DOCUMENT

POL - Make (Privatization) or Buy Analysis: EMS Billing and Collection Services

  • TYPE OF DOCUMENT: POL - Policies/Procedures
The document provides background information on the EMS billing and collection services in Seminole County, Florida. Currently, the county has a contract with Medical Claims Processing Group (MCPG) for these services, but the performance of the contractor has been deemed unsatisfactory with a collection rate average of 42.33%. The county advertised a solicitation for these services and received three proposals from Advanced Data Processing, Inc. (ADP), L.V. Financial Services, and Sackett Medical Management. An evaluation committee determined that ADP met the county's requirements, but the award recommendation was put on hold until the budget process was completed. The document includes a summary of the collection rates during the contract period and states that other government collection rates can vary from 37% to 88%. The current contract does not provide an incentive for aggressive billing, follow-up with reimbursements, and final billing to customers. ADP's proposal includes an incentive plan based on collection rates. The document also presents the option of bringing the EMS billing function in-house by purchasing billing software and hiring two staff members. Staff believes that a 70% collection rate could be achieved in-house, resulting in cost savings compared to contracting out the function. The document concludes by requesting direction on whether to continue contracting out the EMS billing function or bring it in-house.
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