.rre.11, 35.44% ; 54.05% t , r I ---i 2016 2016-02 _ 3256,28825 $113,792291 $144,493.96 $100,47030 544,022.971 36.90% ! 69.53% ; — , 2016 ; 2016-03 1 $245,303.70 $129,978.74 $115,824.96 $117.836.63: 42211.67' 41k04% : 101.91% 1 I 2016 2016-04 ; $,229,041.60 $202,390.87 $19,650.73{ 5122,054321 4102,403.491 54.97% 821.12% i 1 . 2016 2016-05 1 $217,552.55 $106,03725 $111,515.30 $96.828.07; $12,687.231 45.43% 86.62% 2016 2016-06 ; $207,476.75; 6101,29230/ $106,184.45i $100,134.61, $6,049.84i 48.26% 94.30% _; I 2018 , 2016-07 1 $185,964.80 $91,106.59. $94,878.21 i 386.80727 $8,070.94! 46.67% 91.49% i - ! —I- 1 2016 , 2018-08 ; 6195,579.35 Se6.r0e.13: S128,871221 $811,411.18t $60,460.04, 34.96% i 53.08% ; I ! 2016 2016-09 , 6175,16120 $144,163.52! $30,997.66' $135,037.07! -$104,039.39! 7709% 435.64% i I 2016 Sum:' $2,630,427.00' 51,3611,705.44: $1,240,721.54 51,252,075.36 411,35344: ' ! , Sum: $5,253,084.00 U607,126.131 $2,645,957.39 $2,420,182.48 $225,774.91 Unidentified $0.00 WriteOft' $0.00 Pements: / , I This Report May Contain Confidential Information or Protected Hearth Information.Please Treat Accordingly-Copyright it)2013 Intermedix Medicaid intermedix Page Number: 1/2 City of Miami Beach EMS Year- Month , Period i . Net Fecal Enclin Charge : Net , Balance Collection Collection Year g Amount Adjustments 1 Charges . Receipts Due Gross% I Net% 2015 2014-10 $93,071.00 $49,851.89 $43,219.11 $9,803.18 $33,615.93! 10.32% , 22.22% 2015 , 2014-11 $84,665.00 $39,075.67 $45,589.33 $8,210.83 $37,378.50. 9.70% 18.01% --7 — 2015 2014-12 ; $76,934.00 $78,045.19 41,111,19' $16,555.31 417,686.50 I 21.52% -1,489.87% 2015 2015-01 $96,959.50 $78285.08, $22,674.44 $13,935.94 $8,738.50 14.08% 61.48% 2015 i 2015-02 I 870,8134.00 $38.616.711 $32,247.291 $7,66229 $24,585.001_ 10,81% 23.76% J 2015 2015-03 ' $95,228.50 $77,769.58: $17,458.92 $10,915.14 $6,541.78. 11.48% 82.53% 1 ---4 2015 2015-04 S13,686.00 $54.502.22' 819,183.78 $11,107.781 $8,078.00 15.07% 57.90% I 1 2015 2015-05 , $112,662,001 $45,554.11 $61,107,891 $8 313 39 $58,794.50, 7.38% , . 12.39% I ----r- i 2015 2015-06 ' $ets-m.0o I $58,936.60 $22,638.40, $16,152.38 $8,488.02: 19.80% 71.35% I 2015 2015-07 $71,977.50 $82,071.71 -$10,094.21 $17,064.89 -$27,158.901 23.71% -169.05% 2015 201548 $9150 5.00, $73.510.033 $17,994.97; $19,023.99 41,029.021 20.79% 105.72% 2015 2015-09 $79,576.00 $40,953.77 $38,622.23 $9,377.33 $29,244.901 11.78% 24.28% ...., I I 2015 Sum $1,030,701.50 $715,17254 8315,528.96. $147,922.25 $167,80471 I j • This Report May Contain Confidential information or . -4 Protected Health Information,Please Treat Accordingly-Copyright it 2013 Intermecfix to Medicaid interrnedix Page Number:2/2 Year- - Month I i Period Net Fiscal Endin Charge Net Balance Collection Collection Year g Amount Adiustrnents Charges Receipts I Due , Gross% Net% 2016 2015-10 I $89,950.50 $70,868.65 $19,081.85 $17.69160 31,38825 19.67% 92.72% 2016 2015-11 $77,179.00 $50,257.82 $26,921.18 $12,129.64 914,791.54 15.72% 45.06% 2016 2015-12 $67,908.00, $85,962.48 495,074.48 $21,574.35 439,748.81 31.92% i -119.92% — I I , 2016 2016-01 : $89,497.80 $30,538.98 $58,958.82, $6,983.39. $51,975.431 7.80% 11.84% I i IT— -r- 2016 2016-02 . $74,113.50; $55,714.32 $18,399.181 ' $3,823.61 19.94% 80.31% I.-- $14.77&- 47.- , 2016 2016-03 589,664.95 $40,659.69 $49.005.26 $12,659.62. $36,345.84, 14.12% 25.83% -- ,--_ _...,...__ 2016 2016-04 $64,697.20 $51,12225; $13,567.95 I $14,156.751 -$588.80 21.88% 104.34% c , I 2016 2016-05 $86,133.20 $35,001.46 $51,131.74; 97,543.79! $43,587.95, 818% 14.75% ---•,-- 1 2016 2016-06 , $63,647.15 $39,487.84 $24,159.31! $10,816.81 li $13.342,01 1699% 44.7714 2016 , 2016-07 i $54.534.e0 $54,229.74 $304.86- $13295.311 -512,990.45 24.38% 4,361.12% I I 2016 , 2016-08 ' sso,o36.40 $53,264.59 43,228.191 510,954.161, 414,182.351 21.89% -339.33% I i , 1 2016 2016-09 : $55,725.25 $50,306.12 $5,419.13i $11,569.281 -$6,150.15 1 20.76% 213.49% 2016 Sum:, 01163.087.55 $617,440.92. $245,646.63; 5154,252.07 $111,3114.56 Sum: $1,093,789.05 $1,332,613.413. $561.175.59; $302,174.321 $2,59.001-27! ! WriteOff: $0.00 i Unidentified' $0.00 i , $ Payments:' i - This Report May Contain Confidential Information or Protected Health Information.Please Treat Accordingly-Copyright 0 2013 Intermedix Insurance intermedix Page Number: 1/2 City of Miami Beach EMS I i Month. j 1 I Net Fiscal Period Charge Net Balance Collection Collection Year Ending Amount Adjustments Charges , Receipts Due Gross% Net% , 2015 2014-10 $102025.50 $3.25417 $98.770.73 $55.542.73 $33228.00, 64.24% 8826% 2015 2014-11 $114,711.50 $2,020.37: $112.691.13 $36,911.53 $75,779.80, 32.18% 32.75% -I- I I I 1 2015 i 2014-12 I $123215.00 $3.044.55! 8119270.49 575.478.29, $40,79916, 6128% / 63.28% -..- - I , / 2015 j 2015-01 $109,345.50 $971721 5108,62829 510321933/ 53,313.96 94.48% . 96.89% I . / 2015 L 2015-02 ,I_ $139196.50 i $2,088.57 $139107.93/ =swatmem.09 i 3942% i 40.05% 1 ----- 1 1 / 2015 / 2015-03 5145,533.50 84.090.82 $141,442.88 $4720526/ $93,447.42 32.98% 33.93% / ---- 2015 . 2015-04 : $13396.00, $1.391.93 $139009071 $73,1104.76: $69199.31! 54.51% . 55.08% , - 2015 ' 2015-05 :- I$139902.00 3-799.21 $131.701.21 580.30328 551.397.93 6125% ' 6997% r --' I / 2015 2015-08 : $101,146.50: $12,038.22' $89,10828 I 598.964.80/ 47.856.52 95.87% 108.82% 2015 . 2015-07 . $110,630.00 $7,013.15. $103.616.85 $79147.82 $24,489.03. 71.54% 76.39% 1 I 2015 , 2015-08 : $108.518.59 $ 288.01, $103230.49 i $85,180.46 $18650.03 78.49% / 82.51% 2015 ; 2015-09 I $95.846.90, $4.287.49 $91.579.44 i - $54.665.10 536.894.34 57.05% 59.71% 2015Sum! 81,419467.40 547,315.85 $1,343,15135: U5983520, $511,318.35, / ! . , .. . This Report May Contain Confidential Information or . , Protected Health Information.Please Treat Accordingly-Copynght(ID 2013 Intermeofix Insurance interrnedix Page Number: 2/2 Year- • Afontlt Net Fiscal 1 Period Charge i Net I ' Balance 1 Collection ! Collection Year Ending Amount Adjustments Charges Receipts Due Gross% Net% • 2016 2015-10 1 $97,446.001 $6,052.68 ----691,383.32' 5130,586.96 -539,193.64; 134.01% I 142.88% 2016 2015-11 $100,766.50 $3.382.19 $97,384.31 _ $93.19622, 54.188.091 92.49% 95.70% 2016 2015-12 ---$105,178.05( $3,657.43 $101,520.621 $42, 858.38] $58,88226' 40.56% 42.02% 2018 2016-01 $113,642.55+ 59,856.14 --$103,986.41 $48,733.42 $57,252.99 41.12% I 44.94% . • 2016. • 2016-02 j $120,712.95 5-647.67. $121,38062 570,448.401 $50,91222; 58.36% !j 58.05% _--2016 ' 2016-03 , $116,557.60 $5,686.38 $110,871.22 579,449.071 $31,422.15. 68.16% 71.66% —�--- - ---..- - .-_._ , __.___ 2018 2016.04 $10216450. - $6,244.87.— $95,919.83 $83284.981 512.634.85! 81.52% 1 86.83% 2018 2016-05 $130,453.501 $5,567.87 $124,885.63 $56,872.74 $68,012.89: 43.60% j 45.54% 2016 Z016416 $90,421251 -----^---- --- .-- _-- $6,64922 $83,772.03 $78,462.345 $5,309.691 86.77%—L. 93.66% 2016 1 2016-07 $103,561.15, 57,10923`— $96.451.92: $70,454.94; __525.996.98 68.03% 1 73.05% • • 2018 2016.08 $7,315.87_$81,531,631 $66,717.941 -15,188.311 96.91% -- 106.43% �__ -� $68,847.50 —08 2016 !. 2016-09_.,_-- $74,388.55 $13,226.97 $61,161.581 _ $77,826.14' _-$16,664.56' 104.82%~ 12725% 2010 Sum: 11,224,140.10 $73,801.15 $1,150,236.92' $896,691.51' $253,547.41 ---� Sum: $2,634,607.50 $121,217.03 $2,513,390.471 $1,748,526.71. $764,863.76. WrrteOff: $914.50 Unidentified: 00' . Payments:' $0 _ This Report May Contain Confidential information or • Protected Health Information.Please Treat Accordingly-Copyright©2013 Intermedix Self Pay intermedix Page Number: 1/2 I City of Miami Beach EMS Year- Month earMonth Net Fiscal Period Net Balance Collection Collection Year Ending Amount Adjustments I Charges Receipts Due Gross% Net% 2015 2014-10 $182,414.00] 182,!14.00 $iS,7S4.36 $168,629,64; 8.65% 815%._. 2015 2014-11 $194,266.001 $454.76 8193.81124 $818578' $185,625.48; 4.21% 4.22% 20152014-12 $211,003.501 43.31_,-- $211,006.81 I �_ --- $9,080.11; $201,948.701 4.29% 42914 . 2015 2015-01 5174,418_50 -___--_ $174,418.50 $13,653.50; $160,765.00. 7.83% 7.83% 5132 ----- 7.85% I 2015 j 2015-02 8144240.50 8144,240.50' $11,326.50,914.00; 7.85% 2015 2015-03 I $214,588.00 8438.56. $214,149.44 $13,325.481 5200,823.96: 621% 6.22% 2015--. 2015.04 ] $193,040.00--- 8193,040.00i $9.158.161 $183,881.84! 4.74% 4.74% iI 2015 2015-05 , $257,301.50 $520.43! $256,781.07. $7,894.28 $248,888.79 3.07% 3.07% Y- — I 2015 - 2015-08—j $178,942.00 $12,364.00 $166,57$.00] $12,160.74 5154,41728! 6.80% 7.30% 2015 2015-07 $184,187.50 $184,187.50 $11,553.89: $172,633.61627% 627% I 1 11 — • 2015 ; 2015-08 I $197304.83, $0.00, $197,304.83 -__- y 513,31925 $183,985.58: 8.75% 1 6.75% • 2015 ; 2015-09 5177,859.50, - 345920 $177,400.30. $8,951.95' $168,448.35. 5.03% 5.05% , 2015 Sum: 82,302565.63, $14,233.64; 52,295,332.19' $134,374.00; 62,160,956.19 1 This Report May Contain Confidential Information or Protected Health Information Please Treat Accordingly-Copyright Q 2013 Intermedix Self Pay 1 intermedix Page Number:2/2 Year- ! Month 1 f Net Fiscal Period Charge . i Net Balance , Collection , Collection Year , Ending Amount Adjustments 1 Charges Receipts Due Gross% Net% 2016 • 2015-10 5179,371.05 $179,371.05 $12,526.75 $188,844.30! 6.90% 8.98% _ 1 2018 2015-11 $162,878.50 $182,878.50 $7,947.87 $154,730.83 4.89% 4.89% . , — -r- 2016 . 2015.12 $170,092.50 i : $170.092.50. $7,03820 $163,054.301 4.14% 4.14% ---.—. 2016 2016-01 $148,589.00! ' $uasattoo $wistoo,r $142,108.00: 3.96% . 3.98% 1 -7- 2016 ; 2016-02 $153,954.10: $153,954.10. 511,011.55 i $142,942.55; 7.15% : 7.15% 1 2016 2018-03 5254,594.85: • 5254,594.85 $12,872.41! $241,722.44 i 5.06% ' 5.08% 2016 2018-04 . $239,096.65 i i $239.098.65. $12,527.57 $226.571.061 5.24% ' 524% 1 ! . 2016 ! 2018-05 ! $181,490.95: $849.50: $180,841.45 $10,193.00 i $170,448.45! 5.62% 5.64% 2018 , 2016-08 • $189,366.95: $851.411 $188,715.54; $7,615.591 5181,099.95 4.02% 4.04% 2018 2016-07 ii $230,194.65' $230,194.65' $7,498.87 $222695.78 326% 3.26% 2016 zole-ce E $222,946.95! $222,946.95: $9,583.83 5213,363.12 4.30% .... 4.30% I ! 2016 ! 20113-09 $231,311.45 $2.506.52 $228,804.93 $11,715.60 $217,089.33: 5.06% i 5.12% 1 i 2016 Sum:! $2.363,689.60 $4,007.43 $2,359,682.17 5116,412.24 $2,243,280.93 : Sum: $4,673,255.43 618.241.07! 64,885,014.36 $250,788.24. $4,404,228.12 i I VV n te Off: $1,772.50 Unidentified $0.00r Payments:' 1 , .:.... ,. This Report May Contain Confidential Information or . ' - Protected Health Information.Please Treat Accordingly-Copyright(t)2013 Intermedix Collected intermedix Page Number: 1/2 City of Miami Beach EMS . Fiscal Year Year-Month Collected Fiscal Collected Period Ending . Period Ending Receipts Year Cumulative i 2015 2014-10 ! $199.772.27 $199,772.271i $199,772.271 • 2015 2014-11 : $118,382.17 $318,154.44 $318,154.44 2015 2014-12 : $206,945.12! $525,099.56. $525,099.561 2015 ' 2015-01 ; $251,629.93; $776,729.49 $776,729.49 --i--- ; , 2015 2015-02 ' $181,260.60; $957,990.09 $957,990.091 2015 2015-03 , $158,701.45, $1,116,691.54 $1,116,691.54, . — 2015 2015-04 1 $178,8807.01 $1,295,572.03 $1,295,572.03! -. I -— 2015 2015-05 $184,266.14 $1,479,838.17; $1,479,838.17; 7 i 2015 2015-06 , $229,380.94; $1,709,219.111 $1,709,219.11: I . r-- 2015 2015-07 ! $224,251.871 $1,933,470.98, $1,933,470.98 2015 2015-08 $216,124.85 $2,10, 83 595. 1 $2,149,595.83 f 2015 2015-09 $166,235.381 $2,315,831.21 $2,315,831.21i I 2016 2015-10 $274,778.011 $274,778.01 $2,590,609.221 — ---1 2016 2015-11 $226,288.231 $501,066.24 $2,816,897.45, 2016 2015-12 $178,968.95! $680,035.19; $2,995,866.401 2016 2016-01 $150,975.21 $831,010.40, $3,146,841.61 2016 2016-02 $200,337.23, $1,031,347.63 $3,347,178.841 . i 2016 2016-03 $224,140.20' $1,255,487.831 $3,571,319.04: 2016 2016-04 7 , $237,912.831 $1,493,400.661 $3,809,231.87; 2016 2016-05 $178,446.011 $1,671,846.6711 $3,987,677.88 2016 2016-06 $198,322.651 $1,870,169.321 $4,186,000.53 2016 201 4-o 7 $178,830.30 $2,048,999.62 $4,364,830.83 1 , 2016 2016-08 1 $157,814.93 $2,206,814.55] $4,522,645.76. 2016 2016-09 $237,298.68, $2,444,113.231 $4,759,944.44, Fiscal Year Period Ending Receipts 2015 $2,315,831211 2016 $2,444,113.23 Sum: $4,759,944.44. tkt : This Report May Contain Confidential Information or ..,, Protected Health Information.Please Treat Accordingly-Copyright©2013 Intermedix Collected Intermedix Page Number: 2/2 Fiscal Year I Quarter by Period Ending I Period Ending Receipts 2015 01 5525,099.561 2015 Q2 $591,591.98 1---- , 2015 03 $592,527.57 1 . 2015 i , 04 $606,612.10 2,015 Sum: $2,315,831.21 Fiscal Year Quarter by Period Ending Period Ending Receipts 2016 01 $680,035.191 2016 02 $575,452.64 2016 1 Q3 $614,681.49 . -4• 2016 04 $573,943.91 2,016 Sum:. $2,444,113.23 Sum: 1 $4,759,944.44 This Report May Contain Confidential Information or Protected Health Information Please Treat Accordingly-Copyright®2013 Intermedix N 7 1 N z 'o t."-'I In '- 2 Fi R P. P' "t 1` A 3 Z N co 0_ G h P • iV x F- 0) _� W mE /�♦� ti ao CO a Is CO Is01, "' y tit c W d a �c`7 E m _ • a C fl G ' E L 8 al C T, u a; OCD 2 o U14.1.1 . r 1 S�. '-^7 dap o �y V m N (1 N N ^ d' N �y O U N N N N N : O O U yy 4y �p ^^ ��pp ms U Ps CO Is 1s 1s CO CO CO ••CO d - - 1 Z $$ E , fn u cu I 'z 4 4 4 of uS usi uSi u� 45 R R R R R R' o Nj R R R R I en 1 J 1_ i N N h 1f1 IA It) in 1n N � H o �- �- r r r r r r N t r N N N RIR R R RI Ri R R R Level of Service intermedix Page Number:2/2 Yaw-Month Fiscal Date of ' lot I Year Service Accounts BLS ALS 1 ALS2 1 TNT SCT None 20161 2015-10 670 244 399 9 18 . ' 2016 2015-11 677 227 419 9 22 —,- f . 2016 2015.12 1 703 236 419 ' 12 ! 36 2016 2016-01 715 203 474 14 24 2016 2016-02 728 201 500 5 22 I -1-- 2016 2016-03 842 247 536 15 44 2016 2016-04 741 207 J502 7 25 • 2016 2016-05 726 188 506 15 17 2016 2016-06 649 174 444 8 I 23 I-- 2016 2016-07 666 169 473 9 15 __...,. 2016 2016-08 629 ' 150 452 10 17 -r- 2016 ! 2016-09 619 174 424 15 1 6 2016: Sum: 8,365 . 2,420 5,548 : 128 269 Sum:! 16,886 5,214 10,980 : 219 1473 ! of - Fiscal Year Accounts BLS% ALS% ALS2% TNT SCT None% 2015 8,521 1 32.79% 63.75% 1.07% I 0.00% I 0.00% 2.39% 1 2016 8,365 . 28.93% 1 66.32% I 1.53% I 0.00% ! 0.00% 3.22% I I Sum:' 16,886 1 I 1 • , , This Report May Contain Confidential Information or . , . Protected Health Information Please Treat . . . Accordingly-Copyright 0 2013 Intermedia X intermedix City of Miami Beach EMS E M S Billing Management Summary Reports FOR PERIOD ENDING February 28,2017 Prepared by.htermedix, hc. Collection by Financial Class City of Miami Beach EMS-E M S Billing Collection Report-By Financial Class Penod: 02/01/2017 00 2/28/2017 REPORT#1 Insurance Classification Transports Current Month Fiscal Year-To-Date Auto Insurance 31,702.84 $19,651.79 Contract $0.00 $911.50 Medi00 $13,971.32 $70,635.73 Medicare $81,515.58 $379,362.57 Pnvate Insurance $32,790.39 1203,180.91 Self Pay $29,303.49 f120,814.93 Work Comp $1,620.70 $12,130.90 Collecticn Accounts $0.00 10.00 SUB-TOTAL $155,854.32 $806,687.78 Insurance Classification Non Trans0orts Current Month Ful Year-To-Data $0.00 $0.00 Collectian Accounts $0.00 $0.00 SUB-TOTAL $0.00 30.00 Unidentified Payments 10.00 (10.00) Refunds ($1.99476) ($11,818.72) NET TOTAL $153,859.56 $794,869.04 Collection by Financial Detail BILLABLE ACCO Invoice Account Incident One of I 'Transaction Invoice Transaction Pim,be,I Ntolba, Service I LDS ID Insurance Classification Amount 11/52014 BLS_ Aulo hsurance (615.09) 11/5/2014. BLS __ _$15.09 ._. :8/282018^ALS1 ._.._ __— . i 11/92016�_BLS ___.,- 8648.001 Auto Insurance $1,702841 MI Invoice Aaasiat dueTtaeeactien1111111ninvoice Transaction • b ID Insurance Classification , Amount 129/2016 ALS1 Medical 2/3/2016 ALS1 - $190.00; I. 3/1520181 ALS1 1 694.35 7/112016 ALS1 ' $190.00' . I ! 8/4/2016 I ALS1 1 I I $190.00' I i i 8/52016 ALS1 1 8/5/2016 $19000 ALS1 _ 3190.00 i 8/6/2016 ,ALS2 i . (250.001 I i 9/42016 / BLS 1 11I $250.04! I 19/1020161 ALS1 1 I _6190.00 { I !9/172016 1 ALS1 i I $190.00 I i 9/172015 BLS 1 _ 1 ' $81.69. II `9/182018 I ALS1 I 1 i $190.01 I '9/202016 j ALS1 I I ) 8465.20 i 92/2 ! I 0181 BLS I I ($136.00) i 1 9242016 I BLS 1 I (6136.00) Billing Activity Summary City of Miami Beach EMS-EMS Billing Billing Activity Summary Report For the month ended: 2/28/2017 REPORT#2 AMOUNT Fnandal Class Cyn Fiscal YTD Auto insurance • $0.00 $13,188.85 0% Contract ' $0.00• $0.00 Medicaid $51,255.90 $9,751,067.65 78% Medcare $235,445.75 51,159,817.05 9% Private Insurance $47,791.30 $336,331.90 3% ' Unnsured $0.00' $0.00 • Unknown $239,776.85 $1,227,023.95 10% Workers Comp ' 60.00 512,852.35 0% TOTAL BILLABLE $574,269.80 iii##iiia#gig BILLABLE TRANSPORTS Emergency AL51 $420,867.30 $2,341,803.75 19% ALS2 $11,982.00 $59,404.50 0% BLS 6140,601.00 510,095,687.00 81% $573,450.30 iiia!#iiia egg Non-Emergency AIS1 ' $0.00 $901.00 27% BLS $819.50 62,485.50 73% $819.50 $3,386.50 i## None ' $0.00' $0.00 • $0.00• $0.00 `SUBTOTAL $574,269.80#a####i###egg BULLA BEE Pal-IRA NSPORTS SUBfiOTAL • $0.00' $0.00 --------. $0.00' $0.00 NON-BILLABLE ACCOUNTS Voided ($65,045.50)########## TOTAL NON-BILLABLE ($65,045.50) ($9,854,415.00) TOTAL ACCOUNTS CREATED $509,224.30 52,645,866.75 Billing Activity Summary Detail New wm.or 41.1mI unt er I s.,..,�Cats at I Les I � / ' ..,... a...,b.� r+,n.,..Han. ,� 2(Y70,Ti 4, yv- µC Q.ian 500000 • ~2(]2 ` 011 ALS1 i tGamer*FW. ,SD j 17/320,7 ALS,I 1� ' UAC CCarm,nil'M .5 521.00 2/8/2Ot) ALM1 I - K Krum Cram Mtar 800.00 • INY1017!ALS11 Hoerr j Hr_Ott11.1•1.m 38900-' '2202011;ALS, I i Hnrr.Cam lAti! $2500.. • :2/2/20171 ALS1 1 }Hama a Orr Waif I 525.00 -• 2337017;ALS1 1 i Haan.Ore War '(( 830* • 12(52011:AU1 _1SrywNWbam(31C0)f 580000 t --_--,-- -,7 ALS1 I :9b�w�SNAb«.CIC01I 52.50 t `2I820t7 AL31( 1 .Sevr.MArre 17001 $2500 1 102/!01!'Am Scalar Writr SWritfan I 7800.00 ~• —1 I2 MO„�ALS1 S 3. 9br Wert fan 372502/!2017 ALS, •9una5.,.Stele 14•114•113 lin 50000 1 7/4120171 ALS1 Y ------ TBrrr Stale meets mel, 777.50 I. 1V7I20,T;AU, I1 k.,..,.- ,.*sr 7800.00 �]/Tl20,lI Aut i 1 Harem-arm ILad- U210 L 2///20111 ALS1I ;it., •Owe!War 1 72500 I 4217/201T'.ALN I Hanna^ Waal aal $25.00 I i 2/7/2017,ALS1 I. i Sr11y H..gcare 7800.00 IiN/20171ALS1 • I SrplHwlcre 51800 I 2/7/20171 ALS1 I Sam”m..rcan $25.00 2/7120„1 ALS1 f Sims/N..ecare SSm 1 i 2/720171 AUt I I Se0.rn Wa10cmotto 000 1 2f7/2017 I,AUt I i Papers 1i.N Services 33705 f 7/7120„I ALS1 1 I Marren Ir.0 Services 78 1 00.00 • _2/7/2017 ALS1 Papers II.ek 9rvare 331120 I ' y2 77/22017 ALS1 i ! UC Roe t 500.00 I -[ �_ UC Commie M 5000 1 12/1/2017� J A1U8ryt: Res $2 UHC Comm*C.mm.* m 1200 2( . 4Ir: 20,7 11.11111111- Sar07'I.elrre 7500.00 12(6201,4. S1 9x01/MHNcare 7N.50 . ( 12/2/7017 L,ALS1, S • Sap/...Irate $25.00 : I 2(N20171 ALS, 1I Ws*IMNcar. 7800.00 Management Summary City of Miami Beach EMS-E M S Billing Management Summary Report (Report as pf- 2/28/2017 REPORT 03 AMOUNT ACCOUNT BALANCE PRIOR TO I/1/17 117,456,425.% BILLING ACTIVITIES $509,724.70 Accounts bled in February-2017 COLLECTION(PAYMENTS) Payments in February-2017 8155,654.32 Undetti6M Payments $006 Refunds (11.994.76) ACCOUNTS RETURNED FOR CANOE UTION Account Closed 80.09 Account Closed-Ome 5000 Unfreeze/Unclose 1.40 AdReme,VAsagnme t-Medicaid Not Medically'Mc 94,347.45 8dRS04 74/Assi9nment-Omer (8132.94) AdluAmenVAsspnment-Omer Reduction (5700.89) Adluemett/Assgnrtent-Primary Insurance $137,444.65 Mrystment/Assigns t-Secondary Insurance $7,6233.18 ACCOUNT BALANCE AS OP 02/21/0937 917,007,300.09 i • • !OL'fEK .pmun•,hewud-luetualsypu.u.snlpy; 507I;9191/9 011901S *poem..keupd-we wlsyOw u6u.sn)gr S19 ; 909'91 OS0L9S puamsu�.wjy-luiwu6isYnu.u..nlpy I ZS1y 1 90919 WOOS poen..Lieu%-Wwu6np/wou.r.0y1 1S1w J 9199; 0009LS puemsul N.wud-Iwwm6nsypwwm1py 10-ww 9L9K:: • !991195 mammoth Anwud-Lw wu6ispaueu.mlpy'—' 1511• 91.IN9 1 —. O9-L9S9 puelnsul/us wud-Iwwu6ispou.unsnlpr.---- ;S18 '9U1LL IOL'S IK puunsul Al.wly-w.wu6•yPuemsn�py. 1 1011 9U01�L' T OS60LS Imams,A,.wud-w.wu8..0u.wmlptl ' 1SW i 91111/1 S ..muni lu>wu3ap/wewmlpy l(0T/!91/009; : ;LES609emsulAnwud-us wuelsypwwsnlpy, i 1 K1;99919; ILI'MS mun•upAnwpd•w.wu6np/lwwmlpy. TLS1y 91/!9 ? i(5we 5'615) 4 ...m•o.Med-weLuol Mpmwsu.•nlpy IS-11, 91079 ZS'LLSS eaugunwjaanukj W.wuSeaM/w...mlp✓ IS•5 9(099 j 1 l(9C09K) ammo.;/:wud-w.wu0laypu...mipy, /STI 91/1/9' tOS1ESS a•NL11.!9.11 !low j 906'5 1(OSLK) 1 SOUllA-.1411=1111.444.1.11117,11.91111•11./.10(I .spI Sl9 91/00/1 I /CURLS arruun..keLuald-/us wuSsp/w.wenyy �$l9 9WF11 I 09'6ETS T su ry..M_. ---^ �!!��. '/STI 9111 l/0 J la.L.K J _I A+.wud-Lw wu6lspnwwmlpy: LOW9u011 (Lf'9EK) ! puWMW/N we ud:luewudlfp/lwwmip ~l5ld f 9901/11 !1 KSMS 1 ) puunsu AmLuod•Lu.wu pu.u.miw' 1511'9011/1_ i J 560005 yy_6.1.1.(111.1...1 9 Allp'P 110T/I 9UL0/0 490'0095 I I loam nwl A,_wud'w:W�61•an11.m.;nlpl'! i(511 j 9 R t ,(9905) — --- — w+uemiuj LST/ 90601 i --.��__A.ua,�o---.,m.,w"w.,��w,.+mom_---;—_7 1 FOLK l 6 m•ul 519 91/91111 i j IL.EVU j .( eouwnsul Alf wud-luewu6.sp/lu.u.snlpy : 1011.099'11 l(0Y9S) i *ammo..A/•wud_ws wu9ney9ulwsnlpy. J LOW+SU9l/9i J OL'SOLS Iuem•ul j 1sT/ e9£7/LII 1(60.sig— I Ai.luud-ry.Lu6.p.u.wplpy .019 ii, 1L i _.. I(69OOZS) I ..munp.if,n90-lu....blsppww n/py 1019 911E L/6 —._ !9ZL9IS ,w.u.m1IN. a.m..4.ninad•wta wuSispOua u.mlpy IOW 11/5719------ .mauve I pl,A 1 �.wuu.•l.o,u• 4610.4. .oIesst.I 9T1 ...... ........a."'L"'wu I •.....a _. 4 .eQ6 swum. j.. s.ma. s9v9/951 S-Lc/4mm}or&.p e Ilelao kewwns luawa2eueyy AR Aged Trial Balance City of Miami Beach EMS-E M S Billing Accounts Receivable Aged Trial Balance Report as of: 2/28/2017 REPORT#4 AGE A/R Balance Percent of A/R CURRENT $492,851.36 2.79% 30 DAYS $401,358.49 2.27% 60 DAYS $331,332.31 1.88% 90 DAYS $241,952.92 1.37% 120 DAYS $255,929.10 1.45% 150 DAYS $280,822.35 1.59% 180 Days $268,464.57 1.52% 210 Days $15,394,721.24 87.14% TOTAL ########## ng A/R shown on Report#3 n net of unidentified payments to date in the amount of 5-0.00 AR Aged Trial Balance Detail City of Miami Beach EMS-Accounts Aging Details Oates of Service through:2/29/11 Current • I 100/20171 BLS unmown 5}+5001 1 2i 1/30/2017 452' Unknown 51.055.501 3 + ;14020174 431 1 Unknown --___ -$g�5p7 4 1(30/2017'12511 Medlea. I Median-FL , 390951 —f----r---1 ___ I ?aNrn^wnm: ".1 __5J ;1[102017 4311 Median _ Plans Inc. � $895.501 • 8! 11/30/2017 431 Median ' Mediare-FL ! $85950' yI 11140/2017 4011 Median 1 Median-FL $871.50; 81 114012017 451 1 Median Medicare-FL $93 72' __6 _ 1 __1/3020171 KS!i Unmown 1839_30? 10! 10020171 401 i Median Median_FL:3934.00 11+ :1402017BLS unknown - T T--;833.00. ._ • 121 1130/20171/4.01' Unmown 31.019.50: 13 11002017 4911 Medicare 1 IMle.n-FL C $92.99 i 14 11412017 401; Unknown 0849.951 r 15 '1412017 4511 Un/Mown $892.501 1811` 1002017 4511 Mn ediaPlana.Inc. $842.45, 17; • :1402017;.431 i Unknown 1 t 3873.001 18', •_ 11/302017/4511 Unmown 1 _ $83450 X191 _ 141201714511 Unknown 1 $895,50 ' 201 1 11012017,401: Unmown 1 1 $89400 211 • • :1131/20171231• MedianMIMer. F -FL I •59095: ..._�.--t-- 2211'1412017 BLS Unmown $84850' 23 11412017'.BLS Unmown 1 1 38315' 24 . 11412017 4S1 Median j Medicare-FL , $857.75 25 ;101/20171231: UnknownSkIBO 200' 126 114120177/0511• Median w Medie •FL i $811851 27 1 i 14/2017431? Unknown -- I 5870D0 23• i 1 202017 451; Medicare 'Medicw _FL , 390.85,' • ;• Healthcare 1 29 1Medicaren M 017 4911 MediMears . $843951 1 30 1 200017;431 11orketa InsuraneelOeford M.u.ne,i 191750, +t 31 1141201714511 Mldiaid l'""'"..,4„8. ..".'..".f 989700/ 1-3 12020171/001 i Median 7 Median-FL ' $845.00, 33 1 '.2/12017;x$-Median 1 Mediae-FL 1 3888.50; Unidentified Payments City of Miami Beach EMS Unidentified Payments Posting Posting Deposit Insurance .Posting Remitted Check Number Date :Penalty Amount :Amount Posting Amount '058744002 {2/82017 $0.00 $0.00 $0.0101 058772032 2/23i2017 $0.00 i $0.00 $0.00i Sum:1 $0.001 90.001 �► intermedix Responsibilities of the City of Miami Beach 1. The City of Miami Beach will comply with all Federal,State and Local laws,rules and regulations as applicable to the services being contracted. Acknowledged. 2. The City of Miami Beach will agree to use the successful firm for all medical billings exclusively for the service specified herein as long as the contract agreement is in force. Acknowledged. 3. The City of Miami Beach will make every effort to obtain the proper billing address for all billable patients prior to forwarding to the Contractor. Acknowledged. 4. The City will pay the Contractor additional fees for any postage increases that may occur during the contract period. However,this fee will only be the actual cost of increase. Acknowledged. Service Fees The Selected Proposer shall perform EMS Billing and collection services on behalf of the FIRE-RESCUE DEPARTMENT, and shall conform to the following: 1. All monies collected by the Selected Proposer shall be deposited in the designated lockbox. Intermedix works with the City's current bank as all monies are deposited into the City bank lockox account.We access EMS bank deposit information via the internet and retrieve payment information for posting purposes.This also allows us to reconcile to the bank deposit amount for accurate month end reporting.The lockbox address is used as the pay to address on all correspondence and insurance claims. We have worked with the City over the years to get several payers setup through EFT which allows for direct payments into the City bank lockbox account. 2. At the end of each calendar month Selected Proposer shall send an invoice to the Department with collection details of all Department transports entered in the Selected Proposer's billing system from the preceding month. We support this functionality currently and will continue doing so. 85 0 2017 Intermedix Corporation www.intermedix.com '► intermedix 3. The fees shall be based upon contractor performance and expressed as a percentage of actual collections remitted to the City of Miami Beach.This fee shall be all-inclusive. No additional payments shall fall due under this contract except for any refunds due contractor due to patient overpayment refunds. Please see our fees and pricing provided in Tab 4. 