WALKER COUNTY PURCHASING OFFICE www.o.walker.xus  Email: Purchasingoco.alerixis-Telephone (936)436-4937"  1846  Amendment 001- July 26, 2024  C2360-24-013  Ambulance Billing and Collection Services Closing Date August 12, 2024 at 11:00 AM  This Addendum is being issued to answer questions received for the above listed Request for Proposal and provide information for clarification. Also, revisions have been made to the solicitation by adding al Pricing  Schedule.  1. Questions and answers are provided and attached. 2. Revise solicitation by adding the attached Pricing Schedule.  Issued By: Cheryl! L. Cowart, CTCD,CTCM  7  Signature:  Heb UeM  1301 Sam Houston. Avenue, Suite 235 Huntsville, TX77340 (936)436-4937 Purhaingecowaler.skus    Addendum 001 C2360-24-013  Ambulance Billing and Collection Services RFP  1. Please reconfirm the due date for this procurement by providing it in response to answers to Answer: As stated ont the front oft the Solicitation the due date is August 12, 2024 at 3:00 pm (CT). Answer: The received questions will be answered as they are received and an Addenda will be 3. Can you please provide greater explanation of your expectations related to any required subcontracting to minority-owned, women-owned, or other types or categories of small or disadvantaged businesses? For example, what is required with the proposal, and what is required Answer: It is not a requirement of the Walker County to designate the ethnicity of a Contractor 4. Are bidders permitted to deviate in any way from any manner of quoting fees you may be expecting? For example, ift there is a pricing page int the RFP, can bidders submit an alternate fee structure? Ifthere isi no pricing pagei int thel RFP, doyoul have any preference for how bidders should Answer: There is noj pricing page in the RFP, however, a fee schedule has been provided. Walker 5. Please describe your level of satisfaction with your current or recent vendor(s) for the same  questions.  2. What is the date by which you will answer these questions?  issued the next day of receipt.  to comply during the term of the contract?  Subcontractor.  quote fees or can bidders create their own pricing categories?  County is open to other pricing categories. purchasing activity, ifa applicable.  Answer: EMS Department has no complaints with current vendor.  Tov what extent will the location oft the bidder's proposed location or headquarters have al bearing Answer: Please see the evaluation factors listed in Section VI-Evaluation Factors. WalkerCounty prefers the Service Provider tol be located int the state ofTexas and have overall knowledge base of 7. How are fees currently being billed by any incumbent(s), by category, and at what rates?  ona any award?  EMS operations within the state ofTexas.  Answer: Please see attached Billing for Walker County. Answer: Please see attached Billing for Walker County.  8. Whate estimated or actual dollars werej paid last year, last month, or last quarter toa any incumbent(s)? 9. What were your annual contractual allowance write offs for last year or for the last 12 months?  Answer: Please see attached reports. 10. What are your per-mile ground transport charges?  Answer: $23/mile.  1    Addenda 001 C2360-24-013  Ambulance Billing and Collection Services RFP  11. What are your advanced life support emergency level 1 charges? 12. What are your advanced life support emergency level 2 charges?  Answer: $1,500.00 Answer: $1,700.00 Answer: $1,200.00 Answer: $1,200.00 Answer: $1,850.00 Answer: No Charge. currently charged? Answer: 2023  13. What are your basic life support charges?  14. What are your basic life support emergency charges?  15. What are your specialty care transport charges? 16. What are your treatment without transport charges?  17. When were the last changes to your transport rates, and are you considering raising any oft the rates  18. Are there any other charges you assess not otherwise covered by our questions?  Answer: Oxygen - $125.00 ALS Disp $450.00 BLS Disp $350.00  19. What percentage of your patients are residents versus non-residents, and do you charge the two  groups differently?  Answer: Same charge regardless of resident status. in the region and, ifs so, with whom?  20. Do you operate any shared services agreements with any other municipal or county governments  Answer: No. months?  21. What were your transports per year for specialty care transport for last year or for the last 12 Answer: No, Walker County does not have crew members with specialty certifications. Only the 22. What were your transports per year for treatment without transport for last year or for the last 12  Chiefand Assistant Chiefh have specialty certifications.  