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Professional Services Agreement between CMB & Digitech EMS Billing LLC 2 cz3-321z3 DocuSign Envelope ID:48899663-5Al2-46BD-B728-2A028FB0A560 Contract no.23-0 t 5-01 PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI BEACH AND DIGITECH EMS BILLING LLC FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES PURSUANT TO RFP-2023-015-ND MAR 2 9 2024 This Professional Services Agreement ("Agreement") is entered into this ("Effective Date"), 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 (the "City''), and DIGITECH EMS BILLING LLC, a Limited Liability Company whose address is 480 Bedford Road, Chappaqua, New York, 10514 ("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 Jorge Linares, Division Chief, Fire Department 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. Proposal Documents: Proposal Documents shall mean City of Miami Beach RFP, No. 2023- 015-ND for EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION, together with all amendments 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 Proposal Documents and this Agreement, the following order of precedent shall prevail: this Agreement; the RFP, and the Proposal. 1 DocuSign Envelope ID'4B899663-5Al2-46BD-B7213-2AD28FB0A560 Contract no.23-015-01 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. 26724; and fax number(305)673-7529. 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: Jorge Linares, Division Chief Email: iordeliriarescmiamibeachfl.dov 2.2 Contractor's Services, and any deliverables incident thereto, shall be completed in accordance with the timeline and/or schedule in Exhibit "A" hereto. SECTION 3 TERM The term of this Agreement ("Term") shall commence upon execution of this Agreement by all parties hereto(the Effective Date set forth on p. 1 hereof), and shall have an initial term of three (3) years with two (2), one (1) year renewal options, 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. Notwithstanding the Term provided herein, Contractor shall adhere to any specific timelines, schedules, dates, and/or performance milestones for completion and delivery of the Services. as same is/are set forth in the timeline and/or schedule referenced in Exhibit 'A" hereto. DocuSign Envelope ID:4B899663-5Al2-468D-B728-2AD28FB0A560 Contract no.23-015-0 t SECTION 4 FEE 4.1 In consideration of the Services to be provided, Contractor shall be compensated in accordance with the established fees attached hereto as Exhibit"A." 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 Exhibit "A", 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 the City disputes any part of the invoice amounts, such dispute shall be raised in writing to Contractor within (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 hereof. 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: Payables(miamiheachfl.gov 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. 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 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, the Contractor may terminate this Agreement upon the expiration of said thirty(30) day calendar period. DocuSign Envelope ID:4B899663-5Al2-46BD-B72B-2AD28FBOA560 Contract no.23-015-0I 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 rights 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, defend and hold harmless the City of Miami Beach and its officers, employees, agents, and contractors, from and against any and all 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 4 DocuSipn Envelope ID:48899663-5Al2.46BD-B72B-2AD28FB0A560 Contract no.23-01.5-0 I 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 parties agree that one percent (1%) of the total compensation to Contractor for performance of the Services under this Agreement is the specific consideration from the City to the Contractor for the Contractor's Indemnity agreement. The provisions of this Section 6.1 and of this indemnification shall survive termination or expiration of this Agreement. 8.2 INSURANCE REQUIREMENTS The Contractor shall maintain the below required insurance in effect prior to awarding the agreement and for the duration of the agreement. The maintenance of proper insurance coverage is a material element of the agreement and failure to maintain or renew coverage may be treated as a material breach of the contract, which could result in withholding of payments or termination of the Agreement. A. Workers' Compensation Insurance for all employees of the Contractor as required by Florida Statute Chapter 440 and Employer Liability Insurance with a limit of no less than $1,000,000 per accident for bodily injury or disease. Should the Contractor be exempt from this Statute, the Contractor and each employee shall hold the City harmless from any injury incurred during performance of the Contract. The exempt contractor shall also submit (i) a written statement detailing the number of employees and that they are not required to carry Workers' Compensation insurance and do not anticipate hiring any additional employees during the term of this contract or (ii) a copy of a Certificate of Exemption. B. Commercial General Liability Insurance on an occurrence basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence, and $2,000,000 general aggregate. C. Automobile Liability Insurance covering any automobile, if vendor has no owned automobiles, then coverage for hired and non-owned automobiles, with limit no less than $1,000,000 combined per accident for bodily injury and property damage. D. Professional Liability (Errors & Omissions) Insurance appropriate to the Contractor's profession, with limit no less than $1,000,000. 6.3 Additional Insured - City of Miami Beach must be included by endorsement as an additional insured with respect to all liability policies (except Professional Liability and Workers' Compensation)arising out of work or operations performed on behalf of the Contractor including 5 DocuSign Envelope ID:4B899663-5Al2-46BD-B728-2AD28FBOA560 C'onirnct no.23-015-0 I materials, parts, or equipment furnished in connection with such work or operations and automobiles owned, leased, hired or borrowed in the form of an endorsement to the Contractor's insurance. 6.4 Notice of Cancellation - Each insurance policy required above shall provide that coverage shall not be cancelled, except with notice to the City of Miami Beach c/o EXIGIS Insurance Compliance Services. 6.5 Waiver of Subrogation - Contractor agrees to obtain any endorsement that may be necessary to affect the waiver of subrogation on the coverages required. However, this provision applies regardless of whether the City has received a waiver of subrogation endorsement from the insurer. 6.6 Acceptability of Insurers - Insurance must be placed with insurers with a current A.M. Best rating of A VII or higher. If not rated, exceptions may he made for members of the Florida Insurance Funds (i.e. FWCIGA, FAJUA). Carriers may also be considered if they are licensed and authorized to do insurance business in the State of Florida. 6.7 Verification of Coverage- Contractor shall furnish the City with original certificates and amendatory endorsements, or copies of the applicable insurance language, effecting coverage required by this contract. All certificates and endorsements are to be received and approved by the City before work commences. However, failure to obtain the required documents prior to the work beginning shall not waive the Contractor's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements, required by these specifications, at any time CERTIFICATE HOLDER ON ALL COI MUST READ: CITY OF MIAMI BEACH do EXIGIS Insurance Compliance Services P.O. Box 947 Murrieta, CA 92564 Kindly submit all certificates of insurance, endorsements, exemption letters to our servicing agent, EXIGIS, at: Certificates-miamibeachRriskworks.corn 6.8 Special Risks or Circumstances - The City of Miami Beach reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances Compliance with the foregoing requirements shall riot relieve the vendor of his liability and obligation under this section or under any other section of this agreement. 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. ii DocuSign Envelope ID:4B899663-5Al2-46BD-B7213-2AD28FBOA560 Contract no.23-015-01 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 by jury of any civil litigation related to or arising out of this Agreement. SECTION 8 LIMITATION OF CITY'S LIABILITY Excluding any willful misconduct or gross negligence by the City and/or any violation by City of its obligations under the Business Associate Agreement (Exhibit "X" 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. 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; COPYRIGHTi AND CONFIDENTIAL FINDINGS 9.1 DUTY OF CARE With respect to the performance of the Services 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 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 and relating to the City, as well as all information specifications, processes, data and findings, are intended to be the property of the City and DocuSign Envelope ID 4B899663-5Al2-4613D-B72B-2AD28FB0A560 Contract no.23-015-01 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-Contractors, without the prior written consent of the City Manager. 9.4 EXCLUDED PERSONS If any refunds of patient's 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 Persons Refund or otherwise include such Excluded Person Refunds in its calculation of Net collection 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 INSPECTOR GENERAL AUDIT RIGHTS (A) Pursuant to Section 2-256 of the Code of the City of Miami Beach, the City has established the Office of the Inspector General which may, on a random basis, perform reviews, audits, inspections and investigations on all City contracts, throughout the 8 DocuSign Envelope ID'.4B899663-5Al2-468D-B7213-2AD28FBOA560 Contract no.23-015-01 duration of said contracts This random audit is separate and distinct from any other audit performed by or on behalf of the City. (t3) The Office of the Inspector General is authorized to investigate City affairs and empowered to review past, present and proposed City programs, accounts, records, contracts and transactions. In addition, the Inspector General has the power to subpoena witnesses, administer oaths, require the production of witnesses and monitor City projects and programs Monitoring of an existing City project or program may include a report concerning whether the project is on time, within budget and in conformance with the contract documents and applicable law. The Inspector General shall have the power to audit, investigate, monitor, oversee, inspect and review operations, activities, performance and procurement process including but not limited to project design, bid specifications, (bid/proposal) submittals, activities of the Contractor, its officers, agents and employees, lobbyists. City staff and elected officials to ensure compliance with the contract documents and to detect fraud and corruption. Pursuant to Section 2-378 of the City Code, the City is allocating a percentage of its overall annual contract expenditures to fund the activities and operations of the Office of Inspector General. (C) Upon ten (10) days written notice to the Contractor, the Contractor shall make all requested records and documents available to the Inspector General for inspection and copying. The Inspector General is empowered to retain the services of independent private sector auditors to audit, investigate, monitor, oversee, inspect and review operations activities, performance and procurement process including but not limited to project design, bid specifications, (bid/proposal)submittals. activities of the Contractor its officers, agents and employees, lobbyists, City staff and elected officials to ensure compliance with the contract documents and to detect fraud and corruption (0) The Inspector General shall have the right to inspect and copy all documents and records in the Contractor's possession, custody or control which in the Inspector General's sole judgment, pertain to performance of the contract, including, but not limited to original estimate files, change order estimate files, worksheets, proposals and agreements from and with successful subcontractors and suppliers, all project-related correspondence, memoranda, instructions, financial documents, construction documents, (bid/proposal) and contract documents, back-change documents, all documents and records which involve cash, trade or volume discounts, insurance proceeds, rebates, or dividends received, payroll and personnel records and supporting documentation for the aforesaid documents and records. iE) The Contractor shall make available at its office at all reasonable times the records, materials, and other evidence regarding the acquisition (bid preparation) and performance of this Agreement, for examination, audit, or reproduction, until three (3) years after final payment under this Agreement or for any longer period required by statute or by other clauses of this Agreement. In addition: 9 DocuSign Envelope ID:4B899663-5A 12-46BD-872B-2AD28F80A560 Contract no.23-015-01 If this Agreement is completely or partially terminated, the Contractor shall make available records relating to the work terminated until three (3) years after any resulting final termination settlement; and ii. The Contractor shall make available records relating to appeals or to litigation or the settlement of claims arising under or relating to this Agreement until such appeals, litigation, or claims are finally resolved. (F) The provisions in this section shall apply to the Contractor, its officers, agents, employees, subcontractors and suppliers. The Contractor shall incorporate the provisions in this section in all subcontracts and all other agreements executed by the Contractor in connection with the performance of this Agreement. (C) Nothing in this section shall impair any independent right to the City to conduct audits or investigative activities. The provisions of this section are neither intended nor shall they be construed to impose any liability on the City by the Contractor or third parties. 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 o1 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 DocuSign Envelope ID;48899663-5Al2-46BD-B72B-2AD28FBOA560 Contract no.23-015-0 t 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, filrns, 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, it 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; ('1) 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 11 DowSign Envelope ID:4B899663-5Al2-46BD-B72B-2AD28FB0A560 Contract no.23-015-01 (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. (2) Contractor's failure to 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 attorneys' fees, if: a. The court determines that the Contractor unlawfully refused 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 formal. (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(a7MIAMIBEACHFL.GOV PHONE: 305-673-7411 12 DocuSign Envelope ID:48899663-5Al2-46B0-872B-2AD28FB0A560 Contract no.23-015.01 10.8 FORCE MAJEURE (A) A"Force Majeure"event is an event that (i)in fact causes a delay in the performance of the Contractor or the City's obligations under the Agreement, and (ii) is beyond the reasonable control of such party unable to perform the obligation, and (iii) is not due to an intentional act, error, omission, or negligence of such party, and (iv) could not have reasonably been foreseen and prepared for by such party at any time prior to the occurrence of the event. Subject to the foregoing criteria, Force Majeure may include events such as war, civil insurrection, riot, fires, epidemics, pandemics, terrorism, sabotage, explosions, embargo restrictions, quarantine restrictions, transportation accidents, strikes, strong hurricanes or tornadoes, earthquakes, or other acts of God which prevent performance. Force Majeure shall not include technological impossibility, inclement weather, or failure to secure any of the required permits pursuant to the Agreement (B) If the City or Contractor's performance of its contractual obligations is prevented or delayed by an event believed by to be Force Majeure, such party shall immediately, upon learning of the occurrence of the event or of the commencement of any such delay, but in any case within fifteen (15) business days thereof, provide notice: (i) of the occurrence of event of Force Majeure, (ii) of the nature of the event and the cause thereof, (iii) of the anticipated impact on the Agreement, (iv) of the anticipated period of the delay, and (v) of what course of action such party plans to take in order to mitigate the detrimental effects of the event.The timely delivery of the notice of the occurrence of a Force Majeure event is a condition precedent to allowance of any relief pursuant to this section; however, receipt of such notice shall not constitute acceptance that the event claimed to be a Force Majeure event is in fact Force Majeure, and the burden of proof of the occurrence of a Force Majeure event shall be on the requesting party. (C) No party hereto shall be liable for its failure to carry out its obligations under the Agreement during a period when such party is rendered unable, in whole or in part, by Force Majeure to carry out such obligations. The suspension of any of the obligations under this Agreement due to a Force Majeure event shall be of no greater scope and no longer duration than is required. The party shall use its reasonable best efforts to continue to perform its obligations hereunder to the extent such obligations are not affected or are only partially affected by the Force Majeure event, and to correct or cure the event or condition excusing performance and otherwise to remedy its inability to perform to the extent its inability to perform is the direct result of the Force Majeure event with all reasonable dispatch. (D) Obligations pursuant to the Agreement that arose before the occurrence of a Force Majeure event, causing the suspension of performance, shall not be excused as a result of such occurrence unless such occurrence makes such performance not reasonably possible. The obligation to pay money in a timely manner for obligations and liabilities which matured prior to the occurrence of a Force Majeure event shall not be subject to the Force Majeure provisions. (E) Notwithstanding any other provision to the contrary herein, in the event of a Force Majeure occurrence, the City may, at the sole discretion of the City Manager, suspend the City's payment obligations under the Agreement, and may take such action without regard to the notice requirements herein. Additionally, in the event that an event of 13 DocuSign Envelope ID 48899663-5Al2-46BD-872B-2AD28FB0A550 C.ontract no.23-015-01 Force Majeure delays a party's performance under the Agreement for a time period greater than thirty (30) days, the City may, at the sole discretion of the City Manager, terminate the Agreement on a given date, by giving written notice to Contractor of such termination. If the Agreement is terminated pursuant to this section, 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 In no event will any condition of Force Majeure extend this Agreement beyond its stated term. 10.9 E-VERIFY (A) Contractor shall comply with Section 448.095, Florida Statutes, "Employment Eligibility" ('E-Verify Statute"), as may be amended from time to time. Pursuant to the E-Verify Statute, commencing on January 1, 2021, Contractor shall register with and use the E- Verity system to verify the work authorization status of all newly hired employees during the Term of the Agreement. Additionally, Contractor shall expressly require any subcontractor performing work or providing services pursuant to the Agreement to likewise utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract Term. If Contractor enters into a contract with an approved subcontractor, the subcontractor must provide the Contractor with an affidavit stating that the subcontractor does not employ, contract with, or subcontract with an unauthorized alien. Contractor shall maintain a copy of such affidavit for the duration of the Agreement or such other extended period as may be required under this Agreement. (B) TERMINATION RIGHTS. (1) If the City has a good faith belief that Contractor has knowingly violated Section 448.09(1), Florida Statutes, the City shall terminate this Agreement with Contractor for cause, and the City shall thereafter have or owe no further obligation or liability to Contractor. (2) If the City has a good faith belief that a subcontractor has knowingly violated the foregoing Subsection 10.9(A), but the Contractor otherwise complied with such subsection, the City will promptly notify the Contractor and order the Contractor to immediately terminate the Agreement with the subcontractor. Contractor's failure to terminate a subcontractor shall be an event of default under this Agreement, entitling City to terminate the Contractor's contract for cause. (3) A contract terminated under the foregoing Subsection (B)(1) or (B)(2) is not in breach of contract and may not be considered as such. (4) The City or Contractor or a subcontractor may file an action with the Circuit or County Court to challenge a termination under the foregoing Subsection (B)(1)or (B)(2) no later than 20 calendar days after the date on which the contract was terminated. (5) If the City terminates the Agreement with Contractor under the foregoing Subsection (B)(1), Contractor may not he awarded a public contract for at least 1 year after the date of termination of this Agreement. (6) Contractor is liable for any additional costs incurred by the City as a result of the termination of this Agreement under this Section 10 9. 1. DocuSign Envelope ID:4B899663-5Al2-46BD-8728-2AD28FB0A560 Contract no.23-015-I)I SECTION 11 NOTICES Until changed by notice, in writing, all such notices and communications shall be addressed as follows: TO CONTRACTOR: DIGITECH EMS BILLING LLC 480 Bedford Road Chappaqua, New York, 10514 Attn: Mark Schiowitz, President and CEO Ph: 866-300-3334 1407-242-8120 Email: contractstc7i.digitechcomputer.com TO CITY: Fire Department City of Miami Beach 2300 Pinetree Dr. Miami Beach, FL 33140 Attn: Jorge Linares, Division Chief Ph: 305-673-7000 ext. 22076 Email: iorgelinares(c�miamibeachfl.gov All notices mailed electronically to either party shall be deemed to be sufficiently transmitted. 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 WAIVER OF BREACH A party's failure to enforce any provision of this Agreement shall not be deemed a waiver of such provision or modification of this Agreement. A party's waiver of any breach of a provision of this Agreement shall not be deemed a waiver of any subsequent breach and shall not be construed to be a modification of the terms of this Agreement. 15 DoeuSign Envelope ID 4B899663-5A I 2-46BD-B72B-2AD28FBOA560 Contract no.23-015-0I 12.4 JOINT PREPARATION The parties hereto acknowledge that they have sought and received whatever competent advice and counsel as was necessary for them to form a full and complete understanding of all rights and obligations herein and that the preparation of this Agreement has been a joint effort of the parties, the language has been agreed to by parties to express their mutual intent and the resulting document shall not, solely as a matter of judicial construction, be construed more severely against one of the parties than the other. 12.5 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] 1 r, Contract no.23-015-01 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: 124 J/t(J M By: r.J'l Rafael E. Granado, City Clerk na T. Hudak, City Manager Date. MAR 2 9 2024 • F-94 \ IHCORP ORATED' FOR CONTRACTOR: 2 .;:;';.A CH.. APPROVED AS TO DIGITECH EMS BILLING LLC FORM & LANGUAGE &,}FOR EXECUTION E3 Mark Stkiowiti `�,1IA4 174�� y - M City Attorney Date Mark Schiowitz, President and CEO l� Date: Feb 29,2024 17 DocuSign Envelope ID:48899683-5Al2-46BD-8728-2AD28FB0A560 Contract no.23.015-01 EXHIBIT A DESCRIPTION OF SERVICES AND CLIENT RESPONSIBILITIES The City of Miami Beach Fire Rescue collects medical data in the field. Using ESO Solutions, EMS personnel will complete the required computerized patient care report, including billing information; and submit the file,via cellular network,to an offsite location where the server resides.The reports are reviewed by field staff, station officers,medical supervisors, and quality improvement officers remotely at their respective stations. The services to be provided include Exhibit A in addition to the RFP Scope of Services hereby incorporated by reference. I. BILLING SERVICES A. DIGITECH shall provide the following billing and collection services which are contingent upon CLIENT providing all information required: 1. DIGITECH shall perform Patient Care Report ("PCR") processing including: a) Review client-prepared PCR'S for content, level of service and diagnosis; b) Procedure Coding;and c) Eligibility and Insurance Research and Verification. 2. DIGITECH shall perform billing as follows: a) Electronic Invoicing (1) Medicare; (2) Commercial Insurance;and (3) Medicaid (billed weekly). (b) Paper Invoicing (1) CMS-1500 for Commercial Insurance;(2) Self-Pay; (3) Facility (where applicable); and (4) CMS-1500 for Medicaid (where applicable). II. COLLECTION SERVICES A. DIGITECH will provide the following collection services covering the following types of providers: 1. Facility a) Submit a maximum of 3 invoices/notices,at 30 day intervals; and b) Perform follow up as needed, in DIGITECH's discretion. 2. Patient or Self Pay 18 DocuSign Envelope ID:48899663-5Al2-468D-B72B-2AD28FB0A560 Contract no. 23-015-0I a) Mall a maximum of 3 invoices/notices,at 30 day intervals; b) Make a maximum of 2 follow-up calls;and c) Recommend to CLIENT amounts to be placed in legal proceeding upon the earlier of DIGITECH'S determination that the amount is uncollectible or 120 days from the first invoice date. 3. Insurance a)Submit a maximum of 3 invoices/notices,at 45 day intervals; b)Perform follow up as needed,per DIGITECH's discretion;and c) File appeals upon notice of denial,where applicable. 4. Medicaid a) Process denials; b)Follow-up on pending Claims; and c) Resubmissions. S. Medicare a)Process denials; b) Follow-up on pending Claims;and c) Resubmissions. 6. Claims resolution and appeals 7. Remittance Posting 8. Resubmission of denials,pending and held items 9. Interfacing with carriers on behalf of CLIENT 10.All payments received by payers for CLIENT shall be deposited into one or more bank accounts controlled by CLIENT,pursuant to CLIENT's written instructions. 11,The City will inform Contractor if a claim is a potential workers'compensation claim. III. REPORTING SERVICES A. DIGITECH will grant CLIENT access to its billing services reporting system. Such reporting includes but is not limited to, Master Files, Receivable Tracking, Receivable Reporting, Financial Scorecard and System Reporting. B. DIGITECH shall send to CLIENT, via email, its standard monthly reporting package which shall include; 1 Accounting Reports 19 DocuSign Envelope ID:46899663-5Al2-46BD-B72B-2AD28FB0A560 Contract no.23-015-01 a) Sales original, sales payer re-class, adjustments, cash, and aged accounts receivable (accounts receivable roll forward for general ledger entry); and 2. Transport Reports a) Per Trip Data and Collection Percentages. IV. FEES/BILLING,COLLECTION AND REPORTING SERVICES A. DIGITECH will charge a fee for the Services described above as follows: PERCENTAGE OF REVENUE 10 BE PROVIDED TO THE VENDOR Estimated Annual Gross Percentage of Revenue to the Annual kem Collections' Vendor' Estimated Cost {a) (bl to the City (aXn=c) 1 SI483,872 4 t' % S 68.110 SUB-TOTAL $ 68.110 MEDICAID ACCOUNT Bill!NO SERVICE Estimated Annual Annual Item Humber of Medical Fee Per Claim Filed Estimated Cost Claims' (b) to the City (a) (a X D=c) 2 2,004 S 7 75 $ 15,531 SUB-TOTAL $ 15,531 ESO SOFTWARE Estimated Annual Gross Annual Item Collections' Percentage Cost Estimated Cost (a) lb) to the City (aXh-c) 3 $1.48�+572 1,59 % $ 23,594 SUB-TOTAL. $ 23.594 _J CERTIFIED PUBI IC E XPE RIM I URI:ICPE1 PUBUC EMEREOENCY MEDICAL TRANSPORTA 110N WEN f 1 Estimated Annual Annual Item ArnutxR+ Percentage Cost Estimated Cost (a) (b) to the City (aXb=c) 4 S300,000 a s`3 % S 13,770 SUB-TOTAL S 13.770 Description of fees as stated above: Digitech shall be paid by Client a monthly amount representing fees for the Services provided by Digitech hereunder,computed as follows: 20 DocuSIgn Envelope ID:4B899683-5Al2-468D-B728-2A0281 B0A580 Contract no.23-015-01 (a) 4.59% of all monies for non-Medicaid accounts collected by Digitech for EMS provided by Client less refunds("Net Collections"); (b) $7.75 per Medicaid account process; (c) 4,59%for PEMT consulting services; (d) 0.0%for MCO consulting services; (e) No additional cost for H1PAA-compliant Notice of Privacy Practices sent to patients as more specifically described in Exhibit B- Optional Services. CLIENT shall pay to DIGITECH its collection fee as set forth in this Section IV on all payments received by CLIENT on any claim processed by DIGITECH, including but not limited to revenue received by CLIENT related to any State administered Ambulance Services Supplemental Payment Program. Said payment shall be in addition to any other fees CLIENT is obligated to pay to any other entity or subcontractor to analyze and report costs that will help CLIENT realize said revenue. Notwithstanding the foregoing, DIGITECH acknowledges that claims for which DIGITECH provided no processing services and that have been processed prior to the go-live date may be assigned by CLIENT to other third-party collectors and that DIGITECH has no interest in or responsibility for such claims. Note: DIGITECH's fee in Section IV(A) above does not include the processing of claims in which the CLIENT has a contractual obligation to transport and not bill (and are therefore uncollectible), such as financial hardship cases and prisoner transports. In addition, DIGITECH's fee does not cover non-ambulance transports such as ambulette,wheelchair, and medivan transports.Such additional fees will be negotiated per Rider A,Section V—Fees/Other below. B. The DIGITECH fees do not cover costs or additional fees associated with the placement of delinquent accounts with a third-party collection agency. Any fees earned by third party collection agencies from the collection or settlement of past due accounts placed with such agency shall be the responsibility of the CLIENT. [Signature page follows) 21 Contract no.23-015-01 The parties hereto have executed this Rider on the day and year first above written on the Agreement. CITY OF MANAGER DIGITECH COMPUTER LLC By: (A- B Mark.Schrowrta Name: ALINA T. HUDAK Name: MARK SCHIOWITZ Title: CITY MANAGER Title: PRESIDENT AND CEO Feb 29,2024 Date: ATTEST gad • ti��. � .IN-ORP ORpiED By: h= 4,�j•. CH 26 Name: RAFAEL E.GRANADO APPROVED AS TO FORM&LANGUAGE &FOR EXECUTION Title: CITY CLERK {{ ?City Attorney • Da e MAR 2 9 2024 Date: 22 DocuSign Envelope ID.4D899663-5Al2-46BD-B72B-2AD2BFB0A560 Contract no.23-015-0] EXHIBIT B BUSINESS ASSOCIATE AGREEMENT THIS BUSINESS ASSOCIATE AGREEMENT("Agreement"), is made and entered into by and between CITY OF MIAMI BEACH,FLORIDA("Covered Entity")and DIGITECH COMPUTER LLC("Business Associate"). This Agreement shall form a part of all agreements and other engagements as are currently in effect between the parties under which Protected Health Information ("PHI") (as defined in Article 1 of this Agreement) is provided, created or received by Business Associate from or on behalf of Covered Entity, and shall supersede and replace any business associate agreement or amendment previously entered Into between Covered Entity and Business Associate in accordance with the requirements of HIPAA (as defined below) and/or the HITECH Act (as defined below). This Agreement is effective as of the effective date of the Billing Services Agreement(the"Effective Date"). RECITALS WHEREAS, Covered Entity and Business Associate are parties to that specific PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI BEACH AND DIGITECH EMS BILLING LLC FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES PURSUANT TO RFP-2023-015-ND effective as of (the"Billing Service Agreement");and WHEREAS, in connection with the performance of their respective obligations under the terms of the Billing Service Agreement,Covered Entity may disclose certain Information to Business Associate,and Business Associate may use and/or disclose certain information,some of which may constitute PHI;and WHEREAS,Coveted Entity and Business Associate intend to protect the privacy and provide for the security of PHI disclosed to,or created,utilized or disclosed by,Business Associate pursuant to the Billing Service Agreement in compliance with the Health Insurance Portability and Accountability Act of 1996, and its implementing regulations and guidance issued by the Secretary of the U.S, Department of Health and Human Services (the "Secretary"), all as amended from time to time("HIPAA"), as well as the requirements of the Health Information Technology for Economic and Clinical Hearth Act,as incorporated in the American Recovery and Reinvestment Act of 2009,and its implementing regulations and guidance issued by the Secretary,all as amended from time to time (the"HITECH Act"),and other applicable laws; The parties do hereby agree as follows: Article 1:Definitions 1.1 Definitions. For the purposes of this Agreement, the following defined terms shall have the following definitions,All capitalized terms used in this Agreement but not otherwise defined herein shall have the meaning given in HIPAA or the HITECH Act,as applicable. (a) "Breach" has the meaning given to such term under HIPAA and the HITECH Act, including, but not limited to,at§13400(1)of the HITECH Act and 45 CFR§164.402. (b) "Data Aggregation" has the meaning given to such term under the Privacy Standards (as defined below),including,but not limited to,at 45 CFR§164.501. (c) "Designated Record Set" has the meaning given to such term under the Privacy Standards, including,but not limited to,at 45 CFR§164.501. 23 DocuSign Envelope ID:46899663-5Al2-468D•872B-2AD28FB0A560 Contract no.23-015-01 (d) "Health Care Operations" has the meaning given to such term under the Privacy Standards, including,but not limited to,at 45 CFR§164.501 (e) "Limited Data Set"has the meaning given to such term under the Privacy Standards,including,but not limited to,at 45 CFR§164.514. (f) "Privacy Standards"means the HIPAA Privacy Rule and HIPAA Security Rule codified at 45 CFR Parts 160,162 and 164. (g) "Protected Health Information" or "PHI" has the meaning given to such term under HIPAA, the HITECH Act,and the Privacy Standards,including,but not limited to,at 45 CFR§160.103. (h) "Unsecured Protected Health Information" has the meaning given to such term under HIPAA and the HITECH Act,including,but not limited to,at§13402(h)of the HITECH Act and 45 CFR§164,402. Article 2:'Duties of Business Associate 2.1 Compliance with Privacy Provisions.Business Associate shall only use and disclose PHI in performance of its obligations under the Billing Service Agreement and as permitted or required by law, Business Associate agrees to be in compliance with each applicable requirement of 45 CFR§164.504(e)and all requirements of the HITECH Act applicable to Business Associate. 2.2 Compliance with Security Provisions. Business Associate shall: (a) 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; (b) implement and document reasonable and appropriate policies and procedures as required by 45 CFR §164.316;(c) use its best efforts to implement and maintain technologies and methodologies that render PHI unusable, unreadable or indecipherable to unauthorized individuals as specified in the HITECH Act; and(d) be in compliance with ail requirements of the HITECH Act related to security and applicable to Business Associate. 