4. The Successful Proposer shall be entitled to fees on all collections for billings during Contract term,up to six(6) months after expiration or termination of Contract.The Department will be entitled to a refund of fees due to refunds on collections for billings during Contract term,up to one(1) year after expiration or termination of Contract. Acknowledged. Florida Certified Public Expenditure (CPE) Program 1. At the request of the City,the Selected Proposer shall provide ongoing consulting/costing services to enroll and/or maintain the City of Miami Beach in the Florida Certified Public Expenditure(CPE) Program for Emergency Medical Transportation (PEMT) and the Intergovernmental Transfer(IGT) PEMT which includes Medicaid managed care transports revenue programs. Intermedix is pleased to partner with Public Consulting Group, Inc. (PCG). PCG will perform all work in response to this requirement. PCG is a management consulting firm with 30 years of experience in providing a full array of supplemental payment program, revenue enhancement,cost reporting,and cost allocation services to state and local governments. PCG worked with the State of Texas Health and Human Services Commission (HHSC)to launch the TASPP,and was intricately involved in gaining federal approval for the program through a comprehensive regulatory process. Following inception of the program, PCG has worked with more than 30 EMS providers statewide on both program implementation and cost reporting.Through the TASPP,PCG has helped Texas providers capture an additional$135 million in supplemental payments. As a firm dedicated to serving the public sector, PCG understands the fiscal challenges that the City faces in providing quality affordable emergency medical services for its citizens.We are confident that our team's knowledge,combined with our deep experience and highly successful approach,uniquely qualifies PCG to be the firm that will help the City generate incremental revenue to alleviate fiscal pressure on the city's budget. Our firm's experience and staff expertise is unsurpassed in designing,gaining approval for, and implementing Ambulance Supplemental Payment Programs for clients,and we would be honored to be able to work with the City to do the same. PCG is an established, nation-wide consulting firm With 61 offices across the country,a presence in all 50 states,and a growing international practice,PCG offers the advantages of an established consulting firm to its clients.The 86 0 2017 Intermedix Corporation www.intermedix.com �► intermedix firm has nearly 30 years of experience working with state and local governmental agencies across the country, including a wide array of healthcare providers encompassing hospitals,school districts, public health agencies, behavioral health care agencies, and ambulance services providers.As an established,nation-wide consulting firm, PCG is financially sound and capable of withstanding the financial burden of paybacks in the case of potential audit findings by the federal government. PCG has a multitude of staff with healthcare regulatory expertise, proficiency in financial management,and strong technical and operational skills.The experienced professionals from the revenue enhancement team at PCG have worked with thousands of state and local governmental entities and have successfully recovered hundreds of millions of dollars for clients. PCG consultants are experts in OMB Supercircular(2 CFR Part 200) and Medicare/Medicaid principles of reimbursement.We have extensive experience with Centers for Medicare and Medicaid Services(CMS) cost reporting requirements and provide clients with unmatched cost reporting services. PCG has multiple staff members trained and certified by HHSC to prepare Ambulance Supplemental Payment Program cost reports. While PCG will be able to draw on a host of cost reporting experts from around the country,the City can rest assured that the project team for this engagement will be readily accessible. 87 C 2017 Intermedix Corporation www.intermedix.com . RFP 2017-002-JC / Tab 4: Cost Pro os a ( p • • • • • • • • 1 0 i :i t C r f •. d • • J. • • 1 • L h • r li- U. _ 3, e IC .11 X .• o 144 E.. ..-... II is • r i . M:. .a):___, c •..� • ©2016 Intermedix Corporation 1 www.jntermedix;com r . . t RFP 2017-002-JC TripTix Solution Along with our EMS billing and collection services, Intermedix provides the following key software and hardware items for this pricing solution: - TripTix ePCR software - 18 Panasonic CF20 laptop devices - 15 Panasonic devices for large scale events - This solution will meet all of the City's RFP criteria - Additional information provided in Appendices section aC).), " C u 31‘) u -__,, , WO eN: ..'-' x ©2016 Intermedix Corporation www.intermedix.com APPENDIX E MIAMI BEACH Cost Proposal Form 2017-002-JC Emergency Medical Transport Billing and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 RFP 2017-002-iC 47 APPENDIX E PROPOSAL TENDER FORM Failure to submit Proposal Tender Form, in its entirety and fully executed,by the deadline established for the receipt of proposals will result in Proposal being deemed non-responsive and being rejected. Proposer affirms that the prices stated on the cost proposal form below represents the entire cost of the items in full accordance with the requirements of this RFP, inclusive of its terms, conditions, specifications and other requirements stated herein, and that no claim will be made on account of any increase in wage scales, material prices, delivery delays, taxes, insurance, cost indexes or any other unless a cost escalation provision is allowed herein and has been exercised by the City Manager in advance. The Cost Proposal Form shall be completed mechanically or, if manually, in ink. Proposal Tender Forms completed in pencil shall be deemed non-responsive.All corrections on the Cost Proposal Form shall be initialed. The numbers are provided based on the City's current contract and last fiscal year performance. The City does not guarantee the same amount for future contract years. Proposer must calculate and state the extended total amount for each line, Items 1-4, culminating in a Grand Total Price to be entered below. Item Description Estimated amount %Discount Extended Total (a) (b) (aXb=c) 1 I Cost for Billing Services $2,000,000.00 7.50% % $ 150,000.00 SUB-TOTAL Extended Total Item• Description Estimated Quantity Unit Cost (Quantity X Unit Cost) 2 Medicaid Account Billin. Service 2,200 $ 9.00 $ 19 800.00 SUB-TOTAL ■ Extended Total Item Description Quantity Unit Cost (Quantity_X_Unit Cost) Lease of Computers: 3 Proposer must state an additional fee,if any for the lease of the 18",ruggedized field t8 $ 0.00 $ 0.00 com.uters as requested in Appendix C. SUB-TOTAL Extended Total Item Description Estimated Quantity Unit Cost (Quantity_X_Unit Cost) 4 Privacy Notices I 7500 $ 0.00 $ 0.00 SUB-TOTAL GRAND TOTAL(ITEMS 1-4) : $ 169,800.00 RFP 2017-002-JC 48 Proposer's Affirmation Company: Advanced Data Processing, Inc.,a subsidiary of Intermedia Corporation Authorized Representative: Ken Cooke,Chief Operating Officer Address:6451N. Federal Highway, Suite 1000, Fort Lauderdale, FL 33308 Telephone: 954-308-8700 - Email: Ken.Cookeaintermedix_corn Authorized Representative's Signatu.___ .( 13_,____ Balance of Page Intentionally Left Blank RFP 2017-002-IC 49 RFP 2017-002-JC Alternative ESO Solution Along with our EMS billing and collection services, Intermedix provides the following key software and hardware items for this pricing solution: - ESO ePCR software - 18 Panasonic CF20 laptop devices - 15 Panasonic devices for large scale events - This solution will meet all of the City's RFP criteria - Further information about ESO is provided in our the Appendices section ^ IsC) u --, ©2016 Intermedix Corporation www.intermedix.com APPENDIX E LCA MIA/\AIE A Cost ProposalForm 2017-002-JC Emergency Medical Transport Billing and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 RFP 2017-002-JC 47 APPENDIX E PROPOSAL TENDER FORM Failure to submit Proposal Tender Form, in its entirety and fully executed,by the deadline established for the receipt of proposals will result in Proposal being deemed non-responsive and being rejected. Proposer affirms that the prices stated on the cost proposal form below represents the entire cost of the items in full accordance with the requirements of this RFP, inclusive of its terms, conditions, specifications and other requirements stated herein, and that no claim will be made on account of any increase in wage scales, material prices, delivery delays, taxes, insurance, cost indexes or any other unless a cost escalation provision is allowed herein and has been exercised by the City Manager in advance. The Cost Proposal Form shall be completed mechanically or, if manually, in ink. Proposal Tender Forms completed in pencil shall be deemed non-responsive.All corrections on the Cost Proposal Form shall be initialed. The numbers are provided based on the City's current contract and last fiscal year performance. The City does not guarantee the same amount for future contract years. Proposer must calculate and state the extended total amount for each line, Items 1-4, culminating in a Grand Total Price to be entered below. Item Description Estimated amount %Discount Extended Total (a) (b) (a X b=c) 1 Cost for Billing Services $2,000,000.00 8.25% % $ 163,000.00 SUB-TOTAL Item Description Extended Total P Estimated Quantity Unit Cost (Quantity_x_Unit_Cost) 2 Medicaid Account Billin. Service 2,200 $ 9.00 $ 19 800.00 SUB-TOTAL Extended Total Item Description Quantity Unit Cost (Quantity X Unit Cost) Lease of Computers: 3 Proposer must state an additional fee,if any 18 for the lease of the 18th ruggedized field $ 0.00 $ 0.00 cam.uters as requested in Ap.endix C. SUB-TOTAL Item Description Estimated QuantityUnitExtended Total Cost IQuantiry X Unit Cost) 4 Privac Notices 7500 1 $ 0.00 $ 0.00 SUB-TOTAL GRAND TOTAL(ITEMS 1-4) : $ 134,800.00 RFP 2017-002-JC 48 Proposer's Affirmation Company: Advanced Data Processing, Inc., a subsidiary of Intermedic Corporation Authorized Representative: Ken Cooke, Chief Operating Officer Address:6451N. Federal Highway, Suite 1000, Fort Lauderdale, FL 33308 Telephone: 954-308-8700 Email: Ken.Cooke(iintermedix.com Authorized Representative's Signature. _ Balance of Page Intentionally Left Blank RFP 2017-0021C 49 RFP 2017-002-JC Alternative SafetyPad Solution Along with our EMS billing and collection services, Intermedix provides the following key software and hardware items for this pricing solution: - SafetyPad ePCR software - 18 Xplore D10 Tablet devices - 15 Samsung tablet devices (with protective cases) for large-scale events - This solution will meet all of the City's RFP criteria - Further information about ESO is provided in our the Appendices section ©2016 Intermedix Corporation www.intermedix.com APPENDIX E 1\/\ lA/V\ 1 BEACH Cost Proposal Form 2017-002-JC Emergency Medical Transport Billing and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 RFP 2017-002iC 47 APPENDIX E PROPOSAL TENDER FORM Failure to submit Proposal Tender Form, in its entirety and fully executed,by the deadline established for the receipt of proposals will result in Proposal being deemed non-responsive and being rejected. Proposer affirms that the prices stated on the cost proposal form below represents the entire cost of the items in full accordance with the requirements of this RFP, inclusive of its terms, conditions, specifications and other requirements stated herein, and that no claim will be made on account of any increase in wage scales, material prices, delivery delays, taxes, insurance, cost indexes or any other unless a cost escalation provision is allowed herein and has been exercised by the City Manager in advance, The Cost Proposal Form shall be completed mechanically or, if manually, in ink. Proposal Tender Forms completed in pencil shall be deemed non-responsive.All corrections on the Cost Proposal Form shall be initialed. The numbers are provided based on the City's current contract and last fiscal year performance. The City does not guarantee the same amount for future contract years. Proposer must calculate and state the extended total amount for each line, Items 1-4, culminating in a Grand Total Price to be entered below. Item Description Estimated amount %Discount Extended Total (a) (b) (a X b z c) 1 Cost for Billing Services $2,000,000.00 8.00% % $ 160,000.00 SUB-TOTAL Extended Total Item Description Estimated Quantity Unit Cost (Quantity X Unit Cost) 2 Medicaid Account Billin• Service 2,200 $ 9.00 $ 19 800.00 SUB-TOTAL Extended Total Item Description Quantity Unit Cost (Quantity_X_Unit Cost) Lease of Computers: 3 Proposer must state an additional fee, if any 18 $ 0.00 $ 0.00 for the lease of the 18th ruggedized field computers as requested in Appendix C. SUB-TOTAL Extended Total Item Description Estimated Quantity Unit Cost (Quantity_X.Unit Cost) 4 Privac Notices 7500 $ 0.00 $ 0.00 SUB-TOTAL GRAND TOTAL(ITEMS 1-4) : $ 179,800.00 RFP 2017-002-JC 48 Proposer's Affirmation Company: Advanced Data Processing, Inc.,a subsidiary of Intermedix Corporation Authorized Representative: Ken Cooke,Chief Operating Officer Address:6451N.Federal Highway, Suite 1000, Fort Lauderdale, FL 33308 Telephone: 954-308-8700 Email: Ken_Cookeaintermedlycom Authorized Representative's Signature: ----7 - . &:::_w____ Balance of Page Intentionally Left Blank RFP 2017-002-IC 49 RFP 2017-002-JC Appendices L f ©2016 Intermedix Corporation 'wiw.intermedix.com RFP 2017-002-JC Tri pTix Solution ©2016 Intermedix Corporation www.intermedix.com TripTix ePCR TripTix ,the Intermedix'proprietary ePCR(Patient Care Record)solution,is a NEMSIS 2.2 Gold and NEMSIS 3.0 Compliant data-collection toot for individual EMS,fire,and first responder agencies.With TripTix,ambulance crews can quickly and securely complete patient incident reports that are then automatically integrated with our powerful billing system for quick revenue return. The application's unique call flow design allows the field user to enter data into their medical record as they progress through the natural flow of their call.Each screen is designed for ease of use to maximize data capture while minimizing effort.This approach allows the report writer the flexibility of real-time data entry and the ability to generate documentation at call conclusion.The ePCR records reside on the same platform as our billing system,allowing transfer without any translation or restriction of data. Currently,two solutions are offered-TripTix Mobile's and TripTix Webs.TripTix Mobile is available as an application on a number of devices,including any Windows 7 device or higher.These devices are portable and allow you to open,complete,and upload PCR data in the field as a call is taking place. jkt raft k TripTix Web provides the same functionality within P.riEV• :N4E$E v-n:I„ RUN RECORD BILLING SYSTEM a Web interface and provides the option for your medics to.upload their run records from their devices and finish at a later date.The Web application provides additional features for administrators,such as reporting,QA/QI,and other administrative tasks. DEVICE COMPATABILITY TripTix 4.0 will run on any Windows operating device,version 7.0 or higher. We recommend the following devices: • Surface Pro 15/128 GB SSD model Nexus Tablets Optimal recommended screen resolution for TripTix 4.0 is a combination touch and digitizing screen(stylus) for best user experience and signature capture fidelity. Screen Size Sweet Spot:10-12" Screen Resolution:As low as 1024x768/Best at 1920x1080 or higher CPU:Best with Intel Core i3 or higher. ©2015 intermedix Corporation f www.intermedix.com STARTING A NEW RUN Demo 13l1) gra DE NODepRn.nt Opp VNwt Can Wad Now.Records bateirs MA OM 1.0trantall .0.W ft! ,Mall avtl.0WQ \ vC�CRSYWTR°4:a Q a°Y&x,a.Wn9Q i fnr ret TN>nl,f.wase •na.r i.]OV L5••to iaJ trnr SECURITY TripTix meets all federal and state confidentiality,security,and transaction code requirements,including the HIPAA Transaction Code,Privacy,and Security Regulations.TripTix systems are fully compliant with Medicare and Medicaid guidelines,adhere to HIPAA HITECH regulations,and are NEMSIS Gold compliant. TripTix 4.0 is NEMSIS 3.0 compliant,ensuring that our solutionis ready to meet the future needs of the industry. In addition,TripTix requires an individually assigned user log-in and password.This approach ensures security for crew entry and data transfer.When one crew member needs to exchange a tablet with another crew member,the first crew member logs out of TripTix and hands off the tablet to a second crew member who can immediately log in and begin recording a run report. IMPORTING PATIENT INFORMATION SSN AND DRIVER LICENSE LOOKUP After opening a new PCR,a medic can look up patient demographics electronically - """°`"""MO by entering the patient's Social Security +7 '.'p,. 0 PATIENT 0 IDENTRI Number or Driver License number.The system then locates the patient's 1=1 --- � .p...m,.aa.° O.a.,llap. information in a comprehensive database ,°,�Munn,nam , •to quickly and accurately fill out their °w�" �'oft"�" waW pp. demographics and medical history on _ w � DENocwA°Hlcs your run record.You can also use devices "°""p° " °°°�^�_ ,-' ' .K..II..u, dit "R with uilt in scanners to scan a patient's .o,aa,p,.a. p driver license barcode directly. ©2015 Intermedix Corporation www.intermedix.com For new patients,the Address,DOB,SSN,and Phone fields may be populated.For repeat patients,the previously mentioned fields plus Gender,Ethnicity,History,Medications,Allergies,Physician,Insurance,and Responsible Party/Next of Kin may be populated. CAD Within the application,you can import CAD data into your run record when your system has been configured for CAD integration.Some items that are imported include response times,destination and pickup locations, and specific incident information. CARDIAC MONITOR You can transfer your patient's critical data into the run record using various technologies,such as Bluetooth•', from the ZOLL©E,M,and X series monitors;Philips MRx monitors;and LIFEPAK"12 and 15 EKG directly into the application on your device.You can select the monitor icon on your system toolbar to interact with the monitor device you are using on the patient.The system allows you to select any cases,waveforms,and any additional data that you want to include in the run record.You can edit and review the imported information within the Monitors page,which opens immediately after import. ENTERING EPCR DATA • EFFICIENT TOUCH SCREEN AND TABLET ENTRY TripTix extensively uses the touch screen and pen-tablet entry features to increase efficiency for field personnel. The application minimizes the time required to enter data and complete patient records with features such as drop-down lists,point-and-click methodology,and color-coded fields.It also provides protocol-based and medical-oriented choices,which simplifies on-scene medic entry and documentation of patient care. Additionally,the handwriting recognition software has proven to be adaptable to a wide range of users,even those with poor handwriting characteristics. 4'_'a" 0 CHIEF COMPLAINT 0 CHIEF COMPLAINT '+•a O ra+awa, ..,.. 0I== 111.77Mrilerliniing C2:9 Oisatawat 9 mann w 3 - ��2015 Intermedix Corporation ! www.intermedix.com FLEXIBLE FIELDS AND PICK LISTS You have the ability to customize fields as well as add new fields and field options to meet variations driven by your specific department protocols.Fields can be set to auto-populate your pick-up and destination facility information so that crews simply choose a facility from a pick list to populate the full address in the ePCR.In addition,the Incident page can be formatted to include agency-specific default information. Customization is accomplished at the client level with TripTix 4.0. CONTEXT-SENSITIVE FORMS TripTix simplifies medic interaction through context-sensitive forms,which causes the application to display specific fields and pages based on other field selections.For example,data required exclusively for motor vehicle accidents appears only after selecting MVA as the incident type. SIGNATURE CAPTURE TripTix provides Medicare and HIPAA-compliant signature capture for billing authorization purposes.Medics can choose from several signature templates available in the application,and the language can be customized to meet your needs or provide typical compliance language.After a medic captures the necessary signatures and submits the run record,the signatures are stored on the application's server for legal proof of authorization and patient acknowledgement. In addition,these"smart"electronic signature forms pull information from the run record at signing so that very little,if any,manual entry is necessary. W JMR W MY RMNI, 4.•t-14...1rM•••W Orr 4+owx Rem.*wr.w..w• sb.er.:rna m. • Cave* • ©2015 Intermedix Corporation j www.intermedix.com EVENTS The Events page allows you to document a chronological list of treatments and interventions provided during the call as well as the date and time •."'""" e` EVENTS they took place.Required events are flagged as " " —` errors when they are left blank,which forces a medic to add the necessary events before submitting the e.PCR.Information entered into the Events page is m�•. r .w- linked to the narrative generator for automatic insertion into the narrative. """"` ° n.m� •� --- Additionally,events can be imported directly from ... . .,R _,– a CAD when your system has been configured for CAD integration. TRANSMITTING RUN RECORDS FAXING The Fax-on-Demand feature allows you to send report drafts at will FAX SELECT CONTENT and transmit 12-and 15-lead data to the destination hospital.This 123457890(Sample Fax 1) gia_ electronic routing eliminates the need for field printing by offering a simple way to maintain and manage facility FAX phone numbers and Li Transfer of Care automatically send ePCR data to these facilities. Cl Run Record _'Signature Card EKG TRANSFERRING CARE _ First Responder Report Using the Transfer of Care functionality,one crew member can send incident information via BluetootV to a different TripTix device.After the second device receives the transfer,the medic can import the data directly into their ePCR for the incident. UPLOADING TO THE WEB The TripTix platform allows you to upload any unfinished ePCRs to the Web interface,where medics can complete,a record started in the field and submit it for review or to billing. ©2015 lntermedix Corporation www.intermedix.com QUALITY ASSURANCE CLOSE CALL RULES TripTix automatically validates data before finalizing a patient care report by P fla go sing s ecific fields with errors and ERROR REMAINING(4sl,W WARNING REMAINING,O) b warnings.Department administrators °®`"" " :m.. ,,""°° "" """" 0 .'"° '.°�""' CMS*to.Ingo. ,a can set specific fields to generate errors I icazadmon and warnings with TripTix 4.0.The NsponeaMS W.A..EyNMp system flags errors and warnings while „,,,,L,,. CalkS,lepa,° the record is being created and lists "`o"""- ,,.�. j I them on the Final page.The medic must O ,ecnealer bowmen Itssah correct all errors prior to submitting the e- Vataa*Caaatn�'we.Gal a.. I . report,which reduces documentation �. errors that can delay the billing process. _ . ; _ _ SUPERVISOR REVIEW Based on your department configuration,an administrator may perform a Supervisor Review on the Web interface before a PCR is finalized to ensure that the report contains the necessary information and does not contain any errors.During Supervisor Review,the administrator can enter comments and return the report to the writer for modifications or approve the report for finalization.After the PCR has been finalized and submitted to billing,it can undergo both Peer Review and Audit Review for quality improvement. PEER REVIEW With Peer Review,administrators can assign a redacted version of a completed run record to any user in a department.The assigned user receives an email regarding their review assignments and can then make comments regarding weak points in the report.He or she saves any comments and submits it back to the administrator,who can then return the report to the writer.The reviewer and the writer remain anonymous to protect the privacy of all involved parties. AUDIT REVIEW With Audit Review,administrators can review all-inclusive(unredacted)versions of a completed run record.In addition to being able to make comments about the run record,administrators can request addendums and add instructions regarding additional information the writer should gather for the run record.The addendum request appears on the writer's home page,and the administrator receives an email when the addendum has been added.Once approved,addendums become part of the legal ePCR. • ©2015 Intermedix Corporation www.intermedix.com Administrators who perform audit reviews can amplify the process by using audit protocols,which allow them to specify rules that run records should follow.For instance,a rule can be created which indicates that on all calls where a seizure is involved,the medic should always document blood glucose levels.If the blood glucose levels field is empty in a seiz ure incident,the system flags it and displays the flag next to the run record on the Audit Review page.The administrator can then review the flags before performing the audit review and indicate whether any remediation activities were conducted for the break in protocols. Comments entered during the Supervisor Review,Peer Review,and Audit Review processes are for internal use and do not become part of the legal ePCR. REPORTS Intermedix•is committed to providing clients with flexible and innovative reporting solutions.The reports available in the Web application are designed to allow administrators to analyze operational,clinical,and mission-critical data within the system.The ability to analyze trends by incident type,such as illness,injury, symptoms,and procedures,is provided as a standard feature. SYSTEM ARCHITECTURE The TripTix ePCR solution is offered in the Software as a Service(SaaS)model,which means crews will access the latest version of the system each time their device goes through the power-up sequence. 2015 Intermedix Corporation ! www.intermedix.com Panasonic _ ___ _ _ . . , ___________ _ _ 0.,.....„, •. . . , 3 _ 1 yd a .,...may - .Ejro. Panasonic recommends Windows_ • tOUGHB0OK20 , • io.r Fully Rugged PC For Use asa Laptop THE WORLD'S FIRST FULLY or Tablet ■ Sunlight-viewable Display Works With or RUGGED DETACHABLE LAPTOP. Without Gloves The Toughbook 20 is the first fully rugged detachable PC with a removable a Optional Bridge Battery Enables Hot-swap MILS I U- keyboard that quickly transforms from a laptop into a fully functioning Battery Replacement for Continuous Use 8106 tablet with just one hand.At only 3.9 pounds,its good on the go with a n Integrated 2nd Battery,SmartCard,Barcode, MILS I U- clever built in handle that also functions as a kickstand,an optional bridge Magstripe,Fingerprint.Serial Options 461 F and More battery allows hot swappable battery replacement white running without IP65 disruption and the broadest range of ports and integrated options in its ® Built-in Handle Also Functions as a Kickstand ANSI class.The Toughbook 20 display can be used with or without gloves and • Industry leading driver packages for ease of Jaz LOC its sunlight-viewable 800 nit IPS display with direct bonding enables wider deployment and support CACP PATNG viewing angles and richer colors. 