months?  2    Addendum 001 C2360-24-013  Ambulance Billing and Collection Services RFP  Answer: for fiscal year 2023 Walker County EMS had 908 transports.  23. What is your payer remit mix expressed as percentages of 100% ofv what you typically receive?  Answer: CY23: Medicare- 39%  Medicaid-11% Commercial Insurance- 16% Facilities-23% Private Pay-11%  24. How many total transport vehicles do you now operate?  Answer: 8  25. What is your average loaded miles per trip?  Answer: 11.81 Answer: No Answer: N/A  26. Do you have a lockbox provider and, ifs so, which provider?  27. Ifyoul have al lockbox provider, will that provider remain inj place as ai result ofthis procurement?  28. What EHR system does Walker County use? Answer: ESO ist the EHR Walker County uses.  29. Will we be allowed tol have access to the EHR system for billing purposes?  Answer: ESO will give billing access and NEMSIS information to the Service Provider and generally pushes all completed patient charts around midnight tot the billing company.  30. Is the use ofoff-shore staff prohibited?  Answer: Walker County prefers the Service Provider to be located in the state ofTexas and have 31. Int thel RFPi its states the Service Provider will charge a one-time all-inclusive fee for performing this service ifa applicable listed out separately in RFP. For clarification, does that mean Walker County isg goingt toi issuea as single payment fors services for the duration oft the contract or will Walker County for example issue aj payment once a month to cover all services being rendered? Answer: Transfer of data from current vendor to the awarded Service Provider is to be a one-time inclusive charge. Monthly charges for services would be billed and paid monthly.  overall knowledge base ofEMS operations within the state ofTexas.  3    Addenda 001 C2360-24-013  Ambulance Billing and Collection Services RFP  32. My assumption after reading the RFP is that we are to process claim information as provided, however I wanted to know if Walker County will handle the verification of patient insurance Answer: Walker County EMS will try and input as much insurance information as possible, however, this should primarily be handled by the billing company as a lot of times this is not  information or ist that a service the Service Provider is expected to provide?  available to them.  33. What is the historic spend for this service with Walker County?  Answer: Monthly services are currently billed at a 6% charge on amount collected, if collected within the first 120 days. After that, 16% of collected amount, current based on passage oft time  from date ofr run criteria only. Please see attached billing for these services.  PAGE 7: Section E. Billing and Collections  34. Walker County will submit tot the selected Service Provider non-billed ambulance calls with a date of service of September 1,2024 and later. The Service Provider shall invoice ambulance calls submitted by the County from that date forward. Walker County reserves the option to bill State, Local and Hospital accounts in-house. Wouldi the Servicel Provider be ablet tol bill for these accounts Answer: The Service Provider shall handle all accounts, regardless oft the entity. Walker County 35. The Service Provider will review the previous two years of EMS billing activities and make recommendations to the County on their ability to place outstanding bills and data into their new  if we could come to ai mutual agreement? prefers not tol bill anything in-house.  billing system from our current EHR Vendor. Just needing some additional clarification around this request.  Answer: Outstanding bills shall be sent to Walker County's collection agency. The awarded Service Provider will be provided the necessary information SO the outstanding bills and 36. The Service Provider will charge a one-time all-inclusive fee for performing this service if  information can be transferred. applicable listed out separately in RFP. Ist this in regard to the item directly listed above?  Answer: Yes.  37. Will Walker County, TX entertain separate bids for EMS Billing andl Bad Debt Collections? Answer: Walker County has al Debt Collections agency and does not need these services. 38. What are the total number of accounts and dollar amount of those accounts for1 the last three years?  Answer: Please see attached reports.  4    Addenda 001 C2360-24-013  Ambulance Billing and Collection Services RFP  39. Does Walker County, TX have a goal for WMOE contracts?  