2.3 Breach of Unsecured PHI. (a) With respect to any suspected or actual unauthorized acquisition, access, use or disclosure ("Acquisition")of Covered Entity's PHI by Business Associate, its agents or subcontractors, and/or any Acquisition of data in violation of any applicable federal or state law,Business Associate shall(i) investigate such Acquisition; (ii) determine whether such Acquisition constitutes a reportable Breach under HIPAA, the HITECH Act, and/or applicable federal or state law ;(iii) document and retain its findings under clauses (i)and (ii), and (iv)take any action pertaining to such Acquisition required by applicable federal or state law. (b) If Business Associate discovers that a Breach has occurred, Business Associate shall notify Covered Entity in writing without unreasonable delay and In no case later than five(5)days after discovery of the Breach. Business Associate's written notice shall include all available information required by 45 CFR § 164.410 and other applicable law. Business Associate's written report shall be promptly supplemented with any new or additional information. Business Associate agrees to cooperate with Covered Entity in meeting Covered Entity's obligations under the HITECH Act and other applicable law with respect to such Breach. Covered Entity shall have sole control over the timing and method of providing notification of such Breach to the affected individual(s) or others as required by the HITECH Act and other applicable law. 2.4 Permitted Uses of PHI. Satisfactory performance of its obligations under the Billing Service Agreement by Business Associate may require Business Associate to receive or use PHI obtained from Covered Entity, or created or received by Business Associate on behalf of Covered Entity; provided, however, that Business 24 DocuSign Envelope ID 48899663-5Al2-46BD-B72B-2AD28FB0A560 Contract no.23-0I5-0I Associate shall not use PHI other than for the purpose of performing Business Associate's obligations under the Billing Service Agreement(including this Agreement),as permitted or required under the Billing Service Agreement(including this Agreement), or as required by law. Business Associate shall not use PHI in any manner that would constitute a violation of HIPAA if so used by Covered Entity, 2.5 Permitted Disclosures of PHI. Business Associate shall not disclose PHI other than for the purpose of performing Business Associate's obligations under the Billing Service Agreement(including this Agreement), as permitted or required under the Billing Service Agreement(including this Agreement),or as required by law. Business Associate shall not disclose PHI in any manner that would constitute a violation of HIPAA if so disclosed by Covered Entity.To the extent that Business Associate discloses PHI to a third party in carrying out its obligations under the Billing Service Agreement,Business Associate must obtain,prior to making any such disclosure, (i) reasonable assurances from such third party that such PHI will be held confidential as provided pursuant to this Agreement and only disclosed as required by law or for the purposes for which it was disclosed to such third party,and(ii)an agreement from such third party to immediately notify Business Associate of any breaches of confidentiality of the PHI,to the extent the third party has obtained knowledge of such breach. 2.6 Minimum Necessary.Business Associate shall limit Its use,disclosure or request of PHI to only the minimum necessary as required by law. 2.7 Retention of PHI. Unless otherwise specified in the Billing Service Agreement, Business Associate shall maintain and retain PHI for the term of the Billing Service Agreement and make such PHI available to Covered Entity as set forth in this Agreement. 2.8 Safeguarding PHI. Business Associate shall use appropriate safeguards to prevent the use or disclosure of PHI other than as permitted by the Billing Service Agreement and this Agreement Business Associate will appropriately safeguard electronic PHI in accordance with the standards specified at 45 CFR§164.314(a).In particular, Business Associate will implement administrative, physical and technical safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI that it creates,receives,maintains or transmits on behalf of Covered Entity. 2.9 Agents and Subcontractors. Business Associate shall ensure that any agents (including subcontractors) of Business Associate to whom Business Associate provides PHI received from Covered Entity,or PHI created or received by Business Associate on behalf of Covered Entity, agree in writing to the same restrictions and conditions that apply to Business Associate with respect to such PHI, including the requirement to implement administrative,physical and technical safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of PHI. Business Associate shall implement appropriate sanctions against agents and subcontractors that violate such restrictions and conditions,including termination of the agency or subcontractor relationship,if feasible,and shall mitigate the effects of any such violations 2.10 Reporting Unauthorized Use or Disclosure. Business Associate shall report in writing to Covered Entity any use or disclosure of PHI not provided for under the Billing Service Agreement or this Agreement as soon as possible after Business Associate becomes aware of such an incident but in no case later than five(5)days after the date on which Business Associate becomes aware of any such Incident; provided, however, that 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 below). "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. Business Associate shall take (i)prompt corrective action to cure any deficiencies that caused the unauthorized use or disclosure,and(ii)any corrective action required by applicable federal and state law. 25 DocuSign Envelope ID:4B899663-5Al2-46BD-B72B-2AD28FBOA560 Contract no.23-015-01 2.11 Access to Information. Within five (5) days of Covered Entity's request, Business Associate shall provide Covered Entity with access to Covered Entity's PHI maintained by Business Associate or its agents or subcontractors to enable Covered Entity to fulfill its obligations under the Privacy Standards,including, but not limited to,45 CFR 4164.524, 2.12 Availability of PHi for Amendment.The parties acknowledge that the Privacy Standards permit an individual who is the subject of PHI to request certain amendments of their records.Upon Covered Entity's request for an amendment of PHI or a record about an Individual contained in a Designated Record Set, but not later than five (5) days after receipt of such request, Business Associate and its agents or subcontractors shall make such PHI available to Covered Entity for amendment and incorporate any such amendment to enable Covered Entity to fulfill its obligations under the Privacy Standards, including, but not limited to, 45 CFR§ 164.526. If any individual requests an amendment of PHi directly from Business Associate or its agents or subcontractors, Business Associate must notify Covered Entity In writing within five(5)days of the request. Covered Entity has the sole authority to deny a request for amendment of PHI received or created under the terms of the Billing Service Agreement and maintained by Business Associate or its agents or subcontractors. 2.13 Accounting of Disclosures.Upon Covered Entity's request,Business Associate,its agents and subcontractors shall make available the information required to provide an accounting of disclosures to enable Covered Entity to fulfill its obligations under the Privacy Standards,including, but not limited to,45 CFR § 164,528 For this purpose,Business Associate shall retain a record of disclosure of PHI for at least six(6)years from the date of disclosure.Business Associate agrees to implement a process that allows for an accounting to be collected and maintained by Business Associate and its agents or subcontractors for at least six (6) years prior to the request,but not before the effective date of the Billing Service Agreement.At a minimum,such information shall include: (i)the date of disclosure;(ii)the name of the entity or person who received PHI and, if known, the address of the entity or person;(iii)a brief description of PHI disclosed;and (iv)a brief statement of the purpose of the disclosure that reasonably informs the individual of the basis for the disclosure,or a copy of the individual's authorization,or a copy of the written request for disclosure.Where a request for an accounting is delivered directly to Business Associate or its agents or subcontractors, Business Associate shall within five(5)days of a request forward it to Covered Entity in writing. It shall be Covered Entity's responsibility to prepare and deliver any such reply to the requested accounting. 2.14 Agreement to Restriction on Disclosure. If Covered Entity is required to comply with a restriction on the disclosure of PHI pursuant to§13405 of the HITECH Act,then Covered Entity shall 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. 2.15 Accounting of Disclosures of Electronic Health Records ("EHR"). If Business Associate is deemed to use or maintain an EHR on behalf of Covered Entity, then Business Associate shall maintain an accounting of any disclosures made through an EHR for Treatment, Payment and Health Care Operations,as required by law. Upon request by Covered Entity, Business Associate shall provide such accounting to Covered Entity in the time and manner specified by law.Alternatively,if Covered Entity responds to an individual's request for an accounting of disclosures made through an EHR 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. 2.16 Access to Electronic Health Records.If Business Associate is deemed to use or maintain an EHR 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 EHR 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 PHI in the EHR in an electronic format and, if the individual so chooses, transmit such copy directly to an entity or person designated by the 26 DocuSign Envelope ID:4B899663-5Al2-48BD-B72B-2AD28FBDA560 Contract no 23-015-01 individual. Business Associate may charge a fee, not to exceed Contractor's labor costs to respond, to the individual for providing the copy of the PHI.The provisions of 45 CFR 4 164.524,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 Covered Entity.At Covered Entity's request,Business Associate shall provide Covered Entity with a copy of an individual's PHI maintained in an EHR 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. 2.17 Remuneration for PHI. 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 law. 2.18 Governmental Access to Books and Records.For purposes of determining Covered Entity's compliance with the HIPAA, Business Associate agrees to make available to the Secretary its internal practices, books, and records relating to the use and disclosure of PHI received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity. 2.19 Data Ownership. Business Associate acknowledges that Business Associate has no ownership rights with respect to the PHI. 2.20 Insurance. Business Associate shall maintain commercial general liability insurance, with commercially reasonable liability limits,that includes coverage for damage to persons or property arising from any breach of the terms of this Agreement. 2.21 Audits, Inspection and Enforcement.Within ten (10)days of a written request by Covered Entity, Business Associate and its agents or subcontractors shall allow Covered Entity to conduct a reasonable inspection of the facilities,systems,books,records,agreements,policies and procedures relating to the use or disclosure of PHI pursuant to this Agreement for the purpose of determining whether Business Associate has complied with this Agreement;provided,however,that(i)Business Associate and Covered Entity shall mutually agree in advance upon the scope,timing and location of such art inspection; (ii)Covered Entity shall protect the confidentiality of all confidential and proprietary information of Business Associate to which Covered Entity has access during the course of such inspection; and (iii) Covered Entity shall execute a nondisclosure agreement, upon terms mutually agreed upon by the parties, if requested by Business Associate.Covered Entity and its authorized agents or contractors, may, at Covered Entity's expense, examine Business Associate's facilities,systems,procedures and records as may be necessary for such agents or contractors to certify to Covered Entity the extent to which Business Associate's security safeguards comply with HIPAA, the HITECH Act or this Agreement, to the extent that Covered Entity determines that such examination is necessary to comply with Covered Entity's legal obligations pursuant to HIPAA or the HITECH Act relating to certification of its security practices.The fact that Covered Entity inspects,or fails to inspect,or has the right to inspect,Business Associate's facilities,systems,books,records,agreements,policies and procedures does not relieve Business Associate of its responsibility to comply with this Agreement,nor does Covered Entity's (i) failure to detect or(ii)detection, but failure to notify Business Associate or require Business Associate's remediation of any unsatisfactory practices,constitute acceptance of such practices or a waiver of Covered Entity's enforcement rights under the Billing Service Agreement or this Agreement. 2.22 Return of PHI at Termination. Upon termination of the Billing Service Agreement, Business Associate shall, where feasible, destroy or return to Covered Entity all PHI received from Covered Entity, or created or received by Business Associate or its agents or subcontractors on behalf of Covered Entity.Where return or destruction is not feasible, the duties of Business Associate under this Agreement shall be extended to protect the PHI retained by Business Associate. Business Associate agrees not to further use or disclose information for which the return or destruction is infeasible. Business Associate shall certify in writing the destruction of the PHI and to the continued protection of PHI that is not feasible to destroy. 27 DocuSign Envelope ID:4B899663-5Al2-46BD•B72B-2AD28FBOA560 Contract no.23-015-01 2.23 Retention of PHI. Business Associate and Its contractors or agents shall retain communications and documents required to be maintained by HIPAA for six (6) years after termination of the Billing Service Agreement. 2.24 Business Associate's Performance of Obligations of Covered Entity.To the extent the Business Associate is to carry out one or more of Covered Entity's obligation(s) under the HIPAA Privacy Rule, Business Associate shall comply with the requirements of the Privacy Rule that apply to Covered Entity when it carries out such obligation(s), Article 3: Duties of Covered Entity 3.1 Using Appropriate Safeguards. Covered Entity shall be responsible for using appropriate safeguards to maintain and ensure the confidentiality, privacy and security of PHI transmitted to Business Associate pursuant to the Billing Service Agreement.in accordance with the standards and requirements of HIPAA. Article 4:Term and Termination 4,1 Term.The provisions of this Agreement shall become effective on the Effective Date and shall continue in effect until all of the PHI provided by Covered Entity to Business Associate, or created or received by Business Associate on behalf of Covered Entity is destroyed or returned to Covered Entity, or, if it is infeasible to return or destroy the PHI,protections are extended to such information in accordance with the termination provisions in Section 4.2 of this Agreement. 4.2 Termination by Covered Entity. (a) A breach by Business Associate of any material provision of this Agreement, as determined by Covered Entity,shall constitute a material breach of the Billing Service Agreement and shall provide grounds for immediate termination of the Billing Service Agreement by Covered Entity. (h) 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 the provisions of this Agreement or another arrangement and does not terminate the Billing Service Agreement pursuant to Section 4.2(a)of this Agreement,then Business Associate shall take reasonable steps to cure such breach or end such violation, as applicable. If Business Associate's efforts to cure such breach or end such violation are unsuccessful, Covered Entity shall either(i)terminate the Billing Service Agreement, if feasible or(ii)If termination of the Billing Service Agreement is not feasible, Covered Entity shall report Business Associate's breach or violation to the Secretary. 4.3 Termination by Business Associate. 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 the Billing Service Agreement or this Agreement, then Business Associate shall immediately notify Covered Entity. With respect to such breach or violation. Business Associate shall (i) take reasonable steps to cure such breach or end such violation,if possible;or(ii)if such steps are either not possible or are unsuccessful, upon written notice to Covered Entity,terminate the Billing Service Agreement;or(iii)if such termination is not feasible,report Covered Entity's breach or violation to the Secretary. 4.4 Termination by Either Party. Either party may terminate the Billing Service Agreement, effective immediately,If(i)the other party is named as a defendant in a criminal proceeding for a violation of HIPAA, the HITECH Act or other security or privacy laws, or (ii) a finding or stipulation that the other party has violated any standard or requirement of HIPAA, the HITECH Act or other security or privacy laws is made in any administrative or civil proceeding in which the party has been joined. 28 DocuSign Envelope ID:48899683-5Al2-468D-B728-2AD28FB0A560 Contract no.23-0 15-01 4.5 Notices. All notices or other communications required or contemplated herein shall be in writing,sent by certified mail return-receipt-requested,overnight delivery,or personal delivery,addressed to the party at the address indicated below,or as same may be changed from time to time by notice similarly given. Notices shall be deemed given three(3)business days after mailing,if by certified mail,the next business day,if by overnight delivery,or,if hand delivered,on the date of such delivery. if to Business Associate: Mark Schiowitz President&CEO Digitech EMS Billing LAX 480 Bedford Road,Bldg.G00,2nd floor. Chappaqua,NY 10514 Email:compfiancgRdigitechcomputef.com If to Covered Entity: Fire Department City of Miami Beach 2300 Pinetree Dr. Miami Beach,FL 33140 Attn:Jorge Linares,Division Chief Ph:305-673-7000 ext.22076 Email:jorgelinares@miamibeachfl.gov Article 5:Miscellaneous 5.1 Acknowledgment. Business Associate recognizes and agrees that it is obligated by law to comply with the applicable provisions of the HITECH Act 5.2 Change in Law, The parties agree to promptly enter into negotiations concerning the terms of the Billing Service Agreement (Including this Agreement), and to negotiate in good faith, if, in either party's business judgment,modification of the Billing Service Agreement(including this Agreement)becomes necessary due to legislative, regulatory, or judicial developments regarding HIPAA or the HITECH Act. Covered Entity may terminate the Billing Service Agreement upon thirty (30) days written notice in the event (i) Business Associate does not promptly enter Into negotiations to amend the Billing Service Agreement when requested by Covered Entity pursuant to this § 5.2, or (il) Business Associate does not enter into an amendment to the Billing Service Agreement providing assurances regarding the safeguarding of PHI that Covered Entity, in its sole discretion, deems sufficient to satisfy the standards and requirements of HIPAA and the HITECH Act. 5.3 Disclaimer.Covered Entity makes no warranty or representation that compliance by Business Associate with HIPAA, the HITECH Act or this Agreement will be adequate or satisfactory for Business Associate's own purposes.Business Associate is solely responsible for all decisions made by Business Associate regarding the safeguarding of PHI. 5.4 Assistance in Litigation or Administrative Proceedings. Business Associate shall make itself, and any subcontractors, employees or agents assisting Business Associate in the performance of its obligations under the Billing Service Agreement or this Agreement, available to Covered Entity, at no cost to Covered Entity, to testify as witness, or otherwise, in the event of litigation or administrative proceedings being commenced against Covered Entity, its members/shareholders, managers/directors, officers or employees 29 DourSign Envelope ID:48880663-5Al2-468D-B728-2AD28F80A560 Contract no.23-015-01 based upon a claimed violation of HIPAA or the HITECH Act or other laws relating to security and privacy, except where Business Associate,or its subcontractor,employee or agent is a named adverse party. 5.5 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. 5.6 Interpretation. Section titles in this Agreement are for convenience only, and shall not be used in interpreting this Agreement. Any ambiguity In this Agreement shall be resolved to permit the parties to comply with the requirements of HIPAA and the HITECH Act. In the event of conflict between the Billing Service Agreement and this Agreement,the provisions of this Agreement shall prevail.Any reference in this Agreement to a section in the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part 160 and part 164,subparts A and E, the Security Standards for the Protection of Electronic Protected Health Information at 45 CFR part 164, subpart C, or the HITECH Act means the section as in effect or as amended. ]Signature page follows] 30 Contract no.23.0IS-01 The parties hereto have executed this Rider on the day and year first above written on the Billing Service Agreement. CITY OF MIAMI BEACH,FLORIDA DIGITECH EMS BILLING LLC t'k&i1iowi4Z By: / �.. 114CdfC— By: MA Name: Alina T.Hudak Name: MARK SCHIOWITZ Title: CITY MANAGER [itle. PRESIDENT AND CEO Feb 29,2024 Date: Attest: By: APPROVED AS 10 FORM & LANGUAGE Name: of el .Gr nado & FOR EXECUTION rI l` Title: CITY CLERK k 0 /Z"/ MAR 2 9 ?.0?4 • City Attorney Date Date: %%%%g"E9a,,� INCORP OAATEQ Q m• JJ 31 ATTACHMENT A RESOLUTION &COMMISSION AWARD MEMO RESOLUTION NO. 2023-32723 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE RECOMMENDATION OF THE CITY MANAGER, TO AUTHORIZE NEGOTIATIONS RELATING TO REQUEST FOR PROPOSALS NO, 2023-015-ND, FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES; AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS WITH DIGITECH EMS BILLING LLC, AS THE TOP-RANKED PROPOSER; FURTHER, IF THE ADMINISTRATION IS NOT SUCCESSFUL IN NEGOTIATING AN AGREEMENT WITH DIGITECH EMS BILLING LLC, AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS WITH EMS MANAGEMENT AND CONSULTANTS, INC., AS THE SECOND-RANKED PROPOSER; FURTHER, IF THE ADMINISTRATION IS NOT SUCCESSFUL IN NEGOTIATING AN AGREEMENT WITH EMS MANAGEMENT AND CONSULTANTS, INC., AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS WITH CHANGE HEALTHCARE TECHNOLOGY ENABLED SERVICES, LLC, AS THE THIRD-RANKED PROPOSER; AND FURTHER AUTHORIZING THE CITY MANAGER AND CITY CLERK TO EXECUTE AN AGREEMENT UPON CONCLUSION OF SUCCESSFUL NEGOTIATIONS. WHEREAS, on February 9. 2022. the Mayor and City Commission authorized the issuance of Request for Proposals (RFP) 2022-019-ND for Emergency Medical Transport Billing and Collection Services; and WHEREAS, RFP 2022-019-ND was released on February 11, 2022; and WHEREAS, on April 13, 2022, the City received a sole responsive proposal from Digitech EMS Billing LLC; and WHEREAS, on August 3, 2022, because the RFP's specifications inadvertently contained requirements that severely limited competition, the City Manager, pursuant to Section 2-367(b)(1) of the Miami Beach City Code. approved the rejection of the sole responsive. responsible bidder and authorized the issuance of a new solicitation once the specifications and requirements had been revised; and WHEREAS, on April 25, 2023, the RFP 2023-015-ND for Emergency Medical Transport Billing and Collection Services (the "REP')was issued: and WHEREAS, a voluntary pre-proposal meeting was held on May 10, 2023, and WHEREAS, on June 9. 2023, the City received four (4) proposals from Air Methods Corporation d/b/a Cypheron Healthcare Solutions, Change Healthcare Technology Enabled Services, LLC, Digitech EMS Billing LLC, and EMS Management and Consultants, Inc.; and WHEREAS, on June 8, 2023. the City Manager, via Letter to Commission No 260-2023, appointed an Evaluation Committee consisting of the following individuals: Joseph Florio, Firefighter I, Fire Department; Jorge Linares, Fire Division Chief, Fire Department; Femi Ogunmola, Financial Analyst III, Finance Department; and Victor White, Division Chief, Fire Department; and WHEREAS, the Evaluation Committee convened on June 26, 2023, to review and score the proposals; and WHEREAS, the Evaluation Committee received an overview of the project, information relative to the Citys Cone of Silence Ordinance and the Government Sunshine Law, general information on the scope of services, and a copy of each proposal; and WHEREAS, the Evaluation Committee was instructed to score and rank each proposal pursuant to the evaluation criteria established in the RFP; and WHEREAS, the Evaluation Committee process resulted in the ranking of proposers as follows: Digitech EMS Billing LLC, as the top-ranked proposer; EMS Management and Consultants, Inc., as the second-ranked proposer; Change Healthcare Technology Enabled Services, LLC, as the third-ranked proposer: and Air Methods Corporation d/b/a Cypheron Healthcare Solutions, as the fourth-ranked proposer; and; WHEREAS, after reviewing all of the submissions and the Evaluation Committee's rankings and analysis, the City Manager concurs with the Evaluation Committee and recommends that the Mayor and City Commission authorize the Administration to enter into negotiations with Digitech EMS Billing LLC, as the top-ranked proposer; further, if the Administration is not successful in negotiating an agreement with Digitech EMS Billing LLC, authorize the Administration to enter into negotiations with EMS Management and Consultants, Inc., as the second-ranked proposer; further if the Administration is not successful in negotiating an agreement with EMS Management and Consultants, Inc., authorize the Administration to enter into negotiations with Change Healthcare Technology Enabled Services, LLC, as the third- ranked proposer, and further authorize the City Manager and City Clerk to execute an agreement upon conclusion of successful negotiations by the Administration. 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 recommendation of the City Manager, pursuant to Request for Proposals (RFP) No. 2023-015-ND for Emergency Medical Transport Billing and Collection Services; authorize the Administration to enter into negotiations with Digitech EMS Billing LLC, as the top-ranked proposer; further, if the Administration is not successful in negotiating an agreement with Digitech EMS Billing LLC, authorize the Administration to enter into negotiations with EMS Management and Consultants, Inc., as the second-ranked proposer; further if the Administration is not successful in negotiating an agreement with EMS Management and Consultants, Inc., authorize the Administration to enter into negotiations with Change Healthcare Technology Enabled Services, LLC, as the third-ranked proposer; and further authorize the City Manager and City Clerk to execute an agreement upon conclusion of successful negotiations by the Administration. PASSED AND ADOPTED this day of 'e, 'ietir 2023. SEP 2 Q 2023 Dan Gelber, Mayor ATTEST_ SEP 7 n /"?1 APPROVED AS TO FORM & LANGUAGE Rafael E. Granado, City Clerk & FOR EXECUTION City Attorney Date Competitive B!dRspQrti C _C MIAMI BEACH COMMISSION MEMORANDUM TO: Honorable Mayor and Members of the City Commission FROM: Aline T. Hudak, City Manager DATE: September 13, 2023 SUBJECT:A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE RECOMMENDATION OF THE CITY MANAGER, TO AUTHORIZE NEGOTIATIONS RELATING TO REQUEST FOR PROPOSALS NO. 2023-015-ND, FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES; AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS WITH DIGITECH EMS BILLING LLC, AS THE TOP-RANKED PROPOSER; FURTHER, IF THE ADMINISTRATION IS NOT SUCCESSFUL IN NEGOTIATING AN AGREEMENT WITH DIGITECH EMS BILLING LLC, AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS WITH EMS MANAGEMENT AND CONSULTANTS, INC., AS THE SECOND- RANKED PROPOSER; FURTHER, IF THE ADMINISTRATION IS NOT SUCCESSFUL IN NEGOTIATING AN AGREEMENT WITH EMS MANAGEMENT AND CONSULTANTS, INC., AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS WITH CHANGE HEALTHCARE TECHNOLOGY ENABLED SERVICES, LLC, AS THE THIRD-RANKED PROPOSER; AND FURTHER AUTHORIZING THE CITY MANAGER AND CITY CLERK TO EXECUTE AN AGREEMENT UPON CONCLUSION OF SUCCESSFUL NEGOTIATIONS. RECOMMENDATION It is recommended that the Mayor and City Commission approve the Resolution accepting the City Manager's recommendation, pursuant to RFP 2023-015-ND, for emergency medical transport billing and collection services, to negotiate with Digitech EMS Billing LLC, the top- ranked proposer. The Resolution also authorizes the Administration, if negotiations are not successful with Digitech EMS Billing LLC, to negotiate with EMS Management and Consultants, Inc., the second-ranked proposer, and, Change Healthcare Technology Enabled Services, LLC, the third-ranked proposer, in order of rank. The Resolution also authorizes the City Manager and City Clerk to execute an agreement upon the conclusion of successful negotiations. The solicitation is currently under the cone of silence. aACKGRO .NDLHISTORY Page 48 of 2938 The Fire Department provides medical transportation services, commonly known as ambulance services, to residents and visitors. Medical transportation services are critical to transfer patients quickly and efficiently from an incident to a health care facility. While in transit, highly trained personnel provide the emergency medical services that may be needed. To assist with receiving reimbursement for the costs of the emergency medical and transportation services provided, the City currently has a contract with a third-party firm specializing in emergency medical transportation billing and collection services. On September 12, 2018, the Mayor and City Commission awarded a contract for the services to Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation, pursuant to RFP 2017-002-JC. The initial term of the Agreement expired on June 26,2022, and in order to seek a replacement contract for these services, on February 9, 2022, the Mayor and City Commission authorized the issuance of Request for Proposals (RFP)2022-019-ND. Bids were due on April 13, 2022, and a sole responsive proposal was received from Digitech EMS Billing LLC. Subsequently, on August 3, 2022, because the RFP's specifications inadvertently contained requirements that severely limited competition, the City Manager, pursuant to Section 2-367(bX1) of the Miami Beach City Code, approved the rejection of the sole responsive, responsible bidder and authorized the issuance of a new solicitation once the specifications and requirements had been revised. ANALYSIS On April 25, 2023, the City issued RFP No. 2023-015-ND for emergency medical transport billing and collection services. A voluntary pre-proposal conference to provide information to proposers submitting a response was held on May 10, 2023. One (1) addendum was issued. The Procurement Department issued bid notices to 5,990 companies through the e- procurement system, with 48 prospective bidders accessing the advertised solicitation. RFP responses were due and received on June 9, 2023. The City received a total of four (4) proposals from the following firms: Air Methods Corporation d/b/a Cypheron Healthcare Solutions Change Healthcare Technology Enabled Services, LLC Digitech EMS Billing LLC EMS Management and Consultants, Inc. On June 8, 2023, the City Manager appointed the Evaluation Committee via LTC # 260-2023. The Evaluation Committee convened on June 26, 2023, to consider the proposals received. The Committee was comprised of Joseph Florio, Firefighter I, Fire Department; Jorge Linares, Fire Division Chief, Fire Department; Femi Ogunmola, Financial Analyst III. Finance Department; and Victor White. Division Chief, Fire Department. The Committee was provided an overview of the project, information relative to the City's Cone of Silence Ordinance, and the Government Sunshine Law. The Committee was also provided with general information on the scope of services and a copy of each proposal. The Committee was instructed to score and rank each proposal pursuant to the evaluation criteria established in the RFP. The evaluation process resulted in the ranking of proposers, as indicated in Attachment A, including the top ttree ranked firms as follows: 1st ranked- Digitech EMS Billing LLC 2nd ranked - EMS Management and Consultants, Inc. 3rd ranked-Change Healthcare Technology Enabled Services. LLC A summary of each top-ranked firm based on information provided in the proposals follows. Page 49 of 2938 D.i�ith_EM Billit141LG Since being founded in 1984, Digitech EMS Billing LLC has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire emergency medical services (EMS) revenue cycle, Digitech leverages its proprietary technology to offer fully outsourced services that maximize collections, protect compliance, and deliver results for clients. Its mission is to provide the highest quality EMS billing service centered around superior technology, responsive customer support, real-time reporting. and integration expertise. Digitech has over 20 years of experience working for Flonda EMS providers. Digitech is the incumbent providing these services to the City. and the City has been satisfied with its work and offered positive feedback. EMS Management ant1C Qnsultants.1nc. For 27 years, EMS Management and Consultants, Inc. (EMS MC) has processed over 3.3 million claims annually across 41 states, including over 226,000 claims in Florida. EMS MC has experience implementing and interfacing with ESO ePCR software as a Platinum Partner, with over 130 ambulance providers nationally. Its success is based on innovation, advocacy, and compliance Change_Healtt nalaila Qlogy Enabled S.ernce..a._LLC Change Healthcare Technology Enabled Services, LLC (Change Healthcare) has 33 years of experience in billing and medical revenue management, and its adept team helps its clients implement successful billing strategies. Change Healthcare works with 200+ agencies to process a high volume of over I million transports, which generates approximately $1 billion in charges. Relevant local experience includes clients such as the City of Miami Department of Fire Rescue, the City of Hialeah, and the City of Coral Gables SUPPORTING SURVEY DATA Not Applicable FINANCIAL INFORMATION Since 2019 Digitech has charged the City an annual fee of 4.75% on reimbursements for medical billing and collections and a $9 fee per Medicaid account processing (approximately $88.520 annually) In its proposal to the RFP, Digitech proposes an annual fee of 4.65% for medical billing and collections and a $8 fee for Medicaid account processing (approximately $85,032 annually), which will result in the City retaining a more significant portion of the reimbursement revenue collected. Moreover, additional cost savings are expected since the City no longer needs to lease the hardware and intends to negotiate a rate for the managed software (ESO ePCR). Amount(s)/Account(s): The RFP is intended to be revenue-generating. CONCLUSION After reviewing the submissions and the Evaluation Committee's rankings and commentary, Digitech EMS Billing LLC (Digitech) is deemed to be the best-qualified provider of emergency medical and transportation billing and collection services. Digitech has provided these services to the City of Miami Beach since 1994. Digitech currently processes over 1,000,000 claims Page 50 of 2938 annually for more than 50 clients in Flonda. The firm maintains two Florida offices (Miami Lakes and Tampa). Digitech has been involved in the Florida Program for Emergency Medical Transportation (PEMT) since 2016 and, therefore. has an in-depth understanding of Florida regulations, including Flonda Medicaid claims processing. EMS Management and Consultants, Inc., the second-ranked proposer, and, Change Healthcare Technology Enabled Services, LLC, the third-ranked proposer, are also well qualified if negotiations with Digitech are not successful. For the reasons stated herein, it is recommended that the Mayor and City Commission approve the Resolution authonzing the Administration to enter into negotiations with Digitech EMS Billing LLC. as the top-ranked proposer; further, if the Administration is not successful in negotiating an agreement with Digitech EMS Billing LLC. authonzing the Administration to enter into negotiations with EMS Management and Consultants, Inc., as the second-ranked proposer, further if the Administration is not successful in negotiating an agreement with EMS Management and Consultants, Inc., authorizing the Administration to enter into negotiations with Change Healthcare Technology Enabled Services, LLC, as the third-ranked proposer: and further authorizing the City Manager and City Clerk to execute an agreement upon conclusion of successful negotiations by the Administration. Applicable Area Citywide lg_ttile aResldentsBight Dottsibii item utlbze G.Q. to_Know"item.pursuant to Bond Funds? City Code Section 2 14? No No Legislative Tracking Fire/Procurement ATTACHMENTS: Description o Attachment A o Resolution Page 51 of 2938 PCV io LS 21Bed 110{000ti.O22. n4 i01 •M LflILM l.OD IO•MO0VY 1221 4 0N04 II1A0 yp 11'200.. 1... 7 • I s + erg ........if .cam '*. M ► N N N -• 4 N K • u N N i• N I N M wraps.rne� w...aw�+ h) 't Z1 ' 1 W 6, a N i ` I. -N i N Y. 11 1. 