Orange County NC Website
Browse       Search
EMS Management and Consultants, Inc. have been in business since 1996 and its reputation <br /> precedes it in the ambulance service billing arena. EMS Management and Consultants, Inc. <br /> currently handle the ambulance billing for 40-plus counties within the State of North Carolina. <br /> (See Attachment 2) Additionally, the company has a number of private ambulance service <br /> clients within the State and has an extensive process in place with dedicated staff to research <br /> front end eligibility and verification of patient information. All claims initially filed are paid on an <br /> 85% success rate. There is also an extensive appeal and research process for the public. <br /> The company's process is currently allowing an ultimate return of payment of 97% for <br /> Medicare, 94% for Medicaid, and 79% for commercial insurance claims filed on behalf of <br /> existing clients. <br /> Staff recommends outsourcing the initial invoicing and insurance claim process which will free <br /> up the equivalent of .75 FTE to redirect the work on delinquent collections. This will result in <br /> an anticipated additional $150,000 in annual revenue collections. The current full-time staff <br /> member (1.0 FTE) will work as the liaison between Orange County Emergency Services and <br /> the vendor. This staff member will also work with clients who do not have insurance to <br /> establish ways by which restitution may be attained. <br /> EMS Management and Consultants, Inc. have been fully vetted concerning the expectations, <br /> policies and procedures currently in place through the Revenue Department. The company is <br /> aware of the EMS Assistance Program availability and agrees that anyone qualifying for this <br /> program will be immediately directed to Orange County staff for individual handling with no <br /> cost to the County. <br /> Estimated annual costs to outsource this operation is $195,240, which represents direct <br /> personnel costs, administrative overhead costs, operational costs, and contract costs. With <br /> the anticipated additional annual revenue of $150,000 in delinquent collections, the net County <br /> costs for this operation is estimated at $45,240. (See detailed table below): <br />