Medicare Consultant, Ambulance Billing & Financial Services

Post InformationPosted At:Tue, Nov 15, 2022 12:06 PMSealed Bid Process:Yes (Bids Sealed / Pricing Sealed)Private Bid:No1. Introduction1. SummaryIn accordance with attached specifications, it is the intent of Pinellas County to establish a contract for Medicare Consultant, Ambulance Billing & Financial Services, as and when required.2. BackgroundGiven the highly regulated nature of medical billing, the Pinellas County Safety and Emergency Services (SES) Department has historically utilized a Medicare consultant to navigate the complexities of billing ambulance claims subject to Title XVIII of the Social Security Act, commonly know as Medicare. The Financial Service Division of SES processes approximately 180,000 ambulance claims annually with a payer mix of: 55% Medicare and Medicare Part C Plans; 8% Medicaid; 20% Commercial Insurance; 9% Facilities; and 8% Patient pay. The application of rules and regulations pertinent to the predominant portion of Medicare in the payer mix is highly scrutinized at the Federal level. These services require a vendor that is highly proficient and experienced in this area of law. The continuity of contracting with a vendor to provide these services is critical to SES operations and to avoid/reduce the potential of civil or monetary penalties associated with Medicare billing. These services consist of technical guidance, claim level review, interpretation/application of new or revised regulations, post-billing audits, and keeping the Department abreast of pending regulations and trends impacting the ambulance industry.3. Contact InformationPamela UlrichLead Procurement Analyst Email: plulrich@pinellascounty.orgPhone: (727) 464-3150Department:Safety & Emergency Services - Ambulance Billing & Financial Services4. TimelineRelease Project Date:November 15, 2022Question Submission Deadline:December 1, 2022, 3:00pmSubmission Deadline:December 13, 2022,