1.800.662.3537 TOUGH PADS us.panasonic.com/toughbook/20 PSC-M162SBss TOUGHBOOK20 r Panasonic recommends Windows. SOFTWARE Windows°10 Pro 64-bit(available Windows 7 Professional downgrade option) SECURITY FEATURES Panasonic Utilities(including Dashboard).Recovery Partition ■.Password Security:Supervisor,User,Hard Disk Lock Enterprise ready driver packages including CAB files and one-click driver bundles ■Kensington cable lock slots x2(on tablet and keyboard dock) •Trusted platform module(TPM(security chip v.1.2' DURABILITY MIL-STD-810G certified—(4'drop-5'tablet only,shock,vibration,rain,dust,sand,altitude,freeze/thaw, ■-Persistence°technology by Absolute embedded in BIOS' high/low temperature,temperature shock,solar radiation,salt fog,humidity,explosive atmosphere)' •■Optional fingerprint reader' MIL-STD-461F certified' U Optional insertable Smartcard reader' IP65 certified sealed alt-weather design' ■Optional contactless SmartCard/NFC reader' Optional hazardous location class I division 2,groups ABCD certified model - -ISO 14443 A/B compliant Magnesium alloy chassis encased with ABS and elastomer edges WARRANTY Built-in dual purpose handle&kickstand Solid state dove heater ■3-year limited warranty,parts and labor Removable battery Optional rotating hand strap DIMENSIONS&WEIGHT Reinforced locking port covers •10.7'(U x 9.2'(W)x 1.3'(H)" Raised bezel for LCD impact protection •3.9 lbs." Preinstalled replaceable screen film for LCD protection CPU Intel°Core"m5-6Y57 vPro"Processor •HIWSI/(SAS L0001ATI201 CERTIFICATIONS 3 -1.1GHz with Turbo Boost up to 2.8GHz -Optional I division 2,groups ABCD certified model -4MB Cache • INTEGRATED OPTIONS" STORAGE&MEMORY ■8GB or 16GB SDRAM(DDR3L-1600MHz). ■Choice of dedicated GPS(u-blox NEO-M8N1 or 4G LTE multi carrier mobile ■ 128GB SSD with heater' broadband with satellite GPS ■Optional 256/512GB SSD with heaters' ■Choice on tablet of 10/20 capable barcode reader)N6603),serial(true), •Optional OPAL encrypted SSD with heater or second US8 2.0 ports ■Choice on tablet of magstripe reader(future availability),insertable Smartcard DISPLAY ■10.1"WUXGA 1920 x 1200 reader,contactless SmartCard/NFC reader or fingerprint reader' -10-point� capacitive gloved multi touch •8MP yrear camera -2-800 10pt nitpacitive gloved multi touch r•digitizer BridIll■256/512GB SSD with heaters IPS display with direct bonding •OPAL encrypted SSD with heater Anti-refflective(AR)and anti-glare(AGI screen treatments Intel HD Graphics 515 ACCESSORIES" 4 monitor support L AC Adapter 65W(3-prong) CF-AA6413CM Concealed mode(configurable) Battery Pack CF-VZSUOQW AUDIO 4-Bay Battery Charger CF-VCB201M Integrated dual array microphone LIND Car Charger T20W CF-LNDDC120 Intel°High Definition Audio compliant LIND Solar Charge System PASC1580-4464 Integrated speaker ToughMate ComUniversal Jr.Carrying Case TBCCOMUJR-P On-screen and button volume and mute controls • ToughMate Backpack TBCBPK-P ToughMate Mobility Bundle TBC2OMBB0L-P CAM ERAS 1080p webcam with dual array mic and camera on/off indicator Rotating Hand Strap CF-VST2011 U Optional 8MP rear camera with autofocus and triple LED flash Desktop Dock CF-VEB201U Vehicle Cradle(no electronics) KEYBOARD&INPUT Waterproof IP55 stylus pen with integrated stylus holder,tether and cleaning cloth -Panasonic Keyed Alike CF-CDS2OVMO5 Supports glove mode and rain mode -Panasonic Keyed Differently CF-CD520VM06 7 tablet buttons(2 user-definable A1/A2 buttons) ■Vehicle Docks Ino pass-through) On-screen QWERTY keyboard -Panasonic Keyed Alike CF-CD52VM02 82-key with dedicated Windows•key -Panasonic Keyed Differently CF-CDS20VM04 Emissive backlit keyboard •Vehicle Docks(dual pass-through) Pressure-sensitive touchpad with multi touch -Panasonic Keyed Alike CF-CD52 -Panasonic Keyed Differently CF-CDS2OVM01 VM03 INTERFACE&EXPANSION On the tablet: •AntennaPlus Dual LTE&GPS Antenna Kit a,a -Threaded Black Mount AP-PAN-CCGPD-Q-BL -USB 3.0 x1(optional 2nd USB.1 Type A -Threaded White Mount AP-PAN-CCGPD-Q-WH -US8 3.0 is high powered 1.5A USB(Always on USB,USB rapid charging) •Cradlepoint Router -MicroSOXC UHS-I -Verizon CP-18R1100LPE-VZ -HDMICP-IBR1100LPE-AT -10/100/1000 Ethernet RJ--45 •Multi Touch 1P55Stylus CF-VNP022U -Optional Serial(True)'.' D-sub 9-pin ■Multi Touch+Digitizer IP55 Stylus CF-VNP023U -Headphones/speaker Mini-jack stereo -■Tether CF-VNTO02U -Micro-SIM 3FF ■Spare Keyboard CF-VEK201LMP ■10.1'LCD Protector Film CF-VPF31U ■On the keyboard dock: -USB 3.0 x2,USB 2.0 xl Type A Please consult fare matter or Panasonic representative before purchasing. -SDXC UHS-I 'Tested by national Independent third gp -HDMI Type A p party 4.21 and 1n MIL-SN-810G Method 111.6 Procedure IV for tiro -VGA D-sub 15-pin test and IEC 60529 Sections 116.116.1,1415 and 11.71or IP65. -10/100/1000 Ethernet RJ-45 '1G8.1,000,000,000 bytes iota)usable memory will be less depending upon actual system configuration. -Serial(USB( D-sub 9-pin Please contact your resdtu or Panasonic representatived you are interested in the 1668 memory. 'Barcode.Serial Itruel and 2nd USB 2.0 Port are mutually esdusne. WIRELESS Optional 4G LTE multi carrier mobile broadband with satellite GPS' 'Serial 2nd USB and the Magstripe reader integrated options increase the overall height and prohibit use in Optional dedicated GPS(u-blox NEO MON(' convertible mode. Dual high-gain antenna pass-through 'Dedicated GPS and 4G LTE are mutually volume. Optional contactless SmartCard/NFC reader Intel°Dual Band Wireless-AC 8260 Wi-Fi 802.11a/b/g/n/ac 'Battery performance features such as charge time and Ole span can vary according to the conditions under which Bluetooth•v4.1(Class 1)+EDR the computer and battery are used Battery operation and recharge times will very based on many factors,including Security screen brightness.applicators,features.power management battery conditioning and other customer preferences. -Authentication:LEAP.WPA,802.1x,EAP-TLS,EAP-FAST,PEAP Battery testing results from MobihMark 2007. -Encryption:CKIP,TKIP,128-bit and 64-bit WEP,Hardware AES 'TPM 2.0 available upon request-please contact your reseller or Panasonic representative. 'Requires software and actuation to enable theft protection. POWER •Li-Ion battery pack: 'Magstdpe,Insertable Smartcard.Contactless SmartCardJNFC and Fingerprint mutually -Standard in tablet;optional 2nd battery in keyboard dock ger riot Readers are exclusive. -11.4V,2600mAh(each battery) e Includes tablet and keyboard dock with handle.Tablet when detached rotor(Lit 7.7"IWI a 0.6"IHI.SeriaL •Battery operation:10 hours(20 hours with opt.2nd battery)' 2nd USB,Magstiipe reader or Barcodednsertable Smartcard it tegrated options increase overall height and prohibit •Battery charging time:3 hours(3.5 hours with opt.2nd battery!' use in convertible mode. •Optional bridge battery:1 minute hot swap time "Includes tablet and keyboard dock with handle.Tablet when detached is 2.1 1k Optional TM battery weighs 0.4 Ile. •AC Adapter:IGC 100V-241V 50/60Hz,auto sensing/switching worldwide power supply "Accessories and Integrated Options m n depending on 9 P may 7 P 9 your configuration.Visit the Panasonic website POWER MANAGEMENT •Suspend/Resume Function,Hibernation,Standby kr me accessades and details. • s Ofimooaxocaq COREmS kick- ....--,-.z ma 1.800.662.3537 TOUGHBOOK° us.panasonic.com/toughbook/20 Panasonic is constantly enhancing product specifications and accessories.Specifications subject to change without notice.Trademarks are property of their respective owners. ©1016 Panasonic Corporation of North America.All rights reserved.Toughbook 20 Spec Sheet_11/16 RFP 2017-002-JC Alternative ESO Solution F;. __-.) 3‘) ("\O 31‘.: 31‘2) '--n ("..)31‘' '-.) B 2016 Intermedix Corporation www.intermedix.com .eso PROPOSAL FOR PATIENT CARE REPORT SOFTWARE City of Miami Beach RFP# - 2017.002-JC Prepared By: ESO Solutions, Inc. March 9, 2017 Table of Contents Section A: Executive Summary 3 Business Information 3 The ESO Story 3 ESO Product Suite 4 Technical Features/Security 5 Quality Management and Reporting 5 Interfaces 6 Reporting 7 Data Migration 8 Section B: Professional Qualifications 9 Company Background 9 ESO Management Team 9 Section C: Project Management and Implementation Plan 11 Electronic Healthcare Record (EHR) 11 Training Plan 11 Summary Work Plan 14 Detailed Work Plan 15 Maintenance and Support 20 Appendices: ESO Software Support Agreement 22 2 Section A—Executive Summary The ESO Story ESO has been a leading provider of integrated, innovative and user-friendly solutions for the pre- hospital healthcare industry since 2004, bringing together industry leaders in EMS, software design and information technology to deliver clinically sophisticated, end-user friendly Software-as-a- Service (SaaS) solutions for hospitals and emergency medical and fire services. The products are designed to help EMS and hospitals enhance the quality of care, improve efficiencies and reduce costs. Our mission is to make a difference by improving Community Health through the power of data.We have a clear strategy to help EMS create better healthcare: Digitize. Connect. Improve. We are the only company in the industry that solely focuses on this. By sharing data with hospitals, nursing homes, public health, physicians, health information exchanges and other areas of the healthcare system,EMS will take its seat at the healthcare table. Healthcare Connected ` ,.01"a • eso eso „4--# as, ESO connects EMS and a healthcare so information can be easily shared and patient care improved. Digitize Connect Improve _. _ _ . _ SySt�n'� - `FS^^ _ .. ._ ,.- =JSP srar;r-y 3 1 ESO Product Suite ESO's product experience focuses on synergistic approaches to patient care centered on ESO's flagship product — ESO ePCR. Built on next generation web technologies, the ESO Software Suite delivers powerful reporting capabilities, unmatched quality management features, and clinical and operational tools to save time and improve the quality and accuracy of patient documentation. The ESO Software capabilities include: • ESO ePCR: Designed with the user in mind with flexible workflow, sleek modern design, and user- friendly features. ESO Solutions is a NEMSIS compliant software that sends data to EMSTARS on behalf of our clients, making data submission worry free. • ESO Quality Management Designed for administrators to powerfully manage operations through standard and ad hoc reports as well as ESO's recently released Analytics platform. • ESO QuickSpeak:An award-winning industry tool enabling EMS field providers to communicate with non-English speaking patients. • ESO Personnel Management: A centralized, organized, and complete view of important time- sensitive employee data. • ESO Fire:An NFIRS reporting tool that integrates seamlessly with ePCR and Personnel Management. • ESO Health Data Exchange (HDE):A unique, and system-agnostic exchange platform enabling secure data sharing between EMS and hospitals along the continuum of care. Our HDE platform, is the only truly bi-directional data platform on the market,where ePCR data is sent to the hospital(without the need for user intervention)and is in turn able to accept any outcome or billing demographic data the hospital returns.This powerful exchange allows EMS to increase efficiency, improve quality and ultimately improve end-to-end patient care. 4 Technical Features and Security ESO uses the Software-as-a-Service (SaaS) model of software delivery. Our data hosting facilities are SAS 70, Type II, PCI compliant and meet a number of rigorous requirements that help ensure the security of customer data at all times: • High Availability Standards — Each data center location offers 24 x 7 x 365 onsite staffing, plus a robust backbone network, redundant power and environmental controls, and other backup equipment designed to keep servers continuously up-and-running. • Unsurpassed Physical Security—ESO's state-of-the-art data centers are equipped with video surveillance systems and intercoms and require dual-token authentication for access. • Reliability and Backup — ESO schedules off-site,automatic client data backups nightly, up to the last committed transaction. • Disaster Recovery—ESO's disaster recovery measures include built-in redundancy for each component of the hardware infrastructure, including multiple database servers with a Raid-5 configuration. ESO employs robust encryption technology to protect client data and communications, including 256-bit SSL Certification and 1024-bit RSA public keys — the lock icon in the browser indicates that data is fully shielded from access while in transit.All HIPAA-sensitive data stored on the field device is encrypted. Any data transmitted over HTTPS protocol to the central database is encrypted. In addition, ESO employs strict operating system security, two-factor authentication and database security measures at its data hosting facilities: • All HIPAA-sensitive data stored on the field device is encrypted. • Any data transmitted over HTTPS protocol to the central database is encrypted. Additional safeguards ensure that information is not inadvertently shared with unauthorized individuals on an end user level: • Email addresses and/or fax numbers are assigned to specific incident locations. If a user wishes to email or fax a record, that record can be sent only to the address or fax number associated with that facility. • Hospital administrators who are assigned login access using ESO Hospital Linkup or Health Data Exchange will be able to access only the records for patients transferred to their particular hospital. Quality Management and Reporting ESO Solutions also provides organizations with invaluable reporting and quality management tools to mine, manage, and analyze data more effectively. ESO Quality Management allows for a paperless audit of reports for both clinical and/or operational purposes, and ESO's Analytics platform, canned reports an ad hoc reporting tools allow for graphical reporting, drill-down, report scheduling, and export capabilities 5 ESO Quality Management enables designated QM administrators to approve,evaluate, and rate a documented record electronically via a confidential messaging system.The Quality Management module makes the auditing process truly paperless by giving users the ability to message internally and allowing system administrators to provide feedback to crews without the need to print reports. ESO Reporting functionality includes real-time reporting tools for the easy creation of both canned and ad hoc reports, including report production on everything from ALS, BLS, CCT, and Detox events,to individual employees,to departmental statistics,to patient data. ESO Analytics,our newest reporting platform,gives the agency unparalleled control over their data with the ability to create, share, and save custom reports in just a few clicks. Reports can be emailed,faxed,and/or exported into Word, Excel, and PDF formats and then printed. Both providers and non-providers can access these reports and other pertinent information using their unique login ID and password;the level of security they have been assigned will determine how much and what type of data they may access once they have logged on. ESO Reporting tools are user-intuitive and eliminate the need for reporting expertise or extensive training. Interfaces ESO has been a leader in promoting interoperability across the continuum of pre-hospital and hospital care. ESO has hundreds of interfaces in production, including CAD,cardiac monitor, billing, 3rd party fire/NFIRS,and hospital information systems to name a few. CAD Interfacing ESO Solutions has more than over 300 customers actively integrating CAD data into their ePCR. CAD integration can be facilitated in one of 2 ways,depending on client and CAD vendor preferences: 1. The CAD vendor writes an output file directly to our API. 2. ESO accesses a real-time backup database of the CAD data and installs a small application that points to the database and sends the data to our Web Service where it is then easily accessed by the ePCR. Cardiac Monitor ESO currently supports Bluetooth and cable-connected integration with Physio Control cardiac monitors (LP12 and LP15). ESO is also in the process of building the Physio LIFNET cloud-based integration, slated for release this fall. Because we cannot directly go into a cardiac monitor and retrieve data,we rely on the manufacturer to develop a process to export this data,and then we import into our software.ESO processes the file and not only import the relevant data into the ePCR,but will attach the entire file to the incident so it can be reviewed in its entirety using the monitor manufacturers'review software.In addition to Physio,ESO also integrates to Zoll and Phillips cardiac monitors. 6 Reporting AD HOC Reporting ency data on hoc reporting tools available in the ESO Suite, administrators a in istr torsed, can query e ESO ad hoc, Using the any fieldp application.Reports can beexported virtually in the app� and schedule reports. administrators can also create recipient groups Anal ics of agency weaves it into an easy to understand story avesit into whileealso benchmarkingstory of ainternal pe Analytics gathers way,l dataaa and seamlessly kin g againstta that's data as ell as otherIn and nationalas measure performance we believe that it's not just of what an agency can learn from the data. Below are just a few examples data as well state and data. At ESO, important, it's also Analytics reports. T a is dDANALYTICs v •Chest?d,r. At Po:ort T r-e tJ t:. ,Ne-CG -. _AAS At Ir +',Mr+ ',MrMO iteM K4 • i ' 0 , , I. ;1 I 1 \I k% ,,,k " - k Ok k 45:22 4 7 Data Migration data from your current system into ESO so that it i file into can you run reports awellrom as ESO Solutions For can additionaldte ort a NEMSIS compliant xm one system. an fee,ESO can imp rch. take a pdf from your current system and make it available through an archive sea data from your current For those customers converting to the ESO NFIRS software,we can also import software vendor as long as they provide us with a file in the standard NFIRS foNr'mll�etermine as it takes a ro ects,which ESO Other terms and conditions will apply to data migration p 1 closer look at individual projects. 8 Section B—Professional Qualifications Company Background ESO's CEO, executive staff and management team, account managers, implementation specialists and certified software trainers have extensive experience in the pre-hospital environment.Together they bring more than 150 years of combined healthcare experience to ESO and the agencies we serve. They have served as EMT's, fire chiefs, medics, and led hospital emergency services, and relate quickly and easily to all of our clients. With a 97%client retention rate for five years running, we know that our people make the difference—and we are well known in the industry for character, integrity, reputation, and judgment. We encourage the City to contact our references and to also ask about ESO Solutions throughout the industry. ESQ Management Team Chris Dillie, Chief Executive Officer Chris was the co-founder of ESO and has been with the company since its 2004 inception, first as Vice President of Marketing and Sales and now as President and CEO,a position he has held since 2009.He brought 13 years of EMS experience and a solid business background to ESO, having served in roles ranging from EMS manager to founder of a real estate company that bought, sold and managed properties. Chris designed the first several versions of the ESO ePCR software, and his vision continues to be the driving force behind the development of new products to meet the changing demands of the healthcare market. Jim Keane,Senior Vice President of Engineering Jim brings to ESO more than 25 years of diverse industry experience with expertise encompassing software product development,web-scale solution architectures, classic Enterprise Architecture and interactive experience design. He has held director and executive positions at Hewlett-Packard,AMD, Microsoft and most recently headed Engineering Operations and Architecture for Dell.com ensuring a seamless ecommerce experience for a $12B revenue channel. Brandon Martinez, Chief Software Architect Brandon has more than eight years of experience building distributed applications across multiple industries. He is responsible for managing the design and development of ESO Solutions' diverse portfolio of SaaS products while spearheading internal research and development initiatives. Prior to joining ESO Solutions, he developed and deployed high-volume, transactional messaging applications for Dell Inc.'s global warehouse management system and authored interfaces for relaying the execution of fixed income security trades to various back-end applications at JPMorgan Chase &Co. Allen Johnson, Vice President of Health Data Exchange&Analytics Allen brings to ESO almost 30 years of EMS experience as a paramedic, educator and administrator. He most recently served as the Executive Director for Emergency Services for the HCA Gulf Coast Division where he worked closely with local EMS agencies and hospital service lines to integrate continuity of care and improve service delivery and outcomes. Prior to his work at HCA, Allen led the Montgomery County Hospital District as Chief Executive Officer and has served on numerous boards including the Southeast Texas Regional Advisory Council, Medilife, and the Wartburg 9 Theological Seminary. Allen holds a BS in Psychology and a Masters of Public Administration from Texas A&M University. Richard Hale, Director of Development Richard is an accomplished software development manager and architect with more than 12 years of diverse industry experience, including emphasis on enterprise relevant business intelligence and large scale highly transactional systems development. In his last position prior to joining ESO Solutions, he served as Director of Business Intelligence for Multimedia Games Inc., where he expanded the company's product line to include geographically dispersed centrally managed electronic video lottery and back office casino systems. Richard's primary role at ESO is to advance the company's product development processes and to expand our product portfolio utilizing innovative techniques and cutting-edge technologies. Michael Sias, Legal Counsel Michael has held a variety of positions in both business and the legal industry,including attorney, Corporate Counsel and Director of Business Development, analyst and marketing strategist. He completed his undergraduate studies at Duke University and then went on to earn M.B.A.,J.D.and L.L.M. degrees. Prior to joining ESO, he worked for the Office of the Colorado State Attorney General, Savoy Holdings, Savvy Marketing Group, Cam ras Vision and Sias Law Offices. He is responsible for contracts and process improvement at ESO. 10 Section C—Project Management and Implementation Plan ESO Solutions,founded in 2004,currently serves 1,900-plus agencies and 55,000-plus end users across more than 46 states.We serve agencies large and small, urban and rural,and our clients include federal, regional, and local government agencies, hospitals,volunteer departments,and private agencies, by providing an electronic patient care reporting(ePCR) software solution for the pre-hospital environment. Electronic Health Record(EHR) ESO's hosted, Software as a Service (SaaS) solution enables agencies to run the EHR system from any computer with an internet connection, as well as from a mobile component for data entry at the patient's side.This hosted model makes our solutions fast and easy to implement,and there is no upfront investment for server hardware. Updates to the software are automatically deployed to end users, reducing demands on the ever-increasing needs of agency information technology staff. Further, our customers rest assured that our data hosting facilities meet rigorous requirements to protect customer data at all times through high availability standards, unsurpassed physical security, reliability and backup, and a disaster recovery plan. ESO employs over 100 employees, most of whom work in the Austin office. Regional account representatives typically live in the region in which they work,while support, implementation and development staff work out of the office in Austin,TX. In implementing the SaaS model, ESO works with agencies in proposed 11-step implementation process. The process is led be one of ESO's three implementation specialists and delivered by a client services administrator, a support manager assisting in the CAD and billing interfaces, and a technical product manager assisting agencies with new software features as well as billing and state extract processes. In addition, based on the segment of implementation,specialists that are part of the client services team assist the agency in implementation. Training Plan Strategy ESO Solutions' blended implementation and training plan relies on both on-site and remote,off-site training. Having implemented over 1,400 customers, ESO provides flexible training options to meet the specific needs of your agency. Outlined in the section above is our typical approach, however we can customize the plan according to your desired roll-out plan. Vendor Roles&Responsibilities The roles and responsibilities of ESO Solutions in the design and implementation of training is included in the sections above and below,detailing the milestones of project implementation. ESO understands the importance of making sure you know how the product works and how to best incorporate the product into your dailyoperations. We take great in working hand in hand with the customer during 11 implementation and beyond. Staff Roles&Responsibilities The milestones listed below include the responsibilities of your agency's staff in the implementation of ESO software. Coordinating training dates, and testing the software are a few of the items that can either speed up or delay the implementation timeline. The proposed work plan is a guide. We will work closely with designated project managers for a smooth implementation. We understand the scheduling needs of the emergency services environment, having successfully implemented the software for more than 1,400 clients of varying sizes and needs. Interfacing with CAD typically involves assistance from the CAD vendor and while we can typically complete the ePCR portion of the interface within a six-week period, we do not have control over the CAD vendor's participation, schedule, and needs. In this case, with multiple vendors involved, the ESO software will be up, running, and working but there are no guarantees that the interfaces will be complete by the desired go-live date. Personnel involvement and decision points milestone stages include: a. ESO's implementation specialist provides your agency's project manager a project planning worksheet to identify the organization's key players who will participate in implementation and the ongoing administration of the software.These individuals include agency administrators,quality management administrator(s), and any software release recipients. b. Agencies provide ESO with vendor contacts(i.e.,fire, billing, CAD,or any other). c. ESO's implementation specialist and your agency's project manager will work together on scheduling, frequency of meetings, and other meetings to discuss progress. d. You return a 'setup' file prior to milestone 3. This information includes personnel, medic units, vehicles, facilities to and from which your agency commonly transports patients, and more. e. ESO provides designated users with a user name to create a password, log in to the system, and complete the agency setup process. f. You install ESO ePCR Mobile on agency tablets computers. g. Online administrative training (milestone 4) typically lasts three hours and should be attended by those individuals participating in system administration and having a good understanding of your processes. h. ESO utilizes GoToMeeting for online training and the maximum number of attendees is 25. i. Online Quality Management/Reporting takes place on a scheduled bi-monthly basis. We recommend that those individuals involved in the overall performance process attend. The training takes about two hours. j. About ten days before the system goes live, ESO provides onsite training in order to familiarize end users with the features and functionality of the suite. The goal is to reach as many field users as possible. ESO offers two classes per day with each class lasting about 3-4 hours. Power users—those individuals that will use and teach—will generally attend a morning and afternoon session. k. Power users received advanced information about the ePCR suite and should be comfortable with technology, be ESO champions, and have a clear understanding of the organization's internal processes. I. Ideally, the number of participants in an onsite training class is 20, and in a training room with 12 a projector and wireless Internet connection. m. System administrators should also plan to attend at least one of the power or end user classes. n. ESO suggests that attendees be off-duty for power user/end user training. o. ESO suggests to administrators that the personnel/hardware ratio be no more than 3:1 to create an optimal learning environment. p. Agencies are encouraged to move to full system use within ten days of training. q. ESO provides training guides and videos at all points of set up, training, and live use. Such tools are regularly updated to include during software upgrades. r. Designated users will go through training on the state registry site. s. The agency submits a copy of the executed business associates agreement. Knowledge Transfer ESO places a special emphasis on the 'train the trainer concept' by identifying the need for"power users"to receive more advanced,or detailed,training.These power users are expected to learn the product well enough to educate future employees and provide refresher training if necessary. Further, once the system is placed into production, ESO offers customer support,regional learning opportunities, and a host of materials available for training.We do not train our agencies and leave—we support our agencies and their end users through the lifetime of the contract. Customer support is included within your contract. Implementation Schedule ESO's schedule contains specific milestones with a description of the deliverables associated with each milestone. During the project kick-off phase dates will be defined with the project implementation team. Our summary and detail work plan below presents a typical rollout process that we can condense or expand based on each agencies specific needs.Variables not controlled by ESO are items such as getting the setup file completed,providing training dates,delivery of hardware and integration with other services(i.e.CAD). Post-Initial Implementation Process ESO provides continual support to the customer.The assigned implementation manager remains the primary point of contact for 60-90 post go-live to make sure the process is running smoothly.After that initial time period,while the implementation manager and regional account manager are always available to you,the primary point of contact of any issues becomes our support department. 