AGENDA CITY COUNCIL - Granicus

ACTION:

____________________________ Clerk/Secretary

Department: Fire Item No: C8

Prepared by: Cynthia Graciano, Management Analyst Meeting Date: March 24, 2020

Approved by: Ned Vander Pol, Fire Chief Patrick Johnson, City Manager Agenda Location: Consent Calendar

SUBJECT: EMERGENCY MEDICAL SERVICES BILLING SERVICES AGREEMENT

RECOMMENDATION: Adopt City Council Resolution 2020- , approving the agreement with Wittman Enterprises, LLC for emergency medical services billing services.

CORRELATION TO CITY COUNCIL GOALS: Supports the following City Council goals: (1) Fiscal Responsibility and (2) Public Safety.

PRIOR ACTION: On May 13, 2014, adopted City Council Resolution No. 2014-64, approving an agreement with Critical Care Specialty Billing, Ltd. for emergency medical services billing services (Vote: 4-1, Campbell opposed).

STATEMENT ON THE SUBJECT: The current agreement for Emergency Medical Billing Services is set to expire on May 12, 2020. On November 4, 2019, the City issued a Request for Proposals (RFP) for Emergency Medical Services Billing Services. The RFP was sent to eight vendors, was noticed in the U-T San Diego publication, and was placed on the City’s website and on eBidboard. On December 16, 2019, five proposals were received and three were deemed responsive, as follows:

Company Name Location Digitech Computer, LLC Chappaqua, NY Non-Responsive EMS Management & Consultants, Inc. Winston-Salem, NC Quick Med Claims, LLC Pittsburgh, PA Non-Responsive R1 RCM, Inc. Chicago, IL Wittman Enterprises, LLC Rancho Cordova, CA

Staff reviewed the responsive proposals based upon criteria identified in the RFP, including qualifications, technical expertise, and price/fees. Based on the evaluation of the three responsive proposals, staff recommends awarding the contract to Wittman Enterprises, LLC (Wittman). Wittman was determined to be the most responsive to the RFP due to their extensive billing experience, especially with other North San Diego County fire agencies, and their established relationship with the local hospitals. Wittman is solely focused on emergency medical billing and they have extensive knowledge of California laws and regulations governing the emergency medical field. Based on these factors, staff recommends the City Council approve an agreement with Wittman Enterprises, LLC. The proposed agreement is for five years.

AGENDAREPORT

CITY COUNCIL COMMUNITY DEVELOPMENT COMMISSION SUCCESSOR AGENCY BUENA SANITATION DISTRICT JOINT POWERS FINANCING AUTHORITY

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MEETING DATE: March 24, 2020 PAGE 2 SUBJECT: EMERGENCY MEDICAL SERVICES BILLING SERVICES AGREEMENT

FISCAL IMPACT: The cost of the agreement is based on a percentage of the net revenue received. Based on historical average annual emergency medical services revenue of $3.4 million, the cost of the agreement would be approximately $144,500 per year. This expense is budgeted in the Fiscal Years 2019/20 and 2020/21 Operating Budget in the Emergency Medical Services Service Contract account (No. 0010280.521040), and will be included in future years’ operating budgets. EXHIBITS: 1. City Council Resolution No. 2020- , approving the agreement with Wittman Enterprises, LLC for

emergency medical services billing services 2. Agreement with Wittman Enterprises, LLC for Emergency Medical Services Billing Services

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00083085 2

RESOLUTION NO. 2020-

A RESOLUTION OF THE CITY COUNCIL OF THE CHARTERED CITY OF VISTA, CALIFORNIA, APPROVING THE AGREEMENT WITH WITTMAN

ENTERPRISES, LLC FOR EMERGENCY MEDICAL SERVICES BILLING SERVICES

The City Council of the City of Vista does resolve as follows:

1. Findings. The City Council hereby finds and declares the following:

A. The City of Vista requires billing services for its emergency medical servicesprogram.

B. On November 4, 2019, a Request for Proposal was sent out to eight vendors andfive proposals were received on December 16, 2019.