1 .,..a 02v0VP • I 0 i 01~_ K I 2 Z- sr M . ii 1{ N A GI N . life 0+�.�2 Mtr�o�Ow+w a 1 "t { . Oi Cl / (1 2 II t[ GI II ' Q Yn1Lir.�O I- 1 A11.0! •01�0 . NSW 0 A.J•, j...0/1.r I.�0 , li.r11 t.SON 0� WPM ONIMPS j .., 1 .1NI,. ,_1*.mod , run Now i UMW IOW illailiMilln ..i... 6.9.21111.1. t . _ V 10,3R143/VA-02 ATTACHMENT B ADDENDUM AND RFP SOLICITATION M I A M I BE/\ 2I-I PROCUREMENT DEPARTMENT 1755 Meridian Avenue,3rd Floor Miami Beach, Florida 33139 www.miamibeachfl.gov ADDENDUM NO. 1 REQUEST FOR PROPOSALS NO. 2023-015-ND FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES June 1, 2023 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. RESPONSES TO QUESTIONS RECEIVED: Q1: Are bidders permitted to deviate in any way from any manner of quoting fees you may be expecting? For example, if there is a pricing page in the RFP, can bidders submit an alternate fee structure? If there is no pricing page in the RFP, do you have any preference for how bidders should quote fees or can bidders create their own pricing categories? Al: Failure to submit Appendix B, Cost Proposal Form, in its entirety by the deadline established for the receipt of proposals will result in the proposal being deemed non- responsive Q2: Please describe your level of satisfaction with your current or recent vendor(s) for the same purchasing activity, if applicable. A2: Level of service has been satisfactory. Q3: What estimated or actual dollars were paid last year, last month, or last quarter to any incumbent(s)? A3: Please refer to Appendix A, Minimum Requirements and Specifications of the RFP, Subsection A2. Statement of Work Required for revenue fees collected by the City for the past two (2)fiscal years. 04: What were your annual contractual allowance write-offs for last year or for the last 12 months? A4: The City does not write off payments. Q5: When were the last changes to your transport rates, and are you considering raising any of the rates currently charged? A5: The City follows Miami Dade County Ordinance, last revised in 2012. 1 ADDENDUM NO.1 REQUEST FOR PROPOSALS NO.2023-015-ND FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES M I AM I BEi\CI-1 PROCUREMENT DEPARTMENT 1755 Meridian Avenue,3rd Floor Miami Beach, Florida 33139 www.miamibeachfl.gov Q6: Are there any other charges you assess not otherwise covered by our questions? A6: The residents or visitors transported are charged a Basic Life Support (BLS) or Advanced Life Support (ALS) transportation fee, a mileage fee, and other charges including, but not limited to, oxygen administration, cardiac monitoring, intubation, and/or spinal immobilization fees. Q7: What percentage of your patients are residents versus non-residents, and do you charge the two groups differently? A7: Approximately 36% are residents, and they are charged the same rates. Q8: Do you operate any shared services agreements with any other municipal or county governments in the region and, if so, with whom? A8: The City does not operate any shared services agreements with other municipal or county governments in the region. Q9: What is your payer mix expressed as percentages of 100% billed? A9: Fiscal Year #of Accounts Financial Class Payer Mix Charge Mix Oct 1 2020-Sept 2022 4,500 Medicare 55.11% 36.87% Oct 1 2020-Sept 2022 2,000 Medicaid 6.1% 11.74% Oct 1 2020-Sept 2022 2,100 Private Insurance 32.73% 16.82% Oct 1 2020-Sept 2022 4,500 Self-Pay 6.06% 34.57% Q10: What is your payer remit mix expressed as percentages of 100%of what you typically receive? A10: See response to Q9. Q11: How many total transport vehicles do you now operate? All: The City currently operates seven frontline transport vehicles, with additional vehicles used during large event times. Q12: What is your average loaded miles per trip? Al2: The average loaded miles per trip is 4.5 Q13: If you have a lockbox provider, will that provider remain in place as a result of this procurement? A13: The current lockbox provider is SunTrust Bank. However, this is subject to change; the City is currently negotiating an agreement with JP Morgan Chase for banking services. TDDENDUM NO.1 EQUEST FOR PROPOSALS NO.2023-015-ND OR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES M I A M I BEi\CI-I PROCUREMENT DEPARTMENT 1755 Meridian Avenue,3rd Floor Miami Beach,Florida 33139 www.miamibeachfl.gov Q14: Do you have a collection agency provider and, if so, which provider? A14: The City does not have a collection agency provider. Q15: Which local hospitals or care facilities typically receive most of your patients? A15: Below is a list in order from high 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 Q16: Will the vendor be financially responsible for the cost of your ePCR software and hardware? If so, please provide all specifications. A16: The vendor will not be financially responsible for the cost of the ePCR software or hardware unless mutually agreed upon during negotiations. Q17: Can you please provide the net charges for your most recent complete fiscal year? All: Please refer to Appendix A, Minimum Requirements and Specifications of the RFP, Subsection A2. Statement of Work Required for last year's total charges. Q18: Can you please provide the average revenue collected per transport for your most recent complete fiscal year? A18: Please refer to Appendix A, Minimum Requirements and Specifications of the RFP, Subsection A2. Statement of Work Required for the average revenue collected per transport for FY21/22. Q19: Can you please provide a breakdown of your most recent complete fiscal year transports by primary payor for the following categories? a. Medicare b. Medicaid c. Commercial Insurance d. Patient Pay A19: See response to Q9. Q20: Can you please provide the average loaded mileage per transport? A20: See response to 012. ADDENDUM NO.1 REQUEST FOR PROPOSALS NO.2023-015-ND FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES M I A M I BEACI-1 PROCUREMENT DEPARTMENT 1755 Meridian Avenue,3rd Floor Miami Beach, Florida 33139 www.miamibeachfl.gov Q21: Can you please confirm how many invoices do you require and at what interval? A21: A monthly invoice is required. Q22: Can you please provide the number of transports for each call type for your most recent complete fiscal year? (a) ALS Emergency, (b) ALS Non-Emergency, (c) BLS Emergency, (d) BLS Non-Emergency, (e) ALS 2, and (f) SCT. A22: The number of transports for each call type for the City's most recent complete fiscal year is as follows: ALS Emergency — 4.265, ALS Non-Emergency - N/A, BLS Emergency — 2,228, BLS Non-Emergency- N/A, ALS 2—132, and SCT- NIA Q23: Please describe your current practice for managing Notice of Privacy Practice (NPP). Will the successful vendor be responsible for mailing NPP's? A23: NPP is currently mailed to all initial customers. Yes, the successful vendor will be responsible for mailing NPP's. Q24: Do you currently use a lockbox for all payments and correspondence? If so, who will be responsible for the cost of the lockbox? A24: The City uses a lockbox for all payments and correspondence and is responsible to bear the cost of any and all lockbox services Q25: What is the reason for your RFP? A25: The City is looking for the awarded Proposer to increase the collection rate and reduce the internal workload. Q26: Contractors are requested to include pricing for managing the PEMT for the City of Miami Beach. The Cost Proposal Form does not include a place to include these costs. Please provide a new costs proposal form. (Appendix B) A26: As stated in Appendix A, Minimum Requirements and Specifications, Section A3. Specifications, Subsection 12, Florida Certified Public Expenditure (CPE) Program, at the request of the City the 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. 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 RafaelGranado@miamibeachfl.gov 4 ADDENDUM NO.1 REQUEST FOR PROPOSALS NO.2023-015-ND FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES M I AM I BE1ACI-1 PROCUREMENT DEPARTMENT 1755 Meridian Avenue,3rd Floor Miami Beach,Florida 33139 www.miamibeachfl.gov Contact: Telephone: Email: Natalia Delgado 305-673-7000 ext. 26263 NataliaDelgado@miamibeachfl.gov Proposers are reminded to acknowledge receipt of this addendum as part of your RFP submission. Sincerely, Natalia Delgado Procurement Contracting Officer Ill ADDENDUM NO.1 REQUEST FOR PROPOSALS NO.2023-015-ND FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES MIAMI BEACH Request for Proposals (RFP) 2023-015-ND EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES TABLE OF CONTENTS SOLICITATION SECTIONS: 0100 INSTRUCTIONS TO PROPOSERS 0200 GENERAL CONDITIONS 0300 PROPOSAL SUBMITTAL INSTRUCTIONS & FORMAT 0400 PROPOSAL EVALUATION APPENDICES: APPENDIX A MINIMUM REQUIREMENTS & SPECIFICATIONS APPENDIX B COST PROPOSAL FORM APPENDIX C INSURANCE REQUIREMENTS APPENDIX D EMS BILLING PROCEDURES & RATES MIAMI BEACH SECTION 0100 INSTRUCTIONS TO PROPOSERS 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 revenue 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 with 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[s]") if this RFP results in an award. The City utilizes Periscope S2G (formally known as BidSync) (www.periscopeholdinqs.com or www.bidsync.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 Periscope S2G must register immediately with Periscope S2G 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 Department provides medical transportation services, commonly known as ambulance services, to residents and visitors. Medical transportation services are critical to transferring patients quickly and efficiently from an incident to a health care facility. While in transit, highly trained personnel provide the emergency medical services that may be needed. To assist the City with receiving reimbursement for the costs of the emergency medical and transportation services provided, the City currently has a contract with a third-party firm specializing in emergency medical transportation billing and collection services. The third-party services 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 activity reports on a monthly basis or as specified by the City. On January 13, 2017, the City issued RFP 2017-002-JC for Emergency Medical Transport Billing and Collection Services. On September 12, 2018,the Mayor and City Commission awarded a contract to Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation. The current term of the Agreement expires on June 26, 2024. The City currently pays monthly Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation, 7.7% of all monies collected in addition to$9.00 per Medicaid account for providing all billing services related to such accounts. The current contract expires on June 26, 2024. To seek a replacement contract for the services, the Administration has issued Request for Proposals (RFP) 2023-015-ND seeking proposals from qualified third-party providers of emergency medical and transportation billing and collection services. 2.1. Interested Parties. Interested parties are invited to submit proposals in accordance with Section 0300. In accordance with the instructions of Section 0300, interested parties should provide detailed information that demonstrates their experience in providing emergency medical and transportation billing and collection services. Responsive proposals will be evaluated in accordance with Section 0400. This RFP is under the cone of silence pursuant to Section 2-486 of the City Code. All communications and questions are to be directed to the procurement contracting officer identified in Sub-section 4 below. MIAMI BEACH 3. ANTICIPATED RFP TIMETABLE. The tentative schedule for this solicitation is as follows: RFP Issued April 25, 2023 Pre-Proposal Meeting May 10, 2023 at 2:30 pm ET Join on your computer or mobile app Click here to join the meeting Or call in (audio only) +1 786-636-1480 United States, Miami Phone Conference ID: 842 729 054# Deadline for Receipt of Questions May 24, 2023 at 5:00 pm ET Responses Due June 9, 2023 at 3:00 pm ET Join on your computer or mobile app Click here to join the meeting Or call in (audio only) +1 786-636-1480 United States, Miami Phone Conference ID: 632 165 076# Evaluation Committee Review TBD Tentative Commission Approval TBD Contract Negotiations Following Commission Approval 4. PROCUREMENT CONTACT.Any questions or clarifications concerning this solicitation shall be submitted to the Procurement Contact noted below: Procurement Contact: Telephone. Email: Natalia Del•ado 305-673-7000 x26263 NataliaDel•ado• miamibeachfl.•ov Additionally, the City Clerk is to be co•ied on all communications via e-mail at: RafaelGranado • miamibeachfl..ov; or via facsimile: 786-394-4188. The Bid title/number shall be referenced on all correspondence. All questions or requests for clarification must be received no later than ten (10) calendar days prior to the date proposals are due as scheduled in Section 0200-3. All responses to questions/clarifications will be sent to all prospective Proposers in the form of an addendum. 5. PRE-PROPOSAL MEETING OR SITE VISIT(S). A pre-proposal meeting or site visit(s) may be scheduled. Attendance for the pre-proposal meeting shall be via web conference and recommended as a source of information but is not mandatory. Proposers interested in participating in the Pre-Proposal Meeting must follow these steps: Join on your computer or mobile app Click here to join the meeting Or call in (audio only) +1 786-636-1480 United States, Miami Phone Conference ID: 842 729 054# Proposers who are participating should send an e-mail to the contact person listed in this RFP expressing their intent to participate. 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 Periscope S2G. Any prospective proposer who has received this RFP by any means other than through Periscope S2G must register MIAMI BEACH immediately with Periscope S2G 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.ADDITIONAL INFORMATION OR CLARIFICATION. 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). 9. 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 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. 10.DETERMINATION OF AWARD.The City Manager may appoint an evaluation committee to assist in the evaluation of proposals received. The evaluation committee is advisory only to the city manager. The city manager may consider the information provided by the evaluation committee process and/or may utilize other information deemed relevant. The City Manager's recommendation need not be consistent with the information provided by the evaluation committee process 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 Manager 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 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. 11. 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. 12. E-VERIFY. As a contractor you are obligated to comply with the provisions of Section 448.095, Fla. Stat., "Employment Eligibility." Therefore, you shall utilize the U.S. Department of Homeland Security's E-Verify system to MIAMI BEACH verify the employment eligibility of all new employees hired by the Contractor during the term of the Contract and shall expressly require any subcontractors performing work or providing services pursuant to the Contract to likewise utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the Contract term. 13. PERISCOPE S2G (FORMERLY BIDSYNC). The Procurement Department utilizes Periscope S2G, Supplier-to- Government electronic bidding (e-Bid) platform. If you would like to be notified of available competitive solicitations released by the City you must register and complete your vendor qualifications through Periscope S2G, Supplier-to- Government www.bidsync.com/Miami-Beach. Registration is easy and will only take a few minutes. For detailed instructions on how to register, complete vendor qualifications and submit electronic bids visit https://www.miamibeachfl.gov/city-hall/procurement/for-approval-how-to-become-a-vendor/. Should you have any questions regarding this system or registration, please visit the above link or contact Periscope S2G, Supplier-to-Government at support(a.bidsync.com or 800.990.9339, option 1, option 1. 14. HOW TO MANAGE OR CREATE A VENDOR PROFILE ON VENDOR SELF SERVICE (VSS). In addition to registering with Periscope S2G, the City encourages vendors to register with our online Vendor Self- Service web page, allowing City vendors to easily update contacts, attachments (W-9), and commodity information. The Vendor Self-Service(VSS)webpage(https://selfservice.miamibeachfl.qov/vss/Vendors/default.aspx)will also provide you with purchase orders and payment information. Should you have any questions and/or comments,do not hesitate to submit them to vendorsupport(a)miamibeachfl.gov 15. SUPPLIER DIVERSITY. In an effort to increase the number and diversity of supplier options in the procurement of goods and services, the City has established a registry of LGBT-owned businesses, as certified by the National LGBT Chamber of Commerce(NGLCC)and small and disadvantaged businesses,as certified by Miami-Dade County. See authorizing resolutions here. If your company is certified as an LGBT-owned business by NGLCC, or as a small or disadvantaged business by Miami-Dade County, click on the link below to be added to the City's supplier registry (Vendor Self-Service) and bid system(Periscope S2G,Supplier-to-Government).These are two different systems and it is important that you register for both. Click to see acceptable certification and to register: https://www.miamibeachfl.gov/city-hall/procurement/how-to- become-a-vendor/. Balance of Page Intentionally Left Blank SECTION 0200 GENERAL CONDITIONS FORMAL SOLICITATIONS TERMS &CONDITIONS -GOODS AND SERVICES. By virtue of submitting a proposal in response to this solicitation, proposer agrees to be bound by and in compliance with the Terms and Conditions for Services(dated 10.27.2022), incorporated herein, which may be found at the following link: https://www.miamibeachfl.gov/city-hall/procurement/standard-terms-and-conditions' SECTION 0300 PROPOSAL SUBMITTAL INSTRUCTIONS AND FORMAT 1.ELECTRONIC RESPONSES(ONLY). Proposals must be submitted electronically through Periscope S2G(formerly BidSync) on or before the date and time indicated. Hard copy proposals or proposals received through email or facsimile are not acceptable and will be rejected. A proposer may submit a modified proposal to replace all or any portion of a previously submitted proposal until the deadline for proposal submittals. The City will only consider the latest version of the bid. Electronic proposal submissions may require the uploading of attachments. All documents should be attached as separate files in accordance with the instructions included in Section 4, below. Attachments containing embedded documents or proprietary file extensions are prohibited. It is the Bidder's responsibility to assure that its bid, including all attachments, is uploaded successfully. Only proposal submittals received, and time stamped by Periscope S2G (formerly BidSync) prior to the proposal submittal deadline shall be accepted as timely submitted. Late bids cannot be submitted and will not be accepted. Bidders are cautioned to allow sufficient time for the submittal of bids and uploading of attachments. Any technical issues must be submitted to Periscope S2G (formerly BidSync) by contacting (800) 990-9339 (toll free) or S2Gperiscopeholdinqs.com. The City cannot assist with technical issues regarding submittals and will in no way be responsible for delays caused by any technical or other issue. It is the sole responsibility of each Bidder to ensure its proposal is successfully submitted in BidSync prior to the deadline for proposal submittals. 2. NON-RESPONSIVENESS. Failure to submit the following requirements shall result in a determination of non- responsiveness. Non-responsive proposals will not be considered. 1. Bid Submittal Questionnaire 2. Failure to comply with Minimum Eligibility Requirement(See Appendix A, Section Al) 3. Cost Proposal 3. OMITTED OR ADDITIONAL INFORMATION. Failure to complete and submit the Bid Submittal Questionnaire (submitted electronically) and the Cost Proposal with the bid and by the deadline for submittals shall render a proposal non-responsive. Non-Responsive proposals will not be considered. With the exception of the Bid Submittal Questionnaire (completed and submitted electronically) and the Cost Proposal, the City reserves the right to seek any omitted information/documentation or any 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. Failure to submit any omitted or additional information in accordance with the City's request shall result in proposal being deemed non-responsive. 4. ELECTRONIC 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 tabs,and sections as specified below.The electronic submittal should be tabbed as enumerated below and contain a table of contents with page references. The electronic proposal shall be submitted through the "Line Items"attachment tab in Periscope S2G. TAB 1 Cover Letter&Minimum Qualifications Requirement 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 Minimum Qualifications Requirements. Submit verifiable information documenting compliance with the minimum qualifications requirements established in Appendix A, Minimum Requirements and Specifications. TAB 2 Experience &Qualifications 2.1 Qualifications of Proposing Firm. Submit detailed information regarding the current or prior contracts or engagements that the bidder has with public sector agencies that demonstrates its relevant experience and proven track record of the firm and/or its principals in providing similar scope of services as identified in this solicitation, including experience in providing similar scope of services to public sector agencies,with emphasis on the following areas of expertise: • Emergency Medical Services(EMS)ambulance billing integration and management for other governmental entities; • Experience with the Florida Agency for Health Care Administration (AHCA) in the supplemental payment programs relating to Certified Public Expenditure (CPE) for both Medicaid and managed care cost reimbursements; and • EMS ambulance billing and EPCR system installation, integration, and management for a Florida EMS Provider. For each contract or engagement submitted as evidence of experience for the firm and/or any principal,the following is required:detailed description of the services provided,agency name,agency contact, contact telephone&email, and year(s), and term of engagement. For each project, identify whether the experience is for the firm or for a principal (include name of principal). 2.2 Qualifications of Proposer Team. Provide an organizational chart of all personnel and consultants/sub- contractors intended for this contract if awarded and the role each team member will play in providing the services detailed herein. For each team member, include a resume that includes, at a minimum, relevant experience and other pertinent information. For each firm, submit detailed information regarding the current or prior contracts or engagements that the bidder has with public sector agencies that demonstrates its relevant experience and proven track record of the firm and/or its principals in providing similar scope of services as identified in this solicitation, including experience in providing similar scope of services to public sector agencies,with emphasis on the following areas of expertise: • Emergency Medical Services(EMS)ambulance billing integration and management for other governmental entities; • Experience with the Florida Agency for Health Care Administration (AHCA) in the supplemental payment programs relating to Certified Public Expenditure (CPE) for both Medicaid and managed care cost reimbursements; and • EMS ambulance billing and EPCR system installation, integration, and management for a Florida EMS Provider. For each contract or engagement submitted as evidence of experience for the firm and/or any principal,the following is required:detailed description of the services provided, agency name,agency contact, contact telephone&email, and year(s) and term of engagement. For each project, identify whether the experience is for the firm or for a principal (include name of principal). TAB 3 Scope of Services Proposed Submit detailed information addressing how Proposer will achieve each portion of the scope of services and requirements outlined in Appendix A, Minimum Requirements and Specifications. At a minimum, response is to include the following: • A detailed procedure explaining how the firm will provide the City with a refund request including all pertinent information relating to refund payments to patients and/or insurance company. • Sample bill forms and the messages that will be used on each successive bill mailed. • Firm shall provide a process for collecting information from local law enforcement agencies and gross billable and payments on all incidents involving motor vehicles. • Details on how contractor will increase collection rates annually. • A copy of the firm's disaster and recovery policies and procedures. • Details on procedures and controls for receiving payments whether received in person, by mail, or electronic transfer. • Compliance with SAS70 and/or SSAE 16. • Details on how firm will ensure the highest level of customer service. • A sample monthly report. Responses shall be in sufficient detail and include supporting documentation, as applicable, which will allow the Evaluation Committee to complete a fully review and score the proposed scope of services. TAB 4 Cost Proposal Submit a completed Cost Proposal Form (Appendix B). Balance of Page Intentionally Left Blank SECTION 0400 PROPOSAL EVALUATION 1. EVALUATION COMMITTEE INITIAL REVIEW OF PROPOSALS.An Evaluation Committee, appointed by the City Manager, may meet to evaluate each Proposal in accordance with the qualitative criteria set forth below. In doing so, the Evaluation Committee may review and score all proposals received, with or without requiring presentations. It is important to note that the Evaluation Committee is advisory only and does not make an award recommendation to the City Manager or the City Commission. The City Manager will utilize the results to take one of the following actions: a. 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 ITN, may, without an evaluation committee, recommend to the City Commission that the Administration enter into negotiations; or b. The City Manager may recommend that the City Commission authorize negotiations or award a contract to one or more firms in accordance with Section 0100, Sub-section 12; or c. The City Manager may Recommend that the City Commission short-list one or more firms for further consideration by the Evaluation Committee; or d. The City Manager may recommend to the City Commission that all firms, if more than one (1) responsive submittal is received, be rejected. 2. PRESENTATIONS BY SHORT-LISTED FIRMS. If a short-listing of firms responding to this RFP is approved, the short-listed firms may be required to make presentations to and be interviewed by the Evaluation Committee. In further considering the short-listed firms, the Evaluation Committee will utilize the criteria set forth in Sub-section 4 below. 3. TECHNICAL ADVISORS. The City, in its discretion, may utilize technical or other advisers to assist the evaluation committee or the City Manager in the evaluation of proposals. 4. EVALUATION CRITERIA. Responsive, responsible proposals will be evaluated in accordance with the following criteria: Qualitative Criteria Maximum Points (Points Assigned by Evaluation Committee) Experience &Qualifications (Tab 2) 45 Scope of Services Proposed (Tab 3) 30 TOTAL AVAILABLE POINTS for Qualitative Criteria 75 Quantitative Criteria Maximum Points (Points Assigned by Procurement Department) Veteran's Preference Points 5 Cost Pro•osal 25 TOTAL AVAILABLE POINTS for Qualitative and 105 Quantitative 5. QUALITATIVE CRITERIA. The Evaluation Committee shall review responsive, responsible proposals and assign points for the qualitative factors only. The Evaluation Committee shall not consider quantitative factors (e.g. veteran's preference) in its review of proposals. The Evaluation Committee shall act solely in an advisory capacity to the City Manager. The results of the Evaluation Committee process do not constitute an award recommendation. The City Manager may utilize, but is not bound by, the results of the Evaluation Committee process, as well as consider any feedback or information provided by staff,consultants or any other third-party in developing an award recommendation in accordance with Section 0100, Sub-section 10. In its review of proposals received, the Evaluation Committee may review and score all proposals, with or without conducting interview sessions, in accordance with the evaluation criteria. 6. QUANTITATIVE CRITERIA. Procurement Department staff will assign points for the quantitative criteria. Veterans' Preference points will be assigned in accordance with Section 2-374 of the City Code. Cost Proposal Evaluation.The cost proposal points shall be developed in accordance with the following formula: Sample Objective Formula for Cost Example Maximum Formula for Calculating Points Vendor Allowable Points (lowest cost I cost of proposal being Total Points Vendor Cost (Points noted are for illustrative evaluated X maximum allowable Proposal purposes only.Actual points are points=awarded points) Awarded noted above.) Round to • Vendor A $100.00 20 $1001$100 X 20=20 20 • Vendor B $150.00 20 $100 I$150 X 20=13 13 Vendor C $200.00 20 $100 I$200 X 20=10 10 7. DETERMINATION OF FINAL RANKING. The sum of the evaluation criteria points will be converted to rankings in accordance with the example below: Proposer A Proposer B Proposer C Qualitative Points 82 74 80 Committee Quantitative Points 5 5 0 Member 1 Total 87 79 80 Rank 1 3 2 Qualitative Points 82 85 72 Committee Quantitative Points 5 5 0 Member 2 Total 87 90 72 Rank 1 2 3 Qualitative Points 90 74 66 Committee Quantitative Points 5 5 0 Member 2 Total 95 79 66 Rank 1 2 3 Low Aggregate Score 3 7 8 Final Ranking* 1 2 3 It is important to note that the results of the proposal evaluation process in accordance with Section 0400 does not represent an award recommendation. The City Manager will utilize the results of the proposal evaluation process,and any other information he deems appropriate, to develop an award recommendation to the City Commission, which may differ from the results of the proposal evaluation process and final rankings. Balance of Page Intentionally Left Blank APPENDIX A MIAMIBEACH Minimum Requirements & Specifications 2023-015-ND EMERGENCY MEDICAL TRANSPORT AND COLLECTION SERVICES PROCUREMENT DEPARTMENT 1755 Meridian Avenue, 3rd Floor Miami Beach, Florida 33139 Al. Minimum Eligibility Requirements. The Minimum Eligibility Requirements for this solicitation are listed below. Bidder shall submit the required submittal(s) documenting compliance with each minimum requirement. Proposers that fail to comply with minimum requirements shall be deemed non-responsive and shall not have its bid considered. 1. Bidder(defined as the Proposing Firm) shall have at least one contract (current or expired within the last five (5) years) to provide EMS transportation billing and collection services for a governmental entity, quasi-governmental entity, or a not-for-profit/non-profit entity. Required Submittals: For each contract submitted as proof of experience, submit entity name and address, description of services, start and completion dates, entity contact information (phone and email). A2. Statement of Work Required. The City's Fire Department provides medical transportation for the residents and visitors transported from incident scenes to health care facilities in Emergency Medical Services(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, or spinal immobilization fees. The following table lists the relevant Fire Department data regarding medical calls and transports for Fiscal Year 2019/2020 and Fiscal Year 2020/2021 as compiled from the Fire Department's computer- aided Dispatch (CAD) and report management software (RMS) databases: FY 20/21 FY 21/22 EMS Calls 17,734 18,576 EMS Transports 6,509 6,621 The City collected the following revenues fees during the past two (2)fiscal years: FY 20/21 FY 21/22 TOTAL Gross Collection $1,635,661.42 $2,058,658.00 $3,694,319.42 Current Service Provider $134,082.73 $158,516.66 $292,599.39 Fee (7.7%) Net Collection $1,399,667.00 $1,900,141.40 $3,299,808.4 The City of Miami Beach Fire Rescue collects medical data in the field. Using ESO Solutions, EMS personnel will complete the required computerized patient care report, including billing information; and submit the file, via cellular network, to an offsite location where the server resides. The reports are reviewed by field staff, station officers, medical supervisors, and quality improvement officers remotely at their respective stations. The services to be provided include, but are not limited to: • Contractor shall have an interface that provides a daily automated electronic import from EPCR system (currently ESO) into their billing system. • Contractor will submit quarterly aggregated EMS reports on behalf of the City of Miami Beach Fire Rescue to State and Federal entities (i.e., EMSTARs) • Contractor will obtain a 60% minimum gross collection rate between Contractor and the City • Having a local office within the State of Florida, as of the date of issuance of this RSFP. The local office should have staff capable of meeting with City staff on an as-needed basis. • Providing a 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, and that can communicate (read, write and speak) fluently in English, Spanish and Creole; however, it is not required that each CSR speaks in all three (3) languages, but there must be available CSRs to conduct business in each language, as necessary. A3. Specifications. 1. General. • Contractor will 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 the Fire Department. • The Contractor shall maintain files, records and other evidence as required to demonstrate that all contract provisions are being fulfilled. Such files and records will be available for review and/or access by the City of Miami Beach Fire Rescue under agreed-upon procedures. • Contractor will prepare quarterly State of Florida aggregate EMS reports. • Contractor shall have the ability to generate specialized reports upon request and at no additional cost. • Contractor will establish a two-way data exchange system with billing hospitals to electronically transfer(e-Transfer)all EPCRs to the hospital and receive patient and related billing information back from the hospitals. • Contractor must provide a process for requesting Interfacility and/or Routine transfers online with all required MBFD paperwork completed when the request is submitted at no cost to the City. • Contractor must accurately code calls by providing medical necessity determination, assigning medical diagnostic codes, ICD-IO-CM codes, Health Care Procedure Coding System (HCPCS), modifiers, and narratives based on the nature of the ambulance call and the information provided on the patient care report for the purpose of billing in accordance with Medicare, Medicaid, Commercial insurers and private payers for prehospital emergency medical services. 2. Invoicing I Billing I Collections. • Contractor shall be responsible for the invoicing, collection, and generation of all insurance forms and filings, record maintenance and preparation of standard and/or custom reports, as requested or required by the Fire Department. • The invoices for services rendered shall contain the following information: a. Patient account number. 