13 Summary Work Plan Milestone 1 Project Kickoff 2 Information Gathering and System Setup 3 Installation of Mobile Softvare and Cardiac Monitor Interface 4 Online Administrative Training(admin/overview) 5 Mobile Software Testing 6 Billing Interface 7 Online Administrative Training(QM/reporting) 8 Onsite End User Training 9 Regulatory Compliance/Data Reporting 10 System Testing 11 System Go-live and Post-implementation Support 14 Detailed Work Plan Milestone 1: Project Kickoff Deliverables Introductory Kickoff Conference Call Agency Key Players Worksheet ESO Considerations Formal Kickoff Conference Call Vendor Contacts Formal Kickoff Conference Call Meeting Notes&Timeline Project Management Expectations To initiate the implementation process,the ESO Client Services administrator will contact the agency's project manager("introductory call")to schedule a kickoff conference call, At this time, ESO will send the project manager a project planning worksheet on which s/he can identify the key players from the organization who will participate in the project implementation and the ongoing administration of the software, including, but not limited to,the Agency Administrators,Quality Management Administrator, CQI administrator, and any software release notes recipients. At that time, ESO also will send the project manager a document that highlights areas that the agency will need to consider during the transition to the ESO ePCR Suite.These may include the need to re-define certain terminology as well as outline new procedures for the organization's day-to-day operations.The agency will receive a detailed list of these areas during project implementation. Following the introductory call, a more formal kickoff call will allow ESO and agency stakeholders to make contact on a larger scale.The purpose of the call is to enable the agency and ESO implementation team members to introduce themselves and begin to discuss project deliverables, task ownership,and tentative timelines, including possible online and onsite training dates. During the call, ESO and the agency will discuss CAD and billing interfaces as well as identify vendor contacts that will assist with those interfaces. After the call, ESO will send the agency's project implementation team an email summarizingthe call and will develop a project timeline that sets forth project milestones and timeframes for: • Documentation return • ePCR system setup by ESO • Interface programming and testing, if applicable • Online administrative training • Completion of ePCR system setup • Mobile software installation and testing • End user training • End user practice • Post-implementation follow-up At this time, ESO and the agency's project lead can discuss the scheduling (frequency, attendees etc.) of additional meetings and other means to report progress. 15 Milestone 2: Information Gathering and System Setup Deliverables: Agency Account and Build Out in ESO Suite Agency Setup Preparation These activities begin after project kickoff and last for approximately two weeks.(The milestone timeframe may vary depending on how quickly the agency returns the completed setup file after project kickoff,and how quickly the agency completes its portions of the system setup after the initial setup done by ESO.) During this time, ESO creates an agency account for the agency in the ESO Suite and begins to build out the systems with the information provided on the agency's ePCR setup file, including personnel, medic units and vehicles, facilities to and from which they commonly transport patients and the like. When this setup is complete, ESO will provide designated users from each account with a user name so that they may create a password, log in to the system, and complete the agency setup. This includes: • Adding a company logo (can be completed by ESO during initial setup if preferred) • Assigning user names • Assigning roles and claims • Loading patient refusal form and/or other agency-specific,custom forms for capturing signatures in the field (can be completed by ESO during initial setup if preferred) • Adding agency-specific billing authorization language • Establishing agency password and lockout policies • Creating data retention, patient lookup and update settings • Creating new users and assigning user roles and login credentials • Adding additional facilities,units,vehicles etc. beyond those entered by ESO during initial system setup • Configuration and maintenance of clinical data such as interventions,therapies and medications • Configuration of agency's validation routine • Addition of optional, pre-defined data fields ESO will train agency administrators on this functionality during the online administrative training session and also will provide detailed help guides to assist administrators throughout this process. Milestone 3: Mobile Software Installation and Cardiac Monitor Interface Deliverable: Mobile Software Installation This task usually occurs during the client portion of system setup; however, the exact timing is at the client's discretion. ESO will send the links to the mobile software to the designated agency contact so that s/he may begin to install ESO ePCR Mobile on the agency's tablet computers. ESO provides a period of instruction for approximately two hours with,generally,two or three individuals. Installing ESO ePCR Mobile for the first time involves the followingsteps: • Install prerequisites if necessary(included as part of installation package) • Install mobile application and software for cardiac monitor interface (part of installation package)— ESO interfaces a variety of cardiac monitor devices 16 Milestone 4:Online Administrative Training(admin/overview) Deliverable: Online Training This activity typically occurs within one week after ESO receives the completed setup file from the agency. Online administrative training is intended for system administrators and takes place relatively early in the implementation process.Training objectives and activities include: • A brief overview of the ESO ePCR application • Configuration and maintenance of the ESO administrative console o Adding a company logo o Assigning user names o Assigning roles and claims o Loading agency-specific, custom forms o Adding agency-specific billing authorization language o Establishing agency password and lockout policies o Creating data retention, patient lookup and update settings o Creating new users and assigning user roles and login credentials • Adding additional facilities,units,vehicles etc. beyond those entered by ESO during initial system setup • Configuration and maintenance of clinical data such as interventions,therapies and medications This training is generally three hours in duration and should be attended by anyone who will be participating in the administration of the ePCR system and who has a good understanding of the department's processes. However, we understand training needs, and combined with the billing partner, the training event will likely be a two-day session, and we can also provide additional assistance during the on-site training sessions.ESO utilizes GoToMeeting for online training and the maximum number of attendees is25. Milestone 5: Mobile Software Testing Deliverable: Software Testing This activity occurs immediately after mobile software installation. All users should log in to both the web and mobile applications to ensure that they have been assigned an appropriate level of access to the system (i.e.that they have access to the various modules—ePCR,QM, Admin and Reports—that they will require). Milestone 6: Billing Interface(if applicable) Deliverable: Billing Interface Testing ESO Solutions has successfully completed billing interfaces to a variety of billing software packages. During the implementation phase, ESO and the billing partner will work together to test the interface. 17 Milestone 7: Online Administrative Training (QM/Reporting) Deliverable: Online Training This training takes place online as a separate online session. ESO conducts this training using regularly scheduled, bi-monthly GoToMeeting sessions and it is recommended that all of your Supervisory and Billing Staff attend.They do NOT need to pre-register for any given class.A class schedule will be provided to you at the completion of your initial Administrative Training Session as well as information on how to join the ongoing training sessions. At most,the training takes two hours. The focus of the additional administrative training is to provide: • An overview of ESO Reports • Detailed class over the usage of the ESO Quality Management system • Information specific to the processing of Billing Records Milestone 8: Conduct End User Training Deliverable: Onsite training This activity typically occurs around 10 days before system go-live on the ESO ePCR software.This final phase of training is designed to familiarize end users with the features and functionality of the ePCR module. The goal of end user training is to reach as many field users as possible and to develop a core group of power users from the EMS organization who, in turn,will develop a knowledge base for future staff in conjunction with support from ESO (train the trainer).This training takes users through each page of the ePCR application, giving them in-depth views into the functionality and usability of all aspects of the software. During thistime, users will be provided with opportunities for hands-on involvement with the software to enforce whatthey have learned and will be given ample time to ask questions about any issues they may encounter during day-to-day use.Training objectives include: • Overview of data flow and system security, including creating login credentials • Entering patient data on the ESO ePCR Mobile software as well as the web-based application (this will include descriptions of all fields and data flow explanations) • Extended sessions for training end users and troubleshooting issues (if training power users) ESO generally offers two end user training classes per day of onsite training. Each end user session lasts approximately 3 to 3.5 hours(8 hour days for power users, starting with a standard training session in the morning and in-depth training in the afternoon). Each end user only needs to attend one session.Ideally, classes of 20 or less, in a training room with a projector and wireless internet connection while end users follow along on mobile computers, are preferred. ESO's implementation team will work carefully with the agency to meet all training needs and requirements. Selecting which individuals from the organization will learn how to use and teach others to use the software is vital to the success of the project.These power users will gain an in-depth knowledge of ESO ePCR and will ensure continuity in staff education by providing training and mentoring to the rest of the organization, including new employees who join the agency after the initial onsite training and deployment have occurred.The power users selected will receive advanced information about ePCR systems in general and ESO ePCR in particular and should be comfortable with technology, be 18 champions of ESO and have a clear understanding of the organization's internal processes. Note that these individuals will not necessarily be the people with the highest rank or the longest tenure. System administrator(s) should also plan to attend at least one of the power user/end user classes.This not only acknowledges administrators'support of the new program, but it also allows them to acquire additional expertise on the software's functionality so that they may serve as knowledgeable resources. Also,ESO suggests that attendees be off-duty for power user/end user training and administrators offer a personnel/hardware ratio of no more than 3:1 to create an optimal learning environment. Agencies are encouraged to move to full use of the system within 10 days of training.Training guides and videos are available for reference by administrators and users at all points of set-up,training and live use of the system and are updated regularly to include upgrades to the software. Power users may utilize these training materials during later training sessions in the matter they see fit. Milestone 9: Regulatory Compliance Deliverable: Reporting Testing Data reporting to the agency typically happens between end user training and system go-live.As needed, the agency will be required to go through training on the registry site and submit a copy of our jointly executed Business Associates Agreement. ESO also will work with the agency to complete any necessary integration with the State and/or County Regulatory reporting systems. Milestone 10: System Testing Deliverable: Agency Sign Off Agencies are encouraged to initiate testing with ESO and move to full use of the system within 10 days of training. Milestone 11: System Go-live and Post-implementation Support Deliverables: Live System Ongoing Support Ongoing Training 19 Maintenance and Support Program Post Implementation Support ESO's account managers, implementation specialists, and certified software trainers have extensive experience in the pre-hospital environment. Together they bring more than 150 years of combined healthcare experience to ESO and the agencies they serve.Members of the ESO team have served as EMT's, fire chiefs,medics,nurses, led hospital emergency services,and relate quickly and easily to clients. With a 97 percent client retention rate for over five-years running, ESO knows their people make the difference — and are well known in the industry for character, integrity, reputation, and judgment. Agencies can contact ESO by toll free number, chat, or e-mail to handle routine as well as immediate action needs, as well as any technical question related to the software. ESO's client services team is available 24 hours per day, 7 days per week, to include holidays. The benefit of ESO's support function is that — even outside of the client services team—clients can contact ESO and speak to almost anyone and they can assist on both the clinical and operational aspects of the software and its reporting tools. Additional information regarding client support is provided in ESO's draft Subscription Agreement (Appendix A, Exhibit B). Clients may access training documents and videos from a link on the landing page of the application. Training guides and videos are available for reference by administrators and users at all points of set- up, training and live use of the system. ESO updates the training materials regularly to include upgrades to the software. ESO also provides clients a link to a reference materials page from which they may print an unlimited number of reference guides covering ESO EPCR for administrators and end users, quality management, ESO EPCR Mobile, and more. ESO also holds an annual WAVE conference in Austin, holds regional meetings, communicates via newsletters, and provides updated training tools for updates and release notes. Further, ESO implements state mandates into the software immediately, and they evaluate all requests for changes to the hardware for potential implementation. Upgrades and Enhancements Historically, ESO upgrades three to four times per.year.This occurs during the 4:00 am—6:00 am(CST) timeframe and generally only lasts 30 minutes.As a SaaS service, upgrades and product enhancements are "delivered" (available)to the user on log in. It is important to note that mobile reporting is still available during this time. User Groups ESO traditionally holds "Neighborhood Connect" meetings where current and interested end users come together to discuss needs and learn more about the software and other ESO software solutions. "Neighborhood Connect" meetings occur at locations across the country where we have a large 20 presence. Meeting sites are often determined based on a centrally located agency agreeing to host the meeting. ESO also holds an annual conference in Austin where end users across the nation gather to learn and brainstorm, as well as regional user conferences in various geographies. Bug fixes and patches Changes required by state and national agencies are implemented immediately and available to users on log in, as are any mutually beneficial updates, bug fixes,and patches. As a SaaS model, ESO's software automatically pushes upgrades and bug fixes to end users, reducing your efforts and allowing us to deliver targeted customer support. 21 Panasonic , . °apasc,„c •. , - -- - . ASA a - -, a r a , ' Baa. r r Panasonic recommends Windows. TOUGHBOOK20 t� • " . i i • io.r Fully Rugged PC For Use as a Laptop THE WORLD'S FIRST FULLY or Tablet • Sunlight-viewable Display Works With or RUGGED DETACHABLE LAPTOP. 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'Barcode.Serol(true)and 2nd USB 2.0 Port are mutually exclusive. WIRELESS Optional 4G LTE multi carrier mobile broadband with satellite BPS' 'Serial.2nd USB and the Magstripe reader Integrated options increase the overall height and prohibit use in Optional dedicated'GPS(u-blox NEO MBN)' convertible mode, Dual high-gain antenna pass-through 'Dedicated SPS and IC LTE are mutually cactuses Optional contactless SmartCard/NFC reader Intel°Dual Band Wireless-AC 8260 Wi-Fi 802.11a/b/g/n/ae 'Battery performance features such as charge fire and life span can vary according to the conditions under which Bluetooth°v4.1(Class 11 u EDR the computer and battery are used.Battery operation and recharge times will vary based on many factors,Including Securiscreen brightness,applications,features,power management battery conditioning and other wstonee preferences.-Authentication:LEAP,WPA,802.1x,EAP-TLS,EAP-FAST,PEAP Battery testing results'nom MdhleMark 2007. -Encryption:CKIP,TKIP,128-bit and 64-bit WEP,Hardware AES 'TPM 2.0 available upon request-please contact your'esetter or Panasonic represenhtve. POWER I Li—Ion battery pack: 'Requires software and activation to emote theft protection. -Standard in tablet;optional 2nd battery in keyboard dock 'Magstripe,Insertable Sma/Cord,Cantactless SmartCardMFC and 7ingerprint Readers are mutually cactuses -1 I.4V,2600mAh(each battery) "Includes tablet and keyboard dock with handle.Tablet when detached is 10.1"(U a 7.7"Nil c 0.6"IHI.Serial •Battery operation:10 hours 120 hours with opt.2nd battery)' tnd USB,Magshipe reader or Barcede.lnsemble Smarttani integrated options increase oeerall height and prohibit •Battery charging time:3 hours 13.5 hours with opt.2nd battery)` use in convertible mode. ■Optional bridge battery 1 minute hot swap time "Includes tablet and keyboard dock with handle.Tablet when detached is 2.1 tbs.Optional 2M battery weighs 0.4 lbs. ■AC Adapter:AC 100V-240V 50/60Hz,auto sensing/switching worldwide power supply Accessories and Integrated Options may vary depending on your configuration.Visit the Panasonic website POWER MANAGEMENT •Suspend/Resume Function,Hibernation,Standby kr marc accessories and details. MOW • int Imo.,x,cL) COREmS Inside" e,a1...:; • 7.800.662.3537 TOUGHBOOK° us.panasonic.com/toughbook/20 Panasonic is constantly enhancing product specifications and accessories.Specifications subject to change without notice.Trademarks are property of their respective owners. ©2016 Panasonic Corporation of North America.All rights reserved.Toughbook 20 Spec Sheet_11216 RFP 2017-002-JC Alternative SafetyPad Solution u- ,:,, __, u u c x ' (') u. c\ ©2016Intermedix Corporation www.intermedix.com RFP #2017-002-JC - EPCR Software Miami Beach Fire Department The SafetyPAD Solution OPEN incorporated (OPEN) is extremely pleased to have the opportunity along with our billing partner, Intermedix, to propose the SafetyPAD®system, a highly robust, advanced ePCR/EHR and EMS information management technology solution as part of the City of Miami Beach Fire Department(MBFD) Request for Proposal for Emergency Medical Transport Billing and Collection Services. OPEN has been developing highly successful electronic EMS informatics solutions for more than 2 decades. The SafetyPAD ePCR system was first released in 1996 after years of interviewing hundreds of EMS services. Over 20 years ago, OPEN made a corporate commitment to focus exclusively on providing innovative software and information solutions to emergency medical services, with each member of OPEN's team possessing a strong background in EMS, informatics, and EMS customer needs. Since that time,various dramatically improved generations and derivatives of SafetyPAD software and technology have been successfully deployed at numerous high-performance EMS services, effectively capturing and managing approximately 20-million EMS patient encounters electronically. In the United States, SafetyPAD serves... • The largest US EMS provider in 6 of the top 15 Metro areas • The largest US EMS provider in 5 of the top 15 most densely populated areas • 7 of the 30 largest municipal EMS departments in the US As a company with unmatched EMS informatics experience, OPEN has continued to expand its structure and presence, and with the release of our newest technologies has increased its customer base by 300%over the past 2 years. We are especially proud of our team and system's proven history of dramatic improvements in documentation quality, revenue, productivity, information management, and agency satisfaction at all SafetyPAD sites, including major metropolitan sites we support— including • Chicago Fire Department, Illinois • Miami-Dade County,Florida • Miami Fire Department, Florida • Palm Beach County Fire Department, Florida • Boston EMS, Massachusetts • Hennepin County EMS,Minnesota • Washington D.C. Fire/EMS • Detroit Fire &EMS, Michigan OPEN inc/SafetyPAD Confidential-All Rights Reserved RFP #2017-002-JC - EPCR Software Miami Beach Fire Department • Columbus Division of Fire, Ohio • Cincinnati Fire Department, Ohio • ... and numerous additional South Florida agencies SafetyPAD solution is designed for large high performance, innovative EMS agencies such as MBFR, where rapid, user-friendly, comprehensive EMS documentation at patient side along with robust integration, intelligent automation,and system-wide management are keys to overall success. Our latest SafetyPAD Android and Enterprise 5 technologies are a perfect example of listening to our customers and partners to provide an optimal solution to their growing needs by integrating the very latest in software, data sharing, cloud-based, and tablet technologies. SafetyPAD's next generation Enterprise 5 /Android hosted solution can be easily tuned to the unique needs of MBFR, including reduced agency-driven entry,a simplified user interface and entry tools that are a perfect match for larger services. In addition, SafetyPAD's architecture inherently provides incredibly powerful tools for seamless and 'full circle' integration with CAD, Hospitals, Billing, Medical Devices and other disparate systems while offering innovative and proactive monitoring, alerting and analysis technologies. OPEN is proposing a technology upgrade via SafetyPAD's ePCR/EHR system,tightly integrated with Intermedix EMS billing services as well as advanced,portable and ruggedized Android mobile tablets to optimally support field users,operational, clinical, and billing staff, and other various community partners and stakeholders. With this in mind, OPEN is proposing a phased transition from MBFR's current ePCR solution to our new generation SafetyPAD Android/Enterprise 5 system for even greater flexibility with reduced costs, ease of support and use as well as more robust features. OPEN intends to use components of MBFR' existing TripTix system configurations wherever applicable as well as utilize our highly experienced implementation team for project planning, project management/program management, systems,technical interfaces, system wide training and deployment as well as post implementation support. Upon project startup, meetings with all MBFR stakeholders shall occur to develop implementation timelines and a variety of plans to set the path forward to meet and potentially exceed the needs of MBFR. Since this is comprehensive offering,the implementation process consists of plan development, installation,testing and training and ongoing support performed by applicable personnel. The solution offers a hosted, web-based enterprise-wide platform capable of supporting all MBFB's physical and mobile locations while providing: D Rapid availability of patient care data for quality improvement, system analysis, and risk management activities D Consistent and efficient field documentation processes using the SafetyPAD platform D Improved field data capture and protocol compliance using the latest SafetyPAD technologies OPEN inc/SafetyPAD Confidential-All Rights Reserved SAFETY RFP #2017-002-JC - EPCR Software Miami Beach Fire Department > 'Full circle' data sharing and integration included in the per record cost ➢ Highly advanced, rugged, lightweight and mobile-centric Xplore Android tablets which are lighter and more mobile-centric computers than MBFR uses today. This Xplore device is dramatically more usable in the field per ALL of our customers. > Tight integration