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01-20-2015 City Council Study Session Packet City of Grand Island Tuesday, January 20, 2015 Study Session Packet City Council: Linna Dee Donaldson Michelle Fitzke Chuck Haase Julie Hehnke Vaughn Minton Mitchell Nickerson Mike Paulick Roger Steele Mark Stelk Mayor: Jeremy L. Jensen City Administrator: Marlan Ferguson City Clerk: RaNae Edwards 7:00 PM Council Chambers - City Hall 100 East 1st Street Grand Island Study Session - 1/20/2015 Page 1 / 33 City of Grand Island Tuesday, January 20, 2015 Call to Order This is an open meeting of the Grand Island City Council. The City of Grand Island abides by the Open Meetings Act in conducting business. A copy of the Open Meetings Act is displayed in the back of this room as required by state law. The City Council may vote to go into Closed Session on any agenda item as allowed by state law. Invocation Pledge of Allegiance Roll Call A - SUBMITTAL OF REQUESTS FOR FUTURE ITEMS Individuals who have appropriate items for City Council consideration should complete the Request for Future Agenda Items form located at the Information Booth. If the issue can be handled administratively without Council action, notification will be provided. If the item is scheduled for a meeting or study session, notification of the date will be given. B - RESERVE TIME TO SPEAK ON AGENDA ITEMS This is an opportunity for individuals wishing to provide input on any of tonight's agenda items to reserve time to speak. Please come forward, state your name and address, and the Agenda topic on which you will be speaking. Grand Island Study Session - 1/20/2015 Page 2 / 33 City of Grand Island Tuesday, January 20, 2015 Study Session Item -1 Ambulance Billing Presentation by Life Line Billing Systems, LLC dba. LifeQuest Services Staff Contact: Cory Schmidt, Fire Chief Grand Island Study Session - 1/20/2015 Page 3 / 33 Council Agenda Memo From:Cory Schmidt, Fire Chief Meeting:January 20, 2015 Subject:EMS Billing Item #’s:1 Presenter(s):Cory Schmidt, Fire Chief William Clingman, Interim Finance Director Background Currently the City of Grand Island Finance Department staff processes the billing of all ambulance department services. This requires staff time equivalent of 1.5 FTEs in the Finance Department. A request for proposals (RFP) was sent out in August of 2014 in search of an Ambulance and Fire Department billing service provider. The City received three responses and the selection committee invited two for in-depth demonstrations. The recommendation the selection committee is bringing forward is a contract with Life Line Billing Systems, LLC, doing business as LifeQuest Services. Discussion With recent changes in the healthcare industry requiring continued training of city staff to understand the constant changes of rules and regulations surrounding ambulance billing, a third party vendor will be able to bring efficiency as well as expertise in Emergency Management Services billing and collections of insurance submission. LifeQuest Services has the expertise that is required and the ability to keep up to date on the ever changing environment of healthcare billing and insurance submission. The charge for the billing services that LifeQuest will perform for the City is 6% of net fees collected on behalf of the City of Grand Island. For the 2014 fiscal year this would have equated to approximately $72,000 in fees. In reviewing the LifeQuest proposal, we believe the City will reduce the 1.5 FTE staff time spent on ambulance billing to .5 FTE or less. Grand Island Study Session - 1/20/2015 Page 4 / 33 Conclusion This item is presented to the City Council in a Study Session to allow for any questions to be answered and to create a greater understanding of the issue at hand. It is the intent of City Administration to bring this issue to a future council meeting for approval. Grand Island Study Session - 1/20/2015 Page 5 / 33 FIRE Ambulance Billing Grand Island Study Session - 1/20/2015 Page 6 / 33 FIRE History of Ambulance Billing Finance Department has billing services since 1980 One and a half city employees perform duties Future complications of billing: ICD-10, NEMSIS 3.0, and Medicare requirements Full time position currently open due to retirement Grand Island Study Session - 1/20/2015 Page 7 / 33 FIRE Finance Department issued Request for Proposal in August 2014 Three proposals received Evaluated by an Ambulance Billing Committee LifeQuest Services was chosen due to lowest price and services offered Request for Proposal Grand Island Study Session - 1/20/2015 Page 8 / 33 EMS & Fire Billing PartnershipWithGRAND ISLAND,NEBRASKA20 January 2015Grand IslandStudy