201 S. Anaheim Blvd.
Suite #300
Anaheim, CA 92805
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Fax: (714) 765-4008
www.anaheim.net
CITY COUNCIL AGENDA REPORT
City of Anaheim
FIRE AND RESCUE
DATE: APRIL 22, 2025
FROM: FIRE AND RESCUE DEPARTMENT
SUBJECT: APPROVE AGREEMENT WITH WITTMAN ENTERPRISES,
LLC, FOR EMERGENCY MEDICAL SERVICES (EMS) BILLING
SERVICES
ATTACHMENT (Y/N): YES ITEM # 11
GOVERNMENT CODE § 84308 APPLIES: YES
RECOMMENDATION:
That the City Council, by Motion:
1) Waive Council Policy 4.1 and approve an Agreement with Wittman Enterprises, LLC, to provide Emergency Medical Services (EMS) Billing Services for a five-year term commencing on May 1, 2025, with compensation based on a percentage of collections received from net collected revenues; and,
2) Authorize the Fire Chief, or designees, on behalf of the City of Anaheim (Anaheim), to execute the Agreement and any related documents, including any cost-neutral amendments and any documents contemplated by the Agreement, and to take such necessary or advisable actions to implement, fund, and administer the Agreement.
DISCUSSION:
City Council approved the transition to an in-house Ambulance Program operated by Anaheim Fire & Rescue at their regular meeting on July 28, 2020. Ambulance services were previously provided via contract by CARE Ambulance, a private ambulance provider that was also responsible for emergency medical services (EMS) billing within Anaheim.
EMS billing is a complex service that entails gathering patient insurance information, processing Medicare and Medi-Cal claims for reimbursement, continuously training on governmental regulatory requirements, and maintaining compliance with health care laws and regulations. Working with CARE Ambulance, the City received a portion of the EMS billing revenues related to Advanced Life Support (ALS) and Basic Life Support (BLS) ambulance transports, totaling approximately $1.3 million annually.
Since moving in-house, ambulances are operated by Anaheim Fire & Rescue personnel and EMS billing is managed by Wittman Enterprises, a private firm responsible for a variety of cost recovery services, including but not limited to collecting from Medicare, Medi-Cal, Private Insurance, and Private Pay for the EMS and ambulance transport provided within Anaheim. Wittman Enterprises was awarded an agreement at the May 7, Agreement for EMS Billing Services
April 22, 2025
2019 City Council meeting, following a competitive Request for Proposals (RFP) process that started on October 26, 2018. The RFP evaluation panel recommended Wittman Enterprises, at a cost of 3.9% of net collected revenues, because of their depth of experience with the Orange County EMS system, knowledge of local insurance payers, and California regulations. The lowest bidder, who proposed a cost of 3.5% of net collected revenues, did not have the same experience in California or Orange County. In California, Wittman Enterprises is the largest EMS billing company with over 140 public agencies contracting for EMS billing services. In Orange County, Wittman Enterprises provides EMS billing services for Brea, Costa Mesa, Fullerton, Fountain Valley, Huntington Beach, Laguna Beach, Newport Beach, Orange, San Clemente, Santa Ana, and Westminster.
Revenue from the Anaheim Fire & Rescue Ambulance Program has dramatically increased from the $1.3 million collected annually before the Ambulance Program transitioned in-house. Below is the history of net cost recovery from the Anaheim Fire & Rescue Ambulance Program, attributed to the diligent EMS billing services provided by Wittman Enterprises. Also shown is Wittman’s fee, 3.9% of net collected revenue. EMS billing services are vital in support of Anaheim Fire & Rescue’s Ambulance Program.
Fiscal Year Net Cost Recovery to General Fund Wittman Fee % / Amount 2019/20 $4.6 million 3.9% / $178k
2020/21 $4.1 million 3.9% / $161k
2021/22 $5.6 million 3.9% / $217k
2022/23 $9.8 million 3.9% / $383k
2023/24 $13.5 million 3.9% / $528k
2024/25 $15.6 million* 3.9% / $610k*
* Projected for Fiscal Year 2024/25
Anaheim Fire & Rescue recommends waiving Council Policy 4.1 to renew the agreement with Wittman Enterprises for an additional five (5) year term. The proposed renewal offers a reduced collection rate of 3.49% (down from 3.9%) of net collected revenues, resulting in estimated annual savings of approximately $100,000 based on past collection volumes, attributed to increased usage of the Ambulance Program each year. Renewing the contract will not result in any transition costs or service disruptions, and staff believe that conducting a new RFP process will not result in substantial savings or a higher level of service.
To establish a comparison and determine if the proposed rate of 3.49% is advantageous to the City, staff reviewed a recent Request for Proposal (RFP) issued in August 2024 by the City of Santa Ana for EMS billing services. Proposals were received by three (3) private firms. The firms were evaluated on approach to the scope of services, price, responsiveness to specifications, project team experience and client references. Based on these criteria, the City of Santa Ana awarded the contract to Wittman Enterprises at their December 17, 2024 City Council meeting (with a rate of 3.75% of net collected revenues).
The City of Santa Ana awarded Wittman Enterprises due to its extensive experience with EMS billing, successful record of helping their clients ensure compliance with local, state, Agreement for EMS Billing Services
April 22, 2025
and federal laws and statutes, and for providing services to more than 140 EMS clients in California, and most public agencies in Orange County.
During the past five years, Wittman Enterprises has met and fulfilled all contractual obligations and requirements for Anaheim Fire & Rescue. In addition, they have maintained a well-managed organization, staffed by experienced personnel knowledgeable with EMS billing, and who keep Anaheim Fire & Rescue updated on governmental regulatory requirements and maintaining compliance with health care laws and regulations.
The reduced net collections rate of 3.49% of net collections is contingent upon the City’s participation in the Public Provider Ground Emergency Medical Transport Intergovernmental Transfer Program (PP-GEMT IGT). Should the City discontinue participation or if the program ends, Wittman’s compensation will revert to 3.9% of net collected revenues effective the next billing cycle.
The City has participated in the PP-GEMT IGT program since Fiscal Year 2022/23. The PP-GEMT IGT program provides increased reimbursement to eligible public providers of ground emergency medical transport (GEMT) services by applying an add-on to the Medi- Cal fee-for-service (FFS) fee scheduled rates. Upon the City’s separation or the discontinuance of the PP-GEMT IGT program, Wittman Enterprise’s net collections rate will increase from 3.49% to 3.9% of monthly net collected revenue effective the next billing cycle. Net collected revenue is stated as a percentage of collected revenue, minus any refunds or adjustments. Participating in the PP-GEMT IGT program has benefited the City. PP-GEMT IGT revenues to the City have increased from $5.8M to $8.7M annually in the past few years and are expected to continue to grow with continued participation in the PP-GEMT IGT program.
Wittman Enterprises places great emphasis on a quality workforce, advanced technology, and a continued commitment to superior customer care and service. It is in the best interest of the City to continue contracting with Wittman for EMS billing and collection services.
Wittman Enterprises is the largest EMS billing firm in California and has sufficient personnel and expertise to continue supporting Anaheim Fire & Rescue’s Ambulance Program.
This Agreement supports Anaheim’s Strategic Plan Goal E – Support Public Safety.
IMPACT ON BUDGET:
Sufficient funds are available in Anaheim Fire & Rescue’s Fiscal Year 2024/25 General Fund Budget, and future years will be subject to the City Council’s approval of budget appropriations.
Respectfully submitted,
Patrick Russell
Fire Chief
Agreement for EMS Billing Services
April 22, 2025
Attachment:
1. Agreement