and configuration to Intermedix or another 3rd party system to further optimize billing and collections > Full support of NEMSIS 3.x and EMSTARS ➢ Enhanced reporting and automatic alerting > A foundation for future field technology initiatives Solution Objectives and Key Deliverables OPEN and Intermedix's team will target both objectives and deliverables through the formulation of plans, management of the project and enhancement of SafetyPAD mobile/Android and Enterprise and 5 components: ➢ OPEN is proposing a seamless migration path to our new generation SafetyPAD Android/ Enterprise 5 system for even greater flexibility with reduced device costs as well as more robust collection, compliance, and automation features. ➢ Hosted, secure cloud-based system with extensive redundancies to ensure optimal stability and up time (hosted under the Amazon AWS environment) ➢ Complete upgrade lo 18 of the latest hardened Android 5.x portable tablet technology, Xplore's highly rugged D10, lightweight tablet as well as offering 15 dedicated semi-rugged encased Samsung tablets for special events as well as to augment primary tablets during potential repairs. (Note: OPEN does not offer 24 device swapping but is offering Xplore's )(Defend expanded warranty as well as 15 additional, dedicated Samsung tablets—both refreshed every 3 years). ➢ Unlimited licensing and access to applicable SafetyPAD modules > Unlimited SafetyPAD Enterprise components for MBFR users (including features such as Enterprise Reporting, Caseflow Quality Assurance, Automation Agents and Reconciler)... all at no additional cost ➢ Unlimited, secure access for MBFR and its hospitals and care facilities to SafetyPAD's Health Information Exchange API, which will allow data sharing and collaboration between MBFR and each participating hospital at no additional cost ➢ Unlimited, secure SafetyPAD Enterprise ePCR viewing access for all hospitals and care facilities in MBFR and surrounding areas,or as agreed ➢ Integration with other 3rd party systems via SafetyPAD's data sharing AN as well as through data connections provided by our billing partner to ensure smooth interoperability. OPEN inc/SafetyPAD Confidential-All Rights Reserved SAFETY RFP #2017-002-JC - EPCR Software Miami Beach Fire Department > Hospital Ambulance Notification (via Enterprise viewer) ➢ Because of the inherent mobile nature of EMS, SafetyPAD's field software(operating under Android 5.x) is a NATIVE applications, not HTML5 or cross-platform systems, which inherently offer limitations in functionality,performance and features. > Comprehensive field user and administrative training (scoped with train the trainer but optional training for all MBFR staff available). ➢ Health Information Exchange and integration (such as ePCR viewing, alerting/notifications, patient lookups, imports, exports, etc. using SafetyPAD's Health Exchange, API and Enterprise features)along with additional hospital integration provided by our billing partner offering expansive data sharing and outcome capabilities > Built-in system core framework to support potential MBFR Community Paramedicine and Mobile Integrated Health initiatives > CARES (Cardiac Arrest Registry)collection and extract ➢ Proven integration with CAD through a seamless interface as well as potential interfaces with all primary CAD vendor dispatch systems, including automatic wireless delivery of dispatch details and integrated dispatch reconciliation. > Full NEMSIS 3.x and EMSTARS compliance and automated extract capabilities, API and other sharing functionality > Vastly expanded compliance to the MBFR' protocols via SafetyPAD's innovative "Interactive Guidelines", as well as SafetyPAD Android's protocol compliance and rules engine features, all of which are unmatched in the ePCR industry,as well as nearly unlimited yet tightly integrated customer-driven clinical research capabilities and support of the broad spectrum of research, studies, and community outreach programs and support meeting MBFR' objectives of improving protocol compliance and quality of care ➢ Expanded receiving facility data access, disaster management, syndromic surveillance and operational/clinical alerting(ideal for timely awareness of H1N1,etc.),patient tracking, analysis, data management, and communications capabilities via OPEN's Enterprise Agent (formerly BioView) and MCI/patient management technologies, unique in the EMS informatics industry > Tightly integrated Digital Camera, Driver's Licensing Scanning, and other embedded interfaces D Monitor/defibrillator integration(via LifePak RescueNet cloud solution) > Various features including patient lookups, driver's licensing scanning, patient transfers, digital camera and medical device integration, auto-faxing and more > Rapid and easy-to-use yet comprehensive documentation, unmatched in the ePCR industry ➢ Autofax(if needed, may incur additional fee) > Remote,wireless updating and management of each tablet > All SafetyPAD maintenance and support for each applicable component under OPEN's support standards. OPEN inc/SafetyPAD Confidential-All Rights Reserved RFP #2017-002-JC - EPCR Software Miami Beach Fire Department ( ) SafetyPAD provides numerous features along with expansive integration to many of the components requested by most EMS providers, nearly all of which are in production or available today. We truly believe the SafetyPAD solution will exceed most agency requirements. We are confident that SafetyPAD and its array of advanced features and automation, easy of use, uncompromising flexibility, protocol-drive documentation compliance,and seamless integration ... along with a proven history of substantially improved documentation, quality, and revenues, and rapid and successful ePCR/EHR system deployments at large agencies will lead to a positive, beneficial and highly successful SafetyPAD solution for all MBFR constituents and the City of Miami Beach while dramatically reducing risk, cost, and implementation timelines for the MBFR. Key Solution Highlights Summary OPEN is pleased to convey that nearly all Scope of Work specifications can be readily supported through SafetyPAD's latest technologies specifically as defined in the RFP or via a similar means. All `ECPR Software and Patient Reporting Capabilities' and the vast majority of applicable `Security Controls—User Access Control and Security' as specified in the RFP is accommodated via technology and processes that OPEN provides to customers today: > OPEN is proposing initial a seamless migration path to our new generation SafetyPAD Android/Enterprise 5 system for even greater flexibility with reduced device costs as well as more robust features. > A hosted, secure cloud-based system with extensive redundancies to ensure optimal stability and up time > Unlimited licensing and access to applicable SafetyPAD modules > Because of the inherent mobile nature of EMS, SafetyPAD's field software is a NATIVE application, not HTML5 or cross-platform systems, which inherently offer limitations in functionality, performance and features. > Comprehensive onsite field user and administrative training(4 days onsite is included; not unlimited) > A consistent history of dramatic improvements in documentation quality and completeness as well as revenues through the use of SafetyPAD services and technologies as well as tight systems and data integration via partnerships > Health Information Exchange and integration > NEMSIS 3.x and EMSTARS compliance,API and other sharing capabilities OPEN inc/SafetyPAD Confidential-All Rights Reserved nom~ RFP #2017-002-JC - EPCR Software Miami Beach Fire Department ➢ Substantial flexibility for MBFR to shape the collection process for a variety of emergent and non-emergent EMS encounter scenarios as well as the ability to support the data management of patient follow up visits, all within the same flexible SafetyPAD platform > Optimize resource utilization as well as improve quality of care and performance KPIs. > Vastly expanded compliance to the MBFR' protocols via SafetyPAD's innovative rules- drive technologies as well as SafetyPAD Android's protocol compliance features, all of which are unmatched in the ePCR industry, as well as nearly unlimited yet tightly integrated customer-driven clinical research capabilities and support of the broad spectrum of research, studies, and community outreach programs and support meeting MBFR' objectives of improving protocol compliance and quality of care • Expanded receiving facility data access, disaster management, syndromic surveillance and operational/clinical alerting(ideal for timely awareness of HINT, etc), patient tracking, analysis, data management, and communications capabilities via OPEN's Enterprise Agent (formerly BioView) and MCI/patient management technologies, unique in the EMS informatics industry ➢ All available SafetyPAD components, modules, features and interfaces are included at no additional cost. OPEN incorporated has continually maintained a focus of developing innovative and successful mobile computing solutions. We are a technology company comprised of more than a dozen professionals, most of which have their roots in the EMS community. OPEN's staff possesses extensive experience in various aspects of systems engineering, programming, security, virtualization, networking and wireless technology offering our clients a wealth of information. OPEN's support system is second to none. We provide detailed tracking with a customer web portal allowing program managers to not only check in on the progress of projects or support requests but also interact directly with the engineers performing the work. This backend support system insures that requests never fall on deaf ears. Each agency provides primary, first line support for staff and field users while OPEN provides a second tier of support for its primary administrative and support staff 365/24/7. OPEN has a significant resource pool of highly skilled veteran providers who have used and trained others to use SafetyPAD for years and years. This combination of time on the job, teaching experience and time with the product creates a powerful and highly effective training apparatus. OPEN is not only interested in a successfully deployment and ongoing support of SafetyPAD. We also emphasize a consultative approach to work closely throughout the entire implementation process and beyond to provide and expand on a SafetyPAD solution that best suits the unique needs of each high performance agency. Nearly every SafetyPAD site, already utilizes interfaces to CAD, billing, and medical devices with all using SafetyPAD's innovative Active and Interactive Guidelines, Enterprise Reporting, OPEN inc/SafetyPAD Confidential-All Rights Reserved SAFETY RFP #2017-002-JC - EPCR Software Miami Beach Fire Department CaseFlow workflow manager, and Enterprise Agent's Syndromic surveillance and clinical alerting features. Many are also taking advantage of seamless integration to disparate systems (such as hospitals)as well as expansive user access capabilities,wireless patient transfers and automatically `pushed' reports. With all of these components combined we believe all of MBFR' stakeholders will have easy and rapid access of vital information to make informed decisions, reduces costs, improve performance and patient care, and be empowered to meet and exceed various expansive transformation goals. In summary,the SafetyPAD solution is designed for high performance, innovative EMS agencies such as MBFR and we believe that SafetyPAD, its advanced features, health exchange, history of substantially improved documentation, quality and revenues, live interfaces, highly experienced implementation and support staff... and our proven and successful ePCR system deployments at large agencies will lead to a positive, beneficial and successful SafetyPAD ePCR solution for all MBFR constituents and the Miami Beach community. OPEN inc/SafetyPAD Confidential-All Rights Reserved BAP E T • RFP #2017-002-JC - EPCR Software Miami Beach Fire Department , SafetyPAD —Android and Enterprise 5 We took our 20 years of experience in the ePCR information 'A"T""'° business and put it in our brand new SafetyPAD application for _ __---- Android mobile platforms. The full-featured EMS data collection - -- system provides an intuitive - yet fully configurable - user = _ interface that leverages a web-based portal on hosted cloud to cut = hardware costs in half. SafetyPAD Android is an ALS, BLS and First Responder total = solution for on-scene and transport patient care documentation. „ - Quickly and easily document your patient interaction and generate more thorough, error free reports, all while reducing hospital turnaround time so you can focus more on the patient and less on the paperwork. 0`ri9Y ' I SafetyPAD Android is easy to use with A m •..._ quick and easy form entry allows you �' ..�,........ ° to focus on what's important. CI= SafetyPAD Android is also the ONLY 601.• ,� FULLY CONFIGURABLE Android - .77.. application on the market today that is m..„ �'� . . ' also NEMSIS compliant, allowing cm ® r.�•••--- - - -> .�.. M 1 advanced reporting and analysis to • - -" ".= - -occur where and when you need it. Customizable template layouts, using SafetyPAD web 'Enterprise' user interface, allow services to emulate existing paper forms and streamline data entry for reduced training requirements. Mobile Features 1. Android 4.2.2 or newer, optimized for 10.1" devices. 2. Requires No IT experience to customize or maintain. Customize and setup data collection and documentation preferences based on your protocols,treatments and needs. 3. Cut your hardware costs by choosing the right, off-the-shelf Android device that meets your needs while also saving you money. We have recommended and scoped the Xplore D10. 4. 100% designed from the ground up to work on today's mobile tablets. That means information is easy to enter and the interface is optimized for touch. 5. SafetyPAD Android guides you along the way and suggests commonly used medications from our FDA medication interface, complete surgical history lists, so you'll never misspell one again. 6. NEMSIS 3 compliance,out of the box. OPEN inc/SafetyPAD Confidential-All Rights Reserved SAFETY 8 RFP #2017-002-JC - EPCR Software Miami Beach Fire Department 7. No 4G/LTE? No worries. SafetyPAD Android is not Internet based, so you can use it whenever you need it. Your report will be saved and automatically sent when you do have service again. 8. Extremely low cost per record ASP model. 9. An ePCR platform that was designed to require little training to get started. Web-Based Back-End Features 1. Client Access Website — web application server that manages authorized access to a departments PCR database. 2. Client Database — secure database that logs and stores all run data and provides HIPAA compliant storage of all EMS documentation. 3. SafetyPAD Android is fully client configurable via simple to use web-based interfaces. No system on the market today will enable you to control rule management and customization that SafetyPAD offers on our SafetyPAD Android platform. 4. Get access to the intelligence that matters to you in real-time. Detailed statistics about reports are compiled the second the report is submitted. Because the reports are accessible online,you can view them anywhere, anytime. 5. Always going back at the end of the month to fix your call sheets? SafetyPAD Android will let you know if you've missed a required field during the entry process. You control the rules. Implementation is Easy > You decide on the number of tablet devices your department needs. > We help you customize your menus and input screens per your department needs. > We create your secure website to access your PCRs (store, manage amendments, NEMSIS submittals, etc.). > We customize and setup your database (all your destination hospitals, etc.) and authorize your access to our download area. > You download and install the SafetyPAD Android Program to each of your Tablet devices. > You register each device using a Registration code we supply. ➢ We finalize the installation and download all final configurations to each device. > Complete! Your ready to run Calls! OPEN inc/SafetyPAD Confidential-All Rights Reserved • MD RFP #2017-002-JC - EPCR Software Miami Beach Fire Department 14- ) Key Staff- OPEN Mike Vukovich—CEO/Founder Mike Vukovich is the founder and President of OPEN incorporated and has over 20 years specifically in EMS field information management systems. Mr. Vukovich led OPEN over 2 decades ago to become one of the first truly successful ePCR solutions in the industry and that drive to lead the industry continues. Mr. Vukovich has been actively involved with design, development, sales, marketing, and support of the SafetyPAD product since its inception. Josh Austin- CTO (Chief Technology Officer) Josh Austin has nearly 20 years of IT experience, which combined with a background in Fire/EMS, gives him a unique skill set that is custom tailored for the EMS software development industry. Mr. Austin's ongoing goal is to enhance each organization's productivity and streamline business processes by utilizing today's latest technologies. Mr. Austin possesses extensive certifications including MCSE, MCP+I, MCTS and is a licensed Paramedic/Firefighter based in Central Florida. Robert Mirabelle- Chief Architect Robert Mirabelle leads the development team and spearheads the continued modernization and innovation of the SafetyPAD suite of products. Mr. Mirabelle brings over 18 years of experience in web/application design/development and graphic design(including digital artwork, corporate branding& 3D)to the OPEN team. Mr. Mirabelle specializes in object oriented programming, systems architecture, patterns, web services, APIs, database design & management, usability, graphics, branding, web marketing,e-commerce, desktop app development, multimedia production, streaming media and more. Others experienced team members involved with our deployments... Anthony Tackett—Director of Client Services (former Paramedic/FF at Detroit Fire/EMS) Obed Frometa—Lead Field User Trainer (active Paramedic/FF at Miami-Dade Fire Rescue) Craig Prusansky—Implementation/Support Specialist (former Paramedic/FF at Palm Beach County Fire Rescue OPEN inc/SafetyPAD Confidential-All Rights Reserved SAFETY RFP #2017-002-JC - EPCR Software Miami Beach Fire Department Our References - OPEN OPEN incorporated has extensive experience successfully managing the installation, integration and ongoing support of SafetyPAD at several sites with needs similar to LMES. OPEN believes that it differentiates itself in the ePCR industry by focusing on being a true solution provider to each partner agency, not by simply providing a shrink-wrap ePCR system. We take tremendous pride in working closely with each agency to understand its unique requirements to ensure that the system is a true solution both during initial deployment as well as on an ongoing basis. OPEN does not have hundreds of sites to manage—continually supporting this quantity of site's unique requirements and needs would be challenging for any company. Instead, OPEN's approach has been to work as an integral partner and continually improve the solution based on feedback. The references provided below offer a diverse range of attributes associated with the agency and its SafetyPAD system components, incident volume, staff, etc. We wish to especially emphasize that all SafetyPAD sites have experienced revenue increases of AT LEAST 30%, many over 40%or more since implementing SafetyPAD. Most functionality denoted in this response is available today at every SafetyPAD ePCR site. However,we have highlighted some brief details of a few sites as well as provided reference information, case studies and news articles providing unique "stories" from a number of OPEN's sites throughout this response. OPEN inc/SafetyPAD Confidential-All Rights Reserved SAFETY RFP #2017-002-JC - EPCR Software Miami Beach Fire Department Chicago Fire Department Address 1338 S. Clinton St Chicago, IL 60607 USA Contact Information Contact: Mark Kiely(MARC Unit Project Manager) Phone: (312) 746-9360 Email: mark.kiely@cityofchicago.org Quotation "SafetyPAD has had a dramatic and positive impact on the quality and completeness of our documentation, reduction in liability exposure and increased revenue. We always receive superb support from OPEN, with an emphasis on always meeting our unique needs" Joyce Hofmann Former Paramedic Field Chief Chicago Fire Department Summary Chicago Fire Department(CFD) is the largest fire department in the Midwest, and one of the nation's largest departments throughout the United States. It's also one of the oldest major organized fire departments, established before 1833. CFD responds to more than a half a million EMS incidents per year. Chicago Fire was an early adopter of pen-based EMS information management technology, starting this process in 1997/1998. An extensive evaluation of various EMS information management systems in 2004 led to the subsequent pilot and selection of the SafetyPAD system. Approximately 400,000 EMS incidents annually as well as 1,200 field users trained and utilizing SafetyPAD. Term/Service The SafetyPAD ePCR platform, which has been live and deployed on all ambulances in 2005. OPEN is currently in year 11 of SafetyPAD utilization. OPEN also provides ongoing maintenance and support. Future Plans OPEN anticipates that CFD, as part of this upgrade process,will migrate to SafetyPAD Android/Enterprise 5 on 325 Android tablets in Q3 of 2017. OPEN inc/SafetyPAD Confidential-All Rights Reserved SAFETY RFP #2017-002-JC - EPCR Software Miami Beach Fire Department Miami-Dade Fire-Rescue Address 9300 NW 41st Street Miami FL, 33178 Contact Information Name: Lt Marc Hale—ePCR Technical Lead Phone: 786-331-4419(direct) Email: march@miamidade.gov Quotation "Since the inception of using the SafetyPAD system and Interactive Guidelines we have observed an 80% improvement in documentation completeness, which has helped us drive report quality according to our unique policies as well as 3x improvement in collection percentage when compared to paper. " Lt Marc Hale ePCR support/technical lead Miami-Dade Fire Rescue Summary Miami-Dade Fire-Rescue Department provides fire suppression, Emergency Medical Services, Hazardous Materials, Technical Rescue and other emergency services to unincorporated Miami- Dade County and the 30 municipalities that comprise the Miami-Dade Service District. With 67 stations and nearly 2,600 front line dual role fire/medic providers Miami-Dade County spans 2000 square miles and the fire district serves a resident population of 1.6 million people. In addition to the resident population, Miami-Dade plays host to more than 10 million tourists annually. Miami-Dade is considered one of the largest fire rescue departments in the Southeast. Department Details • Approximately 300,000 ePCRs generated annually • Approximately 2,600 field users trained and utilizing SafetyPAD • Web-based backend access from all county locations and stations. Additional access provided to Hospitals and 3rd party entities such as billing vendors via web/cloud • 220 SafetyPAD-loaded tablets in the field. All front line Medics including air rescue units carry an Xplore D10 Android tablet loaded with SafetyPAD. • Wireless patient transfers take place in many instances, providing the quickest transfer of care possible as well as cloud-based LifePak integration. Term/Service The SafetyPAD ePCR platform, which has been live and deployed system-wide since January of 2010. OPEN is currently in the 6th year of a 15 year contract term. OPEN provides hosting, ongoing maintenance and support. OPEN inc/SafetyPAD Confidential-All Rights Reserved 141 RFP #2017-002-JC - EPCR Software Miami Beach Fire Department Hennepin County EMS Address 701 Park Ave S Minneapolis, MN 55415 Contact Information Name: Dave Rogers—Deputy Chief of Operations Phone: (612) 873-2173 Email: david.rogers@hcmed.org Summary Hennepin County EMS is Minnesota's largest 911 EMS service provider, generating over 70,000 ePCRs annually. Approximately 150 field users trained by OPEN and utilizing SafetyPAD,with all front line Medics carrying Xplore D10 Android tablets loaded with SafetyPAD. Term/Service The SafetyPAD ePCR platform, which has been live and deployed on all ambulances in 2005. OPEN upgraded HCMC to its SafetyPAD E5/Android solution at the end of 2016. OPEN provides hosting, ongoing maintenance and support. Other References and Customers available upon request including • Palm Beach County Fire Rescue • Palm Beach Gardens Fire Rescue • Boston EMS **Additional details related to specifications or content in this section may be found elsewhere in this bid response. OPEN inc/SafetyPAD Confidential-All Rights Reserved S A F E T SafetyPAD Offering Summary • SafetyPAD Android/Enterprise 5, hosted • Includes EMSTARS, billing extract, Physio and CAD interface, API-based data exchange, etc • Mobile Data Management software for 18 devices • Cellular service (18 units+ 15 backup units) • Training o 3 days ONSITE (6 sessions of field user/train-the-trainer) o 1 day ONSITE (up to 8 hours of administrative training) • Integration/Setup • Tablet Hardware • 18 x Xplore D10(13 primary and 5 spare) • Excludes docking station o 15 Samsung Galaxy A 2016 or equivalent(15 backup/special event) ■ Includes protective case RFP 2017-002-JC COI ©2016 Intermedix Corporation www.intermedix.com ACO® CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDD/YWY) `.� 06/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Marsh USA Inc.. NAME: 1560 Sawgrass Corporate Pkwy,Suite 300/ INC N.Extl: INC.No): Sunrise,FL 333230 E-MAIL Atte:FtLaauderdale.CertRequest@marsh.com F:212-948-0512 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# 101309-GAWU-PROF-16-17 INSURER A:Continental Insurance Company 35289 INSURED INSURER B:American Casualty Company Of Reading,Pa 20427 Intermedia Corporation. 6451North Federal Highway,Suite 1000. INSURER C:N/A N/A Fort Lauderdale,FL 33308 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-003492646-11 REVISION NUMBER:2 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MM/DDIYYYYI IMM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 6018302277 06/30/2016 06/30/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO NTED PREMISES EaEoccurrence) $ 1,000,000 MED EXP(Any one person) $ 15,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED' AUTOS AUTOS •• . BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED • PROPERTY DAMAGE _ AUTOS' . . (Per accident) $ UMBRELLA LIAB —_ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ B WORKERS COMPENSATION 6018302294(AOS) 06/30/2016 06/30/2017 X PER OTH- B Y/N AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE 6018302280(CA) 06/30/2016 06/30/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) City of Union City is included as additional insured(except workers'compensation)where required by written contract. CERTIFICATE HOLDER CANCELLATION City of Union City. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3715 Palisade Avenue. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Union City,NJ 07087 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Carmen Gordon 44,v I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD RFP 2017-002-JC Financial Statements a),._Th,\,_..,_,,.. , ,31.) . ./ _..,, ,,,, ,,, ,...,, „ 3,‘,,, a2„,,,,,, 3,0 ), --- m 2016 Intermedix Corporation www.intermedix.com 4 > • INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of lnterrnedix Holdings Inc.) Consolidated Financial Statements December 31, 2015 and 2014 (With Independent Auditors' Report Thereon) enf\ Proprietary and Confidential-Intermedix Corp. i INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Table of Contents Page(s) . Independent Auditors' Report 1-2 Consolidated Financial Statements: f: `� �N 4 Consolidated Balance Sheets as of December 31,2015 and 2014 3 cics Consolidated Statements of Operations and Comprehensive Los ,,-4/,:t:the ye ender( December 31,2015 and 2014 ,t> .,. 4 Consolidated Statements of Stockholder's Equity for the years ended December 31';'- 015 and 2014 5 Consolidated Statements of Cash Flows for the years‘ended December 31, 2015 and 2014 6 Notes to Consolidated Financial Statements 7-33 r l �, � r 4ps3r : -" v im` t'a'� 3 A--.7 Proprietary and Confidential-Intermedix Corp. /1,1).1 KPMG LLP Surto 750 450 East Las Olas Boulevard Fort Lauderdale,FL 3330t Independent Auditors' Report The Board of Directors and Stockholder :a Intermed ix Corporation: We have audited the accompanying consolidated financial statements of Intermedix'Corp&ation and subsidiaries (the Company), which comprise the consolidated balance sheets as of December31, 2015 and 2014,and the related consolidated statements of operations and comprehensive loss,changes in stockholder's equity,and cash flows for the years then ended,and the related notes to the.consolidated financial statements. Management's Responsibility for the Financial Statements x:, Management is responsible for the preparation and fair presentation of these consolidated financial statements in accordance with U.S.generally accepted accounting principles; this includes the design, implementation, and maintenance of internal control relevant td the preparation and fair presentation of consolidated financial statements that are fre'' t m m.,erial misstatement, whether due to fraud or error. Auditors' Responsibility Our responsibility is to express an opinion on theese c.t' 'lidatcd financial statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated a rancial stateitteents ate free from material misstatement. An audit involves performing .0,!;.-,ures to obtain audit evidence about the amounts and disclosures in the consolidated financial statemen he procedures selected depend on the auditors'judgment, including the assessment of the riiks of materiafmisstatement of the consolidated financial statements, whether due to fraud or error.In making those.risk asse sments,the auditor considers internal control relevant to the entity's preparation and fair presentation of.the consolidated financial statements in order to design audit procedures that are appropriate itt the'circumstances,but not for the purpose of expressing an opinion on the effectiveness of the entity's internal control.Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management,as well as evaluating the overall presentation of the consolidated financial statements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion. KPMG LLP a a Datahwa Imbed,ability patraostap. We U.S.member arm of KPMG internstanat Coags W,. Proprrelei endCon'fdential-Intermedix Corp. VRna Opinion In our opinion,the consolidated financial statements referred to above present fairly in all material respects, the financial position of tntermedix Corporation and subsidiaries as of December 31,2015 and 2014,and the results of their operations and their cash flows for the years then ended in accordance with U.S.generally accepted accounting principles. K`PM•(G LLP Fort Lauderdale, Florida April 29, 2016 Certified Public Accountants 41,41 i� ✓ `, 2 Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc) Consolidated Balance Sheets December 31,2015 and 2014 (In thousands,except per share data) Assets 2015 2014 Current assets: Cash and cash equivalents $ - / 15,440 Restricted cash 1,32 , 1,337 Receivables,net 43,697' 46,422 Prepaid expenses and other current assets •, 4,858 4,642 Deferred income taxes = , 2,192 Total current assets 68,187, ` y 70,033 sli Property and equipment,net -.4_ 46f 18,651 Goodwill 4-_ 385, 14 388,463 Intangible assets,net 228,948 261,506 Debt issuance costs 6,861 7,742 Other assets 1,408 2,449 Total assets 1;• • $- 702,679 748,844 Liabilities and Stockholder's Equit., ; 4 Current liabilities: .,�.. �,, 'k t. � Accounts payable and accrued expenses $ 11,175 11,637 qtAccrued payroll and related benefits ,, 8,557 8,168 Collections payable to clients 9,850 14,544 Deferred revenue ,_ - 9,853 10,713 Senior term loans 43r �' ' 6,869 6,869 Other current liabilities $� r7q '1. 2,275 - Total current liabilities / 48,579 51,931 Revolving credit facility- \ 58,000 60,000 Capital lease obligation ;.> 1,024 - Senior term loans .-*.' , 254,144 261,012 Subordinated de ' 112,000 112,000 Deferred incomk es = 50,670 66,515 Other long-Reim 1 sFfi ties 4,� `_> 1,889 3,170 Total-liabilities 526,306 554,628 Commitments and contingeneiesP Stockholder's equity: ':-. Common sfOc]c,$0.a1;par value;2,000 shares authorized at December 31;2015 and 2014,respectively; 1,280 shares issued and outstanding at December 31,2015 and 2014,respectively 13 13 Additional paid-in capital 315,101 310,689 Accumulated deficit (137,159) (116,468) Accumulated other comprehensive loss (1,582) (826) Non-controlling interest -- 808 Total stockholder's equity 176,373 194,216 Total liabilities and stockholder's equity $ 702,679 748,844 See accompanying notes to consolidated financial statements. 3 Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc) Consolidated Statements of Operations and Comprehensive Loss Years ended December 31,2015 and 2014 (In thousands) 2015 2014 Revenues: Business services revenue $ 195,430e ; 182,838 Subscription and other revenue 36,734F.: , 40,726 Total revenues 232,164 223,564 Costs and expenses: _•'' t" , Cost of business services revenue � - 12,209 104,711 Cost of subscription and other revenue ,. <>' "\ 75 10,638 Selling,general and administrative expenses r). 57,45 48,369 Stock-based compensation expense '\ 4,412 3,749 Depreciation and amortization expense - ',43,223 40,619 Impairment of intangible assets and goodwill ;t - , 7,429 2,317 Total costs and expenses234,933 210,403 Operating(loss)income "� P g - � (2,769) 13,161 Interest expense,net _: " 29,975 - -3- ( ) (31,106) Gain on business acquisition — 3,0022 Other income(loss),net ¢, ' , 3(16) 386 4 Loss before incot>Ye%{axes _ (32,760) (14,557) Income tax benefit - 12,069 5,522 Net loss '\` (20,691) (9,035) Other comprehensive 1oss��T ', Foreign curren translation a jusWentT (756) (826) f Jy wxt'`t `r:" Compreherls(ve loss-K, $ (21,447) (9,861) See accompanyingnates to '' solidated financial statements. N 4 Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc; . Consolidated Statements of Stockholder's Equity Years ended December 31,2015 and 2014 AI s,tt�� (In thousands) r.. i*:x i' !n Accumulated # Common stock Additional other 1,1 i,;; ;gmberof paid-in Accumulated comprehensive Noncontrolling Total tri 4 1,40:!hares Par value capital deficit loss interest equity Balance at December 31,2013 I° W yo 1,2$0 $ 13 308,275107,433 ( ) 515 201,370 Contribution of stock option proceeds from Parent .Az lf" 1' �iffy`'� 25 25 Contingent acquisition purchase price paid in Parent stock , h - (1,360) — — 1 o Noncontrolling interest distribution „.1,"0 '"°" — — — — (33) ( 333) 13 Income attributable to noncontrolling interest ir`i "4 �"� "` — — 326 326 o Stock-based compensation expense ; "±�s� — v Cumulative foreign translation adjustment ,.::44,47.s sA' = 3,749 — — — 3,749 Net loss fvJ' b — — (826) — (826) v Balance at December 31,2014 i a `,r d (9,035) — (9,035) a , ' 1280 ,k 1 ' 310,689 (116,468) (826) 808 194,216 Noncontrolling interest distribution l/ ^'(i p• _ — Loss attributable to noncontrolling interest " — — — — (804) (804) m Stock-based compensation expense ' 4,412 (4) (4) Cumulative foreign translation adjustment w"' — —— 756) Net loss (20,691)— (756) — (20,691) m-. Balance at December 31,2015 1,380 '$ 13 315 101 (137,159) (1,582) .ii, — 176,373 i See accompanying notes to consolidated financial statements. 5 FO- 3 to a X 4,4 d J j7 a, .r 5 INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc) Consolidated Statements of Cash Flows Years ended December 31,2015 and 2014 (In thousands) 2015 2014 Cash flows from operating activities: Net loss S 0,691) (9,035) Adjustments to reconcile net loss to net cash provided by operating activities: • Depreciation and amortization 40,619 Amortization of debt issuance costs 1, :'j 1,538 Impairment of goodwill and intangible assets 7 42' `,; 2,317 Gain on business acquisition ..LL, "�: — i'3,002) Stock-based compensation expense • '''-'4V7,. 4,__ ' 3,749 Deferred income taxes ( ) .. fitr ) 6,36nning interest 326 Other noncash items \-:;9,,1 (444) Changes in operating assets and liabilities,net of acquisitions: � \-\Accounts and notes receivable ,'', 2 34 (5,298) Prepaid expenses and other current assets is (216) (1,729) Accounts payable and accrued expensesY (462) 951 Accrued payroll and related benefits 389 (1,243) Deferred revenue ''% (1,319) (571 Collections payable to clients 7 At. - (4,694) 3,761) Other assets/liabilities `'4' � 1,115 (461) Net cash provided by operating activities 20982 25,114 Cash flows from investing activities: Deposits 4 4 .,,� _ — Capital expenditures -,',;.-2,N. _ - (24) (8,099) Expenditures for computer software and v d techd{ology (8,254) (8,571) Cost of business acquisitions,net of u'` , ''';`-*N. (280) (12,516) Net cash used in inve ' ctivities (16,633) (30,125) Cash flows from financing activities;, Borrowings under revolving credit.facility 3,000 66,500 Repayments under revolving credit facility ::\ (5,000) (9,500) Repayment of senior term loans, (6,869) (53,869) Contribution from sale of parent common stock — - 25 Distribution of noncontrolling interest (804) (33) Settlement of contingent consideration - (820) — Principal paynients on debt issuance costs (700) (693) Repayment of capital lease obligation (470) — ";-- et cash.(used in)provided by financing activities (11,663) 2,430 Effe -e f foreign currency < s- 186 (43) *\Net decrease in cash and cash equivalents (7,128) (2,624) Cash and ca's t .uivalents Beginning of year 15,440 18,064 Cash and cash e • •;, ,i: end of year $ 8,312 15 440 Supplemental disclosures of cash flow information: Cash paid during the year for: Interest $ 29,067 28,856 Income taxes,net of refunds 1,960 1,134 Non-cash investing activities: Purchase accounting adjustments(note 5) S 580 211 Capital lease obligations to purchase equipment 2,332 — See accompanying notes to consolidated financial statements. 6 Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 (1) Description of Business Intermedix Corporation(the Company)is a wholly owned subsidiary of Intermekoldings,Inc.(Parent), that provides revenue cycle management(RCM)services,physician management services,technology-based solutions,and healthcare data analytics primarily to the emergency medical industry. The mp provides a comprehensive RCM solution,combining technologies and services to manage the poll a• istration, clinical documentation,billing,and informatics needs of its clients,Certain RCM contracts als. include the provision of electronic patient care reporting (ePCR) systems. The Company's RCM customers include (i)emergency room physicians, (ii)hospital emergency medicine.departments, (iii)urgent care providers, (iv)anesthesiology physicians and nurses, (v)emergency medical transporta4 providers (EMS)— both ground and air, (vi)fire departments, and (vii)911-emergency first respondeCustomers include both governmental municipalities and private-sector service providers located throughout the United States. : )The Company also provides physician services to both individual l physicians and established independent physician groups that include a> ce in group formation and first contract acquisition such as practice feasibility studies; proposal developrrt and presentation; contract development and negotiations;practice design and organization;and eptuiting,scheduling,and credentialing.For emergency physician groups,the Company offers a wide range o 'resourcec such as group governance,Web-based peer review tools, accounting and fmanciat reporting, human resource management, malpractice insurance negotiations,tax planning,a> her contractual negotiati . The Company also provid -Web-based informationtechnology solutions primarily to the public health and emergency services ma ke e pany's technology consumers include hospitals,EMS providers,fire departments, law enforcement:dVicies, physician groups, and state and local departments of health. Technology offerings include (i-Nal-time communications, (ii)inventory and resource management, (iii)mass multimedia notification,(ivolunteer registry tracking,(v)patient and evacuee tracking,(vi)fleet management solutioWor real-time elEhange of information between CAD systems and vehicle crews, (vii)collaboration'too i that create a common operating picture, enabling emergency managers to make sound decisions and allow mg users to manage multiple incidents and daily events,assign,and track missions and tasks, provide situation reports, and manage resources, (viii)electronic health care reporting systems (Ehcr)for physician prabtices, (ix)predictive modeling software and (x)prehospital ePCR systems that interface with the Company's RCM billing platform.These solutions integrate a full range of key emergency preparedness and response activities,and scale from daily use to large-scale utilization surges during regional and,or national s'ass casualty and public health incidents. (2) Summary of Significant Accounting Policies (a) Basis of Presentation and Principles of Consolidation The consolidated financial statements include the consolidated accounts and operations of the Company and its majority-owned subsidiaries and have been prepared in accordance with accounting principles generally accepted in the United States of America(GAAP).All significant intercompany accounts and transactions have been eliminated. In March, 2015, the Company acquired the remaining 28% interest in Tucuxi, LLC (Tucuxi), a software development joint venture between the Company's wholly owned subsidiary ESI Acquisition 7 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 Corp (ESI) and an outside third party for a purchase price of$03 million. Prior to the Company's acquisition of Tucuxi.'s remaining interest,the operating results of the join enture with Tucuxi were consolidated with those of the Company,and the noncontrolling interest wasuded in stockholders' equity in the accompanying consolidated balance sheet.The noncontrolling interest expense recorded for 2015 and 2014 was not material and was included within other income (1 ss) t in the accompanying consolidated statements of operations and comphensive loss (b) Use of Estimates ` The preparation of the consolidated financial statements in confId ty with GAAP requires management to make estimates and assumptions`that affect 'the rep . amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of tie consolidated financial statements and the reported amounts of revenue and expenses ;during the reporting periods. Management utilizes estimates in determiing the value of stock-based compensation awards, the useful lives of its long-lived and intan jbl assets, allowances for doubtful accounts, the impairment of goodwill and other intangible assets, " val _, 'on of deferred tax assets, income tax uncertainties, and purchase price allocations puI t t• 14Cness combinations, as well as certain consolidated financial statement disclosures,,,-etu results 4 d di from such estimates. dryer (c) Cash and Cash Equivalen'?s, :., The Company coni•-:: all highly liquid invetments with original maturities of three months or less to be cash equivale z, Cash : d cash equivalents include amounts billed and collected on behalf of clients(see item01')be . • scussion of related liability).A book overdraft of$1.4 million for 2015 was included in offie'' liabilities on the consolidated balance sheet and included as an operating activity foi icassl lowlurpo (d) Receivables,Are " ..S.. Trade Receivaes •. Trade receivablesiprimarily consist of amounts due to the Company pursuant to service,subscription, and/or license contracts with its customers.Also included in trade receivables is the current portion of notes receivables' due from certain customers, which totaled $3.5 million and $3.9 million, respectively, as of December 31, 2015 and 2014. The carrying amount of trade receivables approximates fair value given the short maturities of such receivables. Allowances for Refunds and Doubtful Accounts Reserves related to trade receivable collectibility are recorded when specific accounts are identified as being at risk based on review of past-due accounts and the related facts and circumstances. As of December 31, 2015 and 2014, the allowance for refunds and doubtful accounts totaled $1.6 million and$1.0 million,respectively,in the accompanying consolidated balance sheets. 8 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 (e) Prepaid Expenses and Other Current Assets "Prepaid expenses and other current assets" consist of amounts paid i dvance for insurance, maintenance contracts, and other customary and routine items required fo e operation of the business. q•,._. • (n Property and Equipment,Net Property and equipment, net is stated at cost less •« ula . •ep ion aamortization. Depreciation and amortization on property and equip e calcul• on -Straind ght-line basis over the estimated useful life of each asset.Leasehold imprroov�eme k,. e am. et over the shorter of the underlying lease term or useful life of the asset. Mamtenancerepai are charged directly to expense as incurred,while betterments and renewals are generally capitalized as property,equipment, and leasehold improvements.When an ite retued or otherwise dispsed of,the cost and applicable accumulated depreciation and amortiza•3,;- e removed and<'the-resulting gain or loss is recognized. (g) Computer Software and Technology De '7tL,,,A+t Costs.. Certain computer software and technolo ! • opm costs are capitalized in "Intangible assets, net'' in the accompanying consolidated li c ,>: . In accordance with Accounting Standard Codification (ASC)Topic 350-40, .._Interna:., se .oftware (ASC Topic 350-40), the Company capitalizes costs incurrtd�during.the applicatio development stage related to its proprietary software platforms and to its',enterprise cloud computing application services, as well as for modifications to existing computer software that result in additional functionality.Costs incurred for the development of internal-use software 1ar6ly consjt of payroll and payroll-related costs for employees and consultants-rho are directly asociated with and who devote time to the internal-use computer software projects.Such costs are expensuntil(i)the preliminary project stage is completed,(ii)management has authorized and committed filEding for the project, and(iii)it is probable that the project will be completed and the software wall be used to perform the function intended,at which time,in accordance witASC Topic 35040, any additional software development costs are capitalized. Ar Amortization of internally developed computer software, which is included in "Depreciation and lr amortization expense,"begins when development is substantially complete and the computer software is ready for its intended use.These costs are amortized over the period in which the asset is expected to contribute directly or indirectly to future cash flow. The Company generally amortizes internally developed'software on a straight-line basis over a five-year period and periodically reassesses the estimated useful lives of its internally developed software in consideration of,among other factors,the effects of(i)obsolescence,(ii)technology,(iii)competition,and(iv)other economic factors. To a much lesser extent, the Company capitalizes certain development costs related to software licenses sold to customers(note 2(m))in accordance with ASC Topic 985-20,Costs of Software to Be Sold, Leased, or Marketed, in which capitalization begins upon the establishment of technological feasibility. The Company assesses the recoverability of computer software development costs by comparing the carrying amount to the fair value whenever events or changes in circumstances indicate that its carrying 9 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 amount may not be recoverable.An impairment loss is recognized if the carrying amount exceeds the fair value. In determining fair value of internally developed comput.t. oftware, the Company considers whether(i)it is expected to provide continued substantive servic`=a,tential, (ii)significant changes in the extent or manner in which the software is used or is exPected to used,(iii)it is or is expected to undergo a significant change, or (iv)projected develc"__ nt or '•ifi .:on costs significantly exceed original estimates. ti (h) Goodwill and Intangible Assets y Goodwill is recorded in accordance with ASC Topic 805';_ whencotideration paid for an acquisition exceeds the fair value of identifiable net tangible,and i s 1+:ifiable intangible assets acquired. In accordance with ASC Topic 350, Intangibles — Gdodwill an- Other (ASC Topic 350), goodwill and other indefinite-lived intangible assets are reviewed forimpairment at least annually. The Company has elected to perform its . .1 impairment testing as of October 31 of each year and as required should any triggering even ,cur indicating a potential for impairment. Goodwill impairment is determined using a two=step process.The first step of the impairment test is used to identify potential impairment by comparing theair value of a reporting unit to the book value, including goodwill.If the fair value of a reporting unit ee eeds its book value,goodwill of the reporting unit is not considered impaired,and the second stepof the measurement of goodwill impairment is not required.If the book value of a reporting unit exceeds its fair value,the second step of the impairment test is performed to: =a ure the amount of the impairment loss,if any. The second step of the fin a.:pent test compares the implied fair value of the reporting unit's goodwill with the book value of the'A. The reporting unit's implied fair value of goodwill is determined by allocating the fair value to I;; reporting unit's assets other than goodwill.The excess of any residual fair value after this allocation i used as the implied fair value of the reporting unit goodwill. If the book value of a'reporting 'unit's goodwill exceeds the implied fair value of that goodwill, an impairment loss is recognized in an amount equal to the excess. (i Impairment of Long-lived Assets The Company reviews long-lived assets and intangible assets subject to amortization for impairment J p ‘wheneverk events or changes in circumstances indicate that the carrying amount may not be =recoverab .Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset or group of assets to future net cash flows expected to be generated by the asset or group of assets. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the fair value of the assets. Assets to be disposed of are reported at the lower of the carrying amount or fair value less costs to sell. Q) Debt Issuance Costs,Net The Company capitalizes and amortizes costs incurred to obtain financing over the term of the underlying obligation using the effective-interest method. The amortization of debt financing fees is included in "Interest expense, net" in the accompanying consolidated statements of operations and comprehensive loss. 10 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 (k) Other Assets Other assets consist of the long-term portion of other notes receivable, c.-;,.oasis investments, and deposits. (1) Collections Payable to Clients Collections payable to clients represents amounts collected on eralf of clients that hav not yet been remitted to clients. Collection held for customers is included in"Gash and cash equivalents" in the accompanying consolidated balance sheets. ` (m) Revenue Recognition The Company recognizes non-software related revenue in accordance with the provisions of ASC 605, Revenue Recognition, and software-related)revenue in accordance with ASC 985-605, Software — Revenue Recognition. In general, revenue is recognized when all of the following criteria have been met(i)when there is persuasive evidence,of an arrangement, (ii)the service or product has been provided to the customer, (iii)the collection of,the fees is reasonably assured,and(iv) the amount of fees is fixed or determinable. The Company's revenue iS divided into two major ponents: Business Se r''sRevenue ro Business' services revenue represents fees earned from the Company's Rvq,businessel, r account billing and clinical systems use,and from its physician support sdrvices,ick „Prig' ing rec ting,scheduling,credentialing,accounting,financial reporting, human resouce r is iagement, Insurance negotiations, planning, and other contractual negotiations • - i Technology Reve`n} ;Technology revenue includes: (i)subscription revenue for fees earned from the Company's oftware-as-a-service (SaaS)offerings, whereby customers are granted access to the Co hpany's Internet-based software solutions,(ii)sales of software licensing rights to end-users and value added resellers or VARs; (iii)professional services, including implemental on,training,and consulting services and(iv)software support and maintenance. >.The Company—recognizes revenue for each of its major revenue components as follows: B ia.ervices Revenue Business Services Revenue is typically charged to the customer based on a percentage of total collections or on a per incident fee. Fees based on a percentage of collections are not fixed or determinable until collections are realized; thus, in accordance with ASC Topic 605, Revenue Recognition (ASC 605), revenue is recorded when such collections are made. Fees on a per incident basis are recognized in the month in which the incident occurs. 