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. • Contractor shall use the electronic Patient Care Report (ePCR) and additional documents obtained as the basis for coding the service and billing the individual, Medicare, Medicaid, insurance companies, or other appropriate third-party payers for services provided.Contractor shall mail 80%of bills/invoice forms to patients within three (3) days of receiving the patient information. This is to include return envelope and address specified by the City of Miami Beach. • All invoices and reporting shall be automated. • Contractor shall be responsible for sending follow-up bills at thirty-day (30), sixty-day (60), and ninety-day(90)intervals. If the bill has not been paid in full within 120 days,the patient will be notified by letter(electronic emails in some cases)and/or telephone of the delinquent amount. • 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). • Contractor shall post all payments as received directly or electronically within one (1) business day and process refund requests with the month following an overpayment. • The Contractor shall agree to make every effort to locate and correct any incorrect billing address for billable patients. • Contractor will be required to collect the patient's signature in cases where the City's EMS personnel were unable to obtain a signature during transport. The record of this signature shall be maintained by the Contractor for review by Medicare and City auditors. The Contractor shall make and document no less than two (2) attempts to obtain the patient's signature. • In the course of collecting the debt,the Contractor will employ additional skip tracing or other discovery methods at no additional cost. • Contractor shall agree to include in the invoice mailing a citizen satisfaction survey and a return, self-addressed and postage-paid envelope 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. • If necessary, Contractor will check hospital information twice per self-pay account to obtain/verify patient insurance and contact information. • 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. • Accept the hard copy or electronic information pertaining to patients' pay or billing documentation from Fire Department for all patients transported by Fire Department. • 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. • Contractor shall maintain and update all billings for ambulance services to include update of address and telephone numbers obtained through billing and collection efforts. Report shall be provided as necessary. • If Contractor received payment for services that are later disallowed (such as bad checks paid directly to Fire Department, or adjustments) by Fire Department, Fire Department may offset the amount disallowed from any payment due to the Contractor. • Contractor shall not add a charge of any kind to a billed account. • To the extent necessary to fulfill its billing and collection efforts under the Agreement, Contractor is granted limited authority to sign in an administrative capacity on behalf of Fire 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 Department tax exempt status; and insurance filings and related forms. Contractor has no authority to sign any document on behalf of Fire Department, which imposes liability on Fire Department. • A Fire Department designee must approve all written billing and collection correspondence. All payments and correspondence shall be directed to the mailing address designated by Fire Department. • Contractor agrees to negotiate and arrange modified payment schedules for those individuals unable to pay the total amount when billed. • Contractor agrees to refund patient or insurance company refunds within forty-five(45)days of receipt and conforms to all applicable Florida Statutes. • 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 will process all third-party reimbursements within one (1) week after receiving appropriate billing information from the primary payer. • Contractor shall not settle any accounts for less than the amount indicated by the Fire Department without the prior written approval of the Fire Department designee. • Contractor shall provide copies of remittance advice as required by Fire Department. • 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 Department. • Contractor shall expeditiously begin the billing and collection process for those accounts provided to Contractor by Fire Department based upon established rates(Refer to Appendix D). The method utilized by Contractor to process the accounts shall be a means approved by Fire Department Contract Administrator. • 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 Department shall not be required to pay Contractor any collection fees on an account until the corresponding account number can be identified. • Contractor shall reconcile the number of patient invoices against the number of collected invoices. • Termination. If this Agreement is terminated,all accounts will be returned to Fire 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 Department or other firm identified by Fire Department. Contractor agrees to provide a raw flat file containing all relevant data needed to re-create an EPCR for any purpose. Finally, the Contractor agrees to provide the City a one-time column header file with 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. • 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 three(3)days of service. • 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. • Contractor shall be responsible for all fees associated with the credit card acceptance solution. • Contractor shall provide a process for collecting information from local law enforcement agencies and gross billable and payments on all incidents involving motor vehicles. • Contractor shall increase collection rates annually. • Contractor shall have a mechanism to find a revenue source for all patients outside of contacting the hospitals. • Contractor shall be able to provide litigation services related 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. 3. Medicare and Medicaid Requirements. • 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. • Contractor will provide Medicare/Medicaid billings in accordance with all federal, state, and local laws and Medicare/Medicaid rules and requirements. • Contractor shall provide electronic claims processing for Medicare and Medicaid and re-file Medicare, Medicaid, or insurance claims as necessary to obtain payment. • Contractor shall be prepared to assess service levels before billing and classify services into levels that meet Medicare and Medicaid transport criteria. In a limited number of cases, these service levels may differ from what is indicated on internal documents based upon interpretation and must be brought to Fire Department's attention to determine if changes may be necessary. • Contractor will provide support for Medicaid or Medicare audits. • Contractor shall provide Electronic Claims Processing for Medicare and Medicaid to the City's lockbox. 4. Compliance with Applicable Federal, State, and Local Laws and Requirements. • Provide Health Insurance Portability and Accountability Act (HIPAA) privacy practice requirements to all patients transported in accordance with current regulatory requirements. • 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. • 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. 5. Customer Service. • Respond to all patients' requests and inquiries, either written or verbal, in a timely manner, and not to exceed two (2) business days. • Provide and furnish all material and personnel required for the performance of the Agreement. • Provide Multilingual Customer Service Representatives (CSRs), available during normal business hours.These CSRs shall be able to assist patients and/or other third-party payees with all billing inquiries in a timely and courteous manner. Customer calls will be facilitated within the County or through a "toll free" exchange, published on all invoices. Contractor shall respond within three(2) business days to Fire Department and patients on requests for information or records. All scripts and protocol for answering and placing calls shall be agreed upon between Contractor and the Fire Department prior to the commencement of services. A record of telephone calls and contacts shall be maintained. • Contractor shall be responsible for mailing all forms (i.e., HIPAA, customer survey, and related forms) and responsible for all associated costs. • 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. • Contractor shall provide a designated liaison for patient/payer concerns. 6. Document Maintenance. • 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. o The Contractor shall keep and maintain adequate records of work, information, expenses,costs, invoices, materials provided, and services performed pertaining to the City's EMS ambulance transport billing. These records shall be maintained as required by Florida Statues. • Any and all data created by Fire 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. • Contractor shall provide access to its database and a data dictionary for Fire Department to use for report writing capabilities. 7. Communications with City of Miami Beach Staff. • Contractor shall attend meetings with the Fire Department staff to review contract operations when requested. • Contractor shall participate in a yearly audit conducted by the Fire 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. • Contractor will notify the Fire Department of any changes in federal,state or local laws,rules, regulations and codes that affect this subsequent agreement. • Contractor shall designate a Program Manager responsible for all matters related to the Agreement, including performance. The Project Manager's name shall be provided upon commencement of this Agreement. The Project Manager shall be available during Fire Department business hours of 8:30 am to 5:00 pm, Monday through Friday, and shall respond to Fire Department within one (1) hour. • Upon request by the Fire Department, a written response shall be provided to all complaints received by the Fire Department of any alleged actions taken by the Contractor and/or its agents. The response shall be provided by Contactor's Project Manager and shall be received by the Fire Department within thirteen (13) days from the date the request is sent to the Contractor. The response shall address all questions and statements made by the Fire Department concerning the alleged actions. • Contractor shall provide the Fire Department with read-only access to accounts,at locations determined by Fire Department. • Contractor shall provide all necessary developing,copying,faxing, mailing,and other related services at no additional cost to the Fire Department. • Contractor shall maintain and inform Fire 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 Department of any changes. • Fire Department, its staff, consultant, and/or contractors shall have the right to visit the offices of the Contractor and/or its agents periodically to inspect the facilities and operations used in the performance of any resultant agreement. • For record-keeping purposes (not related to billing/collection cycle), Contractor shall retain all account information for a minimum of three(3)years. • Contractor shall continually review Medicare and Medicaid policies, rules, regulations, and laws pertaining thereto,and shall immediately incorporate new requirements or changes into its procedures, and make prompt, appropriate recommendations to the City in order to maximize revenue. Contractor shall keep the Division Chief of EMS aware of any anticipated or actual changes in the laws pertaining to collections that may impact City's revenue. 8. Reports. Contractor shall establish a comprehensive reporting system that will enable the City to monitor Contractor's performance. Reports must be designed to provide data required to measure performance accurately. Reports must be provided on a regular schedule and in a format approved by the City. At City's request, Contractor shall provide additional or different reports than those stated herein, or as modified by City. • Prepare and process quarterly Fire Department's State of Florida EMS pre-hospital data collection report, in a format designated by EMS Tracking and Reporting System (EMSTARS). • Contractor will keep full and accurate accounts of services performed by the Fire Department, billing and collections received, and other records related to the emergency medical transport billing and collection services. • Contractor will prepare and provide the Fire Department Administration monthly reports as required by Fire Department. • Contractor shall provide, every month, a copy of all monthly financial activity, billing and receivable reports, consistent with GAAP on the account. • Monthly Financial Report. Contractor shall submit a financial report to the Division Chief of EMS on or before the 4th business day of each month,which shall,at a minimum,contain the following information: o Summary by transport month of payments received during the preceding month. o Summary report for expense fees incurred during the billing process (i.e. privacy notices, correspondence costs, shipping, postage, survey, etc.) o Detailed report for each transport month since contract inception including: • The percentage of missing data entry for each month, and cumulative percentage for the fiscal year, by each Fire Department personnel; • The percentage of inaccurate data entry for each month, and cumulative percentage for the fiscal year, by each Fire Department personnel; • Transport Type (BLS,ALS-1 and ALS-2); • Number of EMS cases billed to date; • Gross amount billed to date; • Prior payments to date; • Preceding month payments; • Total mandated contractual adjustments for transport month to date; and • Lockbox monthly statement. o Provide Electronic Claims Processing for Medicare and Medicaid to the City's lockbox. o Reconciliation of payments received directly by the City in account(s) other than lockbox, if any, for the preceding month. • Monthly Refund Report. Contractor shall submit to the Division Chief of EMS on or before the 4th business day of each month a monthly refund report for refunds issued by Contractor during the preceding month which shall, at a minimum, contain the following information: o Responsible party on the account; o EMS incident number; o Selected respondent payment reference; o Refund amount; and o Date of refund. • Vendor Performance Report. Contractor shall submit a vendor performance report to the Division Chief of EMS on or before the 10th calendar day of each month, which shall, at a minimum, contain the following information: o Gross amount billed; o Number of EMS cases billed by transport type to date; o Contractual adjustments by category (i.e., Medicare, Medicaid, Medicare Replacement Insurance non-allowed amounts, homeless patients, etc.); o Net amount billed; o Collections from all sources by category (i.e. Medicare, Medicaid, commercial insurance, private pay); o Total gross collections; o Refunds and deductions due to dishonored checks; o Total net amount collected; o Net effective collection rate; and o Collection per account. • Quarterly Analysis Report. Contractor shall submit a quarterly analysis report to the Division Chief of EMS on or before the 10th calendar day as follows: o January Report: October—December(Q1) o April Report: October—March o July Report: October—June o October Report: October—September(full Fiscal Year) At a minimum, the quarterly analysis report shall contain the following information for fiscal year to date: o Transport type (BLS,ALS-1 and ALS-2); o Collection source category(i.e., Medicare, Medicaid,commercial insurance, private pay); o Number of EMS cases billed by transport type; o Total amount billed; o Gross collection rate; and o Collection per account. 9. Reports Compilation and Listing. Contractor shall maintain a computerized database of all accounts and shall provide the Fire Department with reports to show management and financial information. The Fire Department will determine the format of reports required under this contract. In addition to the reports described below, the Contractor shall provide any custom reports at the request of the Fire Department in a mutually agreeable timeframe and at no additional cost to the City. Monthly reporting is produced after month closing and provided to Fire 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. The following are major reports that the Contractor shall produce for the Fire Department: • 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. • 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 activity type and computes average collections for both gross and net. Note: All payment activity is reflected against the original month billed to reflect accurate collection percentages. • 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. • 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 the number of accounts collected by class and the percentage of total. • 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. • 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. • Account Activity—Monthly Billing Report(Charges) Shows all billing (new charges) processed alpha sorted by last name and summarized total billing for period. • 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 Explanation of Benefits (EOB) detail for secondary filing, refund processing, and adjustments. • Collections—Summary to Date, Monthly Running Shows receivables as applied to "original billed month." • Monthly Refund Schedule Report provided by account detail of associated payments reflecting an overpayment and necessary refund to be processed. • Refund Request Provides for previous billing month, a separate sheet per account, requesting refund on overpayment accounts. This includes all information pertinent to determining refund. • Distribution of Charges and Collections This report will track the charges, payments and financial class mix of all patients for a given month. • 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. • Patient Alpha Listing This report lists all invoices alphabetically by patient name. • Monthly Payment Listing This report lists payments, bad checks, required charge offs, and refunds posted to each patient's account. • Overpayment Reports This report lists all patients' due refunds as a result of overpayment of account. • 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. 10. Responsibilities of the City of Miami Beach. • The City of Miami Beach will comply with all federal, state, and local laws, rules and regulations applicable to the contracted services. • 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 Agreement is in force. • The City of Miami Beach will make every effort to obtain the proper billing address for all billable patients prior to forwarding it to the Contractor. • The City will pay the Contractor additional fees for any postage increases during the contract period. However, this fee will only be the actual cost of the increase. 11. Service Fees. The Contractor shall perform EMS Billing and collection services on behalf of the Fire Department and shall conform to the following: • All monies collected by the Contractor shall be deposited in the designated lockbox. • At the end of each calendar month Contractor shall send an invoice to the Department with collection details of all Department transports entered in the Contractor's billing system from the preceding month. • 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, and no additional payments shall fall due under this contract except for any refunds due to the Contractor due to patient overpayment refunds. • The Contractor shall be entitled to fees on all collections for billings during the contract term and 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 the contract term and up to one(1)year after expiration or termination of Contract. 12. Florida Certified Public Expenditure (CPE) Program. At the request of the City, the 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. A4. Special Conditions 1. TERM OF CONTRACT. This contract shall remain in effect for three (3) years from date of contract execution by the Mayor and City Clerk. The City of Miami Beach has the option to renew the contract at the sole discretion of the City Manager for an additional two(2), one(1)year periods, on a year-to-year basis. Renewal of the contract is a City of Miami Beach prerogative, not a right of the Contractor. Such option will be exercised, if at all, only when it is in the best interest of the City of Miami Beach. In the event that the contract is held over beyond the term herein provided it shall only be on a month-to-month basis and shall not constitute an implied renewal of the contract. Said month to month extension shall be upon the same terms of the contract and at the compensation and payment provided herein, and shall not exceed six (6) months. 2. COST ADJUSTMENTS. On or about the anniversary of each contract year, the contractor may request, and the city manager may approve, a cost adjustment based on documented cost increases for the following contract year. Typically, cost adjustments should be limited to changes in the applicable Consumer Price Index (CPI) for the local region. The Contractor's adjustment request must substantiate the requested increase. The City of Miami Beach, through its city manager, reserves the right to approve a requested adjustment or may terminate the agreement and readvertise for bids for the goods or services. 3. NEGOTIATIONS. Upon approval of selection by the City Commission, negotiations between the City and the Contractor(s) will take place to arrive at a mutually acceptable Agreement, including final scope of services, deliverables, and cost of services. 4. ADDITIONAL FEES. In the future and at the City's option, there may be additional fire rescue vehicles added due to annexation(s), Ambulance Response Fee and/or Supply Fees based on a fee structure(s) determined by the City. Contractor should be able to accommodate these potential changes. 5. PERCENTAGE OF REVENUE. The City reserves the right to negotiate the percentage of revenue rate during contract negotiations, and any renewal term, of the Agreement. Balance of Page Intentionally Left Blank APPENDIX B MIAMIBEACH Cost Proposal Form 2023-0 1 5-N D EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES PROCUREMENT DEPARTMENT 1755 Meridian Avenue, 3rd Floor Miami Beach, Florida 33139 APPENDIX B COST PROPOSAL FORM Failure to submit Appendix B, Cost Proposal Form, in its entirety by the deadline established for the receipt of pro s osals will result in s ro'osal bein• deemed non-res'onsive and bein' re'ected. Proposer affirms that the prices stated on the cost proposal form below represent 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 (Appendix B) shall be completed in its entirety. All corrections on the Cost Proposal Form (Appendix B)shall be initialed. PERCENTAGE OF REVENUE TO BE PROVIDED TO THE VENDOR Estimated Annual Gross Percentage of Revenue to the Annual Item Collections' Vendor' Estimated Cost (a) (b) to the City (aXb=c) 1 $1,483,872 % $ SUB-TOTAL ITEM 1 $ MEDICAID ACCOUNT BILLING SERVICE Estimated Annual Annual Item Number of Medical Fee Per Claim Filed Estimated Cost Claims' (b) to the City (a) (aXb=c) 2 2,004 $ $ SUB-TOTAL ITEM 2 $ 'The City reserves the right to negotiate the percentage of revenue rate during contract negotiations. 2The estimated amounts stated herein are for calculation purposes only.Actual amounts may be greater or less than the estimated amounts. TOTAL ANNUAL ESTIMATED COST TO THE CITY(ITEMS 1-2)3: $ 3The total annual estimated cost to the City shall be utilized to allocate Cost Points in the Evaluation of Proposals. Balance of Page Intentionally Left Blank APPENDIX C MIAMIBEACH Insurance Requirements 2023-015-ND EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES PROCUREMENT DEPARTMENT 1755 Meridian Avenue, 3rd Floor Miami Beach, Florida 33139 MIAMI BEACH INSURANCE REQUIREMENTS The vendor shall maintain the below required insurance in effect prior to awarding the contract and for the duration of the contract. The maintenance of proper insurance coverage is a material element of the contract and failure to maintain or renew coverage may be treated as a material breach of the contract, which could result in withholding of payments or termination of the contract. A. Workers' Compensation Insurance for all employees of the Contractor as required by Florida Statute Chapter 440 and Employer Liability Insurance with a limit of no less than $1,000,000 per accident for bodily injury or disease. Should the Contractor be exempt from this Statute, the Contractor and each employee shall hold the City harmless from any injury incurred during performance of the Contract. The exempt contractor shall also submit(i) a written statement detailing the number of employees and that they are not required to carry Workers' Compensation insurance and do not anticipate hiring any additional employees during the term of this contract or(ii) a copy of a Certificate of Exemption. B. Commercial General Liability Insurance on an occurrence basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence, and $2,000,000 general aggregate. C. Automobile Liability Insurance covering any automobile, if vendor has no owned automobiles, then coverage for hired and non-owned automobiles, with limit no less than $1,000,000 combined per accident for bodily injury and property damage. D. Professional Liability (Errors & Omissions) Insurance appropriate to the Consultant's profession, with limit no less than $1,000,000. Additional Insured - City of Miami Beach must be included by endorsement as an additional insured with respect to all liability policies (except Professional Liability and Workers' Compensation) arising out of work or operations performed on behalf of the contractor including materials, parts, or equipment furnished in connection with such work or operations and automobiles owned, leased, hired or borrowed in the form of an endorsement to the contractor's insurance. Notice of Cancellation - Each insurance policy required above shall provide that coverage shall not be cancelled, except with notice to the City of Miami Beach c/o EXIGIS Insurance Compliance Services. Waiver of Subrogation — Vendor agrees to obtain any endorsement that may be necessary to affect the waiver of subrogation on the coverages required. However, this provision applies regardless of whether the City has received a waiver of subrogation endorsement from the insurer. Acceptability of Insurers— Insurance must be placed with insurers with a current A.M. Best rating of A:VII or higher. If not rated, exceptions may be made for members of the Florida Insurance Funds (i.e. FWCIGA, FAJUA). Carriers may also be considered if they are licensed and authorized to do insurance business in the State of Florida. Verification of Coverage— Contractor shall furnish the City with original certificates and amendatory endorsements, or copies of the applicable insurance language, effecting coverage required by this contract. All certificates and endorsements are to be received and approved by the City before work commences. However, failure to obtain the required documents prior to the work beginning shall not waive the Contractor's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements, required by these specifications, at any time. CERTIFICATE HOLDER MUST READ: CITY OF MIAMI BEACH do EXIGIS Insurance Compliance Services P.O. Box 4668—ECM #35050 New York, NY 10163-4668 Kindly submit all certificates of insurance, endorsements, exemption letters to our servicing agent, EXIGIS, at: Certificates-miamibeachriskworks.com Special Risks or Circumstances-The City of Miami Beach reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. Compliance with the foregoing requirements shall not relieve the vendor of his liability and obligation under this section or under any other section of this agreement. Balance of Page Intentionally Left Blank APPENDIX D MIAMIBEACH EMS Billing Procedures and Rates 2023-01 5-ND EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES PROCUREMENT DEPARTMENT 1755 Meridian Avenue, 3rd Floor Miami Beach, Florida 33139 tr`�tU Be.4 '• 4314- City of Miami Beach EMS I• II) EMS Billing 9oEpACCItTP ,�'` Procedures & Rates City of Miami Beach EMS has established the following rates for various ambulance service charges. At any time, in accordance with the Service Agreement, City of Miami Beach EMS may modify these rates and/or billing procedures, with proper notice. Additional instructions regarding billing procedures and rates are located near the end of this document. City of Miami Beach EMS's current rate schedule (the "Chargemaster") begins on the next page. Printed on 10-31-2017 Page 1 of 3 �`�‘soy City of Miami Beach EMS 4. EMS Billing 1,Fo � Procedures & Rates Chargemaster Item Rate Medicaid Medicare ALS Emergency Mileage 15.00 15.00 15.00 ALS Non-Emergency Mileage 15.00 15.00 15.00 ALS Supplies- IV Therapy 25.00 * * ALS Supplies- Intubation 25.00 * * ALS1 Emergency Base Rate 800.00 800.00 800.00 ALS1 Non-Emergency Base Rate 800.00 800.00 800.00 ALS2 Base Rate 800.00 800.00 800.00 Auto Pulse Lifebands 175.00 * * BLS Emergency Base Rate 800.00 800.00 800.00 BLS Emergency Mileage 15.00 15.00 15.00 BLS Non-Emergency Base Rate 800.00 800.00 800.00 BLS Non-Emergency Mileage 15.00 15.00 15.00 Defibrillation Pads 100.00 * * EKG(Cardiac Monitoring) 25.00 * * EZ 10 Needles 100.00 * * Endotracheal lntubation 0.01 * * 10 Initiation 0.01 * * IV infusion,Addt'l infusion of new drug, up to 1 hr 0.01 * * IV infusion, concurrent infusion 0.01 * * IV infusion, each addt'l hour 0.01 * * IV infusion, initial up to 1 hr 0.01 * * IV med, each addt'l IV push different drug 0.01 * * IV med, each addt'l IV push of same drug 0.01 * * IV push medication, singe or initial drug 0.01 * * Oxygen, Administration, &Supplies/hr 30.00 30.00 * Rescue Pods 100.00 * * Special Handling 25.00 * * Spinal Immobilization 25.00 * * Temporary Transcutaneous pacing 0.01 * * Tracheostomy, Cricothyroid Membrane 0.01 * * Printed on 10-31-2017 Page 2 of 3 • City of Miami Beach EMS I• ; — EMS Billing 9FOOA Procedures & Rates * indicates that charges are waived. Medicaid patients are only billed the indicated charges. Only one base rate charge shall be applied to each account. Base rate and mileage charges shall be applied in accordance with guidelines established by the Center for Medicare & Medicaid Services. City of Miami Beach EMS instructs its billing agent(s)to assign/adjust off all amounts as permitted or required by Federal and State law and applicable payment policy. Night Rate should be charged for all patient encounters occurring between the hours of 8 pm to 8 am, as determined by the call dispatch time, unless otherwise prohibited or excluded by the Chargemaster. Weekend Rate should be charged for all patient encounters between 8 pm Friday to 8 am Monday, as determined by the call dispatch time, unless otherwise prohibited or excluded by the Chargemaster. Dispatch Fee should be charged for all patient encounters, unless otherwise prohibited or excluded by the Chargemaster. Routine Disposable Supplies should be charged for all patient encounters, unless otherwise prohibited or excluded by the Chargemaster. The BLS Emergency Base Rate and supplies used shall be applied to all accounts where the patient has been determined as deceased on Scene after the dispatch but before the patient has been loaded onboard the ambulance. No mileage will be charged in that case. If the patient is determined as deceased after pickup but prior to arrival at the receiving facility, the medically necessary level of service will be billed. In that case, it would be at least ALS-1 Emergency if a paramedic assessment was performed, or other ALS interventions where provided. Loaded mileage may also be billed in accordance with Federal and State law and applicable payment policy. Unless determined Dead on Scene, patients that are not transported by ambulance are not billed. Supply and procedure charges should be billed for attempted procedures (IV, intubation, bone needles), even if the attempt is not successful, unless otherwise prohibited or excluded by the Chargemaster. The Emergency Rate should be applied to all accounts,when transport to the destination facility is deemed an emergency by the reporting medic, unless otherwise prohibited or excluded by the Chargemaster. Printed on 10-31-2017 Page 3 of 3 ATTACHMENT C SUNBIZ & PROPOSAL RESPONSE TO RFP D..ISION OF CORPOR TIONS D1Y1:;icM0 of . 4m.Org c J_►'?_.possyrio an off iclut State of Florida writhe Department of State / Division of Corporations / Search Records / Search by FEI/EIN Number / Detail by FEI/EIN Number Foreign Limited Liability Company DIGITECH EMS BILLING LLC Cross Reference Name DIGITECH COMPUTER LLC Filing Information Document Number M21000012041 FEI/EIN Number 11-2693136 Date Filed 09/10/2021 State DE Status ACTIVE Principal Address 480 BEDFORD RD., BLDG.600, 2ND FLOOR CHAPPAQUA, NY 10514 Mailing Address ATT: REGULATORY 5000 TUTTLE CROSSING BLVD. DUBLIN, OH 43016 Registered Agent Name&Address CT CORPORATION SYSTEM 1200 SOUTH PINE ISLAND ROAD PLANTATION, FL 33324 Authorized Person(s)Detail Name&Address Title MGR SCHIOWITZ, MARK 480 BEDFORD RD. BLDG. 600, 2ND FLOOR CHAPPAQUA, NY 10514 Title CFO KERULO, JOYCE 480 BEDFORD RD. BLDG. 600, 2ND FLOOR CHAPPAQUA, NY 10514 Title CEO SCHIOWITZ, MARK 480 BEDFORD RD. BLDG. 600, 2ND FLOOR CHAPPAQUA, NY 10514 Annual Reports Report Year Filed Date 2022 01/31/2022 2023 01/25/2023 Document Images 01/25/2023--ANNUAL REPORT View image in PDF format 01/31/2022--ANNUAL REPORT View image in PDF format 09/10/2021--Foreign Limited View image in PDF format Hn v',nvi .f,,,.,nt or St42,D vis,on of Co;po ahnns 11111 Digitech® Digitech Computer LLC 480 North Bedford Road Building 600,Second Floor Chappaqua,New York 10514 (914) 741-1919 digitechcomputer.com RFP 2023-015-ND Emergency Medical tra Transport Billing and Collection Services MI AM I B EAC H Miami, FL June 9th, 2023 • s. TAB 1 - Cover Letter and k 4 Minimum Reauirements li •., i. e n r q.1 ..., sue$ f w ram, .i$Rt, F''' Nst _ _ 5 ite 4tpe , '' — i. !;� ".y Y,!$Po 4., _ - j`� 44 ' y. ,u��,,4y. ` Ulu , ,.. '' - " tc 1. 