Finance and Management Services
www.santa-ana.org/finance
Item # 17
City of Santa Ana
20 Civic Center Plaza, Santa Ana, CA 92701
Staff Report
December 17, 2024
TOPIC: Ambulance and Paramedic Billing and Collection Services
AGENDA TITLE
Agreement with Wittman Enterprises, LLC for Ambulance and Paramedic Billing and Collection Services (Specification No. 24-104) (General Fund)
RECOMMENDED ACTION
Authorize the City Manager to execute an agreement with Wittman Enterprises, LLC to provide ambulance and paramedic/medical billing and collection recovery services, based on a contingent collection fee rate of 3.75%, for a term beginning January 1, 2025 and expiring December 31, 2027, with provisions for three optional one-year extensions (Agreement No. A-2024-XXX).
GOVERNMENT CODE §84308 APPLIES: Yes
DISCUSSION
The Treasury and Customer Service Division of the Finance and Management Services Agency (“FMSA”) is responsible for the administration of the City’s ambulance/ paramedic billing and cost recovery services. The primary tasks include the following:
•Assure the City is reimbursed in a timely manner for emergency medical services (“EMS”) and transport provided through the City’s contracts with the Orange County Fire Authority (“OCFA”) and Falck dba Care Ambulance Services (“CARE”).
•Maximize the legal cost recovery to the City from all resources, including but not limited to, Medicare, Medi-Cal, Private Insurance, and Private Pay for the EMS and transport provided.
•Manage provider compliance with Medicare and Medi-Cal to ensure the City has a record of clean claims and a history of proper billing. •Supply comprehensive revenue recovery involving appeal of Medicare, Medi-Cal, and private insurance denials, researching all private pays to find viable insurance, and working with patients to arrange alternate methods of repayment. •Help coordinate patient participation in the City’s paramedic subscription program with other insurance coverage payments.
•Support the City’s efforts in the upcoming contract cycle to develop policies pertaining to billing and collection efforts, as well as hardship guidelines. These
Ambulance and Paramedic Billing and Collection Services December 17, 2024
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efforts will incorporate standard and accepted industry practices to ensure compliance with the most recent legislation.
EMS billing and collections 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 dynamic health care laws and regulations. The tasks listed above are accomplished using a third-party billing and collection recovery service provider.
Request for Proposals (RFP) 24-104 was issued on August 22, 2024 on the City’s online bid management and publication system. A summary of vendor participation and results is as follows:
351 Vendors notified
1 Santa Ana vendor notified
20 Vendors downloaded the RFP packet
3 Proposals received
0 Proposals received from Santa Ana vendors
Proposals were solicited, opened on September 26, 2024, and evaluated. Three proposals were submitted by the RFP deadline and all three were determined to be responsive to the specifications and meet the City’s requirements. An evaluation committee reviewed and rated the proposals according to the criteria listed in the RFP.
The following summarizes the responding firms and their rankings:
Firm Location Rank
Wittman Enterprises, LLC Rancho Cordova, CA 1
Digitech Chappaqua, NY 2
GeBBS Healthcare Solutions, Inc. Culver City, CA 3
The evaluation committee of three City FMSA staff members evaluated proposals in accordance with the RFP criteria, and determined that Wittman Enterprises, LLC best met the City’s specifications, demonstrated vast experience working in this field, and has the capacity to meet the City’s current and future needs.
Staff recommends the selection of Wittman due to its extensive experience and its specialty with invoicing, categorizing, recording, monitoring, supervising, and managing of ambulance billing and EMS cost recovery systems and services. Furthermore, staff is confident in Wittman’s capability to promote, administer, and collect on the City’s Paramedic Subscription Program if that optional service is triggered.
For the City Council’s knowledge, the Paramedic Subscription Program is currently managed by the Treasury and Customer Services Division. The Program is voluntary and provides coverage of emergency paramedic services within the City of Santa Ana to permanent residents at the cost of one annual subscription fee, presently $70. The Ambulance and Paramedic Billing and Collection Services December 17, 2024
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subscription fee, included as part of the Miscellaneous Fee Schedule, may be changed by the City Council in compliance with certain Medicare guidelines.
Lastly, for the City Council’s knowledge, Wittman Enterprises has provided their clients complete ambulance billing services in compliance with current local, state, and federal laws and statutes since 1991. Additionally, Wittman presently provides services to more than 140 public EMS clients in California, including 12 cities in Orange County such as Santa Ana’s neighboring cities of Anaheim, Orange, Costa Mesa, and Fountain Valley.
ENVIRONMENTAL IMPACT
There is no environmental impact associated with this action.
FISCAL IMPACT
Payment for services is contingent upon successful collection; Wittman will share in the total revenue recovered from their billing/collection efforts and paid from the Fire Suppression / EMS Contract Services Professional account (no. 01115330-62300).
Revenues generated as a result of this agreement will be as follows:
•Paramedic Subscription Fee (Ambulance Transport) – 01115002 - 53509 •Paramedic Services Charge (Paramedic Subscription Program) – 01115002 - 53510
EXHIBIT(S)
1. Consultant Agreement for Wittman Enterprises, LLC
2. RFP No. 24-104
Submitted By: Kathryn Downs, FMSA Executive Director
Approved By: Alvaro Nuñez, City Manager