11 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 Technology Revenue . Subscription and Other Revenue = \, Under the Company's SaaS-based product offerings,customers do nothave the ri r to take possession of the software,and in accordance with ASC Topic 985,Software(ASC 985),theseagangements are considered service contracts,which are outside the scope of Age 985. Subscription and support services revenue constitutes a majority of.the technology revenue and is recognized ratably over the contract terms in accordance with.ASC 605:,Implementation and training revenue,when sold with SaaS offerings,is accounted for separately whetilhere is objective evidence of the fair value of each deliverable. Implementation and training revenue is recognized as the corresponding services are performed,and were not material for 2015 r 2014. Hosting services revenue represents f "`charged to manage and host customers' hardware and software solutions at the Company's da-1 enters Hosting services revenue is recognized ratably over the contract term in accordance with.AS ,i 5,4' ' Hardware revenue, which represents the sale ofnaobiletievices that are utilized in conjunction with the Company's SaaS-based-solutions,is recognized'uapon delivery to the customer when all of the other revenue recognition cri is ate,met. Support services that are sold together with hardware devices are accounted for separar , when ere is objective evidence of the fair value of each deliverable, and are recognized ratabl" ver th service term. Software Licensin'Arrangements Involving Multiple Elements Some of the Company's technolvy offerings are sold under licensing arrangements and may contain multiple elements of the deliverables noted above. Revenue earned on software arrangements involving multiple elements s allocated to each element based on the relative fair values of those eletents. The fair value of an element is based on vendor-specific objective evidence (VSOE). The ‘37-1-CornKny limits its assessment of VSOE to either the selling price charged when the same element is LY- _ sold separately or_ ' e selling price established by management having the relevant authority to do so. The selling, rj e-or each element is set based on an established and maintained price list for each customer atfi'. In determiningsellingprices, the Company considers; P p y (i)competitor pricing, '` ii)supply;and demand of professional services staff,(iii)overall economic conditions, and(iv)cost to provide'the software system element. Prices and/or VSOE are updated and reviewed annually depending on the nature of the product or service. In most cases, VSOE is established for each software element at the point of sale. Provided the fees are fixed or determinable and collection is considered probable, revenue from these licensing rights and related software sales are generally recognized upon physical or electronic shipment and transfer of title.For some of the Company's technology offerings,no VSOE can be established until significant customized installations have been completed usually requiring several months to complete. In these cases, licensing rights and related software sales are recognized on a percentage of completion basis in accordance with ASC 985-605. 12 (Continued) Proprietary and Confidential-Intermedix Corp. I INTERMEDIX CORPORATION SAND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31, 2015 and 2014 Revenue from implementation, training, and other professional services is recognized as the • corresponding services are performed, or in certain instances upon acceptance of the services by the customer. Support and maintenance revenue is recognized ratably over the contractual maintenance period,typically 12 months. �� Amounts that have been invoiced for technology revenue are r cordedin accounts receivable and in deferred revenue or revenue,depending on the whether the reveecogiitioncritena have been met. (n) Cost of Revenues \' , Cost of business services revenue primarily includes direct production costs such as labor, patient statement printing and mailings, telecommunications, facility, and e-commerce costs. Cost of technology revenue includes labor,hardware, and data center costs.` (o) Employee Stock-based Compensation j' a Certain employees and directors of the Companyttarticipake in a stock option plan of the Parent.Stock • option grants made to Intermedix Corporation employees';and directors to acquire Parent common stock are accounted for pursuant to ASC 718, Campenson—Stock Compensation(ASC Topic 718) and any resulting stock based compensation is rushed down to Intermedix Corporation with a corresponding offset to additional paid-in capital': Compensation expense for all stock-based compensation awards granted iS.based on the grant-date fair value estimated in accordance with the provisions of ASC Topic 718. 'I eCompany recognizes these compensation costs on a straight-line basis over the requisite scrvic)perta2f the award, which is generally the option vesting term. The Company's options vest over'terms of a years.As stock-based compensation expense recognized is based on ,awards ultimately'expected to vest, such .expense is generally reduced for estimated forfeitures. ASC Topic 718 requites forfeitures to be estimated at the time of grant and revised, if necessary,>in subsequent periods if actual forfeitures differ from those estimates. The,Company estimates the fair value of stock-based compensation awards on the date of grant using the Black-Scholes-Mertdn(BSM) option pricing model,which was developed for use m estimating the value of traded options that have no vesting restrictions and are freely transferable. The BSM t< option pricing model considers,among other factors,the expected life of the award and the expected volatility of the Company's stock price. k 'a (p) Income Taxes The Company's operations are included in the consolidated federal income tax return of the Parent. The Company's income tax provision was prepared on a separate return method as if the Company filed a separate income tax return.Income tax payable or receivable generally represents amounts due to the Parent for current taxes calculated under the separate return method.Income taxes are accounted for under the asset-and-liability method in accordance with ASC Topic 740, Income Taxes (ASC Topic 740). Deferred tax assets and liabilities are recognized for(i)the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and(ii)operating loss and credit carry-forwards.Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the 13 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized it 'income in the period that includes the enactment date. Net deferred tax assets are recorded to the extent that these assets will ``.more.likely t not" be realized. In making such determination, all available positive._and negative evidencesi:si nsidered, including future reversals of existing temporary differences, projected future taxahcome, tax planning strategies, and results of recent financial operations. The,Company has elected the early adoption of Financial Accounting Standards Board (FASB) Accounting Standards Update (ASU) No.2015-14 (ASU 2015-14), ASC Topic 740, .Income Tares, regarding the balance sheet classification of deferred taxes on a prospective basis. Pursuant to ASU-20' 15-17, the Company is presenting all deferred tax assets and liabilities as noncurrent liabilities in its accompanying consolidated financial statements as of December 31, 2015. Prior year amounts have not been reclassified. ASC Topic 740 prescribes a recognition t 'esholtl and measurement attributes for financial statement disclosure of tax positions taken or expected to lie taken in alax return,if that position is"more likely than not"of being sustained upon examination by the relevant taxing authority,based on the technical merits of the position.The tax benefits recognized itt ie Company's consolidated financial statements from such a position are4neasured based on the largest benefit that has a greater than 50%likelihood of being realized upou� .Ylimate resol utc`on. Changes in recognition or measurement are reflected in the period in which the' nge in judgment occurs. There was no liability for unrecognized tax benefits as of December 31 201 tAtic121314. (q) Concentration of C e1i1 Rti Financial instruments'that potentially subject the Company to significant concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. _TheCompany attempts to limit its credit risk by maintaining deposit relationships with high=credit-quality financial institutions. No individual account receivable accounted for more than 10% of consolidated accounts receivable as of December 31, 2015 and 2014 and no individual customer accounted for more than 10% of consolidated revenue for the years ended December 31, 015 and 2014. (3) Restricts §b As of December 31, 2015 and 2014, respectively, the Company had $1.3 million of restricted cash, representing collateral to secure a letter of credit and certain performance bonds. The letter of credit is secured by a collateralized bank account and the performance bonds are secured by six-month auto renewable Certificates of Deposit(CD's).Pursuant to the contractual terms to provide RCM and/or technology services to certain clients,the Company was required to furnish such letter of credit or CD's to assure its performance under the respective contracts. 14 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES . (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 (4) 2014 Acquisitions During 2014,the Company entered into three separate transactions,as described =; •w,wherein it acquired a business or substantially all the assets of a business.The transactions were funded .1$ internally generated cash and borrowings under the Company's revolving credit facility.The allocation of the'purch• e price of the assets acquired and liabilities assumed for each transaction is reflected in the table below tine,t. ='' rchase Price Allocation of 2014 Acquisitions."The transactions resulted in'ggregat400dwill of$4;, million,of which$1.7 million is deductible for tax purposes.In general, goodwill rditcts the value of the Company's expectations for future growth opportunities resulting from expansion of its few RCM and software lines of business, and the unique synergies created by leveraging its'Current pro duor.fferings with those of the acquired companies, to broaden both its existing customer base and to differe 1-+•te itself with new sales opportunities. Specific discussion with respect to the factors giving rise to\goodwill is included below by 1.4 transaction. 4e, (a) The Optima Corporation Limited On March 31, 2014, the Company entered into Nhare Purchase Agreement(SPA)with the Optima Corporation Limited (Optima), a registered New Zealand limited company, whereby the Company acquired 100%of the issued and outstanding shares of tP Optima for a purchase price of$6.1 million. The purchase price was fittikled by borrowings un4 r the Company's revolving credit facility and internally generated cash l Optima is a softwareEdevelopmmen �•mp2 t provides a narrowly focused system of services and products,primaril'in tli Ogen ices space.Optima's primary product offerings are its"Live" and "Predict" prod actsch are g't ed toward the science of utilizing operational research (mathematly:base' so ) to drive enhanced situational awareness to improve managing a „„, ,,,„ client's resout 1 The acqui y;n res ted tn" a recordation of$2.9 million of goodwill. The goodwill recognized reflects the value:of tleCompany's expectations that the acquisition of Optima will(i)provide entry into a,niche market With complex mathematical techniques (algorithms) not easily replicated; . (ii)provide a scalable business platform which can be integrated into the Company's Technology business with a revenue model of license fees, implementation fees, maintenance and support and consultann ; and (iii)provide a significant pipeline of opportunities which can be coupled with the r pan existing customer base. (b) RevCycle+,Inc. Pursuant to an Asset Purchase Agreement(APA)dated June 6,2014,Intermedix Physician Services, LLC(IPS),a newly formed,wholly owned subsidiary of the Company,acquired the RCM operations of RevCycle+, Inc. (RevCycle) from T-Systems, Inc. in consideration for (i)the amount of the liabilities assumed by the Company which aggregated$3.8 million, (ii)a working capital adjustment that equated to$0.9 million and (iii)plus or minus an Earn-Out Payment as described below. At the date of acquisition,the fair value of assets, primarily customer relationships and accounts and notes receivable, exceeded the value of the consideration assumed and tendered and accordingly, the Company accounted for the acquisition as a bargain purchase. ASC 805-30-30 defines a bargain 15 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 purchase as a business combination in which (a) the net of the acquisition-date amounts of the identifiable assets acquired and liabilities assumed in the acquisiti.;:: exceeds (b) the total acquisition-date value of the acquired company and mandates that the resu'';-..•; "negative goodwill" be recognized as an extraordinary gain in the income statement. Accordin_'''.4 the Company has recognized a gain on business acquisition of$3.0 million in the accompanying con-%;'dat-.1_ atement of operations and comprehensive loss for the year ended Dece} ber 31, 2014 z The APA also provided for an Earn-Out Payment to be pair erther,the buyer orsellerdepending on whether Annualize Revenues,as defined in the APA, exceeded or fell short of$10.0 million(Target Amount).The amount of the payment was to be equal to the atnount by whicl 'Annualized Revenues exceeded or fell short of the Target Amount,but in no event was it to exceed..$2.0 million.On June 30, 2015,the Calculation Date,it was determined that the Annualized Revenues were short of the Target Amount and accordingly,the Seller paid tote Company an Earn-Out`'mount of$525,000.This Earn- Out is included in other income (loss), ntn the accompanying consolidated statement of operations and comprehensive loss for the year end December 31,2015. In addition, the APA provided that;`RevCycleould reimburse IPS $1.0 million for the purpose of covering IPS's operating expenses related to tlia.RCAoperations acquired. Reimbursements were received on the 30th and40th day following thete of Closing and have been recognized as a reduction in operating expenses in the accol<npanying consolidated statement of operations and comprehensive loss ftie year ended December.31,2014. VP { RevCycle is engaged tmthe,bsiness of prodding billing,accounts receivable management,medical coding, and pract a maria ement seiyices to emergency medical service providers, emergency departmenrphysicians,staffiii., groups,hospitals and similar entities. (c) IOS Health Systems,Inc r Pursuant to an APA dated November 26,2014,Intermedix Office Based,LLC(OBB),a newly formed, wholly owned-subsidik of the Company,purchased substantially all of the net assets of IOS Health Systems, Inc. (IOS). The purchase price of $6.0 million was funded by borrowings under the Company's revolving credit facility and internally generated cash. IOS is a 42.ftware as a Service(SaaS)based medical practice software platform that provides clinical, financial ad patient engagement solutions.IOS has four(4)product offerings:(i)an electronic health reporting system,(ii)practice management solutions,(iii)patient portals and(iv)partner portals. As a result of this acquisition,the Company recorded goodwill of$1.6 million,which reflects(i)the Company's ability to own its own practice management technology platform to support growth plans, (ii)expansion of the Company's capabilities in office-based physician market and(iii)provides new opportunities with electronic health record products,by offering a full suite of office-based physician solutions. 16 (Continued) Proprietary and Confidential—Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 Determination of Estimated Fair Values of Assets Acquired and Liabilities Assumed In accordance with guidance provided in ASC Topic 805,the Company wequired to estimate and record the fair value of the assets acquired and liabilities assumed in the transacti ns described above. Methodologies and assumptions used in valuation of significant accounts acgvi d are described below: (1) Current Assets Current assets and primarily trade receivables were recorded at'thieir carrying amount, which approximates fair value given the short maturity of these balances,_.with the exception of the RevCycle acquisition, where accounts and notes receivable- ere rerded at fair value which was less than the respective carrying values. The fair value receivables acquired includes management's estimate of the cashflows not expected to be collected. (2) Property and Equipment In the estimation of the fair value of praperty and_:equipment, the Company used varying methods and procedures; however,those Xoced s followed the same basic principles of the cost approach,(i)a current cost to replace the new is calculated,and then(ii)the estimated replacement cost is reduced to reflect a ap !cable decline in value resulting from physical deterioration,funaional obsolescencew erein and/or economic obsolescence. (3) Intangible 4ssets Other Than"Goodwill Customer-related Intangible Assets The fair value of customer elationships was established based on an income approach using the excess earnings rnethod,Ny comparing the present value of the expected benefits from ownership of the subject intangible asset to the required return on the investment in the assets related to realizing the benefits. Technology-related Intangible Assets Technology'fair values were established based on an income approach using the relief from royalty method,which recognizes that because the Company owns the technology,rather than -j'," licensing it, the Company does not have to pay a royalty for its use. The fair value of the technology is determined based on the present value of the after-tax cost savings. Marketing-related Intangible Assets Trademarks—The fair value of trademarks was established based on an income approach using the relief from royalty method, which recognizes that a trademark has a fair value equal to the present value of the royalty income attributable to it. The royalty income attributable to a trademark represents the hypothetical cost savings that are derived from owning the trademark instead of paying royalties to license the trademark from another owner. 17 (Continued) Proprietary and Confidential-Intermedix Corp. 4 INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 Noncompetition Agreements—The fair value of noncompetition agreements was established based on an income approach, using a differential methodol , since their value is representative of the current and future revenue and profit erosion p .tion they provide. A differential was calculated wherebytheprofit of the business is projected ulKder two scenarios: one"with"and one"without"the noncompetition agreement in place.The esent ue of the profits is determined in each scenario,and the differenti4,1 between the two amoitnt's'is deemed the fair value of the noncompetition agreement. ' . r ,, All of the acquired intangibles,other than good , ' egatins$_14 8 million are amortizable. See note 8 for further disclosures. ;\ \ Deferred Revenue Deferred revenue consists of service'contracts wherein the Copany has a legal obligation to perform services and expects to tncuffuture costs to fulfill those obligations. Estimates related to deferred revenue were based on:. e direct cost of fulfilling these obligations plus a normal profit margin. •>, Purchase Price Allocation of 2014 Acquisit__ioons' The following tables summarize the consideraflon paid along with the allocations of the purchase price paid by the Company to acquire the businesses or assets in the three transactions described above(in thousands): t3r-Y ,• RevCycIe+ IOS Optima Total • Consideration a Cash(net of Optima h acquired of$464) $ 896 6,000 5,620 12,516 \ To#al purchase – i price allocation a 896 6000 5,620 12,516 Recognized aunts of identifiable.assets acquired d liabilities assumed: Current assets 5 4,255 149 792 5,196 � . . Property and equipment 220 160 186 566 Other intangible assets 4,261 4,120 6,449 14,830 Other assets — 975 — 975 Liabilities (3,856) (979) (2,622) (7,457) Deferred income taxes (1,602) — (1,909) (3,511) Total identifiable net assets. acquired 3,278 4,425 2,896 10,599 18 (Continued) Proprietary and Confidential–Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 RevCycle+ [OS Optima Total Goodwill(including assembled $ 620 1,575 2,724 4,919 workforce) Gain on bargain purchase (3,002) — 3,002) $ 896 .0,000 5,620 i -, 12,516 Other intangible assets , included above consist of the following by major -.s* , intangible asset class: ) Customer-related $ 4,210 1,620 60 5,890 Technology-related 51 2,300'' 6,224 8,575 Marketing-related .as, —. 200 165 365 4,261 4,120 6,449 14,830 • (5) Goodwill Goodwill, which amounted to-$385.8 million and . million at December 31, 2015 and 2014, respectively, represents the eacess'of purchase p=' e over net assets acquired. During the year ended December 31, 2015, the Company's g odwi L wa ected by certain adjustments related to prior year acquisitions based on facts and circymst es dist,'ose within the measurement period. The change in carrying amount of oodwill the year ended December 31,2015 is as follows: Balance at Dec r 31,2014 $ 388,463 ARM impairment see note 6) (3,225) Acquisition of?emaining interest in Tucuxi, LLC(see note 2(a)) 280 Purchase price adjustments 580 ' \ Effect of change in Foreign Currency— optima (284) y Balance at December 31,2015 $ 385,814 ASC Topic 350 requires an impairment test be performed at least annually on the carrying value of goodwill at the reporting unit level.The Company 2015 and 2014 impairment testing indicated that the estimated fair value of goodwill exceeds its carrying value for all reporting units,except ARM(see note 6). (6) ARM Contingent Purchase Price Adjustment and Impairment Pursuant to an APA dated November 26,2012,Intermedix ARM,LLC,a then newly formed,wholly owned subsidiary of the Company,purchased substantially all of the net assets of Anesthesia Revenue Management, Inc (ARM) for a purchase price of$13.6 million. The purchase price was funded by $12.2 million in cash and $1.3 million in the Company's common stock. The APA provided for a contingent purchase price adjustment(CPPA)to be made 18 months from the closing date in the event that annualized revenue from 19 (Continued) Proprietary and Confidential–Interrnedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 ARM's customers was less than $7.1 million. The CPPA was calculated as the lesser of the (a)purchase price minus $12.5 million or (b) 1.9 times the difference between $7.4 millionnd the actual annualized revenue from ARM clients.In October 2014,the CPPA Calculation Date,ARM did rip, meet the Annualized Threshold amount by more than$1.3 million.As permitted by the APA,ARM rnanag t agreed to forfeit their shares in the Parent's stock in full repayment of the CPPA. The Company has reflected t, orfeiture of these shares as an adjustment to additional paid-in capital in the acc panying consolidate ce sheets as of December 31,2015 and 2014. rtt. The acquisition of ARM originally resulted in the Compcognizi ood al rewill in the amount of $5.3 million.As a result of the loss of a several major customers,the Company*s tep_I,goodwill impairment testing for both 2015 and 2014, indicated that the carrying value of tbe.,goodwill'exceeded its fair value. Accordingly,the Company performed step 2 of the impairment test thatc tared the implied fair value of ARM's goodwill with the book value of the goodwill. Utilizing the service''.f a third party valuation firm the Company allocated the fair value of the enterprise to ABM's assets other than goodwill. The excess of the residual fair value after this allocation wfs then assigned as the implied fair value of ARM's goodwill. Since the carrying value of ARM's goodwill exceeded the calculated implied fair value of that goodwill,an - impairment loss of $3.2 million and-$2.3 million kas recognized in the accompanying consolidated statements of operations and comprehensive loss for\the''%rs ended December 31, 2015 and 2014, respectively. ; 0In addition, ARM's customer losses also triggered,`an impairment review of ARM's long-lived assets (primarily intangible asse 'The recoveability`of assets to be held and used is measured by a comparison of the carrying amounfcif ant oup`of assets to future net cash flows expected to be generated by the asset or group of assets. If suc sets are csidered to be impaired, the impairment to be recognized is measured by the`'amount by Whir he carrying amount of the assets exceeds the fair value of the assets. Assets to be disposed of are reported at4,he lower of the carrying amount or fair value less costs to sell.Since the carrying=value of ARMs intangible assets (other than goodwill) exceeded the calculated implied fair value of those intangible assets, an additional impairment loss of $4.2 million was recognized in the accompang consolidated statements of operations and comprehensive loss for the year ended De a tnber- 12015. v i 20 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 (7) Property and Equipment,Net Property and equipment, at cost and respective estimated useful lives, are 'classified as follows at December 31, 2015 and 2014(in thousands): 2015 2014 ; g Land $ 640 $ . 640 Building 4,672:.' 4,672 27 years Equipment 20,830.', ''1 14,06 3 years Clinical field data systems 8,256 �. ' 8 22 3 yyears Furniture and fixtures 3;026 22 5-7 years Leasehold improvements 6,514 `,:`�, 5,162 (a) Total 43,938 '?35,309 Less accumulated depreciation and amortization £ ,,,(22,477) (16,658) $ n ' 21,461 '' 18,651 (a) The lesser of the lease term or the economic:use }life of the improvements. A Depreciation and amortizatih_expense rented to property and equipment was$7.6 million and$5.7 million for the years ended December' Yr 415 and-2..014,respectively. .----- 16,,,:t:,,,. ...,,.--,-, a K. X 21 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31, 2015 and 2014 (8) Intangible Assets,Netan,,. Intangible assets and accumulated amortization at December 31,2015 and 2014, 3he remaining weighted average useful life at December 31,2015 consisted of the following(dollars in thousands): Weighted `" ' { average useful - -410,0.- life(in years) -\ 2015. 2014 Customer•related, net of accumulated amortization of$103,193 and$83,083 as {' of December 31, 2015 and 2014, respectively 10 $ '\ 181,537 206,345 Technology•related, net of accumulated amortization of$42,014 and$48,788 as of December 31, 2015 and 2014, V. respectively 6 37,463 43,380 Marketing•related, net of accumulated amortization of$6,438 and$7,171 as if December 31,2015 and 2014, '` •.' respectively x'X. N1 9,948 11,781 4N. VA $ 228,948 261,506 c , --V:-,, � 4 '141/. . -?, All intangible assets are si7b ect "amortizatioh and are amortized over their useful lives using the straight line method.Amatizahon ex ensu lated to intangible assets was$35.7 million and$34.8 million for 2015 and 2014, respect yr Estim ed arlioJtization expense is as follows (in thousands) for the year ending Decemberca: +, a. =I 16.>.- $ 31,892 ` Z 7 30,577 -,..r 227,774 27,312 ,, 23,619 Thereafter 87,774 $ 228,948 22 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 (9) Long-term Debt Long-term debt consisted of the following at December 31,2015 and 2014(in thds): 2015 '\ 2014 Revolving credit facility $. 