C. Wittman Enterprises, LLC was determined to be the most responsible proposer.

D. The City of Vista desires to enter into an agreement with Wittman Enterprises,LLC for emergency medical services billing services.

2. Action.

A. The Agreement with Wittman Enterprises, LLC is approved.

B. The Mayor is hereby authorized to execute the Agreement on behalf of the City.

Adoption. PASSED AND ADOPTED at a meeting of the City Council of the City of Vista held on March 24, 2020, by the following vote:

AYES:

NOES:

ABSTAIN:

APPROVED AS TO FORM: DAROLD PIEPER, CITY ATTORNEY

By:

APPROVED Darold Pieper

20200313100744

JUDY RITTER, MAYOR

ATTEST: KATHY VALDEZ, CITY CLERK

By:

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00081660 2 1 of 9 WITTMAN ENTERPRISES, LLC

CONTRACT FOR PROFESSIONAL SERVICES EMERGENCY MEDICAL SERVICES BILLING SERVICES

THIS “CONTRACT” is entered into by and between the “Parties” as of ___________________ (“Contract Date”).

1.0 THE “PARTIES”

The “City”:

CITY OF VISTA, a chartered municipal corporation 200 Civic Center Drive Vista, CA 92084

Working Contact: Danielle Pearson (760) 643-5349 Billing Contact: Caitlin Hepworth (760) 643-5347

The “Contractor”

WITTMAN ENTERPRISES, LLC., a California limited liability company 11093 Sun Center Drive Rancho Cordova, CA 95670

Contact: Jennifer Gentry (916) 669-4607

2.0 BASIC TERMS

2.1 The “Services” to be performed by Contractor are set forth in the Request for Proposals attached as Exhibit A.

2.2 The “Required License” for the Services is: N/A.

2.3 Contractor, an entity holding the Required License, desires to enter into this “Contract” with City for the Services.

2.4 The “Project” for which the Services are required is described in Exhibit A.

2.5 Contractor has submitted to City a Proposal to perform the Services dated December 16, 2019 (“Exhibit B”).

2.6 Any references in Exhibit A or Exhibit B to “Consultant” shall mean Contractor for the purposes of this Contract.

3.0 CONTRACT TERM

3.1 This Contract shall take effect as of the Contract Date.

3.2 This Contract shall be in effect through March 31, 2025 (“Term”).

3.3 City may terminate this Contract upon 30-days’ written notice to Contractor. In such event, or upon request of City, Contractor shall assemble all City documents in the Contractor's possession, put them in order for proper filing and closing, and deliver the documents to City. In the event of termination, Contractor shall be paid for work performed to the termination date. City shall make the final determination as to the portion of tasks completed and the compensation to be paid.

4.0 SCOPE

Contractor shall perform all Services including, but not limited to, the furnishing of all tools, equipment, materials, software, and supplies, and for furnishing all transportation, services,

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including fuel, power and water, essential communications, and the performance of all labor, work or other operations, as may be required from time to time, in accordance with Exhibit A and Exhibit B. In the event of a conflict between the provisions of Exhibit A and Exhibit B, the provisions of Exhibit A shall control.

5.0 COMPENSATION

5.1 City shall pay Contractor for the Services to be performed as set forth in Exhibit B.

5.2 An invoice for payment shall be submitted in a form satisfactory to City. At a minimum, the invoice shall include: the purchase order number, the work order number, a description of the work performed, and a total amount.

5.3 Changes in, additions to, or deductions from the Services, including increases or decreases in any item or portion of the Services, shall be set forth in a written change order executed by City and by the Contractor which shall specify:

5.3.1 The changes, additions, and deductions to be made.

5.3.2 The increase or decrease in compensation due the Contractor, if any.

5.3.3 Adjustment in the time of completion, if any.

5.4 Contract Ceiling Price

5.4.1 In no event shall City be liable for paying more than the Contract Ceiling Price for Contractor's services rendered under this contract.

