According to the RFP, the Pinellas County Safety and Emergency Services Department’s Financial Services Division is seeking ambulance services billing software to improve its ability to efficiently submit claims for commercial insurance, Medicaid, Medicare and customer invoices while maintaining Health Insurance Portability and Accountability Act (HIPAA) compliance.
For context, the department currently includes ambulance services under the trademark name Sunstar. Sunstar ambulance services are operated by the county’s third-party vendor, Paramedics Logistics, and serve nearly 1 million people with emergency, nonemergency and mental health medical transports.
All transports are billed to facilities, insurance providers, Medicare, Medicaid, private air ambulances and citizens who use these services. More specifically, the department has a mix of county-based and outsourced medical billers, the latter of which are provided via a third-party vendor called EMS Management & Consultants.
“Claims are produced using various tools from disparate sources,” the RFP states. “Data is manually transferred from two different computer-aided dispatch (CAD) software systems and our electronic Patient Care Reporting (ePCR) product used in the field to produce claims in Zoll RescueNet. We process approximately 500 (emergency and nonemergency) claims daily with total collections exceeding 80 million dollars annually.”
The county is looking for a new system that meets the following requirements:
- System data and communications must be secured according to Pinellas County standards
- Secure data transfer capabilities must apply to scheduled backup or real-time duplication to county servers
- Details regarding disaster recovery and related uptime service level agreement options must be provided
- Details regarding maintenance windows and other scheduled downtime must be provided
- The ability to integrate with third-party vendors who process specified claims on the county’s behalf must be provided