0 it 7 IIII� Digitech TABLE OF CONTENTS TAB 1 - COVER LETTER AND MINIMUM QUALIFICATIONS REQUIREMENTS 3 COVER LETTER 3 EXECUTIVE SUMMARY 6 MIGRATING TO AMBULANCE COMMANDER 6 MAXIMIZING COLLECTIONS 7 FLORIDA EXPERIENCE 8 MIAMI BEACH AND DIGITECH PARTNERSHIP 8 ONGOING CONSULTATION 9 THE DIGITECH DIFFERENCE 9 A.1 - MINIMUM QUALIFICATIONS 12 A BRIEF HISTORY OF DIGITECH 12 EXHIBITS Exhibit A Résumés Exhibit B Sample Patient Statements Exhibit C Data Security Plan Exhibit D Reporting Suite Exhibit E Billing Process ATTACHMENTS Attachment 1 Withum SOC Letter Attachment 2 Sample COls and W9 ADDENDA Addendum 1 June 1,2023 g 2023 Digitech Computer LLC RFP No.2023-015-ND 2 ►►MI► Digitech TAB 1 - COVER LETTER AND MINIMUM QUALIFICATIONS REQUIREMENTS COVER LETTER It is with great pleasure that we submit our proposal to continue to provide EMS billing services to the City of Miami Beach. Partnering since 1994 has been a privilege and a great fit, and we look forward to continuing our relationship and service to you. From a technical perspective,we have carefully reviewed the requirements of the RFP,and we are confident that we understand the full scope of the City of Miami's Request for Proposals 2023-015-ND for Emergency Medical Transport Billing and Collection Services.We will meet and exceed the City's expectations should we be awarded this contract. Our response details a comprehensive plan that will achieve your financial, technological, and reporting goals while meeting all requirements.We will deliver all contract requirements to the highest standards of performance, transparency, and integrity. The City will continue to be provided with state-of-the-art technology,flexible reporting capabilities,improved collection results,and complete project management. We believe we are the only ambulance billing firm in the U.S.who offer you this combination of benefits: + Florida experience.We're no strangers to your state and region:we currently process over 1,000,000 claims annually for more than 50 clients in Florida and have several Digitech representatives based in the state. Our Florida clients range from small agencies with fewer than 5,000 annual transports to those running more than 50,000 transports.We partner with Miami-Dade County, Broward Sheriff's Office,City of Fort Lauderdale,Palm Beach County,City of Jacksonville,Leon County,and Orange County,among others - including our existing partnership with the City of Miami Beach. This unrivaled depth gives us a deep understanding of Florida regulations and the unique aspects of Florida Medicaid processing,extensive access to patient insurance information,and a strong voice for our clients with payers and legislators to ensure maximized reimbursements. Through our long-term partnerships, we have become familiar with the hospital systems, demographic trends,and the EMS landscape of the state.That said,we believe that every client is unique. We have customized our solution to the unique needs of the City and look forward to continuing to work together. + Existing relationship with the City. Because of the excellent partnership we already have in place, we are uniquely positioned to provide continuity of operations in addition to the opportunity we present to implement new technology,services,and solutions.As your incumbent vendor,we have a deep understanding of your agency's profile, fees, processes, and policies. We look forward to introducing you to our billing platform,Ambulance Commander. ©2023 Digitech Computer LLC RFP No.2023-015-ND ►IIU Digitech + Reliable revenue growth.We consistently increase collections over our clients' previous solution. Because of our fast, efficient, and accurate billing process, we often start increasing cash flow immediately when we bring clients on board.We go after every dollar of every claim, not just the low-hanging fruit.Your money won't be left on the table. + Innovative proprietary technology.We own the Ambulance Commander platform 100%and use it to power our billing operations end-to-end. It will bring unique value to you because we've been building and improving based on client feedback for over 30 years. + Customization.Owning our technology means we can develop new features and processes tailored to exactly what you need -something we love doing for our clients. + True transparency. You will get 24/7 real-time access to Ambulance Commander. This lets you know exactly what's going on with your claims,money,and data at any moment. + Service to the community you serve.We commit to continuing to deliver a comprehensive, high- quality program to your citizens. + Trust,security, and peace of mind. Our business is built on our relationships with clients, and we conduct our partnerships with integrity.We prioritize data security and compliance practices. It is our goal to make you feel like our only client. For the benefit of members of the evaluation committee who may not be directly familiar with our work on behalf of the City,we offer some introductory information. Digitech Computer LLC is a privately held limited liability company. Since our inception in 1984, — we have specialized in ambulance billing and currently process more than 5,000,000 ambulance claims -- annually for private, municipal, and hospital-based ambulance service providers in 35 states and the District of Columbia.Our contact information follows. • 480 Bedford Road Building 600,2nd Floor ■ Digitech Client States Chappaqua,NY 10514 Phone: (914) 741-1919 Email:sales@digitechcomputer.com Your contact for this proposal is: Scot Metcalf Sales Manager ri Phone: (407)242-8120 .4 smetcalf@digitechcomnuter.com ©2023 Digitech Computer LLC RFP No.2023-015-ND 4 ----- -- --- IqG Digitech We thank you for the opportunity to bid on this contract and look forward to further communications with you. The undersigned further represents and warrants that this bid is a firm and irrevocable offer for a period of 180 days and that he has full and complete authority to submit this proposal to the City on behalf of the bidder and enter into contract if this proposal is accepted.The signature represented is authorized to bind the offeror to contract with the City. Sincerely, 41,-;:""e Mark Schiowitz President&CEO Partnering with Digitech means you'll work with real people who understand EMS and understand your agency. We're big enough to handle the largest clients, but small enough to know each one personally. ©2023 Digitech Computer LLC RFP No.2023-015-ND 5 IIMU Digitech EXECUTIVE SUMMARY We admire Miami Beach Fire Department's mission to provide your residents and visitors with the highest level of safety and security through the delivery of fire 00 4.40 suppression, emergency medical services, disaster response, ocean rescue, fire 411:* y prevention, and public education programs. You'll see throughout this proposal ,� 5 response that we share your values in providing the highest level of service.Your EMS VP providers take risks every day; it is our mission to support these public servants by ensuring that their revenue stream keeps flowing.It is our responsibility to the City to 4DFPAR utilize all of our resources to collect every dollar possible. MIGRATING TO AMBULANCE COMMANDER If we have the honor of being awarded a new contract with the City, one of the most significant and beneficial upgrades we will offer to you is the transition to our proprietary billing platform, Ambulance Commander,which is described more in the following pages.We use Ambulance Commander at Digitech and provide it to our clients to manage all aspects of EMS billing, data management, and reporting. The solution provides the following benefits: + Complete Access and Transparency. All authorized Ambulance Commander users have 24/7 access, including monitoring tools, financial and operational reports, and all claim details. Data is real-time,so key metrics are always up-to-date and at your fingertips. + Comprehensive Reporting Suite. You'll benefit immediately from the most powerful reporting offering in the industry.Specialized solutions like Dashboard and PCR Lens make in-depth analysis easy,and we customize our tools to meet any reporting need.You can view summarized totals and drill down to the individual patient,claim,or transaction level whenever desired. + Solutions for Clients and Patients.Ambulance Commander offers a range of solutions to empower our clients and their patients:SecureDocs,the records system that allows you to securely store and retrieve claim-related documents;Sentinel,the KPI monitoring and alerting watchdog; Portal,your patients'account self-service tool;and more. + Automated Billing Solutions.We've automated the most difficult tasks in the billing process. Our demographic search tool,Sleuth,crawls data sources to find missing patient information.Appeal-IT automatically appeals any short-paid claim. + Seamless ePCR Integration. Our platform is already fully integrated with the ESO ePCR system. We have built,tested,certified,and deployed our standard ESO interface many times,and we have complete confidence in our ability to continue to seamlessly integrate with them. + Innovative Tools and Processes.Building and maintaining our own platform means we continually innovate based on client feedback. We've developed unique products within Ambulance Commander to maximize collections performance. + Technology-Focused Training. Digitech's Account Managers will train your personnel on the Ambulance Commander platform during implementation and whenever training is needed. �;2U23 Digitech Computer LLC RFP No.2023-015-ND gill► Digitech Rest assured that the upgrade to Ambulance Commander will not result in any interruptions to your normal processes. Due to being the incumbent vendor,we already have a deep understanding of all your agency profile information, transport fees, processes, and policies and ultimately, will allow for an extremely smooth upgrade to our billing platform with minimal involvement from City staff. MAXIMIZING COLLECTIONS We are confident that we will continue maximizing collections for your organization.Our proprietary billing platform, Ambulance Commander, has allowed us to consistently increase collections over our clients' previous solution. This track record includes improvements for several major services in Florida that we have recently migrated to the Ambulance Commander platform. The chart below illustrates the improvements in collections per trip that we achieved for several of these clients. CPT Improvements for Migrated Clients 20% i z 18/0 16.2>. 16% 14.0% 14% ° 1 10.9% 11.0°A 11.0% 10.7% 10% 8.3% 8.7% 3.7° 7.8% 8.2% 8.3% 6.5% 6% 5.4% . 115.6 % .5%.. 0 ° 3.1% 2.8% 2.7% :1:11 0% (7\ far \ osc., ree �atF.0 \ \e \ va0p \ �.4` .P 0 a � eoaacf� � �c` �J a Qo o o �� c 0 Qe � 4` 0 e 0 o 6 •oC�° ° o C. a ' 0 C, 6 A' t`� c6 4ca a O aPo •a yaa x„ � 1` G0 OF Qo C.O.§‘ Oce �t ©2023 Digitech Computer LLC RFP No.2023-015-ND 7 MMN► Digitech FLORIDA EXPERIENCE Digitech has a strong history with Florida clients, and we believe our story makes Digitech the most successful billing partner in the state. We will continue to leverage our Florida experience for similar outstanding results in Miami Beach. Okaloosa County Leon County [Hamilton County O Jacksonville .Talton County [Bay County Lake County Longwood] Winter Garden Sanford) Oviedo) [Sumter County The Villages Ocoee Orange County j�lake Mary Orlando Maitland Kissimmee Hillsborough County Plant City St.Cloud (Tampa 114 Polk County Osceola County Manatee County Hardee County Okeechobee County longboat Key DeSoto County Sarasota County [Charlotte County Palm Beach County Palm Beach Gardens Venice Greenacros N.Palm Beach Riviera Beach Broward County Boynton Beach Delray Beach North Port] [Lehigh Acres Coral Springs Lighthouse Pt Tamarac [Pompano Beach) (Collier County Sunrise-ID avie N.Lauderdale in.Lauderdale Plantation Nicklaus Children's Hospital lifeflight) Miami Beach) (Miami-Dade County Key West) Digitech's Clients in Florida MIAMI BEACH AND DIGITECH PARTNERSHIP By continuing to partner with Digitech,you will receive the highest quality EMS billing service centered on innovative technology, responsive customer support, real-time reporting, and integration expertise. We take a long-term consultative approach to ambulance billing projects. Our experience has shown us that every client is different and needs a unique combination of services. Customizing our approach is always beneficial. c-;2023 Digitech Computer LLC RFP No.2023-015-ND IIII► Digitech ONGOING CONSULTATION As part of our consultative style, we consider it our responsibility to keep you up to date on important changes to regulations in the EMS industry in Florida and across the country.We integrate compliance within all our business activities and will continue to ° serve as informed advisors for City officials through our: + Active membership in industry trade organizations + Participation in regional and national ambulance associations and conferences + Consultation with authorities on ambulance industry law + Continuous monitoring of industry trends, regulatory changes, and updates to federal, state, and local rules and regulations + Observation of industry best practices You will receive ongoing consultation related to all aspects of billing and collections for ambulance service. We consider it our responsibility to stay informed and guide you in any new and revised interpretations of relevant laws and policies.We watch closely any developments in the changing landscape of Medicare and Medicaid reimbursements that may affect your collections,and we will keep you informed of any changes to processes or policies. Through our partnership,you are provided with a deep pool of resources and experience to be called upon however you need.These resources include our innovative technology offerings as well as our dedicated staff of EMS billing experts.Our technology and our people work together to create a powerful system. THE DIGITECH DIFFERENCE Detailed below are the aspects of our business that make us unique,the reasons we succeed where others do not,why our clients provide quality references,and the source of our confidence that we will continue to succeed with the City. + Advanced billing platform.Digitech created and continually refines our award-winning proprietary billing software platform, Ambulance Commander. This technology will provide a new level of transparency into your data and result in performance improvements. For example, PCR Lens is a unique tool we developed for EMS providers that helps QI administrators see, measure,compare, and improve the quality of demographic and insurance data collection in the field. + Proprietary technology. Ownership of the Ambulance Commander platform has many benefits. Significantly, we can customize processes based on the City's requirements. We are also able to provide all our clients 24/7 real-time access to the system. + Comprehensive reporting. Digitech's powerful and comprehensive reporting system provides flexibility,ease of use, real-time graphical data,transparency,and the ability to customize to meet any reporting or analysis need. .-,2023 Digitech Computer LLC REP No.2023-015-ND 11111 Digitech + Active industry memberships. Digitech participates in industry trade organizations, attends regional and national ambulance associations and conferences, and consults regularly with authorities on ambulance industry law.We continuously monitor industry trends and track updates to federal,state,and local rules and regulations to keep our clients informed. + Commitment to serving the EMS community. Digitech is committed to providing educational and actionable information to our clients and to the entire EMS community. We offer regular publications covering EMS topics, send regulatory updates, and host webinars and discussions about best practices. Digitech also sponsors major tradeshows and conferences,where we always make sure to connect with clients who are in attendance. + Exceptional account management. Our Account Managers will continue to provide guidance and leadership to the City throughout a comprehensive implementation period and beyond.They will help you leverage our innovative technology and dedicated staff of EMS billing experts. Our technology and our people work together to create a uniquely powerful system that puts a premium on compliance and customer service. + Qualified staff.Digitech's centralized,one-team,one-system approach offers a senior management group with hundreds of years of combined ambulance billing experience and an IT team whose only function is to develop, upgrade, and maintain Ambulance Commander. Many staff members are EMS experts, EMTs, former EMS directors, billing specialists, editors, and certified ambulance coders. Digitech's Quality Assurance team is made up of staff members who have backgrounds as EMTs, paramedics, nurses, or EMS billing professionals. + Dedicated compliance program. Digitech's compliance program incorporates many regulatory safeguards,including random daily and monthly claims audits,independent third- party audits,and an annual SOC 1 Type 2 audit.Each Medicare and Medicaid claim is reviewed and approved by our Quality Assurance specialists before being released to the carrier for payment. + Established data security plan. We offer a state-of-the-art IT framework that includes hosting, complete redundancy, and a fully implemented disaster recovery plan. Redundancy, a Tier 3 data center, mirrored databases, server virtualization, and a secondary data center make up the infrastructure that has yielded 99.999% uptime over the last five years. Our plans prepare assets required to recover from catastrophes quickly,so that the City will not experience data loss or cash flow interruption. + Active participation in the ET3 initiative. Digitech is fully prepared to support our clients' participation in the ET3 model.Since the announcement of ET3,we have prepared our systems to enable billing for expanded treatment in place options and telehealth practices conducted in the field as soon as government payers will allow EMS providers to bill directly for them. We look forward with anticipation to the expansion of billing options for emergency medical services and to the increased acceptance of EMS as an equal partner in pre-hospital care for patients. Cc)2023 Digitech Computer LLC RFP No.2023-015-ND PIIO Digitech As the program has developed, we have sponsored forums to enable our clients to discuss the implications of the ET3 model with a panel of CMMI experts. + Cost recovery program support.Digitech has a decade of deep experience assisting clients with the collection and collation of required data for cost recovery programs. We have partnered with clients of all shapes and sizes to handle every aspect of their supplemental payment programs.Our staff have been involved in the design and development of statewide initiatives to production of customized billing reports,the preparation of cost reports for dozens of clients, and the provision of comprehensive desk review and audit support.Those solutions have helped our clients optimize revenue while maintaining compliance with all federal and state regulations. We have supported supplemental payment programs for more than 100 clients in nearly a dozen states.Through that support,our clients have recovered more than$620M in supplemental payments. + GADCS support. Digitech has been prepared to support our clients through required data collection and reporting for the Medicare Ground Ambulance Data Reporting System since CMS announced the program.Early on,we released a dedicated utility that guides clients through step- by-step collection and collation of all costs related to Medicare transports that are stored in the Ambulance Commander system,reducing the burden on agency finance teams.Now that GADCS is in full swing,we are actively preparing cost reports for any of our clients who need assistance. For clients and non-clients alike who want more support,we offer an end-to-end service to handle the entire process. We recently hosted a public forum in collaboration with Pinnacle and Fitch & Associates to walk agencies through the requirements of the program and help them get organized for successful completion and delivery of their Medicare cost report to CMS. 0 Digitech has met and exceeded our expectations in all areas.They are friendly, courteous, prompt,and professional.They are knowledgeable and up to date on all things CMS.They are quick to respond not only to us, but also to our patients.They are extremely good at what they do,and I believe that is because they take the job of EMS billing very seriously.They are everything we want in a billing company — and more. SONORA COPLING Former Senior Administrative Assistant,EMS Division Plano Fire-Rescue,TX CO 2023 Digitech Computer LLC RFP No.2023-015-ND 11 9l► Digitech A.1 - MINIMUM QUALIFICATIONS Bidder(defined as the Proposing Firm) shall have at least one contract(current or expired within the last five(5)years)to provide EMS transportation billing and collection services Digitech has over three decades of experience helping many EMS agencies navigate their complex business needs related to billing,revenue,and growth,while still focusing on the importance of the communities that they serve.We service more than 200 clients across the nation. The following brief history showcases our deep, longtime experience in the EMS billing industry. A BRIEF HISTORY OF DIGITECH 36 700 390 CO State Reach Professional Staff Years in Business Annual Trips Office Locations Digitech was started as a consulting firm specializing in software for business analytics. In 1987,founder and CEO Mark Schiowitz decided to focus Digitech on technology for the medical transportation market, an industry which he had learned in the family-owned ambulance company.Mark wrote the initial versions of Ambulance Commander, Digitech's proprietary ambulance billing and dispatch platform. Within a few years,much of the New York ambulance industry was using Ambulance Commander.Digitech successfully assisted over 70 companies to set up in-house billing departments.Several are still clients, including one that first partnered with us in 1987. This early experience showed us that we could dramatically improve the billing and collections process for our clients, but we needed to invest in technology and leave behind the traditional software sales model. We began to offer a full third-party billing service that would handle all aspects of claims processing for clients. In 1994, Joyce Kerulo joined Digitech to build our billing services division, and she is now Chief Revenue Officer.Walt Pickett began his role at Digitech that year in customer service and programming, and he is now Chief Operating Officer. Following our early success,we were contracted by several New York hospitals. In every case we showed increases in collections over the previous solution and soon built a reputation for maximized collections, cutting-edge technology,efficient processes,and in-depth reporting.We entered the municipal market by contracting with Burnsville Fire in MN,Orem Fire in UT,and several New York and New Jersey clients.We continued to show significant collections improvements and earned high praise for technology, process, and reporting capabilities that clients found revolutionary. ©2023 Digitech Computer LLC RFP No.2023-015-ND IMO Digitech We continued to grow through partnerships with municipal clients like Memphis Fire, Baltimore City Fire, Gwinnett County Fire and Emergency Services in GA, Dallas Fire-Rescue, Grady Health System EMS in Atlanta, and Houston Fire Department. For Houston, we increased collections from $28 million to $68 million in our first year of service with more than$173 million recovered to date from the Texas Ambulance Supplemental Payment Program. For each contract submitted as proof of experience, submit entity name and address, description of services,start and completion dates,entity contact information(phone and email) Digitech has complied. The table below provides references for whom Digitech provides EMS billing services.We are confident their testimonies will support our success.References are also added to the form provided,per RFP instruction. Current Client Contact Information Scope of Contract Start of Service Holly Newton Polk County Fire Rescue Annual Transports:72,000 1295 Brice Blvd. Financial Administrator EMS Billing Services 06/2006 Bartow,FL 33830 (863)534-5604 EPR Systems ePCR Integration hollynewton@polk-county.net Pompano Beach Fire Rescue Mathew Whitton Annual Transports:15,000 EMS Chief EMS Billing Services 120 SW 3rd St. 01/2001 Pompano Beach,FL 33060 (954)786-4564 ESO ePCR Integration mathewwhitton@copbfl.com Fire Inspection Billing Eric Rodriguez,EMT-P/BHSA Miami-Dade Fire Lieutenant,EMS/Emergency Annual Transports:75,000 111 NW First St,Suite 710 Triage,Treatment&Transport EMS Billing Services 01/2003 Miami,FL 33128-1984 (ET3)Data Analyst SafetyPad ePCR Integration (305)-753-7273 eric.rodriguez@miamidade.gov ©2023 Digitech Computer LLC RFP No.2023-015-ND 13 IIi Dig itech® Digitech Computer LLC 480 North Bedford Road Building 600, Chappaqua,New Second YorkFloor 10514 (914)741-1919 digitechcomputer.com RFP 2023-015-ND Emergency Medical trl Transport Billing and Collection Services M I AM I BEACH Miami, FL June 9th, 2023 ,, TAB 2 - Experience and Qualifications .....:- ... - _,,y1 ~ � 3,14�1 Y - rl�' , iGunrn''�.4(_� -� w, to`*'". ."ALL 'ri i i i ,' _ z '' + Tyg Wr-:✓ ;"i1 €.fir ''„.,t,, 1- "�� _- 4.� • "r^" 1 aP.yam i rf';.,'".. , •-.*,' i',A. .',',, ‘", 1,,,,„ Y1> ...-,'el -,., -- —I. - --t•-• -FX,1;:::0 - ,:',. _.,,„_'",-;.,r.''' -..----.s.,-,,, C, f1YY , . .�. ,A .. a+"� i A It .- l..,,,,, -, ;Y 1 ! , ,! ';� v at a h� / ,ram ' trill Digitech TABLE OF CONTENTS EXPERIENCE WITH FLORIDA EMS PROVIDERS 3 CUSTOMER STORIES 4 SHELBY COUNTY FIRE DEPARTMENT 4 PLANO FIRE RESCUE 4 BALTIMORE CITY FIRE 5 DALLAS FIRE-RESCUE 6 EXPERIENCE WITH THE FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION (AHCA)7 SUPPLEMENTAL PAYMENT PROGRAM APPROACH 7 PEMT ADMINISTRATION 8 COST ALLOCATION METHODOLOGIES 10 COMPARATIVE DATA 11 ADVOCACY FOR MIAMI BEACH 11 YOUR MIAMI BEACH TEAM 12 EXHIBITS Exhibit A Résumés Exhibit B Sample Patient Statements Exhibit C Data Security Plan Exhibit D Reporting Suite Exhibit E Billing Process ATTACHMENTS Attachment 1 Withum SOC Letter Attachment 2 Sample COIs and W9 ADDENDA Addendum 1 June 1,2023 CO 2023 Digitech Computer LLC RFP No.2023-015-ND 2 gill Digitech TAB 2 - EXPERIENCE & QUALIFICATIONS 2.1 Qualifications of Proposing Firm. Submit detailed information regarding the current or prior contracts or engagements that the bidder has with public sector agencies that demonstrates its relevant experience and proven track record of the firm and/or its principals in providing similar scope of services as identified in this solicitation, including experience in providing similar scope of services to public sector agencies,with emphasis on the following areas of expertise: Emergency Medical Services(EMS)ambulance billing integration and management for other governmental entities; Experience with the Florida Agency for Health Care Administration(AHCA)in the supplemental payment programs relating to Certified Public Expenditure (CPE) for both Medicaid and managed care cost reimbursements;and EMS ambulance billing and EPCR system installation, integration, and management for a Florida EMS Provider. For each contract or engagement submitted as evidence of experience for the firm and/or any principal,the following is required:detailed description of the services provided,agency name,agency contact,contact telephone&email,and year(s),and term of engagement.For each project,identify whether the experience is for the firm or for a principal(include name of principal). Digitech has been committed to providing solutions for the municipal marketplace for 39 years.While the firm was started as a technology and consulting firm for business analytics, we pivoted early on to focus Digitech on billing technology for the medical transportation market. We quickly learned that we could dramatically improve the billing and collections process for our clients, but to expand into the public sector we needed to focus our investments on technology and leave behind the traditional software sales model.We began to offer a full third-party billing service and we transitioned to the municipal market. Since then,public sector entities have made up most of our client base.We see our company as an extension of our clients'organizations,and we wholeheartedly support their missions. EXPERIENCE WITH FLORIDA EMS PROVIDERS With more than 20 years'experience working for Florida EMS providers,Digitech is intimately familiar with the requirements of billing for Medicare, Medicaid, and managed care programs in the state. We have assisted many clients with the delivery of cost reporting to the Florida Agency for Health Care Administration and will continue to provide support and assistance to the City of Miami Beach with the preparation of any required reports for Public Emergency Medical Transport reimbursement programs. ©2023 Digitech Computer LLC RFP No.2023-015-ND uuHU Digitech 1111111111111111111111111 CUSTOMER STORIES Here we provide several examples that demonstrate our experience with and dedication to the EMS public sector.These are current satisfied clients each with varying contract components such as integration with ePCR systems, hardware procurement and management, consultative support with supplement payment programs,and exceptional billing and collections services. SHELBY COUNTY FIRE DEPARTMENT Digitech handled an EMS startup operation in Shelby County, Tennessee. Shelby . 0<'z County's ambulance transports had been provided by a private ambulance service,and when the private service asked for a $2.8MM increase in their contract, County Q . 1) officials concluded that both service levels and revenue might improve and patients 11, could be better served by the County taking over ambulance transports directly.They co mcr began an immediate search for equipment and personnel as well as a billing service to handle claims and revenue recovery and reached out to Memphis Fire Rescue for recommendations. Memphis referred Shelby County to Digitech,and we were favored with a contract. Digitech managed all enrollments and registrations for Shelby, providing guidance and support at every step along the way.We were able to begin billing commercial claims for Shelby within 30 days of beginning the implementation process,and even though the Medicare and Medicaid registrations took a little longer, no claims were denied because of untimely filing. Years of Engagement:2017- Present PLANO FIRE RESCUE Prior to choosing Digitech, Plano's previous vendor had been billing most claims as Advanced Life Support transports. Even though we billed far fewer claims at the ALS 41level of service,Digitech increased collections by 11.9%in the first year of our contract. * Revenue to date has grown nearly 30% since we began our relationship with Plano. Further,as part of that contract, Plano required Digitech to undergo periodic external * audits which sharpened our focus on compliance - a focus that we carry over to every client with whom we interact. Years of Engagement:2011 - Present ©2023 Digitech Computer LLC RFP No.2023-015-ND 4 ►iID Digitech BALTIMORE CITY FIRE 0- vitt For the Baltimore implementation, the project included deployment of EMS Billing, „Noe P'0tecHegPeepre^ Imaging, and Hosting services, full integration with the ImageTrend ePCR system, a hardware refresh of their Panasonic Toughbooks,and deployment of mobile hotspots for q % 12 all emergency rescue vehicles. It also required reorganization of the Department's inventory and hardware replacement systems and the establishment of an Emergency Revenue Enhancement Committee consisting of City officials, Baltimore Fire officials, and Digitech senior staff to recommend and implement process and procedure changes to maximize revenue from EMS billing,establish connectivity to the City's hospitals,and hire two local staff members. When we began processing claims for Baltimore City Fire, we noticed a large increase in the volume of claims that were being created compared to the volume before we took over the City contract. Nearly 25,000 claims annually had been lost between the Department's ePCR system and the prior vendor's billing system. Our extensive and effective process of claims reconciliation immediately picked up the missing claims and ensured that a claim was created for each transport. This and the other improvements we brought to Baltimore City's EMS claims processing resulted in a 64% increase in aggregate collections.We have continued to support Baltimore City Fire through: + Initial integration with ImageTrend and an upgrade to the ImageTrend Elite platform + Procurement and support of field equipment and wireless services,including IT Support + Two major refreshes of hardware + Printers,toner,and support for all receiving facilities + Two refreshes of administrative group computers + Consultation and projections on rates, including identifying rates below Medicare approved amounts + Customized and deployed a monthly dump of vital EMS statistics to the City's ERP system + CARES Act guidance and support + Symptom Heat Map for tracking COVID-19 cases and other types of diagnosis codes + Continuous revenue improvement Years of Engagement:2012 - Present ©2023 Digitech Computer LLC RFP No.2023-015-ND 011 Digitech DALLAS FIRE-RESCUE The City of Dallas was faced with a situation where they were no longer comfortable that their previous billing vendor had adequately worked the 4#1° 1 substantial (tens of millions of dollars) Accounts Receivable backlog. The City 1 needed a repository for their prior vendor's claims data.Our solution was to create a clone system, identical to our actual billing system, into which the City could deposit all their old claims data.Once created,we facilitated a data dump into the new system,keeping it segregated from the Digitech system for current claims.The City then assigned two employees who were trained by Digitech to work these aging claims within the clone system. This effort resulted in the reclamation of a substantial amount of collections that would have otherwise been lost due to a lack of recovery efforts. Our Dallas client was the inspiration for the development of Sentinel,Digitech's Key Performance Indicator monitoring system.Trip class is among the KPIs continuously monitored by the application.Using Sentinel, Digitech knows immediately if the ratio of trip classes (ALS vs. BLS) changes beyond a normal range of deviation. DFRD was also instrumental in the beta testing phase of our award-winning PCR Lens data quality monitoring application.Their input during the test phase was critical and appreciated. The results of this collaboration were a 49% increase in collections for Dallas Fire-Rescue from $13.8 million to more than$20 million in the first year of service and an exemplary record of compliance. Years of Engagement:2012- Present 110 Digitech's experience and reputation were important factors in our decision to partner with them. PHIL ONOFRIO Former EMS Director Stratford EMS,CT (c)2023 Digitech Computer LLC RFP No.2023-015-ND 6 1II11 Digitech EXPERIENCE WITH THE FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION (AHCA) We have supported supplemental payment programs for more than 100 clients in a half dozen states. Through that support,our clients have recovered more than$600M in supplemental payments.In the State of Florida,we have helped our clients realize more than$200M in PEMT payments. SUPPLEMENTAL PAYMENT PROGRAM APPROACH Digitech has the resources and experience to support the City in pursuit of additional revenue that may be derived from participation in PEMT programs. We have dedicated staff with 10 years' experience in the development of cost reporting for supplemental payment programs for agencies across the nation, including many Florida ambulance services. We have developed tools, utilities, and processes designed specifically to streamline the gathering and collation of necessary financial and billing data,and will support the City through fiscal impact studies,data analysis,and the preparation and submission of cost reports. Detailed below are aspects of our approach to supplemental payment programs that make us uniquely qualified to support the City's ongoing participation in the PEMT Programs. + PEMT engagement.We currently process over 1,000,000 claims annually for more than 50 clients in Florida, maintain two Florida offices(Miami Lakes and Tampa),and employ a significant amount of Florida residents. Our team has been involved with the PEMT Program in Florida since the beginning of FY16. We have prepared cost reports and represented our clients' best interests in audits. This unrivaled depth gives us a deep understanding of Florida regulations and the unique aspects of Florida Medicaid processing, unmatched access to patient insurance information through an extensive network of hundreds of Florida hospital relationships,and a strong voice for our clients with payers and legislators to ensure maximized reimbursements. + Seasoned support. Digitech staff members are EMS experts, EMTs, former EMS directors, billing specialists,certified ambulance coders,paramedics,nurses,and EMS billing professionals.When we say that you will receive the attention and dedicated support from a cost reporting expert,we mean it. We do not farm out work to a team of entry-level data analysts who may not be familiar with complex Medicaid regulations. The preparation of your cost report will be completed by skilled finance and accounting professionals. Our team has a strong, active relationship with Agency for Health Care Administration (AHCA) and will offer ongoing technical assistance on policy and programmatic issues that matter to the City. Digitech will provide: + Hands-on analysis.While we believe that we employ superior technology in our billing processes, we also understand that detailed manual data analysis is an integral part of cost reporting.We will never sacrifice quality or compliance for the sake of increasing productivity. We believe that the quality of your cost report matters. 