5.4.2 If it becomes foreseeable that Contractor will need to perform services

such that the cumulative total of costs to City will exceed the maximum permitted by this Contract, any such cost overrun will be handled pursuant to the change order procedure in Chapter 3.08. City and Contractor recognize that City lacks authority to exceed the cost ceiling without the express authorization of the City Council. If the maximum cost to City for this Contract is exceeded unexpectedly, payment shall be made as mutually agreeable and disputes shall be handled pursuant to this Contract, but work shall cease as soon as is reasonably feasible once the cost ceiling plus allowable change orders, if any, is exceeded.

5.5 Except as provided in Exhibit B, Contractor shall not be reimbursed for any

expenses incurred in rendering services under this Contract.

6.0 CONTRACT DOCUMENTS

The Contract comprises the following documents including all additions, deletions, modifications and appendices and all addenda setting forth any modifications or interpretations of any these documents: Documents required under Exhibits A–E.

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7.0 TIME FOR COMPLETION AND COMMENCEMENT OF SERVICES

All Services under the Contract must be completed in compliance with the schedule in Exhibit A.

8.0 STANDARD OF PERFORMANCE

8.1 Contractor represents and warrants that it has the training, qualifications, experience and facilities necessary to properly perform the Services required under this Contract in a thorough, competent and professional manner. At all times Contractor shall faithfully, competently and to the best of its ability, experience and talent, perform all services described herein. In meeting its obligations under this Contract, Contractor shall employ, at a minimum, generally accepted standards and practices utilized by persons engaged in providing services similar to those required of Contractor under this Contract.

8.2 Contractor shall keep itself informed of and comply with all applicable federal, state and local laws, statutes, codes, ordinances, regulations and 1rules in effect during the Term of this Contract. Contractor shall obtain any and all licenses, permits and authorizations necessary to perform the services set forth in this Contract, including any business licenses required by City. Neither City, nor any elected or appointed boards, officers, officials, employees or agents of City, shall be liable, at law or in equity, as a result of any failure of Contractor to comply with this Section.

9.0 CONTRACTOR’S STATUS; CONTRACTOR’S EMPLOYEES

9.1 Contractor shall perform the services provided for herein in Contractor's own way as an independent contractor and in pursuit of Contractor's independent calling. Contractor is not to be considered an employee of City, nor shall any employees of Contractor be considered employees of City, for any purpose. Contractor shall be under the direction and control of City staff only as to the results to be accomplished. This Contract is not intended to create the relationship of partnership, joint venture, or association between City and Contractor.

9.2 Contractor represents and warrants that all professional services required under this Contract shall be provided by a person or persons duly licensed by the State of California to provide those types of services.

9.3 Neither Contractor, nor any of Contractor's officers, employees or agents, shall obtain any rights to retirement, health care or any other benefits which may otherwise accrue to City’s employees. Contractor expressly waives any claim Contractor may have to any such rights.

9.4 Contractor is aware of the requirements of the Immigration Reform and Control Act of 1986 and shall comply with those requirements, including, but not limited to, verifying the eligibility for employment of all of Contractor’s officers, employees, agents and subcontractors that are included in this Contract.

9.5 The payment made to Contractor pursuant to this Contract shall be the full and complete compensation to which Contractor and Contractor’s officers, employees, agents, and subcontractors are entitled for performance of any work under this contract. Neither Contractor nor Contractor’s officers or employees are entitled to any salary or wages, or retirement, health, leave or other fringe benefits applicable to employees of the City. City will not make any federal

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or state tax withholdings on behalf of Contractor. City shall not be required to pay any workers' compensation insurance on behalf of Contractor.

9.6 Contractor agrees to defend and indemnify City for any obligation, claim, suit or demand for tax, retirement contribution including any contribution to the Public Employees Retirement System (PERS), social security, salary or wages, overtime payment, or workers' compensation payment which City may be required to make on behalf of Contractor or any employee of Contractor, or any employee of Contractor construed to be an employee of City, for work done under this contract. This is a continuing obligation that survives the termination of this Contract.

10.0 CIVIL RIGHTS

10.1 Contractor agrees to comply with Title VII of the Civil Rights Act of 1964, as amended, the California Fair Employment Practices Act, the Americans with Disabilities Act of 1990, any other applicable federal and state laws and regulations hereinafter enacted.