Answer: No.  5    Addenda 001 C2360-24-013  Billing for Walker County Fiscal Year 2023- -2024  FyBill Year  Billable Actual Billed Actual Billed AVG  Bill Year Bill Month Total Invoice  RATE Billed 6,0000%  Revenues  at6%  at 16%  2024 2024 June 2024 2024 May 2024 2024 April 2024 2024 March 2024 2024 January 2024 2023 October 2023 2023 2023 August 2023 2023 July 2023 2023 June 2023 2023 May 2023 2023 April 2023 2023 March 2023 2023 January 2023 2022 October 2022 2022 August 2022 2022 July 2022 2022 June 2022 2022 May 2022 2022 April 2022 2022 March 2022 2022 January  $ 19,185.67 $ 319,761.21 $ 19,185.71 $  $ 19,705.02 $ 281,040.93 $ 15,157.09 $ 4,547.93 7.0114% $29,688.63 $ 390,346.84 $ 19,660.30 $ 10,028.33 7.6057% $ 22,554.33 $ 303,681.59 $ 15,620.97 $ 6,933.36 7,4270% $ 23,678.32 $ 350,108.66 $ 19,403.89 $ 4,274.43 6.7631% $ 21,271.96 $ 278,630.55 $ 13,985.42 $ 7,286.54 7,5345% $ 15,756.02 $ 220,908.38 $ 11,753.89 $ 4,002.13 7.1324% $ 19,360.93 $ 288,940.98 $ 16,121.98 $ 3,238.95 6.7007% $19,798.29 $ 281,233.54 $ 15,119.67 $ 4,678.62 7.0398% $13,829.32 $ 204,747.09 $1 11,358.34 $ 2,470.98 6.7543% $12,481.32 $ 181,444.58 $ 9,929.71 $ 2,551.61 6.8789% $19,216.49 $288,321.87 $ 16,149.15 $ 3,067.34 6.6649% $19,525.46 $276,337.45 $14,813.30 $ 4,712.16 7.0658% $ 10,137.00 $ 151,595.91 $ 8,470.97 $ 1,666.03 6,6869% $ 16,791.79 $ 262,968.08 $ 15,169.97 $ 1,621.82 6.3855% $ 13,448.73 $ 194,495.29 $ 10,602.24 $ 2,846.49 6.9147% $ 13,790.30 $ 218,602.71 $ 12,711.64 $ 1,078.66 6.3084% $ 14,995.01 $ 227,777.76 $ 12,869.70 $ 2,125.31 6.5832% $ 19,698.59 $ 290,329.63 $ 16,052.37 $ 3,646.22 6.7849% $ 21,158.48 $ 312,385.70 $ 17,293.94 $ 3,864.54 6.7732% $ 16,804.73 $236,776.84 $ 12,647.88 $ 4,156.85 7.0973%  2024 2024 February $ 13,217.95 $ 187,618.36 $ 10,080.90 $ 3,137.05 7.0451% 2024 2023 December $ 18,870.90 $ 244,803.77 $ 12,178.76 $ 6,692.14 7.7086% 2024 2023 November $ 36,342.10 $ 471,060.10 $ 23,416.62 $ 12,925.48 7.7150%  2023 September $ 13,723.95 $ 183,886.53 $ 9,418.94 $ 4,305.01 7,4633%  2023 2023 February $ 11,905.84 $ 166,179.74 $ 8,809.78 $ 3,096.06 7.1644% 2023 2022 December $ 19,118.69 $ 306,838.77 $17,985.54 $ 1,133.15 6.2309% 2023 2022 November $ 13,609.01 $ 207,033.98 $ 11,709.85 $ 1,899.16 6.5733% 2022 2022 September $ 12,464.76 $ 192,135.60 $ 10,966.26 $ 1,498.50 6.4875%  2022 2022 February $ 14,626.14 $ 207,540.44 $ 11,148.27 $ 3,477.87 7,0474% 2022 2021 December $ 14,049.85 $ 215,875.24 $ 12,294.27 $ 1,755.58 6.5083% 2022 2021 November $ 16,766.40 $ 247,862.47 $ 13,735.00 $ 3,031.40 6.7644% 2022 2021 October $18,161.53 $ 282,913.45 $ 16,263.35 $ 1,898.18 6,4195% 2021 2021 September $ 14,997.39 $ 226,765.47 $ 12,771.24 $ 2,226.15 6.6136%  2021 2021 August 2021 2021 July 2021 2021 June 2021 2021 May 2021 2021 April 2021  $ 16,690.81 $250,289.59 $ 14,013.45 $ 2,677.36 6.6686% $ 16,529.21 $ 237,318.25 $ 12,865.07 $ 3,664.14 6.9650% $ 19,853.82 $ 281,113.42 $ 15,075.01 $ 4,778.81 7.0626% $ 19,186.16 $ 286,919.21 $ 16,033.09 $ 3,153.07 6.6870% $ 14,127.05 $ 207,818.17 $ 11,474.68 $ 2,652.37 6,7978% $ 14,088.02 $ 213,106.57 $ 12,056.59 $ 2,031.43 6,6108%  2021 March    Addenda 001 C2360-24-013  Billingf for Walker County Fiscal Year 2023 -2024  2021 2021 February $ 11,266.12 $ 169,622.49 $ 9,524.14 $ 1,741.98 6.6419% 2021 2020 December $ 14,890.84 $240,134.62 $ 14,118.23 $ 772.61 6.2010% 2021 2020 November $ 14,115.01 $ 224,502.69 $ 13,082.95 $ 1,032.06 6.2872% 2020 2020 September $ 12,344.57 $ 203,375.14 $12,117.33 $ 227.24 6.0699%  2021 2021 January 2021 2020 October 2020 2020 August 2020 2020. July 2020 2020 June 2020 2020 May 2020 2020 April 2020 2020 March  $ 12,100.52 $ 189,530.15 $ 10,934.25 $ 1,166.27 6.3845% $ 16,762.32 $277,400.30 $ 16,572.50 $ 189.82 6,0426% $ 13,116.33 $217,757.41 $ 13,034.49 $ 81.84 6.0234% $ 12,240.69 $ 201,793.27 $12,027.43 $ 213.26 6.0660%  $ 12,416.77 $ 206,952.11 $ 12,416.77 $ $16,303.50 $271,730.63 $ 16,303.50 $ 9,372.27 $ 156,209.04 $ 9,372.27 $ > 171.35 $ 2,855.79 $ 171.35 $  5.9998% 5,9999% 5,9998% 6.0001%    E8ER88898 98E18  goNpgo  9888-8908  ERRPR90  858936-  SEERPE6"  8E69RP  gNN  3883886" 5585656  SEego  889893803 BEGEESEE  #Fgs-  38E9a8R"E  888888300    B3HIEE 5514555 BIBBEBEBEBEE S8BERES" 80 f $888: 3888988-5 S9E4E 8888 $998888"" 5845565  AEpp2a  s  888EE  02 BE $585885 - AIEIEE S5EER MI 868888  9558888 8585" Gjs  ssE  #98358:" 394-88800 6889X5609 833986"  N 8  d8e  15382690" 358 134839" 36566 8588"8875 551565  8882388 de 8688  a33RaB- $1515 388888 E838FRE7 4465554  6P-EOs: seNgae    Pricing Schedule  1. 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