2023 Digitech Computer LLC RFP No.2023-015-ND �lll► Digitech + Dual perspective. As part of our approach to proactively identifying audit concerns, we conduct year-to-year variance analysis of billing,cost,and utilization data. In addition,we look at Medicaid payor mixes,EMS utilization statistics from CAD data,and cost per trip amounts across the state to identify outliers.We know that it is important to our clients to understand and monitor these key statistics that are commonly reviewed by auditors. + Communication.We make a commitment to our clients to keep them connected and engaged in the supplemental payment program.To kick off the cost reporting process each period,we set up one- on-one time with our clients to establish a communication plan,discuss a future meeting schedule, and review the data request.Our goal is to ensure that our clients are as involved in the process as they choose to be.We tailor our communication plan to meet each client's unique needs. + Innovation.In our experience with a broad range of EMS providers,we understand that there is no one-size-fits-all approach to cost reporting.We have made participation in supplemental payment programs possible for providers with differing degrees of data reporting capabilities;we tailor our approach to meet clients where they are. We examine different approaches to cost allocation to find the methodology that works best for each client. We are continuously looking for ways to improve our services and solutions.For example,we recently developed a web-based cost reporting utility for Medicare Ground Ambulance Data Collection. PEMT ADMINISTRATION Digitech has managed the implementation of PEMT reporting for many providers in Florida. We are confident that the process that we outline below will work for the City. We will provide We will collect all Digitech will compile and file the comprehensive required billing, reports to manage all aspects of the desk financial,and PEMT for the City. review/audit utilization data. support. We will work with City finance and operations teams to collect all data for the annual cost report. During the project kickoff call,we will walk through We will prepare all the data request and ensure that the working files and submit the cost report to AHCA. City's team is equipped to provide source data needed for completion of the cost report.While the City's team is likely familiar with the PEMT data requirements because of prior Cost Reporting Cycle - Preparing the Annual Cost participation in the program,we take a detailed approach to the data collection process. ©2023 Digitech Computer LLC RFP No.2023-015-ND mil Digitech The source data is the first building block of the cost report,and we want to make sure that we,the City and Digitech teams, are starting off on the right foot.We typically allow for a closing for a fiscal year closing period of at least 30 days before we collect data. Utilizing program guidelines and 2 CFR Part 200(Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards),we will identify all costs eligible for reimbursement. Federal rules prohibit reimbursement for many costs that providers incur.Even if a provider believes that the costs pass the test of being reasonable and necessary for the agency, the costs may still not meet standards defined in 2 CFR Part 200 and state program guidelines. If unallowable costs are claimed and these are identified in audit findings, then the provider could end up in a recoupment. Digitech will comb through your financial data in detail to ensure that only allowable costs are claimed in the final cost report. Below are screenshots of the tools that we utilize to process expenditures data.Throughout the analysis of expenditures and other data elements,we incorporate automated checks as one of the first steps in the QA process. j F ( 0r 1 i 1 Of Dili Cie v•ied:4/if2,' 3 +roan EMS belrp owl t.w.woor 4 i 5 Client Name; 6 7 Name of Source Fie s}a 8 1) i 9 2) 10 3) 11 4) g1.2 1 13 Completed by: V14 Date Source File Received: 11.S Date Source File Processed: !16 Date Working File Finalized: __.... A $ C 0 -- # AMIE spill Digitech 2 From Source data; $ 990.00 3 From Mastar Crosswalk: $ 990.00 a 14 $ Ott teal Cost Center:Cost Object Source Cost Cent CostObjectAmount 5 a 1d Source ■ a al,Leir,u 1 U ., ,:...,L is i 6 Fire Operations:Regular Salaries Fire Operations Regular Salaries 5 100.00 Shared Shared 17 Fire Operations:Fringe Benefits Fire Operations Fringe Benefits $ 50.00 Shared Shared i 8 EMS Operations;Regular Salaries EMS Operations Regular Salaries $ 80.00 MIS MTS 9 EMS Operations:Fringe Benefits EMS Operations Fringe Benefits $ 40.00 MTS MSS 10 Fire Prevention:Regular Salaries Fkt Prevention Regular Salaries $ 100.00 Nan-MIS Nan MIS 11 Fire Prevention:Fringe Benefits Fire Prevention Fringe Benefits $ 50.00 Non MIS Non-MIS 12 Fire Administration:Regular Salaries Fire Administration Regular Salaries $ 100.00 Shared Shared 13 Fire Administration;Fringe Benefits Fire Administration Fringe Benefits $ 50.00 Shared Shared 14 Fire Administration:Office Supplies Fire Administration Office Supplies S 20.00 Shared Shared IS Fire Capital Fire truck Tire Capital Fire truck 5 400,00 Exclude Exclude ©2023 Digitech Computer LLC RFP No.2023-015-ND 9 1I111 Digitech COST ALLOCATION METHODOLOGIES We will develop appropriate cost allocation methodologies.This is a critical step in the completion of the cost report. Because costs are frequently "shared" between EMS other public safety activities, it is important that these costs are allocated in a manner that: 1. meets federal and state guidelines,and 2. allows for optimization of revenues for the department. There is no one-size-fits-all methodology that is utilized for allocation of shared costs.We will analyze the City's data and determine the optimal approach to allocation of costs. While we recognize the value in consistency in reporting, we also understand that Computer-Aided Dispatch(CAD)systems and reporting capabilities change,service areas change,and service mixes change. We review the options for cost allocation each year to ensure that we are complying with regulations and helping our clients achieve the best results. Other vendors in this market, looking to minimize their own resource and time commitments to customized CAD data analysis, will not consider alternatives for allocation of costs. On August 17, 2022, the CMS provided an informational bulletin on federal cost principles for Ground Emergency Medical Transportation programs like the PEMT in Florida.Of particular focus in this memo is the allocation of"shared direct costs." Digitech is aware of this new guidance and will review the City's allocation of costs to ensure that the reporting is consistent with applicable federal cost principles.While this was noted in the context of recent proposals submitted to CMS by states, we believe this serves a reminder that EMS cost reporting programs could soon be subjected to additional scrutiny for impermissible cost-shifting to Medicaid. In addition to the allocation of costs described above,Digitech will commit to the following activities. + We will prepare all working files and present a draft cost report to the City.Working files serve as the bridge from source data to the calculations in the cost report,and they provide backup for any audit inquiries. Digitech believes that it is important and necessary that our process is fully transparent so that the City can have confidence that when they sign off on the final cost report, they understand what they are certifying. ♦ Following the presentation of the working files and draft cost report,we will solicit feedback from the City and make revisions necessary to finalize the initial cost report submission package.We find that there are few,if any,changes required to the cost report at this stage,but we prefer to build in a minimum of 5-10 working days to incorporate final edits. + We will submit the cost report and any required supporting documentation to AHCA no later than November 30.In the event AHCA extends the deadline,we will adhere to AHCA's revised schedule. We will notify the City of any changes to AHCA's schedule for cost report submission or payment disbursement. ©2023 Digitech Computer LLC RFP No.2023-015-ND '1II► Digitech + We will promptly respond to audit requests from AHCA auditors, CMS, or the Office of the Inspector General. Because we will have working files readily available, we don't anticipate any issues with responding to auditors in a timely manner.In the unlikely event that the desk review or audit results require further action,we will incorporate revisions as needed into the cost report and work with the City to certify and submit a final cost report. + We will present results of cost report audits to City stakeholders, showing our commitment to demonstrate full transparency to City leadership.We want to address any of the City's questions or concerns prior to submission of the cost report to AHCA, but if there are any issues that arise during the audit process,we will keep the City engaged. + The final step of the process is working with AHCA to ensure that the payment is correct and set in accordance with program guidelines. Digitech will work with AHCA and the City on the cost settlement process.We will keep the City apprised of national trends in cost recovery programs and any potential impacts on the ASPP.We will offer the City guidance and support on future Medicaid payment reforms and their relation to the ASPP and ACR. COMPARATIVE DATA One of the key benefits to the City of a partnership with Digitech is access to comparative data.We can offer the City a comparison of the City's data with de-identified data from 50 providers across the state. This allows us to determine if there are any outliers that could result in additional scrutiny from AHCA Rate Analysts.Once we are comfortable that the City's data appears to fit with the picture of the data from our other clients,we would be prepared to submit the annual cost reporting package to AHCA via Myers and Stauffer's client portal. Our team has experience in working with implementation of the Managed Care program in Florida,where we serve more than four dozen clients.Annual re-establishment of the PEMT program for Managed Care requires the submission of a Section 438.6(c) Preprint,a form that we have helped to draft in other states. Unlike the FFS program, the MCO program will require the State to track performance measures associated with the directed payment program. We commit to working with AHCA and the provider community to assist however we can in establishing measurable metrics that make sense. We will also work on your behalf to establish letters of agreement (LOAs) with each MCO. In our implementation process with our clients across the country,we routinely work with insurance carriers to set up accounts for claims processing. ADVOCACY FOR MIAMI BEACH We will also assist the City in drafting and executing any required commitment to participation and intergovernmental transfer(IGT)agreements between the City and AHCA.The City can be confident that the experience and expertise that we have with these types of programs will undoubtedly be an asset.The City will have an advocate and reliable resource to offer ongoing technical assistance on programmatic and policy issues for the PEMT FFS and MCO programs. ©2023 Digitech Computer LLC RFP No.2023-015-ND 1110 Digitech 2.2 Qualifications of Proposer Team. Provide an organizational chart of all personnel and consultants/sub-contractors intended for this contract if awarded and the role each team member will play in providing the services detailed herein. For each team member, include a resume that includes, at a minimum,relevant experience and other pertinent information. For each firm, submit detailed information regarding the current or prior contracts or engagements that the bidder has with public sector agencies that demonstrates its relevant experience and proven track record of the firm and/or its principals in providing similar scope of services as identified in this solicitation, including experience in providing similar scope of services to public sector agencies,with emphasis on the following areas of expertise: Emergency Medical Services(EMS)ambulance billing integration and management for other governmental entities; Experience with the Florida Agency for Health Care Administration(AHCA)in the supplemental payment programs relating to Certified Public Expenditure (CPE) for both Medicaid and managed care cost reimbursements;and EMS ambulance billing and EPCR system installation, integration, and management for a Florida EMS Provider. For each contract or engagement submitted as evidence of experience for the firm and/or any principal,the following is required:detailed description of the services provided,agency name,agency contact,contact telephone&email,and year(s)and term of engagement.For each project,identify whether the experience is for the firm or for a principal(include name of principal). As part of your partnership with Digitech,you will have access to our entire team of Digitech EMS billing experts. You will have the mobile numbers of senior officers to ensure that you have emergency access 24/7.Technical Support is available around the clock at(914) 741-1919 ext. 1. Digitech will not be using any partners or subcontractors for this project.A select group will be trained in your specific requirements.Only those billers will work your claims.Additional billers will be cross trained to account for any vacations,unforeseen absences,or temporary reassignment. Our staff of more than 700 employees focuses exclusively on EMS billing. This is one of the greatest resources we offer you.Each of these employees have decades of experience in government EMS services, such as system installation and implementation and managed care projects. Brief synopses are below, and we've also attached their resumes as Exhibit A. YOUR MIAMI BEACH TEAM Let us introduce you to some key members of your team.Their résumés will describe their experience in all facets of EMS billing,from ambulance billing integration to handling managed care cost reimbursements. These principals and senior management staff members have all been instrumental in the engagements described above in response to 2.1. ©2023 Digitech Computer LLC RFP No.2023-015-ND 014 Digitech Walt Pickett,Chief Operating Officer r");►' Walt currently oversees the implementation and execution of all contracts.He heads the teams that manage integrations,credentialing,and support,and he works closely At_Ah with the Account Management and Client Services teams to ensure that all client requirements are met.Walt will be a senior level point of contact for the City. ^) Joyce Kerulo,Chief Revenue Officer r' Joyce will continue to oversee the setup of Digitech's billing process for you and will be your senior-level point of contact during the term of the contract. Her team will Ifikik:',/ handle all aspects of your billing. Ben Lambert,Chief Technology Officer m Ben manages the technical aspects of implementation.His team of programmers and analysts will ensure all your technological needs are met. I t Nancy Spence,Director of Finance Nancy supervises Digitech's finance team, which is responsible for client invoicing, accounts payable, and monthly financial close. She develops the annual operating k iiii plan, prepares reporting packages and presentations for the Board of Directors,and provides variance commentary for month-end financials. Darryl Hartung,Vice President,Client Relations riNt Oik f. Leveraging over 20 years of experience in EMS billing, Darryl manages partnerships and an experienced Client Relations team that works closely with clients.He oversees clients'service delivery to ensure that expectations are being met and exceeded. Fran Cuzzo,Vice President of Billing Services ' Fran will continue to supervise all aspects of patient collections, process electronic ' r and paper billing, and support the IT department with testing new processes on Digitech's platform. ©2023 Digitech Computer LLC RFP No.2023-015-ND BRIO Digitech 1111 Cathy Tenzyk,Vice President of Billing Services Cathy will run regular random audits of your claims to guarantee compliance with all applicable rules. iti Maxine D'Agostino,Vice President of Billing Services Maxine will continue to ensure that your implementations for Medicare and Medicaid are handled in compliance with Florida and U.S.regulations. .i: i Amanda Stark,Risk Manager Amanda's responsibilities include reviewing and auditing clients' claims to ensure they are billed in compliance with each payer's rules. VIP Mitchel Holder,Executive Director of Analytics Mitch will be a day-to-day resource for you. He will guide you in maximizing the financial and operational insights available through the reporting suite and in analyzing, understanding, and responding to the challenges that your organization faces in the ever-changing EMS marketplace. Max Dekle,Senior Software Developer and Data Analyst IA Max will create any custom reports that you need and enroll you in Digitech's award- j` winning PCR Lens solution. IlLtibl David Mead,Director of Cost Recovery Solutions 7 David will help you optimize your reimbursement through participation in a Medicaid cost recovery program. He provides technical support for program implementation and manages Digitech's cost reporting services. ©2023 Digitech Computer LLC RFP No.2023-015-ND RIO Digitech Fillqi Mary DelFranco,Director-Account Management Mary will lead the teams who will implement Ambulance Commander and oversee training and coaching your team on system functionality.You will be able to contact Mary and her team 24/7 with any questions. IIIIIAnthony Santos,Director-Client Relations Anthony is a Director of Client Relations and will manage the onboarding process and �/ authorization of the City as an EMS billing service provider. [rillAmanda Mihalick,Certified Ambulance Compliance Officer Amanda will provide you with compliance plan development support and consultation on fee schedules. • Digitech staff has always gone above and beyond to assist us with increasing our billing numbers and fulfilling any data requests that we have had of them.They have a very'can-do'attitude that has been greatly appreciated by all of us here at DFR who have needed their assistance. NORMAN SEALS Former Assistant Chief,EMS Bureau Dallas Fire Rescue ©2023 Digitech Computer LLC RFP No.2023-015-ND 15 911 Dig itec Digitech Computer LLC 480 North Bedford Road Building 600,Second Floor Chappaqua,New York 10514 (914)741-1919 digitechcomputer.com RFP 2023-015-ND Emergency Medical CI Transport Billing and Collection Services M I AM I BEAC H Miami, FL i. June 9th, 2023 ' ,,r. . :w 110* TAB 3 - Scope of Services Proposed - , _;; , u. - Ili,_ ; `.i_;PiEt .-. .. '. .:L y :^aim' `, '.-.,.,,}.44'..;"t fir$ ,.3 a,�^._'dr owt. EE r' - iy ^ >a ', r. ' st -tea..i...r .: -. , iYk -` ,`` - `. ' ' v _ y vi y.. t.? t.. 1t. 1 ye : S 'C.vrY Z'a ti+ sun Y"� aq't. �7 '-' ''urAii>: �'+fir_. Yss a ,Y. ''a •` a tk n '�,:` E %• > , 4 l �afl1 it p! l ms : 1IMI► Digitech TABLE OF CONTENTS TAB 3 - SCOPE OF SERVICES PROPOSED 3 INTELLIGENT AUTOMATION 4 DOCUMENTATION TRAINING AND REVIEW 4 PATIENT INSURANCE DEDUCTIBLE PROGRAM 4 FINDING MISSING BILLING AND DEMOGRAPHIC INFORMATION 5 PAYMENT VIA PAPER CHECK 6 PAYMENT VIA ELECTRONIC FUNDS TRANSFER 6 PREFERRED METHOD FOR CREDIT CARD PROCESSING 6 SSAE 18 (SOC 1 TYPE 2) AUDIT 7 PHONE SYSTEM FOR PATIENTS 7 ESCALATION OF SERVICE ISSUES 8 SUPPORT AVAILABLE TO YOU 9 DIGITECH RESPONSES TO APPENDIX A 10 A2 - STATEMENT OF WORK 10 CUSTOMER SERVICE REPRESENTATIVES 11 A3.- SPECIFICATIONS 12 1. GENERAL 12 VERIFICATION 15 RECORD RETENTION 24 CUSTOMER SERVICE 25 OPERATIONAL AND FINANCIAL REPORTING & ANALYSIS SOLUTION 33 FIELD DATA QUALITY MONITORING AND REPORTING SOLUTION 33 ADDITIONAL REPORTS AND PACKAGES 34 SUPPLEMENTAL PAYMENT PROGRAM APPROACH 37 PEMT ADMINISTRATION 38 COST ALLOCATION METHODOLOGIES 40 COMPARATIVE DATA 41 ADVOCACY FOR M IAM I BEACH 41 EXHIBITS Exhibit A Résumés Exhibit B Sample Patient Statements Exhibit C Data Security Plan Exhibit D Reporting Suite Exhibit E Billing Process ATTACHMENTS Attachment 1 Withum SOC Letter Attachment 2 Sample COIs and W9 ADDENDA Addendum 1 June 1,2023 ©2023 Digitech Computer LLC RFP No.2023-015-ND 2 o1l► Digitech TAB 3 - SCOPE OF SERVICES PROPOSED Here we describe our processes for ambulance billing services. Specific responses to your Appendix A requirements follow the Tab 3 requirements. A detailed procedure explaining how the firm will provide the City with a refund request including all pertinent information relating to refund payments to patients and/or insurance company. Digitech's established method of processing refunds is as follows: 1. We submit a refund request to the client. 2. The client writes the refund check and notifies Digitech. 3. Digitech makes the financial adjustment to the account. Digitech's billing platform, Ambulance Commander, features an overpayment utility that locates and displays claims for which the reimbursement received exceeds the amount billed for the claim. Overpayments can occur when both the carrier and the responsible party have paid the claim,the insurance carrier has paid the claim twice,the patient is determined after the fact to have been ineligible for coverage at the time of service,or for several other reasons. Digitech billing specialists review these claims to determine why there was an overpayment and to decide if a refund is necessary.When a refund is required, a form is generated that includes all pertinent details related to the overpayment, including the patient's name, the date of service, the policy ID number, the claim number,the Ambulance Commander ID,the amount of the refund,the payee,and the mailing address for the refund. Several insurance carriers allow refunds to be recouped against future payments.When this is the case,we send each carrier a file containing a list of claims for which refunds are due along with all details related to each overpayment. When refunds must be made directly to patients, responsible parties, or to carriers who do not allow recoupment, the refund forms generated by our billing specialists are compiled into client-specific spreadsheets and sent for review by management. Once approved,the file is transmitted securely to the client.As refunds are issued,the client notifies Digitech so that the patient accounts can be reconciled. Should you decide to change the refund process from the current process we use,we will work with you to determine the most advantageous refund processing option. Sample bill forms and the messages that will be used on each successive bill mailed. Please see Exhibit B for a sample of patient invoices and statements. ©2023 Digitech Computer LLC RFP No.2023-015-ND Digitech Firm shall provide a process for collecting information from local law enforcement agencies and gross billable and payments on all incidents involving motor vehicles. Digitech will continue to obtain patients' auto insurance information during our typical course of data verification and will use any additional motor vehicle accident information we are provided during the course of claims processing. In addition, Digitech is in the process of implementing access to the state's Biospatial platform, which will provide Digitech with near real-time access to clinical and operational dashboards along with access to police reports and auto insurance information. Details on how contractor will increase collection rates annually. Our entire billing process from end to end is dedicated to maximizing collections. Due to the speed with which we bill and collect from insurance companies, new clients switching to Digitech typically see an immediate uptick in collections as the previous vendor continues to deliver collections on claims filed prior to the Go-Live date. One of the solutions we will employ is designed to hold claims until the deductible amount has been met. Others manage the process of filing Medicaid claims to the right processing center and customize the patient billing process to maximize payment. INTELLIGENT AUTOMATION Intelligent automation is the key to accelerated cash flows. Through efficient identification of insurance coverage, rapid release of insurance claims, and timely posting of receipts, we will accelerate your cash flow. DOCUMENTATION TRAINING AND REVIEW Miami Beach Fire-Rescue has already taken advantage of Digitech's Documentation Excellence training program and we successfully transferred those training materials to the City's Target Solutions training platform in 2021. Digitech's documentation reviews provide a documentation review on the accuracy and completeness of your field documentation. A random sampling of claims is pulled and thoroughly reviewed by Digitech's Quality Assurance experts for completeness,accuracy,and compliance.We will continue to conduct these reviews for Miami Beach Fire-Rescue as needed. PATIENT INSURANCE DEDUCTIBLE PROGRAM We support a patient insurance deductible program which monitors the unexpired deductible status on patient accounts, pending claim submission until the deductible status reaches a predetermined level or the claim status a predetermined age.Holding insurance claims submissions on patient accounts with active deductibles allows other medical providers to absorb the patient deductible, reducing your patient collectibles and increasing your insurance payments. ©2023 Digitech Computer LLC RFP No.2023-015-ND RIO Digitech FINDING MISSING BILLING AND DEMOGRAPHIC INFORMATION We complete this process within one business day of receipt of PCR data.Our verifiers connect to multiple large databases and clearinghouses to locate missing information, contact patients by phone, contact admitting hospitals, provide invoicing forms with return envelopers to return information by mail, and provide web portals where patience can update demographic profiles and input insurance information. A copy of the firm's disaster and recovery policies and procedures. Please see Exhibit C for our disaster and recovery policies. Details on procedures and controls for receiving payments whether received in person, by mail, or electronic transfer. Remittances are received and processed through Miami Beach's bank lockboxl. A lockbox facilitates the payment process in the following ways: + All payments are immediately credited to your account. Digitech never has control over your cash. + All payments are immediately credited to the patient's account. + The bank will image all documentation so that both parties can view payment details at any time. + The lockbox simplifies the process of reconciling deposits.Once a payment is received,often in the form of an Explanation of Benefits, funds are immediately posted to your account. Cash is reconciled every day.We never have unapplied accounts. 4110 1.5 The City of Houston was profoundly pleased to discover that Digitech does not carry an unapplied funds account. We rest easy knowing that every dollar is correctly allocated. LATOYA JASPER Former Deputy Assistant Director,Finance City of Houston,TX 1 Digitech requires the establishment of a bank lockbox to receive and process payments.We will continue to utilize the existing lockbox solution that is currently in place. ©2023 Digitech Computer LLC RFP No.2023-015-ND 031) Digitech PAYMENT VIA PAPER CHECK + Paper checks are received in a PDF format with the scanned check followed by the EOB. + Each paid claim is pulled into Digitech's general posting function using the invoice number included with the payment. + The payment is posted by procedure code for insurance. + If the insurance carrier provides 835 Electronic Remittance Advice files, the payment is posted using the 835. + If there is no 835-remittance available,the payment is posted in general posting. + Any remaining balance after receipt of payment from insurance providers will be appealed or crossed over to the next payer,depending on the contract the City may have with the payer or the specific type of insurance plan. PAYMENT VIA ELECTRONIC FUNDS TRANSFER + Electronic funds transfer payments are sent to Digitech by the client or made available to us via login to your lockbox. + All electronic funds transfer payments are posted via 835 ERA files. + Each deposit date is balanced using a spreadsheet listing out the totals for the lockbox deposit and each carrier that pays via electronic funds transfer. + Any amount that is not posted by Digitech is shown on the remittance spreadsheet as Non-Digitech Cash. + Each day's report will show total amounts for both Digitech and Non-Digitech payments arranged by payment source(lockbox or electronic funds transfer). PREFERRED METHOD FOR CREDIT CARD PROCESSING Our preferred payment method for credit card payments is to connect our payment portal to the clients' credit card merchant processor. Patients access 111111;141114 their account information through our secure and convenient online interface. Through our portal,patients can provide insurance or demographic information and review the status of their account. Credit and debit card payments, including payments via health saving account and flexible savings cards,can also D S S be made through Portal's 256-bit SSL self-service payment interface.All credit COMPLIANT card transactions processed for you will be handled in compliance with Payment Card Industry Data Security Standard regulations. Patient invoices also provide a mailing address for those clients who wish to pay by check. ©2023 Digitech Computer LLC RFP No.2023-015-ND i l Digitech Compliance with SAS70 and/or SSAE 16. SSAE 18 (SOC 1 TYPE 2) AUDIT Digitech uses Withum (formerly WithumSmith+Brown)to perform an in- depth audit on the controls and related processes we use to manage W IthUnT financial reporting. The results of our SSAE 18 (SOC 1 Type 2) audits, as well as the previous types of audits that the SSAE 18 replaced, have all been favorable. Withum has confirmed that Digitech meets the recognized national standards for safeguards for hosting or processing our clients'data. We have included as Attachment 1 a letter from Withum confirming the scope and results of our most recent SSAE 18 audit. This letter also points out that "AICPA standards restrict the distribution and use of the report to Digitech and A I CPA user entities (customers) and the independent auditors of such user entities of SOC Digitech's services."We would be happy to share our complete audit results with acpa org/soc4so you confidentially at shortlist if it is required and if we are favored with an • s�,p invitation for further consideration. Details on how firm will ensure the highest level of customer service. PHONE SYSTEM FOR PATIENTS While performing services on your behalf, Digitech commits to the highest level of professionalism in patient interactions. We provide clients a toll-free telephone number for customer service and patient inquiries. We have bilingual (English and Spanish) staff onsite in customer service positions during our normal business hours of 8am -6pm ET and utilize translation services for other languages as necessary. After-hours calls are directed to our user-friendly voicemail service that allows patients to leave information for follow-up by our Customer Service Representatives.Calls are returned to patients the next business day.On weekends and holidays,patient voicemail and email communications are checked at least once per day. We will provide a toll-free number for patients to call to update information, check the status of their claim, or ask questions about their bill. In customer service as in all our operations, Digitech is committed to the highest ethical standards. Our Customer Service Representatives are experts at dealing with patient issues and are well trained and knowledgeable in EMS billing practices and procedures. Your calls are answered with a custom greeting and patients are counseled through every step of the payment process. Patients in need are guided to alternative financial resources that may be available.We believe it is important to provide this personalized attention to help your patients identify their options. ©2023 Digitech Computer LLC RFP No.2023-015-ND '►IU Digitech Digitech personnel will continue to ensure that all patient interactions are professional and friendly. Sensitivity to your organization's reputation is our foremost consideration. We pride ourselves on our exceptional customer service.We invite you to contact any of our clients to ask how they feel about the way we handle their patients. Our experience over the years has shown us that those who can pay usually do.We follow compassionate billing practices and treat every patient with kindness and respect with an eye toward helping the patient meet their financial obligation.This includes suggesting community and state-based organizations to help the patient pay,establishing payment plans if acceptable to the client,and managing charity programs for our client. QUICK PHONE FACTS + Our phone system uses dedicated toll-free numbers for each client. + All calls are answered with a greeting approved by the client. + Customer service hours are 8:00 AM to 6:00 PM Eastern. + In a typical month, 94% of calls are answered within 90 seconds. Downtime over the life of the system has been less than.1%. ESCALATION OF SERVICE ISSUES Digitech's Service Escalation Tracking System will log any service issue that requires escalation and enable your administrators to track these issues through to resolution. Digitech will make every attempt to immediately resolve client or patient questions, issues, and queries during the initial phone call or interaction with your clients and patients. All questions received by telephone are logged to the patient record,which includes details of all conversations,issues,and proposed resolutions. 1111 Chief Revenue Officer S Department Supervisor or Area Manager Billing Representative First Response is immediate ©2023 Digitech Computer LLC RFP No.2023-015-ND "II' Digitech Digitech strives to resolve issues and verify resolutions in writing within one business day whenever possible, based on the nature of the problem, and will make all associated records available to you. Concerns regarding the actions of Digitech staff are also logged to the employee's personnel file,addressed through training where possible,and through disciplinary action when necessary. The escalation path for service issues is from the collection or billing specialist through the Department Area Supervisor to the Chief Revenue Officer. Issues and comments received by Digitech will be brought to the attention of your senior executives through your Digitech account manager or through the Chief Revenue Officer of Billing Services when they are of a degree of urgency that requires the involvement of senior management. All actions, notes,and contacts will be entered into the complaint tracking system. SUPPORT AVAILABLE TO YOU Because emergency service providers are always on the job, Digitech's support team is on call around the clock for you. During our normal business hours of 8am - 8pm ET, Monday through Friday, our support team is available to respond to any questions that you may have. Outside of business hours,you can reach the Digitech team by phone to handle any urgent technical needs. Senior Management provides direct contact information to our clients,including personal mobile numbers, to enable the escalation of any issue to the highest levels of attention that may be required. A sample monthly report. Please see Exhibit D for a sample of our reports. ©2023 Digitech Computer LLC RFP No.2023-015-ND 9 HID Digitech DIG ITECH RESPONSES TO APPENDIX A In this section we will respond to each of the City's minimum requirements.Here we would also like to note that Digitech acquired the R1 EMS business unit (formerly Intermedix/ADPI) in 2020. To maintain the processes and service that the City has come to expect, and to fulfill the requirements of this RFP to the best possible standards,we will continue to process the City's claims with the same billing system as has been used throughout our partnership.If we have the honor of being awarded a new contract with the City of Miami Beach,we are offering a migration to the Ambulance Commander platform on a mutually agreed upon schedule. Our responses to requirements in the following pages reflect Digitech's processes using the proprietary Ambulance Commander billing platform. A2 - STATEMENT OF WORK The City of Miami Beach Fire Rescue collects medical data in the field.Using ESO Solutions,EMS personnel will complete the required computerized patient care report,including billing information;and submit the file,via cellular network,to an offsite location where the server resides.The reports are reviewed by field staff,station officers,medical supervisors, and quality improvement officers remotely at their respective stations. The services to be provided include,but are not limited to: • Contractor shall have an interface that provides a daily automated electronic import from EPCR system(currently ESO)into their billing system. Digitech agrees with this requirement. Digitech has an established processes in place that provides an automated electronic import from ESO. • Contractor will submit quarterly aggregated EMS reports on behalf of the City of Miami Beach Fire Rescue to State and Federal entities(i.e.,EMSTARs) Digitech agrees with this requirement.We currently provide this report to the City. • Having a local office within the State of Florida, as of the date of issuance of this RSFP.The local office should have staff capable of meeting with City staff on an as-needed basis. Digitech has office locations in Miami and Tampa and many employees based in the State of Florida. You will continue to have the support of a local Account Manager and Vice President who will continue to visit the City on an as-needed basis. ©2023 Digitech Computer LLC RFP No.2023-015-ND IIiU Digitech • Providing a 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, and that can communicate(read,write and speak)fluently in English,Spanish and Creole;however,it is not required that each CSR speaks in all three (3) languages, but there must be available CSRs to conduct business in each language,as necessary. Digitech will assign an Account Manager to support your account that is available during normal business hours.Account Managers typically provide support in the following activities: + Conducts bi-weekly meetings with the chief and finance + Provides updates and analysis on the current years fiscal year to date revenue and various data points + Resolves escalations + Prepares a monthly reconciliation to assist the Finance department in reconcilng month end reports,cash log,and invoice to bank statements. + Works directly with the City to capture any ACH deposits that do not flow through the lockbox. CUSTOMER SERVICE REPRESENTATIVES While performing services on your behalf, Digitech commits to the highest level of professionalism in patient interactions. We provide clients a toll-free telephone number for customer service and patient inquiries. We have bilingual (English and Spanish) staff onsite in customer service positions during our normal business hours of 8am -8pm ET and utilize translation services for other languages as necessary. In customer service as in all our operations, Digitech is committed to the highest ethical standards. Our CSRs are experts at dealing with patient issues and are well trained and knowledgeable in EMS billing practices and procedures.Your calls will be answered with a custom greeting such as,"Miami Beach EMS" and patients are counseled through every step of the payment process. Patients in need will be guided to alternative financial resources that may be available.We believe it is important to provide this personalized attention to help your patients identify their options. ©2023 Digitech Computer LLC RFP No.2023-015-ND 1 MIIU Digitech • I wa know I believe Digitech's staff to be one organizations haventyou workedto withthat—friendly, professional, and very timelythe withbest our requests. I KRISTI GARLAND Treasury Accountant City of Des Moines,IA Digitech personnel will ensure that all patient interactions are professional and friendly.Sensitivity to your organization's reputation is our foremost consideration.We pride ourselves on our exceptional customer service. We invite you to contact any of our clients to ask how they feel about the way we handle their patients. A3.