Session - 1/20/2015Page 9 / 33 LifeQuest:Discussion Points•Introduction/Overview–Grand Island EMS and Fire Department Priorities–LifeQuest Background•Perspective: Billing/Collections Success•Summary–LifeQuest Partnership–Questions and Answers1Grand IslandStudy Session - 1/20/2015Page 10 / 33 Grand Island Fire DepartmentMission Statement: “The Grand Island Fire Department promptly responds to emergencies that threaten life, property, and the environment. We are dedicated to the prevention of these emergencies through planning and public education.”Additional Attendees:William Clingman, Interim Finance DirectorMarlan Ferguson, City AdministratorJeremy Jensen, MayorCory Schmidt, Fire ChiefCity Council:Linna Dee DonaldsonMichelle FitzkeChuck HaaseJulie HehnkeVaughn MintonMitch NickersonMike PaulickRoger SteeleMark Stelk2Grand IslandStudy Session - 1/20/2015Page 11 / 33 LifeQuestSenior TeamPresenter Michael  Finn Ted Wolf Chip (Earl) Kramer Tim RosinOverviewCEOOwner, Client Partnership DevelopmentCFOFinancial Forecasting/Annual BudgetingSr. Business Dev. ExecutiveSales Project Manager/TrainerSales/Marketing ManagerClient/Customer Care/Business DevelopmentExperience/BackgroundOperations Executive, Performance Improvement Specialist, Consulting, Financial Back OfficeChief Financial Officer, Controller, Financial Analyst, Senior AuditorRetired Fire Captain and Training Officer, Trauma Specialist, Flight Paramedic, Ambulance Service General ManagerEMT‐Paramedic, Director of Paramedic Operations, Internal Auditor, Business DevelopmentEducation/CertificationsUniversity of IL, BS in Nuclear EngineeringThe London School of Economics and Political Science, MsCUniversity of Chicago, MBAUniversity of WI, BS in Business Administration/Accounting Evans Scholarship recipientUniversity of WI, MBA University of Southern CO, Biology/ParamedicineTrauma Specialist/AeromedicalFirefighter IIIFox Valley Technical College, EMT‐Paramedic, Accounting and Business Administration3Grand IslandStudy Session - 1/20/2015Page 12 / 33 LifeQuestBackground•History•Executive/Ownership Team•Key Tenets/Success Criteria–Focus–Results–Fortune 500 Skills/Nimble Delivery–Best Practice Based Partnership–Internal Expertise, Process Control, Tier 1 Partners•Competitive Advantage 4Grand IslandStudy Session - 1/20/2015Page 13 / 33 Inhouse versus Billing Partner•Results – specialists collect more and drive effective processes•Expertise/Experience  – billing companies deal with hundreds of companies – utilizing best practices, lessons learned and thousands of situations with insurance companies, providers, Medicare, Medicaid•Costs/Efficiency – staff/healthcare/postage/legal/processing – billing companies manage the money and take the costs out of your equation•Compliance ‐changing laws and requirements are difficult for an individual or small staff to master and ensure up to date•Trained and certified expert staff •Technology, NEMSIS3, ICD10, Audits,5Grand IslandStudy Session - 1/20/2015Page 14 / 33 LifeQuest:Your Billing PartnerLifeQuestis dedicated to EMS and Fire Billing and Collections •We bring our expertise to provide the Grand Island Fire Department the most comprehensive package in the market today –one that delivers revenue recovery results•We have a unique mix of deep industry expertise and field experience, great success in revenue recovery, and a corporate/operations ownership team•We are confident our suite of services, delivery and execution, and ability to customize makes our services the best value decision a partner in any state can make6Grand IslandStudy Session - 1/20/2015Page 15 / 33 Industry Expertise•Industry Experts•Knowledgeable in Local, State and Federal Rules, Regulations and Laws–Closely Work with WPS–Work with MACs, Partners Across the US–Best Practice View/Processes/Measures•Professionally Trained, Certified CACs•Business Owners and Operators•Innovative Revenue Recovery Support (TRIP)7Grand IslandStudy Session - 1/20/2015Page 16 / 33 Compliance•Unblemished Compliance Record•Expert In‐House Compliance Officer, Support and Legal Partnerships•Licensed/Bonded Collection Agency•Internal Compliance Audits–SAS 70 type II (SSAE‐16) –Professional Practices Management System Certification (PPMS™) ‐Compliant Network Security–PCI DSS Certification8Grand IslandStudy Session - 1/20/2015Page 17 / 33 Billing Processes•Seamless Workflow•Information Verification•Hospital Database Accessibility•Claim Accountability •Report Card Tracking•Quality Assurance •Accountability9Grand IslandStudy Session - 1/20/2015Page 18 / 33 Patient Support/PhilosophyCustomer Service Phone Hours24 Hour Coverage Sunday 4:30 p.m. through Friday 5:30 p.m. CSTDelinquent Account