58,000 60,000 Senior credit facility—term loans 261,013 267,881 Subordinated loans ' 112,000 112,000 Total debt 431,013 439,881 Less amounts payable in less than one year (6.869) (6,869) $ 424,144 433,012 Except as provided for below,aggregate annual i ',,4 j s s of 1or -term debt were as follows at December 31, 2015(in thousands): •_ Year ending December 31: \ 2016 $ 6,869 2017 6,869 20.18 6,869 2019,x, 298,406 2020 112,000 j $ 431,013 Senior Financing - 1 Overview • At the end of 2013, the Company had an outstanding$380.0 million Credit Agreement that provided term loans in the amount off$330.0 million and a revolving credit facility of$50 million (the Senior Credit Facility)and a$112.0 million Senior Subordinated Loan Agreement(the Subordinated Loan Agreement), which. •1lectivelj are herein referred to as the Senior Financing. On March ,2014, the Company amended its Senior Credit Facility to (i) increase the revolving loan commitments from$50.0 million to $82.0 million, (ii)provide a more favorable interest rate structure and less restrictive financial ratio covenants, (iii)use the proceeds of Revolving Credit Loans to repay $47.0 million in outstanding Term Loans and(iv)extended the maturity date of the Senior Credit Facility to December 27,2019. Additionally, in August 2015, the Company amended its Senior Credit Facility and Subordinated Loan Agreement to provide less restrictive financial ratio covenants. The financing fees related to both the March 2014 and August 2015 amendments aggregating approximately$1.4 million, have been capitalized 23 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 and will be amortized as an adjustment of interest expense over the new term of the amended Senior Credit Facility in accordance with the guidance provided in ASC Topic 470 50. <, Senior Credit Facility - + �, The Senior Credit Facility consists of(i)a $330.0 million to 'an:',cility (the Term Loans)maturing December 27,2019 of which$261.0 million and$267.9 millio a `. out"r>>L.ing at'December 31,2015 and 2014, respectively, (ii)an $82.0 million revolving credit f `ie the Re , ingredit Facility), which expires December 27,2019 of which$58.0 million and$60':0 millio ';,. outst '3i2_nggat December 31,2015 and 2014,respectively. The Senior Credit Facility also provides a swing line loan commitment (tti- Swing Line Facility), which expires December 27, 2019, under which there were no borrowings outstanding at December 31,2015 and 2014, and provisions for the issuance of comnircial and standby letters of credit(LOCs)on behalf of the Company,none of which were issued or outstanding aecember,31,2015 and 2014.Borrowings under the Swing Line Facility, together with outstanding LOCA reduce available borrowings under the Revolving Credit Facility,and each are subject to a$15.0 million sublirm All borrowings outstanding under the Swing Line Facility or amounts drawn pursuant to LOCs are to be repaid no later than five business days prior to the expiration of the Revolve Credit,Facility. til Borrowings under the Ser` Credit Facility are secured by substantially all of the assets of the Company and its subsidiaries including . 1.•t,` he Company's outstanding capital stock. The Senior Credit Facility limits the Company's ability to •ose of assets, incur additional indebtedness or contingent obligations, prepay the subo dated debt en• F in mergers or consolidations, suffer additional liens, or engage in certain transactions with'.affiliates. '''e Senior Credit Facility contains various customary covenants requiring that the Company comply with certain specified financial ratios and tests. Interest and Other Fees Borrowings under the Senior Credit Facility bear interest, at the Company's option, at an applicable fixed margin over thejender'vs.base rate or London Interbank Offered Rate(LIBOR).The interest rate on LIBOR borrowings may tip=feed for periods ranging from one to six months or, with the consent of all relevant lenders nine or?twelve months thereafter. LIBORs are set at the greater of the quoted rate or 1.00%(1.25% prior td ttte40 2014 amendment). The Company pays an annual administrative fee of$0.1 million and an unused commitment fee associated with the revolving portion of the facility(see discussion below). Mandatory and Other Prepayments The Senior Credit Facility permits prepayments by the Company at any time in whole or in part without premium or penalty. The Company must make mandatory repayments with the occurrence of specified events such as receipt of major casualty proceeds, proceeds from the sale of debt or equity securities, or proceeds from asset dispositions,which are not otherwise reinvested in the business or used for acquisitions or investments as such are permitted in the facility. 24 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 Provided below is a detailed discussion of each component of the Senior Credit Facility. • (a) Revolving Credit Facility • The Revolving Credit Facility provides for borrowings up to $82.0 million.\Proceeds from the Revolving Credit Facility are used for working capital,capital expenditures,acquisiii ns : 'd general corporate purposes. Advances under the Revolving Credit Facility are unrestricted .ng as such advances are used in accordance with the definition of"use ofproceeds"and the aggregate outstanding balance of the revolving credit loans, swing line loans, and,letter of credit obligations do not exceed $82.0 million. Borrowings under the revolving credit facility(including swing line borrowings) bear interest as discussed above plus a fixed bank margin of 3.0%for LIBOR ldas'or 2.0%for Base Rate Loans. Prior to the amendment in March 2014, the borrowings under the revolver bore interest, as discussed above, plus a fixed bank margin of 4.5%for LIBOR loans or 3.5% for Base Rate Loans. Interest rates on the Revolving Credit Faculty ranged from 4 00% to 5.50% during 2015 and from 4.00%to 5.75%during 2014. e- Interest is payable quarterly in arrears for e4!e loans i?tcludtng swing line borrowings.Interest on LIBOR loans is payable on the last day of each,interest period as determined by the disbursement, conversion,or continuation of such loan and its duration:'Interest is due on each quarterly anniversary of LIBOR loans with ternitin excess of three mono's'. An unused commitrntyfee ranging from 0.50%to 0.75%of the unused portion of the revolving line of the credit facility is Ziue qu erly in arrears.During 2015 and 2014,the Company recognized unused commitment fees at a rate-,of, .75%. LOC fees accrue at the appli°' le rate for revolving credit loans and are paid.quarterly in arrears. In addition fronting fees (not to ed 1.0%per annum)and customary administrative and processing fees are assessed with respectto each LOC. (b) Ten Loans - Term Loans bear interest,as discussed above,plus a fixed bank margin over the lender's base rate or LIBOR.Term Loah margins are 3.75%and 4.75%for Base Rate loans and LIBOR loans,respectively. • Prior to the March 2014 amendment,the Term Loan margins were 5.00%and 4.00%for LIBOR and base rate borrowings, respectively. Interest rates on the Term Loans ranged from 5.75% to 7.25% during 2015 and 5.75%to 7.00%during 2014. The repayment terms under the Senior Credit Facility require quarterly principal payments on the Term Loans of approximately $1.7 million with a balloon payment of approximately $240.0 million on December 27,2019. However, at which time that the Gross First Lien Leverage Ratio, as defined in the facility, is less than 4.25 to 1.00, then the quarterly amortization payments will be permanently reduced to$1.2 million. 25 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 Subordinated Debt Financing Overview .',\ As noted above,as part of the Senior Financing arrangement the Company:has a$r4u.0 million Senior Subordinated Loan Agreement (the Subordinated Loan Agreement) vas amen.•d • ; arch 7, 2014, to provide a more favorable interest rate structure, provide I restrictive ';'.1 mai ratio covenants, and extend the maturity date through June 27, 2020. As of December 31$$15,the Senior Loan Agreement may be prepaid in whole or in part without penalty. The Subordinated Loans are secured by substantially all of the assets of the Company and its su diaries including all of the Company's outstanding capital stock.The Subordinated Loans limit the Company's ability to dispose of assets,incur additional indebtedness or contingent obligations,engage in mergers or consolidations, suffer additional liens, or engage in certain transactions with affiliates. The Subordinated Loans contain various customary covenants requiring that'the Company omply with certain specified financial ratios and tests. Interest and Other Fees ; i Borrowings under the Subordinated Loans bear interest,' at the Company's option, at an applicable fixed margin over the lender's base rate or LIBOR.The interest rate on LIBOR borrowings may be fixed for periods rangi from one to six mo •s or, with the consent of all relevant lenders, nine or twelve months there. • LIBORs are set at a greater of the quoted rate or 1.00%(1.25%prior to the March 2014 am-.) ent). 3,, Subordinated Loans bear ' . est, as discussed above, plus a fixed bank margin of 8.25%and 7.25% for Base Rate-Loans and L :OR Loans, respectively. Prior to the March 2014 amendment the bank margin was 9.00%and 8:00%f IBOR and base rate borrowings,respectively.The interest rate on the Subordinated Loans was 9.256/0 during both 2015 and 2014. he C Company pays an annual administrative fee of$0.1 million. 'fMandator and Other Prepayments The Company must make mandatory repayments with the occurrence of specified events such as receipt of major casualty proceeds,proceeds from the sale of debt or equity securities or proceeds from asset dispositions, which are not otherwise reinvested in the business or used for acquisitions or investments as such are permitted in the Facility. 26 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 (10) Income Taxes Income tax benefit for the years ended December 31,2015 and 2014 was as folloti ,in thousands): ;201-5 � `�; 2014 Current tax expense: ,' ' FedeFeral ` : 2- — € - 5531 -A — Foreign AG l oi, 842 \ 74' 842 Deferred tax benefit: Federal - `,1,177) (5,456) State A, t* (1,429) (489) Foreign (310) (419) N (12,916) (6,364) - Income tax benefit - .4 ''$ (12,069) (5,522) A reconciliation of the benef o a:co , nte ' es toy le expected amount based on the federal statutory rate of 35%for both 2015 and 4 is as ''''.1,..w sTu h•'wands): • , gip'' . -� 2015 2014 Expected federal income tai $ (11,466) (5,096) State taxes,net of federal benefit (582) 265 Nondeductible items32 (729) Rate change e s " ' g on deferred taxe ' (17) 120 Foreign rate differential (97) 169 Other, netV\ 61 (251) .1 $ (12,069) (5,522) 27 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 The tax effects of temporary differences that give rise to significant portions of the deferred tax assets and liabilities at December 31,2015 and 2014 are presented below(in thousands): ,,a,,15 2014 Deferred tax assets: Equity-based compensation $ 7103 5,423 Allowance for doubtful accounts 422vt 368 Accrued bonus 518' - 453 Accrued vacation ,066 835 • Deferred revenue 0_ 364 Acquisition costs 4,248 Net operating loss carryforwards 17,721 12,200 Federal tax credits )1,055 1,024 Other 766 542 Gross deferred income tax assets',, 28,971 25,457 Deferred tax liabilities: ., Intangible and other long-lived assets y -4 57,272 69,896 Goodwill Tri 21,774 18,149 Other 494 721 Gross deferredirtcometax liabilities 79,540 88,766 Less valuation allowance ;- == ,' (101) (595) Net defe ed in,,,, .-x liabilities $ (50,670) (63,904) -,tTF C ,- — 2015 2014' , Consoli, ::d balance sheet preset%ion: Curr- iQ deferred income tax assets,net $ — 2,192 Noncu'`, t deferred income tax assets,net — 419 Noncurr_i deferred income tax liabilities,net (50,670) (66,515) 'et:afirred income tax liabilities $ (50,670) (63,904) The Company has recorded a deferred tax asset of$17.7 million reflecting the benefit of federal and state net operating loss carryforwards. Such deferred tax assets expire at various dates from 2023 through 2035. The Company recognizes valuation allowances on deferred tax assets reported if, based on the weight of evidence,management believes that it is more likely than not that some or all of the deferred tax assets will not be realized. The valuation allowance is based on the Company's estimates of taxable income and the period over which deferred tax assets will be recovered. A valuation allowance of $0.1 million and $0.6 million was recorded at December 31, 2015 and 2014, respectively. The valuation allowance established in 2014 related to certain net operating losses acquired in the Optima acquisition.Management believes remaining deferred tax assets will be recognized due to the reversal of significant taxable temporary differences. 28 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 Due to the change of ownership provisions of the Tax Reform Act of 1986,utilization of a portion of the Company's domestic net operating loss and tax credit carryforwards may be lint d in future periods.The Company does not expect the carryforwards to expire before being applied to reduce future income tax liabilities. A With few exceptions,as of December 31,2015,the Company is no lo er subject to U.S. federal,state,local, or foreign examinations by tax authorities for years before 2011.1:k as no liability for unrecognized tax benefits as of December 31, 2015 and 2014. The Compa 'few s interest accrued related to unrecognized tax benefits and penalties as interest expense i --_ comp ,g consolidated statements of operations and comprehensive loss. , , '-% ). (11) Fair Value of Assets and Liabilities Fair value is defined as the price that would be rived to sell an asset or pal to transfer a liability(i.e.,the exit price)in an orderly transaction between mart participants at the measurement date.In determining fair value,the Company uses various valuation appr'ozches 'ncludmg quoted market prices and discounted cash flows.A hierarchy for inputs used in measuring fair f ue thati aximizes the use of observable inputs and • minimizes the use of unobservable inputs by requirmgthat the ►ost observable input be used when available. Observable inputs are inputs that market participantsuld ee in pricing the asset or liability developed based on market data obtained from independent sources(Unobservable inputs are inputs that reflect a company's judgment concerning the assumptions that market participants would use in pricing the asset or liability developed based on the best information available under the circumstances. The fair value hierarchy is broken down into three levels based on the reliability of inputs as follows: • Level 1 --Valuations based on,quoted prices in active markets for identical instruments that the Company is able to access.Sinc aluations are based on quoted prices that are readily and regularly available in. an active market, valuation of these products does not entail a significant degree of judgment . 4 • . 'ke '4., —Valu:4 ens l ed onquotedprices in active markets �� ,. for instruments that are similar, or quot=` 3 'ces in 6).: kets that are not active for identical or similar instruments, and model-derived valuatio-:N.n-whfd all significant inputs and significant value drivers are observable in active markets. • '"k\Level 3 -':Valuations based on inputs that are unobservable and significant to the overall fair value measurement. Fair Value of Financial Assets The Company does not have any financial assets or liabilities that are required to be measured at fair value on a recurring basis. The carrying amount of accounts receivable,notes receivable,accounts payable and accrued expenses,client collections payable, other current liabilities,and accrued interest approximate fair value based on the short maturity of these accounts. 29 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31, 2015 and 2014 At December 31, 2015 and 2014, the carrying value of the Senior Credit Facility and Subordinated loans approximated fair market values because the interest rates are variable in ;. e and in management's assessment,there has been no significant change in the Company's credit rating. V 14 (12) Transactions with Related Parties `' F Advisory and Professional Services Fees Paid to Related Parties The Company has an Advisory Services Agreement(the ASA)datedAu23,2010,with THL Managers VI, LLC, a Delaware limited liability company (Sponsor) who ivan affiliate of the Company's majority equity holders. Pursuant to the terms of the ASA, the Sponsor agrees to pre de'the Company certain management consulting,financial,and other advisory services as requested from me to time by the Board of Directors(BOD)or other governing body of the Company,as applicable,,and agreed to by the Sponsor. The ASA also provides for a Periodic Retainer-Pe (the Periodic Fee) in an amount per year equal to the greater of(i)$0.8 million or (ii) 1.5% of cosidated Earnings Before Income Taxes, Depreciation and Amortization (EBITDA) (as defined in the ASAfor the immediately preceding fiscal year or such other amount or formula as may be mutually agreed between the Company and the Sponsor.Fees are payable in equal quarterly installments in advance on the first day of eachftscal quarter.The Company paid$1.1 million in both 2015 and 2014, pursuant to the Periodic Fee. Theeiodic Fee payable in respect of the first fiscal quarter of any fiscal year sha be$0.2 million, with the Periodic Fee payable in succeeding quarters to be adjusted to include any inert ental amount deemed payable in connection with the consolidated EBITDA performance measuremen° ;a the event of an initial public offering or change of control event,the Company shall pay an amount al N�the4 et pr quesent value (using a discount rate equal to the then yield on U.S.Treasury securities alike m rity)of the Periodic Fees that would have been payable to Sponsor with respect to the peo a� om tfi dal `` (such transaction until the scheduled date of termination of the APA (the tenth anniversa the erger) In addit o i, upo • ;e co, umm Lc n of any acquisitions, divestitures, financings, refinancings, mergers, recapitalizations,ch:a:=e of '&01 events,or other transactions by the Company,Sponsor is entitled to a fee equal to up Ep 1%oft eg',ggrate gross value of such transaction(plus reimbursement of expenses). w Furthermore, the Company agrees to indemnify the Sponsor and its affiliates against any and all actions including,and without limitation,all professional fees and expenses. (13) Benefit Plan The Company provides a 401(k)plan for the benefit of eligible employees as defined by the plan.The 401(k) plan does not require a Company match. Any employer match is at the discretion of the Company. During 2015 and 2014, the Company agreed to match 25% of participating employees' first 6% of compensation amounting to approximately$0.7 million and $0.5 million, respectively. At December 31, 2015 and 2014, this amount was accrued and included in "Accrued payroll and related benefits" in the accompanying consolidated balance sheets.The 2015 and 2014 accruals were paid in March of the subsequent years. 30 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 (14) Commitments and Contingencies (a) Litigation `\ The Company is from time to time involved in litigation arising in the ordinary`Coyrse of business. It is the opinion of management, after consulting with its legal counsel, that the outcorqe ol,xh cases will not have a material adverse impact on the consolidated financial position or result operations of the Company. (b) Lease Commitments i---3-1- The Company leases office equipment and conductsits operatio a. ,from le-. d office space located in Oklahoma City, Oklahoma; Jacksonville, Fort Lauderdale, an' : iami, 1lorida; Pleasanton, and Artesia,California;Denver, Colorado;Houston,Dallas and San An :o, Texas;Mechanicsburg and Pittsburgh,Pennsylvania;Milwaukee,W. sin;Columbus,Ohio;Augusta,Georgia;Raleigh,North Carolina; Williamsburg and Arlingto irginia; Nashville, Tennessee; Bayside, New York, and Warren,Michigan.The leases expire on ' 'o tes through December 2020 and thereafter. Under the terms of most of the leases,the Companyequired to pay all taxes,insurance,and maintenance. Future minimum rental payments for noncancelab .1zas s having an initial lease term in excess of one year at December 31,2015 are summarized as follow$(in thousands): Operating leases Ye . >- ding December 31: �'� $.20 $ 5,218 . 17 `�,� � „^ 4,558 _ °•. 4,180 3,514 Y - 2020 3,266 hereafter 12,393 Total minimum payments $ 33,129 MI i ,-,sii:r; `e operating leases provide for renewal at varying escalations. Fixed rent escalations have been included in the table disclosed above. Rent expense incurred under operating leases totaled$6.6 million and$6.3 million for the years ended December 31,2015 and 2014,respectively. The Company has been granted lease incentives such as rent abatement periods and leasehold allowances under certain of its leases. The accompanying consolidated statements of operations and comprehensive loss reflect rent expense on a straight-line basis over the term of the respective leases. An obligation of $2.1 million and $1.8 million representing the remaining unamortized lease 31 (Continued) Proprietary and Confidential-Intermedix Corp. I INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 incentives is included in other long-term liabilities in the accompanying consolidated balance sheets at December 31,2015 and 2014,respectively. t:_:. The Company had capital lease obligations totaling$1.9 million and$0 as of 11`k„mber 31, 2015 and 2014. The current portion of the capital lease obligation as of; Decemb "_ , 20 , totaled approximately $0.9 million and is included in other curr nt fiat `ties,)n th • panying consolidated balance sheet. 3 f (15) Stock Based Incentive Compensation Intermedia Corporation 2010 Stock Option Plan(the 2010 Stock Option Plait As noted in note 2(o),the Company participates in a stock option plan: e Parent. Pursuant to the terms of the 2010 Stock Option Plan,the Parent is aut .rized to issue options to'quire up to 501,352 shares of common stock of the Parent to employees an. ice providers of the Company. Certain members of the Company's management and professional st. ere issued 10-year options to purchase shares of common stock of the Parent.All stock options granted un. h.. 10 Stock Option Plan were granted with an exercise price at least equal to the underlying stock's fair v:a:t at the date of grant. The options vest at a rate of 20% per year over a 5-year term. ''^b Any unexercised portion of the options will automatic. y terminate upon the tenth anniversary of the issuance date or following termination of employment. In addition,pursuant to the grant agreements under which such stock options were issued, the board of directors has the right to cause all or any portion of any nonvested options to immediately vest and become exercisable upon a sale of the Company or at such other time as the board of directors may<elect. Stock-based compensation expense ia�shown as an individual line on the accompanying consolidated statements. t. ogerattozns and comprehensive loss. As of December 31, 2015 and 2014, respectively, $10.1 m. F.n ands ,7 3-million of total unrecognized compensation expense related to nonvested option awards i expected' •r,be rec,, gnized over a weighted average period of 2.3 and 1.4 years. The Company aceofls ff its equia. eawards using ASC Topic 718. This statement requires entities to measure co' pensatio i, expense-asor all equity-based awardsgranted, modified, or settled using the fair value msurement `' d to recognize the costs in income over the requisite service period, which is generally the ve ted .eriod.The Company has elected to recognize these costs on a straight-line basis. Y 32 (Continued) Proprietary and Confidential-Intermedix Corp. INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31, 2015 and 2014 The fair value of each stock option award is estimated on the date of grant using BSM option pricing model. The weighted average grant-date value of each option grant awarded during the years ended 2015 and 2014 was as follows: RFs{ 2615--, 2U14 Weighted average grant-date value of options granted '.$ r' 115 0k '41$`x'7 Assumptions > Risk-free rate of return1.63.-1.84°/4 1 .82-1.96% Expected life in years 6.50 Expected volatility . 48.84k 46.6% Expected dividend yield — ,J The risk-free rate of return is determined based of h yield curve Of:CIS.Treasury rates ranging from five to seven years, which is the period commensur�e��tiwith the expected life of options granted. Expected life in years is calculated using the simplified method;�k^e�.. ^itted under ASC Topic 718,given the Parent's lack of historical experience with respect to the Lives of tions granted and postvesting termination patterns. Since the Parent has no historical basis for-deterlritRing5 own volatility, the expected volatility is established based on a peer grouncompri;sing companies''ii r ar to that of the Parent.The expected dividend yield is zero as the Parent has not paid any cash dividends and does not anticipate it will do so in the foreseeable future. „;, A summary of stock option. , i i,def the,2010Stock Option Plan during the years ended 2015 and 2014 is as follows(in thousands;,exc"' or exercise price and term): y z,` Weighted Weighted average Aggregate average remaining calculated J Number exercise contractual intrinsic y of options price term(years) value Qntsfanding at Decembe01,2013 489 $ 100.09 3.68 $ 18,778 Grantedduring2Q14 ,^,'.1 26 106.17 6.29 1,399 Exercised _ J (1) 68.72 2 (14) Can cc1ed or forfeited (22) 103.35 3.78 (959) Outstancling.at December 31,2014 492 116.27 2.82 19204 Granted during 2015 154 155.32 5.79 7,636 Exercised — — — Canceled or forfeited (29) 113.27 2.43 (1,140) Outstanding at December 31,2015 617 126.15 2.97 $ 25,700 33 (Continued) Proprietary and Confidential-Intermedix Corp. • INTERMEDIX CORPORATION AND SUBSIDIARIES (a wholly owned subsidiary of Intermedix Holdings Inc.) Notes to Consolidated Financial Statements December 31,2015 and 2014 (16) Subsequent Events The Company has reviewed and evaluated subsequent events from the balance sh4,,ee date of December 31, 2015 through April 29, 2016. ,-,.., meg , :' L } ;. vat 5�4 }yr ate' e, i - _ _.4-,--il._ --:-) \___ 34 Proprietary and Confidential-Intermedix Corp. ATTACHMENT D INSURANCE REQUIREMENTS APPENDIX F Insurance Requirements 2017-002-JC Emergency Medical Transport Billing and Collection Services PROCUREMENT DEPARTMENT 1755 Meridian Ave, 3rd Floor Miami Beach, Florida 33139 RFP 2017-002-JC 50 leD MIAMIBEACH INSURANCE REQUIREMENTS This document sets forth the minimum levels of insurance that the contractor is required to maintain throughout the term of the contract and any renewal periods. XXX 1. Workers' Compensation and Employer's Liability per the Statutory limits of the state of Florida. XXX 2. Comprehensive General Liability (occurrence form), limits of liability $ 1,000,000.00 per occurrence for bodily injury property damage to include Premises/ Operations; Products, Completed Operations and Contractual Liability. Contractual Liability and Contractual Indemnity (Hold harmless endorsement exactly as written in "insurance requirements"of specifications). XXX 3. Automobile Liability-$1,000,000 each occurrence -owned/non-owned/hired automobiles included. 4. Excess Liability-$ .00 per occurrence to follow the primary coverages. XXX 5. The City must be named as and additional insured on the liability policies; and it must be stated on the certificate. 6. Other Insurance as indicated: Builders Risk completed value $ .00 Liquor Liability $ .00 Fire Legal Liability $ .00 Protection and Indemnity $ .00 Employee Dishonesty Bond $ .00 Other $ .00 XXX 7. Thirty(30) days written cancellation notice required. XXX 8. Best's guide rating B+:VI or better, latest edition. XXX 9. The certificate must state the proposal number and title The City of Miami Beach is self-insured. Any and all claim payments made from self-insurance are subject to the limits and provisions of Florida Statute 768.28, the Florida Constitution, and any other applicable Statutes. RFP 2017-002-)C s 1