- SPECIFICATIONS 1. GENERAL • Contractor will 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 the Fire Department. Digitech will continue to generate invoices per the City's instruction. • The Contractor shall maintain files,records and other evidence as required to demonstrate that all contract provisions are being fulfilled.Such files and records will be available for review and/or access by the City of Miami Beach Fire Rescue under agreed-upon procedures. Digitech agrees to this item. • Contractor will prepare quarterly State of Florida aggregate EMS reports. Digitech will continue to prepare reports for the City,in the City's format. • Contractor shall have the ability to generate specialized reports upon request and at no additional cost. Digitech has this ability now with the City's current system and upon the City's migration to Ambulance Commander. If you have specialized reporting requirements that are not already provided or cannot be created through our report generators,we will customize a reasonable number of reports needed at no cost,often within 24 hours of your request. ©2023 Digitech Computer LLC RFP No.2023-015-ND NI) Digitech You will continue to have access to the reporting experts on our staff, including Max Dekle, our Data Analytics Specialist,and Mitch Holder,our Executive Director of Analytics.We will make sure you have all the reporting tools necessary to effectively monitor and analyze your data. • Contractor will establish a two-way data exchange system with billing hospitals to electronically transfer(e-Transfer)all EPCRs to the hospital and receive patient and related billing information back from the hospitals. Digitech will continue to maintain a two-way data exchange with your billing hospitals. • Contractor must provide a process for requesting Interfacility and/or Routine transfers online with all required MBFD paperwork completed when the request is submitted at no cost to the City. Digitech will work with the Fire-Rescue Department to develop a mechanism for the generation of interfacility transfer requests. The mechanism will enable hospitals, SNFs, and rehab facilities to upload necessary documents such as Physician Certification Statements, insurance information, and other required paperwork. • Contractor must accurately code calls by providing medical necessity determination, assigning medical diagnostic codes, ICD-10-CM codes, Health Care Procedure Coding System (HCPCS), modifiers, and narratives based on the nature of the ambulance call and the information provided on the patient care report for the purpose of billing in accordance with Medicare,Medicaid,Commercial insurers and private payers for prehospital emergency medical services. Digitech will continue to accurately code calls to these standards. 2. Invoicing/Billing/Collections. • Contractor shall be responsible for the invoicing,collection,and generation of all insurance forms and filings, record maintenance and preparation of standard and/or custom reports, as requested or required by the Fire Department. Digitech agrees to this requirement. Digitech's overview of our billing process(Exhibit E) describes all the above requested activity in detail. • The invoices for services rendered shall contain the following information: a. Patient account number. 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. ©2023 Digitech Computer LLC RFP No.2023-015-ND 13 llll' Digitech j. Transport mileage from and to. k. Insurance coverage and instructions(if applicable). Billing inquiry telephone number,800-phone number if not local for satisfaction of the receivable and customer satisfaction. Digitech will continue to add the above elements to the City's invoice. • Contractor shall use the electronic Patient Care Report(ePCR)and additional documents obtained as the basis for coding the service and billing the individual, Medicare, Medicaid,insurance companies,or other appropriate third-party payers for services provided.Contractor shall mail 80%of bills/invoice forms to patients within three(3)days of by the City of Miami Beach. Digitech uses information from the ePCR and additional documents to being the coding process.We agree to mail 80%of invoices to patients within three days. • All invoices and reporting shall be automated. All invoicing and reporting are automated. • Contractor shall be responsible for sending follow-up bills at thirty-day (30), sixty-day (60), and ninety-day(90) intervals. If the bill has not been paid in full within 120 days,the patient will be notified by letter(electronic emails in some cases)and/or telephone of the delinquent amount. Digitech will continue to invoice at 30-,60-,90-,and 120-day intervals. • 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). Digitech agrees to continue with this process. • Contractor shall post all payments as received directly or electronically within one(1)business day and process refund requests with the month following an overpayment. Digitech agrees to post all payments within one business day. Additional information about how Digitech receives payments can be found earlier in this proposal in response to the"Details on procedures and controls for receiving payments..." requirement. • The Contractor shall agree to make every effort to locate and correct any incorrect billing address for billable patients. Digitech will make every effort to locate and correct billing addresses through our Verification process. ©2023 Digitech Computer LLC RFP No.2023-015-ND IIIU Digitech VERIFICATION We define verification as the process of finding missing billing and demographic information and confirming the accuracy of the current data.Our verifiers do the following: + Access multiple public and private databases to locate missing patient information. + Contact patients by phone to get insurance information when necessary. + Contact admitting hospitals to get patient information that we then use to find insurance information with our demographic search tools. When possible, we build electronic bridges to hospitals and directly query databases or transfer patient demographic and insurance data. + Use clearinghouses to find or verify insurance and demographic information. + Provide invoicing forms with a simple insurance information section and return envelope, which makes it easy for patients to return demographic and insurance information to Digitech by mail. + Provide web portals for each client where patients can check the status of their accounts, make payments,update demographic profiles,provide signatures,and input insurance information. USING PUBLIC AND PRIVATE DATABASES Digitech uses our proprietary Sleuth search solution to connect to multiple large databases. Its search algorithms use any available data to locate additional demographic information. Our goal is to find the patient's social security number,which we then submit to other databases to find insurance information. USING CLEARINGHOUSES Using the demographic information available, verifiers use our automated tools to search large clearinghouse databases to find or verify available insurance information and determine eligibility. This process also allows us to identify secondary insurance that field personnel will almost never obtain, and that even the receiving hospitals may not be able to provide. We validate Medicare, Medicaid, and all insurances daily for all the claims that we receive. In addition to verification of insurance information on file,we validate patient insurance status by feeding the verified social security number into our insurance polling system which queries insurance companies in search of a policy number associated with that social security number. Digitech uses Experian and other such databases for this process.We typically complete this validation of patient insurance status in a matter of hours on the same day the trip information was downloaded. • Contractor will be required to collect the patient's signature in cases where the City's EMS personnel were unable to obtain a signature during transport. The record of this signature shall be maintained by the Contractor for review by Medicare and City auditors. The Contractor shall make and document no less than two(2)attempts to obtain the patient's signature. When necessary, Digitech contacts patients to obtain signatures and maintain these records. CO 2023 Digitech Computer LLC RFP No.2023-015-ND 15 IIIU Digitech Ambulance Commander provides an audit trail of every action undertaken,so each time a claim is touched in anyway,the system creates a time-stamped record.Digitech will report all open issues for the month to you. Most issues are resolved prior to closing the month's transactions. • In the course of collecting the debt, the Contractor will employ additional skip tracing or other discovery methods at no additional cost. Digitech will use skip tracing and other discovery methods at no additional cost to the City. Digitech uses the following tools and services for skip-tracing and address corrections: Utility or Service Search Target Experian Demographic data searches RevSpring Address NCOA Address validation and correction Emdeon Demographic data searches Google Demographic data searches Whitepages Telephone number searches Calls to patients Demographic and Insurance information Patient Portal Demographic and Insurance information Return mailers Demographic and Insurance information • Contractor shall agree to include in the invoice mailing a citizen satisfaction survey and a return, self-addressed and postage-paid envelope 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. Digitech agrees to mail a satisfaction survey and a self-addressed postage paid envelope with each invoice. • If necessary,Contractor will check hospital information twice per self-pay account to obtain/verify patient insurance and contact information. Digitech will continue to provide this service for the City. ©2023 Digitech Computer LLC RFP No.2023-015-ND 16 "ID Digitech • 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. Digitech will use the verification processes previously discussed and follow up with a phone call. Any conversations between the patient and the Customer Service Representative are recorded by default. If the City needs a particular phone call recording, it will be sent as an audio file via secure email. All recordings of conversations are stored for one year. All records,Ambulance Commander touchpoints,or phone conversations will be recorded and filed.We retain both physical and digital records per legal and client requirements. • Accept the hard copy or electronic information pertaining to patients'pay or billing documentation from Fire Department for all patients transported by Fire Department. Digitech will accept patients' payment, insurance, or billing documentation in hard copy or electronic formats. • 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. Digitech understands and agrees. Please see the pricing section,Tab 4,where we've defined the services and functions we will perform in the execution of this contract. • Contractor shall maintain and update all billings for ambulance services to include update of address and telephone numbers obtained through billing and collection efforts.Report shall be provided as necessary. Digitech agrees to this requirement.As new information comes in,we document the change in Ambulance Commander and any other locations as necessary.Please see Exhibit D for our reporting capabilities. • If Contractor received payment for services that are later disallowed (such as bad checks paid directly to Fire Department,or adjustments)by Fire Department,Fire Department may offset the amount disallowed from any payment due to the Contractor. We understand and agree to this requirement. • Contractor shall not add a charge of any kind to a billed account. Digitech agrees to this requirement.No new charges will be allowed without City approval. CO 2023 Digitech Computer LLC RFP No.2023-015-ND 17 01) Digitech • To the extent necessary to fulfill its billing and collection efforts under the Agreement,Contractor is granted limited authority to sign in an administrative capacity on behalf of Fire 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 Department tax exempt status; and insurance filings and related forms.Contractor has no authority to sign any document on behalf of Fire Department,which imposes liability on Fire Department. Digitech accepts the limited authority provided by the City. We understand that we do not have the authority to sign documents on behalf of the City. • A Fire Department designee must approve all written billing and collection correspondence. All payments and correspondence shall be directed to the mailing address designated by Fire Department. Digitech understands and agrees to this requirement. • Contractor agrees to negotiate and arrange modified payment schedules for those individuals unable to pay the total amount when billed. Digitech agrees to work with the patient to set up payment arrangements. In customer service as in all our operations,Digitech is committed to the highest ethical standards.Our Customer Service Representatives are experts at dealing with patient issues and are well trained and knowledgeable in EMS billing practices and procedures. Your calls will be answered with a custom greeting and patients are counseled through every step of the payment process. Patients in need will be guided to alternative financial resources that may be available.We believe it is important to provide this personalized attention to help your patients identify their options. • Contractor agrees to refund patient or insurance company refunds within forty-five (45) days of receipt and conforms to all applicable Florida Statutes. Digitech will continue to conform to all applicable Florida Statutes.We commit to a forty-five-day policy. • 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. Digitech agrees to provide a request with the necessary information for your analysis. Our refund processes are described in detail on 0.2 of this document. • Contractor will process all third-party reimbursements within one (1) week after receiving appropriate billing information from the primary payer. Digitech will continue to meet this requirement. ©2023 Digitech Computer LLC RFP No.2023-015-ND 18 llil► Digitech • Contractor shall not settle any accounts for less than the amount indicated by the Fire Department without the prior written approval of the Fire Department designee. Digitech agrees to follow your policy and not settle accounts without specific approval from the Fire- Rescue Department designee. • Contractor shall provide copies of remittance advice as required by Fire Department. Digitech agrees to provide copies of these files as requested. The Ambulance Commander platform is transparent,and the City will find that this and every other detail of the billing process is available,viewable,and exportable 24/7/365 through Ambulance Commander. • 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 Department. Digitech agrees to continue to keep a record of the required forms. • Contractor shall expeditiously begin the billing and collection process for those accounts provided to Contractor by Fire Department based upon established rates(Refer to Appendix D).The method utilized by Contractor to process the accounts shall be a means approved by Fire Department Contract Administrator. Digitech will continue to bill expeditiously for the City of Miami Beach. Should we be awarded a new contract,we will offer the City an upgrade to the Ambulance Commander platform,which will not result in any interruptions to your normal processes. As your incumbent vendor, we already have a deep understanding of your information,fees, processes,and policies, and can ensure a smooth upgrade to our enhanced billing platform. A brief explanation of our process follows,with a full description attached as Exhibit E. Digitech's process for creating and billing claims can be broken down into three stages: Data Collection, Research and Coding,and Resolution. In this section we outline the steps within these phases. 1. Dispatch information is captured by the ePCR application and becomes part of the data we import with the call record. Unlike many other billing companies, Digitech imports ALL of the data and makes it available for analysis. 2. The Patient Care Report is created by your responding providers on scene,during transport,at the destination,or as soon as possible after the call. ©2023 Digitech Computer LLC RFP No.2023-015-ND llll► Digitech DATA COLLECTION RESEARCH &CODING RESOLUTION 0 Upload Denials OCrossovers O Appeals Verification Invoicing Payment Posting Editing (Coding) Follow-up With Payers AO- Quality Adiustment ©Documentation Review 0 Charity Assurance To Collections 41, 0 CLIENT side ill► Digitech side 3. Usually, the client reviews the ePCR data prior to releasing it to the billing company. This review should happen as soon as possible after the call.Steps 1,2,and 3 happen on the client's side. 4. Digitech imports the call records from the ePCR server.Typically,this happens first thing every day. Once the ePCRs are imported into Ambulance Commander and reconciled,billing process activities begin: verification of demographic and insurance information, determination of eligibility, and research to gather missing information. Once the claims have been verified, Digitech's editors review level of service,medical necessity compliance,signature compliance,narrative,and mileage. Verification and editing of claims is usually completed within 24 hours of receipt of ePCR data.We build electronic interfaces with your area hospitals as appropriate. 5. At this stage claims are ready to be invoiced. There is a circular dynamic created here because remittance processing often results in claims returning to the invoicing function for re-billing to secondary and tertiary payers, for denied claims to be corrected and resubmitted, for appeals processing,or for balances to be invoiced directly to patients. Approximately 98% of the compliant claims completed by our clients make it through the Data Upload, Verification, and Editing processes so that they are invoiced within 24 business hours of being received. Digitech will prepare invoices according to the rates and timelines you establish,e.g.,open accounts invoiced at 30,60,and 90 days. 6. Commercial payers, Medicare, and Medicaid are invoiced electronically within 24 hours of claims being edited. Private pay patients are sent an initial invoice within three business days of receipt of ePCR data in those cases where we have exhausted all efforts to locate and verify insurance coverage.We follow up on commercial claims every 20 days until they are resolved. (c)2023 Digitech Computer LLC RFP No.2023-015-ND itIl► Digitech 7. Remittances are processed immediately as they are received, and claims are crossed over to secondary and tertiary payers when additional coverage is available. Denials and appeals are processed within 24 hours of our receipt of remittance advice. 8. When all efforts to collect have been exhausted, Digitech will write off or adjust claims in accordance with policies we have agreed upon with you, e.g., upon sending accounts to your designated collection agency. Uncollectible claims will be adjusted after an amount of time set by the client—usually 120 days. Surrounding and overseeing all claims processing and collection activities is Digitech's active compliance program, consisting of regular internal and external audits and daily oversight by our dedicated Quality Assurance team. • 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 Department shall not be required to pay Contractor any collection fees on an account until the corresponding account number can be identified. Digitech will reconcile all payments to the proper accounts before requesting payment from the City for a patient account.We never carry any unapplied funds. • Contractor shall reconcile the number of patient invoices against the number of collected invoices. Digitech will reconcile the number of patient invoices against the number of collected invoices. • Termination. If this Agreement is terminated, all accounts will be returned to Fire 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 Department or other firm identified by Fire Department.Contractor agrees to provide a rawflat file containing all relevant data needed to re-create an EPCR for any purpose.Finally,the Contractor agrees to provide the City a one- time column header file with 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. Digitech will maintain all data and billing records in a form permitting transfer to a new billing vendor within 30 days of the end of our contract. We will continue processing all existing accounts in our possession until collection efforts have been exhausted,then turn over any uncollectible claims to your designated collection agency in accordance with protocols in our contract. Any ePCR data would be delivered to a new vendor from your existing ePCR vendor. CO 2023 Digitech Computer LLC RFP No.2023-015-ND "ID Digitech • 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 three(3)days of service. Invoices are customizable to your needs and subject to your approval.We will meet these requirements for maximum intervals between invoices and rendering invoices within ten days of receipt of the ePCR. Our patient invoicing currently follows a three-invoice cycle.We use mailers specially designed to make it easy for patients to return valid insurance information.All text,format,and colors are approved by the City. Our patient invoicing process is as follows: + Once we have exhausted all efforts to locate and verify insurance coverage for a patient,an initial invoice is sent,usually within 48 hours of our receipt of the ePCR data. + A statement of account is generated and mailed to the patient's responsible party at most 35 calendar days after the original invoice and followed up with a phone call. + When a patient account is not paid after at most 70 days, Digitech sends a pre-collection notice in accordance with mutually agreed policies and again follows up with a telephone call. + Patient accounts that remain unpaid after 120 calendar days are sent to collections or adjusted in accordance with your policies. • 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. Our preferred payment method for credit card payments is to connect our payment portal to the clients' credit card merchant processor. Patients access Patient card their account information through our secure and convenient online interface. transactions are Through our portal, patients can provide insurance or demographic information PCI DSS compliant and review the status of their account.Credit and debit card payments,including payments via health saving account and flexible savings cards,can also be made through Portal's 256-bit SSL self-service payment interface. All credit card transactions processed for you will be handled in compliance with Payment Card Industry Data Security Standard regulations. DSS COMPLIANT Taking credit cards by phone is not a PCI-compliant practice.When patients call the support center to make a payment, they will receive guidance from our Customer Service Representatives on the portal payment process. • Contractor shall be responsible for all fees associated with the credit card acceptance Digitech agrees with this requirement.Responsibility for credit card fees is included in Digitech's pricing. CO 2023 Digitech Computer LLC RFP No.2023-015-ND 22 RID Digitech • Contractor shall provide a process for collecting information from local law enforcement agencies and gross billable and payments on all incidents involving motor vehicles. Digitech has read and agrees to this requirement. Digitech will continue to obtain patients'auto insurance information during our typical course of data verification and will use any additional motor vehicle accident information we are provided during claims processing. In addition, we expect to have access soon to the state's Biospatial platform. This solution will provide Digitech with near real-time access to clinical and operational dashboards along with access to police reports and auto insurance information. • Contractor shall increase collection rates annually. Our entire billing process from end to end is dedicated to increasing your collection rate. We provided a selection of our solutions and tactics for increasing collections at the start of this Tab 3 proposal on p.3. • Contractor shall have a mechanism to find a revenue source for all patients outside of contacting the hospitals. Our Verification process is this mechanism and more.Please see the previous section in which we described verification. • Contractor shall be able to provide litigation services related 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. While Digitech is not a law firm and does not provide litigation services directly,we will support the City in any litigation that arises from MVA or personal injury claims through the provision of medical records and all available details related to the claims that have been gathered during claims processing. 3. Medicare and Medicaid Requirements. • 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. Digitech agrees to promptly submit Medicare, Medicaid, and insurance claims within 72 hours of a complete claim. • Contractor will provide Medicare/Medicaid billings in accordance with all federal,state,and local laws and Medicare/Medicaid rules and requirements. Digitech agrees to this requirement.We prioritize staying ahead of regulatory requirements and changes, as well as maintaining the resources we need to integrate compliance within our billing and collection activities,training,and quality management programs. ©2023 Digitech Computer LLC RFP No.2023-015-ND 011► Digitech • Contractor shall provide electronic claims processing for Medicare and Medicaid and re-file Medicare,Medicaid,or insurance claims as necessary to obtain payment. Digitech agrees to electronically process Medicare and Medicaid claims. • Contractor shall be prepared to assess service levels before billing and classify services into levels that meet Medicare and Medicaid transport criteria. In a limited number of cases,these service levels may differ from what is indicated on internal documents based upon interpretation and must be brought to Fire Department' s attention to determine if changes may be necessary. Digitech agrees to this requirement. • Contractor will provide support for Medicaid or Medicare audits. Digitech will offer support with any Medicaid or Medicare audits. • Contractor shall provide Electronic Claims Processing for Medicare and Medicaid to the City's lockbox. Digitech agrees with this requirement. 4. Compliance with Applicable Federal,State,and Local Laws and Requirements. • 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. Our plans and collections policies adhere fully to all local,state,and federal laws and regulations regarding collections, financial transactions, privacy, and "standards of reasonable care" for information handling, management, and destruction. This includes full compliance with Fair Debt Collection Practices Act, Fair and Accurate Credit Transactions Act, Fair Credit Reporting Act, Gramm-Leach-Bliley Act, Family Educational Rights and Privacy Acts and Children's On-Line Privacy Protection Act. Digitech is committed to the highest ethical standards. • 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. Digitech agrees to facilitate proper security of confidential information. Our record retention policy follows. RECORD RETENTION We retain both physical and digital records per legal and client requirements. Physical records are scanned and added to the patient's record. ©2023 Digitech Computer LLC RFP No.2023-015-ND 24 'Il Digitech Ambulance Commander's audit trail function creates records of all services performed, including data entry,record modifications,billing events,and all financial transactions.This creates an unalterable record of every action ever taken on an account. You can access these records in real-time. Ambulance Commander users cannot manufacture or edit audit trail records from within the platform and can only access audit trail data through read-only interfaces. Digital records will be retained according to contract requirements and applicable laws and regulations. Digitech will maintain all data and billing records in a form permitting transfer to a new billing vendor within 30 days of the end of our contract.We will continue processing all existing accounts in our possession until collection efforts have been exhausted, then turn over any uncollectible claims to your designated collection agency in accordance with protocols in our contract. 5. Customer Service. • Respond to all patients'requests and inquiries,either written or verbal,in a timely manner,and not to exceed two(2)business days. Patient requests and inquiries will be responded to within two days. LL • Provide and furnish all material and personnel required for the performance of the Agreement. Digitech agrees to this item. • Provide Multilingual Customer Service Representatives (CSRs), available during normal business hours.These CSRs shall be able to assist patients and/or other third-party payees with all billing inquiries in a timely and courteous manner. Customer calls will be facilitated within the County or through a"toll free" exchange, published on all invoices. Contractor shall respond within three (2) business days to Fire Department and patients on requests for information or records.All scripts and protocol for answering and placing calls shall be agreed upon between Contractor and the Fire Department prior to the commencement of services.A record of telephone calls and contacts shall be maintained. We have bilingual (English and Spanish) staff onsite in customer service positions during our normal business hours of 8am - 8pm ET and utilize translation services for other languages as necessary. CUSTOMER SERVICE While performing services on your behalf, Digitech commits to the highest level of professionalism in patient interactions. We provide clients a toll-free telephone number for customer service and patient inquiries. After-hours calls are directed to our user-friendly voicemail service that allows patients to leave information for follow-up by our Customer Service Representatives (CSR). Calls are returned to patients the next business day.On weekends and holidays,patient voicemail and email communications are checked at least once per day. ©2023 Digitech Computer LLC RFP No.2023-015-ND HOU Digitech In customer service as in all our operations, Digitech is committed to the highest ethical standards. Our CSRs are experts at dealing with patient issues and are well trained and knowledgeable in EMS billing practices and procedures.Your calls will be answered with a custom greeting such as,"Miami Beach EMS" and patients are counseled through every step of the payment process. Patients in need will be guided to alternative financial resources that may be available.We believe it is important to provide this personalized attention to help your patients identify their options. Digitech personnel will ensure that all patient interactions are professional and friendly.Sensitivity to your organization's reputation is our foremost consideration.We pride ourselves on our exceptional customer service. We invite you to contact any of our clients to ask how they feel about the way we handle their patients. All scripts and protocol for answering and placing calls shall be agreed upon between Digitech and the Fire Department prior to the commencement of services. A record of telephone calls and contacts will be maintained. • Contractor shall be responsible for mailing all forms (i.e., HIPAA, customer survey, and related forms)and responsible for all associated costs. We will continue to include surveys and HIPAA notices for each patient as part of Digitech's solution. • 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. Digitech agrees to this requirement. • Contractor shall provide a designated liaison for patient/payer concerns. Digitech will assign an Account Manager to act as a single point of contact.See our response to the 4th bullet in the section A2 for duties that Account Managers offer. 6. Document Maintenance. • 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. The Contractor shall keep and maintain adequate records of work, information,expenses,costs, invoices, materials provided,and services performed pertaining to the City's EMS ambulance transport billing.These records shall be maintained as required by Florida Statues. Digitech agrees with this requirement. • Any and all data created by Fire 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. Digitech agrees with this requirement. ©2023 Digitech Computer LLC RFP No.2023-015-ND 26 ilil► Digitech • Contractor shall provide access to its database and a data dictionary for Fire Department to use for report writing capabilities. Digitech agrees with this requirement. 