Collections OnlySaturday 8 a.m. to 12 noon CST•All inquiries addressed promptly•Knowledgeable, friendly staff•All incoming and outgoing calls are digitally recorded•Bilingual staff, Foreign Language Translation•Toll Free Access Numbers10Grand IslandStudy Session - 1/20/2015Page 19 / 33 Patient Support TechnologyPatient information sitewww.MyAmbulanceBill.comPatient ambulance surveyexample:  www.research.net/s/(by Client) 11Grand IslandStudy Session - 1/20/2015Page 20 / 33 Implementation Process•Target Billing Date •Critical Data Profile/Data Accumulator•Pre‐Billing Setup•Technology and Interface Testing•Review Processes, Confirm Protocols•Continual Training•Reports, Report Card, Best Practice Assessments12Grand IslandStudy Session - 1/20/2015Page 21 / 33 ImplementationProcess13Grand IslandStudy Session - 1/20/2015Page 22 / 33 Your LifeQuest Partner TeamBecky GrimmCompliance Officer/Continuous Quality Improvement (CQI)920‐787‐2291 #208bgrimm@lifequest‐services.comCompliance, Quality Assurance, Process Improvements and SSAE‐16 (SAS 70 Type II)Peder CulverOperations Manager920‐787‐2291 #163pculver@lifequest‐services.comPayment Processing, Refunds and Finance SupportElissa ArmstrongBilling Services Manager920‐787‐2291 #104earmstrong@lifequest‐services.comRevenue Recovery, Management and Patient CareTed WolfChief Financial Officer920‐787‐2291 #149twolf@lifequest‐services.comFinance, Accounting, and Revenue ReportingJim MulveyIT Manager920‐787‐2291 #246jmulvey@lifequest‐services.comTechnology ‐infrastructure, and development Kay ForetCollections Manager920‐787‐2291 #214kforet@lifequest‐services.comRevenue Recovery, Management and Patient Care Shawna FingerBilling Specialist/CAC920‐787‐2291 #115sfinger@lifequest‐services.comClaims Coding, Support SpecialistMichael FinnChief Executive Officer920‐787‐2291 #144mfinn@lifequest‐services.comOperational Oversight, Business Development andCompany GrowthChip KramerRetired Fire Captain and Training OfficerSenior Business Development Executive920‐787‐2291 #140chip@lifequest‐services.comSales, Client development and Support,ImageTrend/interface consulting.Tim RosinEMT‐P, Hazmat TechClient Relations/Sales Manager920‐787‐2291 #160twrosin@lifequest‐services.comClient Relations, Marketing Development and Sales Growth14Grand IslandStudy Session - 1/20/2015Page 23 / 33 Our Recent Partners/References•Lincoln, NE•Coral Springs, FL•Racine, WI•Cherokee County, GA•Salisbury, MD•Omaha, NE•Carlsbad, NM•Guam•City of Dallas, TX15Grand IslandStudy Session - 1/20/2015Page 24 / 33 Our Success is Determined by Our Client Partner Success16Grand IslandStudy Session - 1/20/2015Page 25 / 33 Questions and Answers17Grand IslandStudy Session - 1/20/2015Page 26 / 33 Appendix18Grand IslandStudy Session - 1/20/2015Page 27 / 33 Your Revenue Recovery Partner•Assist you with billing database setup, all regulations, customized reporting and best practice assessments•Train all personnel on documentation andmedical necessity•Train your trainers for ongoing sessions •Provide follow up training sessions via audio, webinar, or in person•Quarterly/Annual reviews and comparative report•Client log in site: https://lifequest‐services.com19Grand IslandStudy Session - 1/20/2015Page 28 / 33 Competitor Billing $0.00$200,000.00$400,000.00$600,000.00$800,000.00$1,000,000.00$1,200,000.000 306090120150180210Accounts Receivable BalanceAgeCompany X Aged Accounts ReceivableOct‐12 A/R BalanceNov‐12 A/R BalanceDec‐12 A/R BalanceJan‐13 A/R BalanceFeb‐13 A/R BalanceMar‐13 A/R BalanceRFP2013‐18Addendum 2 Exhibit 220Grand IslandStudy Session - 1/20/2015Page 29 / 33 LifeQuestBilling Results $‐ $200,000.00 $400,000.00 $600,000.00 $800,000.00 $1,000,000.00 $1,200,000.00 $1,400,000.000 316191121151Over 180 Collections(210)Accounts Receivable BalanceAgeCompany W Aged Accounts ReceivableOct‐12 A/R balanceNov‐12 A/R BalanceDec‐12 A/R BalanceJan‐13 A/R BalanceFeb‐13 A/R BalanceMar‐13 A/R BalanceCW‐2013 SweetsoftAmazon, Latitude, LQ 21Grand IslandStudy Session - 1/20/2015Page 30 / 33 LifeQuestOrganization Chart22Grand IslandStudy Session - 1/20/2015Page 31 / 33 Sample Partner Best Practice: Missing Signatures0.0%2.0%4.0%6.0%8.0%10.0%12.0%14.0%May‐14 Jun‐14 Jul‐14 Aug‐14 Sep‐14PERCENTAGE MISSEDPERCENTAGE MISSED0102030405060May‐14 Jun‐14 Jul‐14 Aug‐14 Sep‐14Reasons for Missing Signatures ‐TrendingMISSING LANGUAGE GUARDIANMISSING LANGUAGE FOR RN/CREW SIGMISSING CREW SIGNATUREMISSING RECEIVING FACILITY SIGNO ADDRESS OF SIGNOR, NO REASON WHY PT CANNOT SIGNNO PRINTED NAME OF SIGNORNO REASON WHY PT CANNOT SIGNNO RELATIONSHIP TO PTNOT APPLICABLE ‐VALID SIG23Grand IslandStudy Session - 1/20/2015Page 32 / 33 24Grand IslandStudy Session - 1/20/2015Page 33 / 33