7. Communications with City of Miami Beach Staff. • Contractor shall attend meetings with the Fire Department staff to review contract operations when requested. Digitech will continue to attend meetings to discuss contract operations. Typical topics for the meeting include proactively monitoring account performance, review reports, review account activity, training coordination, fee analysis, reviewing end of month financial reconciliation, and any topics the City finds important. • Contractor shall participate in a yearly audit conducted by the Fire 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. Digitech agrees to participate in a yearly audit. We agree that the audit will cover the common set of accounting principles. • Contractor will notify the Fire Department of any changes in federal, state or local laws, rules, regulations and codes that affect this subsequent agreement. Digitech agrees.As part of our consultative style,we will communicate any changes in federal,state,or local laws. • Contractor shall designate a Program Manager responsible for all matters related to the Agreement, including performance.The Project Manager's name shall be provided upon commencement of this Agreement.The Project Manager shall be available during Fire Department business hours of 8:30 am to 5:00 pm,Monday through Friday,and shall respond to Fire Department within one(1)hour. Digitech agrees to provide an Account Manager for the City.Our Account Managers are available from 8-5. • Contractor shall provide the Fire Department with read-only access to accounts, at locations determined by Fire Department. The City will have full access to accounts. Our level of transparency and visibility into accounts and processes is unmatched in the industry. Authorized users have access to patient accounts which shows all activity, including hyperlinks to related documents including insurance EOBs,patient statements and patient correspondence.This makes training relatively easy and also creates a high level of accountability since the City sees the same flow that our billing specialists are seeing while working on your accounts. ©2023 Digitech Computer LLC RFP No.2023-015-ND 0111 Digitech • Contractor shall provide all necessary developing, copying, faxing, mailing, and other related services at no additional cost to the Fire Department. Digitech agrees to provide the services required. • Contractor shall maintain and inform Fire 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 Department of any changes. Digitech agrees to this requirement. • Fire Department,its staff,consultant,and/or contractors shall have the right to visit the offices of the Contractor and/or its agents periodically to inspect the facilities and operations used in the performance of any resultant agreement. Digitech agrees to this requirement. • For record-keeping purposes (not related to billing/collection cycle), Contractor shall retain all account information for a minimum of three(3)years. Digital records will be retained according to contract requirements and applicable laws and regulations. • Contractor shall continually review Medicare and Medicaid policies, rules, regulations, and laws pertaining thereto, and shall immediately incorporate new requirements or changes into its procedures, and make prompt, appropriate recommendations to the City in order to maximize revenue. Contractor shall keep the Division Chief of EMS aware of any anticipated or actual changes in the laws pertaining to collections that may impact City's revenue. We consider it our responsibility to keep you up to date on important changes to regulations in the EMS industry in Florida and across the country.We will continually communicate with the City and implement necessary changes,as needed. We integrate compliance within all our business activities and will serve as informed advisors for City officials through our: + Active membership in industry trade organizations + Participation in regional and national ambulance associations and conferences + Consultation with authorities on ambulance industry law ©2023 Digitech Computer LLC RFP No.2023-015-ND i H Digitech + Continuous monitoring of industry trends, regulatory changes, and updates to federal,state, and local rules and regulations + Observation of industry best practices 8. Reports. Contractor shall establish a comprehensive reporting system that will enable the City to monitor Contractor's performance. Reports must be designed to provide data required to measure performance accurately. Reports must be provided on a regular schedule and in a format approved by the City.At City's request,Contractor shall provide additional or different reports than those stated herein,or as modified by City. • Prepare and process quarterly Fire Department's State of Florida EMS pre-hospital data • Contractor will keep full and accurate accounts of services performed by the Fire Department, billing and collections received,and other records related to the emergency medical transport billing and collection services. • Contractor will prepare and provide the Fire Department Administration monthly reports as required by Fire Department. • Contractor shall provide,every month,a copy of all monthly financial activity,billing and receivable reports,consistent with GAAP on the account. • Monthly Financial Report. Contractor shall submit a financial report to the Division Chief of EMS on or before the 4th business day of each month, which shall, at a minimum, contain the following information: o Summary by transport month of payments received during the preceding month. o Summary report for expense fees incurred during the billing process (i.e. privacy notices, correspondence costs,shipping,postage,survey,etc.) o Detailed report for each transport month since contract inception including: o The percentage of missing data entry for each month,and cumulative percentage for the fiscal year, by each Fire Department personnel; o The percentage of inaccurate data entry for each month,and cumulative percentage for the fiscal year,by each Fire Department personnel; o Transport Type(BLS,ALS-1 and ALS-2); o Number of EMS cases billed to date; o Gross amount billed to date; o Prior payments to date; o Preceding month payments; o Total mandated contractual adjustments for transport month to date;and o Lockbox monthly statement. o Provide Electronic Claims Processing for Medicare and Medicaid to the City's lockbox. o Reconciliation of payments received directly by the City in account(s)other than lockbox,if any,for the preceding month. Digitech will comply. ©2023 Digitech Computer LLC RFP No.2023-015-ND 29 MN Digitech • Monthly Refund Report.Contractor shall submit to the Division Chief of EMS on or before the 4th business day of each month a monthly refund report for refunds issued by Contractor during the preceding month which shall,at a minimum,contain the following information: o Responsible party on the account; o EMS incident number; o Selected respondent payment reference; o Refund amount;and o Date of refund. Digitech will comply. • Vendor Performance Report.Contractor shall submit a vendor performance report to the Division Chief of EMS on or before the 10th calendar day of each month,which shall, at a minimum, contain the following information: o Gross amount billed; o Number of EMS cases billed by transport type to date; o Contractual adjustments by category(i.e., Medicare, Medicaid, Medicare Replacement Insurance non-allowed amounts,homeless patients,etc.); o Net amount billed; o Collections from all sources by category (i.e. Medicare, Medicaid, commercial insurance, private Pay); o Total gross collections; o Refunds and deductions due to dishonored checks; o Total net amount collected; o Net effective collection rate;and o Collection per account. Digitech will comply. • Quarterly Analysis Report.Contractor shall submit a quarterly analysis report to the Division Chief of EMS on or before the 10th calendar day as follows: o January Report:October- December(Q1) o April Report:October-March o July Report:October-June o October Report:October-September(full Fiscal Year) At a minimum,the quarterly analysis report shall contain the following information for fiscal year to date: o Transport type(BLS,ALS-1 and ALS-2); o Collection source category(i.e.,Medicare,Medicaid,commercial insurance,private pay); o Number of EMS cases billed by transport type; o Total amount billed; o Gross collection rate;and o Collection per account. Digitech will comply. ©2023 Digitech Computer LLC RFP No.2023-015-ND 30 III Digitech 9. Reports Compilation and Listing. Contractor shall maintain a computerized database of all accounts and shall provide the Fire Department with reports to show management and financial information. The Fire Department will determine the format of reports required under this contract. In addition to the reports described below,the Contractor shall provide any custom reports at the request of the Fire Department in a mutually agreeable timeframe and at no additional cost to the City. Monthly reporting is produced after month closing and provided to Fire 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. The following are major reports that the Contractor shall produce for the Fire Department • 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. • 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 activity type and computes average collections for both gross and net. Note: All payment activity is reflected against the original month billed to reflect accurate collection percentages.showing gross and net collection percentages for each period.Summarizes totals for each activity type and computes average collections for both gross and net. Note:All payment activity is reflected against the original month billed to reflect accurate collection percentages. • 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. • 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 the number of accounts collected by class and the percentage of total. • 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. • 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. • Account Activity-Monthly Billing Report(Charges) Shows all billing(new charges)processed alpha sorted by last name and summarized total billing for period. • 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 Explanation of Benefits(EOB)detail for secondary filing,refund processing,and adjustments. • Collections-Summary to Date,Monthly Running Shows receivables as applied to"original billed month." ©2023 Digitech Computer LLC RFP No.2023-015-ND 31 NO Digitech • Monthly Refund Schedule Report provided by account detail of associated payments reflecting an overpayment and necessary refund to be processed. • Refund Request Provides for previous billing month, a separate sheet per account, requesting refund on overpayment accounts.This includes all information pertinent to determining refund. • Distribution of Charges and Collections This report will track the charges,payments and financial class mix of all patients for a given month. • 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. • Patient Alpha Listing This report lists all invoices alphabetically by patient name. • Monthly Payment Listing This report lists payments,bad checks,required charge offs,and refunds posted to each patient's account. • Overpayment Reports This report lists all patients'due refunds as a result of overpayment of account. • 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. We know that your reporting requirements are crucial to this project, and we commit to exceeding your expectations.We believe that the best claims processing software would be inadequate without powerful reporting, and that's why we've integrated our powerful reporting suite across our entire Ambulance Commander platform. You'll find reporting tools in all our solutions.Report generators let you sort,filter,and run reports that you create based on tens of thousands of possible combinations of fields and criteria. This functionality gives you the ability to print virtually any report imaginable. We will provide the reports you need.Throughout our partnership,we will discuss the parameters of each report with you so that we understand exactly what you want to see. All reports can be printed or downloaded in a variety of formats,including Excel,Word,XML,or PDF. If you have specialized reporting requirements that are not already provided or cannot be created through our report generators,we will customize a reasonable number of reports needed at no cost, often within 24 hours of your request. You will have access to the reporting experts on our staff, including Max Dekle, our Data Analytics Specialist, and Mitch Holder, our Executive Director of Analytics. We will make sure you have all the reporting tools necessary to effectively monitor and analyze your data. In addition to the monthly operational and financial reporting packages we provide,you will be armed with our Dashboard and PCR Lens solutions,giving you powerful self-service reporting capability. ©2023 Digitech Computer LLC RFP No.2023-015-ND HIlO Digitech OPERATIONAL AND FINANCIAL REPORTING & ANALYSIS SOLUTION Digitech's Dashboard brings your operational and financial data into an Dashboard iFlik easy-to-use interface that will enable your managers, administrators, and business analysts to get a real-time picture of any aspect of your operations. Dashboard's intuitive user interface provides a set of advanced reporting and analysis tools that will help your organization stay on top of the game and ahead of the curve. The basic setup of Dashboard contains several pre-defined views and layouts displaying critical operational metrics, including a set of Key Performance Indicators validated by Page,Wolfberg&Wirth,the premier EMS law firm. In addition to these default options,Dashboard is also highly customizable,allowing users to configure and save personal views,so you'll see exactly what you need to know when you need to know it. 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A* , !,, ! Maa4,NI 1a4Ya,Y,2011 YN.±1,YI I F.buw,2a11 FAA...,21111 Digitech's Dashboard FIELD DATA QUALITY MONITORING AND REPORTING SOLUTION PCR Lens is our data quality reporting solution. It aggregates the pre-hospital PCR Lens data from your agency's EMS responses as they come to Digitech as Patient Care Reports. PCR Lens then displays the data in an interactive user interface. Here,you're able to create your own views and filters, making it easy to pinpoint problems, push training and re-education where it's needed,and identify high-performing individuals and crews. ©2023 Digitech Computer LLC RFP No.2023-015-NC ►►O Digitech With PCR Lens,you can also compare your agency's pre-hospital data as it comes to us through the ePCR with that same data after we've run it through Ambulance Commander.We perform error-scrubbing and match information against national demographic databases.Then our certified ambulance coders review and edit that data during the creation of the claim. The initial data collected in the field can be compared with the same data after these Digitech processes take place.Chiefs, EMS Directors,and QA/QI Administrators can quickly and accurately analyze the data collected by your medics and compare their efforts to peers, other shifts, other stations, and even other EMS organizations. PCR Lens helps you make sense of the mountains of data collected by your medics and push improvements in efficiency,better patient care and outcomes,and increased revenue for the department. ADDITIONAL REPORTS AND PACKAGES ' TI 1 _, Frnt Name Accurate 1001a prrr 100% ,Dr,r.•..•. 1�' ,,—r i Fret Nam!•Inaccurate / ::::: „ IMQI��Y!{III IIQYpp{ I Ire first Neme-Empty 1 1 1 1111 !:!JO �% 1 �% �+ last Name-Accurate iLast Name-Inaccurate " �'' last Name-Empty 80% ao u 80% :i Zip-Accurate ' Zip-Inaccurate 70% - 561[ �0% 70% Zip-Empty 67% 41%tiwy 67%j SSN-Accurate Sx V I SSN-Inaccurate 60% 60% 60% ,'i 36N-Empty .7, ''. ':i Dale of lit -Accurate SO% cp% � 50% ]tm :' Date deirth-Inaccurate Dale dBIrM-EmIM .'-"'" Medicare-A curate 40% .. aa}tY;; yqp Medicare Inaccurate . Medicare-Empty -rrr ,i- Medicaid-Accurate 30% 3.',S 30% Medicaid-Inaccurate :- Medicaid-Empty 20% 291E 20% 20% 75t4 Medical Rec-Accurate Medical Re<-Inaccurate Medical Rec-Empty 10% 10% 10% Bi1Nr65errture-Accurate c-; 1,.�IBiIIngsNn%ccmInatcarfale , Bill'ry5i6rrtim u -Empt Empty 11 Master Signature-Accurate MBdla/l-Mn Medic N2-Ellie Medic#3-lake Master Sipueure- ...Master Stpmture-Empty Digitech's PCR Lens In addition to Dashboard and PCR Lens, we provide you pre-configured reports, including a monthly reporting package.Two of our most popular pre-configured reports are the Financial Scorecard and the Analytical Scorecard. FINANCIAL SCORECARD The Financial Scorecard allows you to follow the money at any point in your revenue cycle. The report tracks every dollar of your charges until payment is complete, allowing you to instantly review all receivables and view a breakdown by payer,facilities,or patients for any date range. ©2023 Digitech Computer LLC RFP No.2023-015-ND �lll► Digitech ANALYTICAL SCORECARD The Analytical Scorecard gives you a complete picture of your critical data.The report analyzes claim costs and charges on a per-carrier basis.You may define one or more options for Top Priority, Financial Groups, Service Level,Trip Class,and Company data to include in a report. MONTHLY REPORTING & FINANCIAL PACKAGES Digitech's standard monthly reporting package includes both detailed and graphical representations of critical financial data including sales, cash receipts, adjustments, accounts receivable, days sales outstanding,collection percentages,collections per transport,and more. We deliver this package to your specifications on a mutually agreed upon schedule. Whenever needed, authorized stakeholders from your organization can also produce these reports on demand. At the end of each month, Digitech performs a hard close of all books and records, which ensures all accounting numbers related to sales,cash receipts,adjustments,and receivables for that month will never change.This makes it easy for anyone to review performance and identify specific topics to explore. We will deliver a monthly financial reporting package to you that is accrual-based and adheres to Generally Accepted Accounting Principles and includes our Cash Receipts Report, Sales Reports, Adjustment Reports,the Accounts Receivable Report,and the Accounts Receivable Roll Forward report,which ensures that the closing balance of each month is matched to the penny to the next month's opening balance. For samples of our reports,please see Exhibit D. ©2023 Digitech Computer LLC RFP No.2023-015-ND 35 all' Digitech 10. Responsibilities of the City of Miami Beach. • The City of Miami Beach will comply with all federal, state, and local laws, rules and regulations applicable to the contracted services. • 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 Agreement is in force. • The City of Miami Beach will make every effort to obtain the proper billing address for all billable patients prior to forwarding it to the Contractor. • The City will pay the Contractor additional fees for any postage increases during the contract period.However,this fee will only be the actual cost of the increase. Digitech has read and understands. 11. Service Fees.The Contractor shall perform EMS Billing and collection services on behalf of the Fire Department and shall conform to the following: • All monies collected by the Contractor shall be deposited in the designated lockbox. • At the end of each calendar month Contractor shall send an invoice to the Department with collection details of all Department transports entered in the Contractor's billing system from the preceding month. • 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,and no additional payments shall fall due under this contract except for any refunds due to the Contractor due to patient overpayment refunds. • The Contractor shall be entitled to fees on all collections for billings during the contract term and 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 the contract term and up to one (1) year after expiration or termination of Contract. Digitech has read and agrees. 12. Florida Certified Public Expenditure(CPE)Program.At the request of the City,the 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. We have supported supplemental payment programs for more than 100 clients in a half dozen states. Through that support,our clients have recovered more than$600M in supplemental payments.In the State of Florida,we have helped our clients realize more than $200M in PEMT payments. CO 2023 Digitech Computer LLC RFP No.2023-015-ND Digitech SUPPLEMENTAL PAYMENT PROGRAM APPROACH Digitech has the resources and experience to support the City in pursuit of additional revenue that may be derived from participation in PEMT programs.We have dedicated staff with 10 years' experience in the development of cost reporting for supplemental payment programs for agencies across the nation, including many Florida ambulance services. We have developed tools, utilities, and processes designed specifically to streamline the gathering and collation of necessary financial and billing data,and will support the City through fiscal impact studies,data analysis,and the preparation and submission of cost reports. Detailed below are aspects of our approach to supplemental payment programs that make us uniquely qualified to support the City's ongoing participation in the PEMT Programs. + PEMT Engagement.We currently process over 1,000,000 claims annually for more than 50 clients in Florida,maintain two Florida offices(Miami Lakes and Tampa),and employ a significant amount of Florida residents. Our team has been involved with the PEMT Program in Florida since the beginning of FY16. We have prepared cost reports and represented our clients' best interests in audits. This unrivaled depth gives us a deep understanding of Florida regulations and the unique aspects of Florida Medicaid processing, unmatched access to patient insurance information through an extensive network of hundreds of Florida hospital relationships,and a strong voice for our clients with payers and legislators to ensure maximized reimbursements. + Seasoned support. Digitech staff members are EMS experts, EMTs, former EMS directors, billing specialists,certified ambulance coders,paramedics,nurses,and EMS billing professionals.When we say that you will receive the attention and dedicated support from a cost reporting expert,we mean it. We do not farm out work to a team of entry-level data analysts who may not be familiar with complex Medicaid regulations. The preparation of your cost report will be completed by skilled finance and accounting professionals. Our team has a strong, active relationship with Agency for Health Care Administration (AHCA) and will offer ongoing technical assistance on policy and programmatic issues that matter to the City. Digitech will provide: + Hands-on analysis.While we believe that we employ superior technology in our billing processes, we also understand that detailed manual data analysis is an integral part of cost reporting.We will never sacrifice quality or compliance for the sake of increasing productivity. We believe that the quality of your cost report matters. + Dual perspective. As part of our approach to proactively identifying audit concerns, we conduct year-to-year variance analysis of billing,cost,and utilization data. In addition,we look at Medicaid payor mixes,EMS utilization statistics from CAD data,and cost per trip amounts across the state to identify outliers.We know that it is important to our clients to understand and monitor these key statistics that are commonly reviewed by auditors. ©J 2023 Digitech Computer LLC RFP No.2023-015-ND Digitech + Communication.We make a commitment to our clients to keep them connected and engaged in the supplemental payment program.To kick off the cost reporting process each period,we set up one- on-one time with our clients to establish a communication plan,discuss a future meeting schedule, and review the data request.Our goal is to ensure that our clients are as involved in the process as they choose to be.We tailor our communication plan to meet each client's unique needs. + Innovation. In our experience with a broad range of EMS providers,we understand that there is no one-size-fits-all approach to cost reporting.We have made participation in supplemental payment programs possible for providers with differing degrees of data reporting capabilities;we tailor our approach to meet clients where they are.We examine different approaches to cost allocation to find the methodology that works best for each client. We are continuously looking for ways to improve our services and solutions.For example,we recently developed a web-based cost reporting utility for Medicare Ground Ambulance Data Collection. PEMT ADMINISTRATION Digitech has managed the implementation of PEMT reporting for many providers in Florida. We are confident that the process that we outline below will work for the City. We will provide We will collect all Digitech will compile and file the comprehensive required billing. reports to manage all aspects of the desk financial.and PEMT for the City. review/audit utilization data. support. We will work with City finance and operations teams to collect all data for the annual cost report. During the project kickoff call,we will walk through We will prepare all the data request and ensure that the working files and submit the cost report to AHCA. City's team is equipped to provide source data needed for completion of the cost report.While the City's team is likely familiar with the PEMT data requirements because of prior Cost Reporting Cycle — Preparing the Annual Cost participation in the program, we take a detailed approach to the data collection process. The source data is the first building block of the cost report,and we want to make sure that we,the City and Digitech teams, are starting off on the right foot.We typically allow for a closing for a fiscal year closing period of at least 30 days before we collect data. Utilizing program guidelines and 2 CFR Part 200 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards),we will identify all costs eligible for reimbursement. Cc)2023 Digitech Computer LLC RFP No.2023-015-ND Oil Digitech Federal rules prohibit reimbursement for many costs that providers incur. Even if a provider believes that the costs pass the test of being reasonable and necessary for the agency, the costs may still not meet standards defined in 2 CFR Part 200 and state program guidelines. If unallowable costs are claimed and these are identified in audit findings,then the provider could end up in a recoupment. Digitech will comb through your financial data in detail to ensure that only allowable costs are claimed in the final cost report. Below are screenshots of the tools that we utilize to process expenditures data.Throughout the analysis of expenditures and other data elements,we incorporate automated checks as one of the first steps in the QA process. r. . I . A l is D E f G F' 1 r2 NIA Digitech �. . . 3 fxMn r vs tang are wwetoor ,4 5 CNa4 Name: L6 . 7 Nana of Sown - s i 8 1) 9 2) 10 3) 11 4) 02 13 Com lead : i4 Date Source File Received: 15 Date Source File Processed: 116 Date Working File Finalized: A ., B C D E . .T` _" ai Iqil Digitech From 5ource Data: S 990.00 ,smipYy From Master Crosswalk: S gV0.01.1 4 Cost Center.Cost Object • Source Cost Cent Source Cost Object• Amount Initial Anal 16 Fire Operations:Regular Salaries Fire Operations Reguld: ,,-.. . 5 100.00 Shared Stored 7 Fire Operators:Fringe Benefits Fire Operations Fringe Bern-'.' $ $0.00 Shared Shared 8 EMS Operations:Regular Salaries EMS Operations Regtalar Sala rir, 5 80.00 MIS MIS 9 EMS Operations:Fringe Benefits EMS Operations Fringe Benefits $ 40.00 MIS MIS 10 Fire Prevention:Regular Salaries Fire Prevention Regular Salaries 5 100.00 Non MIS Non 1141TS 11 Fire Prevention:Fringe Benefits Fire Prevention Fringe Benefits S 50.00 Non MIS Non-MIS 12 Fire Adminntration;Regular Salaries Eke Administration Regular Salaries $ 100.00 Shored Shared 13 Fire Administration:Fringe Benefits Fire Administration Fringe Benefits 5 50.00 Shared Shared 14 Fire Administration;Office Supplies Fire Administration Office Supplies 5 20.00 Shared Shared 15 Fire Capital:Fire Truck Fire Capital Fire truck $ 400.00 Exclude Exclude CO 2023 Digitech Computer LLC RFP No.2023-015-ND 39 nil' Digitech COST ALLOCATION METHODOLOGIES We will develop appropriate cost allocation methodologies.This is a critical step in the completion of the cost report. Because costs are frequently "shared" between EMS other public safety activities, it is important that these costs are allocated in a manner that: 1. meets federal and state guidelines,and 2. allows for optimization of revenues for the department. There is no one-size-fits-all methodology that is utilized for allocation of shared costs.We will analyze the City's data and determine the optimal approach to allocation of costs. While we recognize the value in consistency in reporting, we also understand that Computer-Aided Dispatch(CAD)systems and reporting capabilities change,service areas change,and service mixes change. We review the options for cost allocation each year to ensure that we are complying with regulations and helping our clients achieve the best results. Other vendors in this market, looking to minimize their own resource and time commitments to customized CAD data analysis, will not consider alternatives for allocation of costs. On August 17, 2022, the CMS provided an informational bulletin on federal cost principles for Ground Emergency Medical Transportation programs like the PEMT in Florida.Of particular focus in this memo is the allocation of"shared direct costs." Digitech is aware of this new guidance and will review the City's allocation of costs to ensure that the reporting is consistent with applicable federal cost principles.While this was noted in the context of recent proposals submitted to CMS by states, we believe this serves a reminder that EMS cost reporting programs could soon be subjected to additional scrutiny for impermissible cost-shifting to Medicaid. In addition to the allocation of costs described above, Digitech will commit to the following activities. + We will prepare all working files and present a draft cost report to the City.Working files serve as the bridge from source data to the calculations in the cost report,and they provide backup for any audit inquiries. Digitech believes that it is important and necessary that our process is fully transparent so that the City can have confidence that when they sign off on the final cost report, they understand what they are certifying. + Following the presentation of the working files and draft cost report,we will solicit feedback from the City and make revisions necessary to finalize the initial cost report submission package.We find that there are few,if any,changes required to the cost report at this stage,but we prefer to build in a minimum of 5-10 working days to incorporate final edits. + We will submit the cost report and any required supporting documentation to AHCA no later than November 30.In the event AHCA extends the deadline,we will adhere to AHCA's revised schedule. We will notify the City of any changes to AHCA's schedule for cost report submission or payment disbursement. ©2023 Digitech Computer LLC RFP No.2023-015-ND ills► Digitech + We will promptly respond to audit requests from AHCA auditors, CMS, or the Office of the Inspector General. Because we will have working files readily available, we don't anticipate any issues with responding to auditors in a timely manner. In the unlikely event that the desk review or audit results require further action,we will incorporate revisions as needed into the cost report and work with the City to certify and submit a final cost report. + We will present results of cost report audits to City stakeholders, showing our commitment to demonstrate full transparency to City leadership.We want to address any of the City's questions or concerns prior to submission of the cost report to AHCA, but if there are any issues that arise during the audit process,we will keep the City engaged. + The final step of the process is working with AHCA to ensure that the payment is correct and set in accordance with program guidelines. Digitech will work with AHCA and the City on the cost settlement process.We will keep the City apprised of national trends in cost recovery programs and any potential impacts on the ASPP.We will offer the City guidance and support on future Medicaid payment reforms and their relation to the ASPP and ACR. COMPARATIVE DATA One of the key benefits to the City of a partnership with Digitech is access to comparative data.We can offer the City a comparison of the City's data with de-identified data from 50 providers across the state. This allows us to determine if there are any outliers that could result in additional scrutiny from AHCA Rate Analysts.Once we are comfortable that the City's data appears to fit with the picture of the data from our other clients,we would be prepared to submit the annual cost reporting package to AHCA via Myers and Stauffer's client portal. Our team has experience in working with implementation of the Managed Care program in Florida,where we serve more than four dozen clients.Annual re-establishment of the PEMT program for Managed Care requires the submission of a Section 438.6(c) Preprint,a form that we have helped to draft in other states. Unlike the FFS program, the MCO program will require the State to track performance measures associated with the directed payment program. We commit to working with AHCA and the provider community to assist however we can in establishing measurable metrics that make sense. We will also work on your behalf to establish letters of agreement (LOAs) with each MCO. In our implementation process with our clients across the country,we routinely work with insurance carriers to set up accounts for claims processing. ADVOCACY FOR MIAMI BEACH We will also assist the City in drafting and executing any required commitment to participation and intergovernmental transfer(IGT)agreements between the City and AHCA.The City can be confident that the experience and expertise that we have with these types of programs will undoubtedly be an asset.The City will have an advocate and reliable resource to offer ongoing technical assistance on programmatic and policy issues for the PEMT FFS and MCO programs. ©2023 Digitech Computer LLC RFP No.2023-015-ND PPH, Digitech® he Digitech Computer LLC 480 North Bedford Road Building 600,Second Floor Chappaqua,New York 10514 (914)741-1919 digitechcomputer.com RFP 2023-015-ND Emergency Medical trl Transport Billing and maw Collection Services M I AM I BEACH Miami, FL June 9th, 2023 TAB 4 - Cost Proposal A r- - `F q' wad 1:,- '- ' t( 4 +'; 1^+ • - b Sr.. .. 1. --- ,..2 -i I - t 1 -fib `` a,ILW-�q'_}}��f.c;.'ter• t �•\ - un i r { ti"" ,.s I. T *h T •_•i *..ail Ef ��•4+ 1 • F No Dig itech TABLE OF CONTENTS APPENDIX B - COST PROPOSAL FORM 3 PRICE PROPOSAL 4 SUMMARY OF FEATURES INCLUDED IN DIGITECH'S PRICE 4 ©2023 Digitech Computer LLC RFP No.2023-015-ND 2 ty o'%tar, Beach Bid 2023-015-ND Digitech Computer LLC APPENDIX B COST PROPOSAL FORM Failure to submit Appendix B.Cost Proposal Form, in its entirety by the deadine established for the receipt of • ••• s will result in u u u.. belle• deemed non-res u -lye and bei u r''ected_ Proposer affirms that the prices stated on the cost proposal form below represent 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,cast 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 (Appendix B)shall be completed in its entirety. All corrections on the Cost Proposal Form(Appendix B) shall be initialed. PERCENTAGE OF REVENUE TO BE PROVIDED TO THE VENDOR Estimated Annual Gross Percentage of Revenue to the Annual Estimated Cost Item Collections2 Vendor+ (a) lb) to the City (aXb=c) 1 S1. 93;7f� 4.65 % S 69.000 SUB-TOTAL ITEM 1 S 60.000 MEDICAID ACCOUNT BILLING SERVICE Estimated Annual Annual Item Number of Medical Fee Per Claim Filed Estimated Cost Claiims2 (b) to the City la) (aXb=c) 22.0C4 $ 8_00 a 16.D32 SUB-TOTAL ITEM 2 $ 16.032 1-11e Cuty*serves Ile tilt nego+aate the percentage of revenue ra*during contact negona¢ons. The estimated amounts stated nerem are for calculat/9n purposes only..Aaual amounts ma'14 be greiffir or less mall She estimalea amounts. TOTAL ANNUAL ESTIMATED COST TO THE CITY ITEMS 1-213: $ 85,032 'he total annual es.annatea cost to the seal be uRl¢ed to allocate Cost Points in.tee E'rak ablrt of Proposals. Balance of Page Intentionally Left Blank 4125/2023 3:40 PM p 43 DID Digitech PRICE PROPOSAL We are offering a fee of 4.65% of Net Collected Revenue' for EMS billing 4• 6 5 0 services and a Medicaid claims fee of$8.00.We have prepared this proposal • 0 under several basic assumptions,including the following: + All billing, collection, and transport data provided by the City in its RFP is accurate and it is understood by both parties that Digitech has relied on the City's data for pricing purposes. If services are added or changed,Digitech reserves the right to renegotiate contracted fees. + The City will provide reasonably complete demographic information as part of your Patient Care Reports, and it is understood that crews will make best efforts to provide insurance information, social security numbers,and other demographic information. + The City will provide any remittance information received through a different account from the EMS lockbox' in a timely manner, including a listing of the ACH deposits by deposit date, referencing the carrier. + After the contract award, good faith negotiations will take place during which both the City and Digitech can discuss and negotiate specific requirements of the RFP. + The City will review claims and mark them as"ready for billing"within 30 days of the date of service. SUMMARY OF FEATURES INCLUDED IN DIGITECH'S PRICE + All hardware and software required by Digitech personnel to perform medical transport billing and collection accurately and efficiently + All mailing forms and envelopes necessary to perform all billing functions + Any postage necessary to mail billing or other information to patients, insurance companies,third parties,and attorneys + All fees associate with mailing NPPs and customer satisfaction surveys + All fees associated with a lockbox solution + Availability of a national toll free 800 number for patients, City personnel, insurance companies, attorneys,and third parties to call for information or discussion of account status + All fees related to our national database searches for patient demographic information + All fees related to the electronic submission of claims 'Net Collected Revenue is defined as total collected revenue less refunds. z Digitech requires the establishment of a bank lockbox to receive and process payments.Digitech will continue using the established lockbox solution. ©2023 Digitech Computer LLC RFP No.2023-015-ND "l Digitech + All fees and expenses associated with the hosting of our application + An electronic interface to the City's ePCR system or to any future ePCR system chosen by the City during the term of the contract + Ongoing review of ePCR documentation by qualified Digitech staff + Ongoing review and analysis of rates,policies,and procedures with City officials + Documentation compliance training for City medics through the Digitech Learning Center + Regular meetings for review of performance on a mutually agreed upon schedule + Distribution of Notices of Privacy Practices and patient surveys + Credit card processing fees 2023 Digitech Computer LLC RFP No.2023-015-ND 5