10.2 Contractor shall not knowingly deny an opportunity or benefit, discriminate against or harass, any employee or applicant for employment on account of the person’s race, color, ethnicity, national origin, ancestry, religion, creed, veteran status, physical disability, mental disability, medical condition, marital status, sex, sexual orientation, age, or other status protected from workplace discrimination by state or federal law.

10.3 Contractor shall not knowingly give preferential treatment to any applicant for employment on the basis of race, color, ethnicity, national origin, ancestry, religion, creed, physical disability, mental disability, medical condition, marital status, sex, or sexual orientation.

10.4 This section shall be interpreted in a manner that is consistent with the California and United States Constitutions and applicable state and federal statutes governing workplace discrimination. The terms used in this section shall have the same meaning as defined in state statutes governing the same subject matter.

10.5 Nothing in this section shall be interpreted as prohibiting bona fide occupational qualifications consistent with applicable state and federal law and reasonably necessary to the normal operation of Contractor. Nothing in this section shall be interpreted as prohibiting regulations and policies to prevent nepotism or conflicts of interest.

10.6 Nothing in this Section shall be interpreted as prohibiting action taken to establish or maintain eligibility for any federal program, where ineligibility would result in a loss of federal funds to City.

10.7 To the fullest extent permitted by law and without limitation by the other provisions of this Contract relating to indemnification and insurance, Contractor shall also indemnify, defend and hold harmless City, and its directors, officers, employees and agents from and against all liability (including without limitation all claims, damages, penalties, fines, and judgments, associated investigation and administrative expenses, and defense costs, including but not limited to reasonable attorneys' fees, court costs, and costs of alternative dispute resolution) resulting from any claim of discrimination or harassment, including but not limited to sexual harassment, arising from the conduct of the Contractor or any of the Contractor’s officers, employees, agents, licensees, or subcontractors. In the event of a discrimination or harassment complaint against any employee, agent, licensee or

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subcontractors of Contractor or its subcontractors, Contractor shall take immediate and appropriate action in response to such complaint, including, but not limited to termination or appropriate discipline of any responsible employee, agent, licensee or subcontractors. The provisions of this Section survive completion of the services or termination of the Contract.

11.0 CONTROL OF SERVICES

Each Party shall appoint a representative who shall have the authority to represent and act for that Party (“Representative”). Any written or verbal directions or requests of City's Representative delivered to the Contractor’s Representative shall have the same force and effect as if delivered to the Contractor. The Contractor's Representative shall have the authority to sign any change order, coordinate the work of all subcontractors and make other decisions pertaining to the Contract.

12.0 ASSIGNMENT AND SUBCONSULTING

12.1 Neither this Contract nor any interest herein may be transferred, assigned, conveyed, hypothecated or encumbered voluntarily or by operation of law, whether for the benefit of creditors or otherwise, without the prior written approval of the City. Transfers restricted hereunder shall include the transfer to any person or group of persons acting in concert of more than twenty-five (25%) of the present ownership and/or control of Contractor, taking all transfers into account on a cumulative basis. In the event of any such unapproved transfer, including any bankruptcy proceeding, this Contract shall be void. No approved transfer shall release the Contractor or any surety of Contractor of any liability hereunder without the express consent of City.

12.2 Contractor shall be fully responsible to the City for any acts and omissions of Contractor's subcontractor, including persons either directly or indirectly employed by subcontractor, in the event Contractor subcontracts any of the work to be performed under this contract. Contractor's responsibility under this paragraph shall be identical to Contractor's liability for acts and omissions of Contractor and employees of the Contractor. Nothing contained in this Contract shall create any contractual relationship between City and any subcontractor of Contractor, but Contractor shall bind every subcontractor and every subcontractor of a subcontractor by the terms of this contract applicable to Contractor's work, unless such change, omission, or addition is approved in advance in writing by the City Manager or the City Manager’s designee. All subcontractors are subject to the prior written review and approval of the City Manager or the City Manager’s designee.

13.0 LICENSES

If a license of any kind, which term is intended to include evidence of registration, is required of Contractor, its employees, agents, or subcontractors by federal, state or local law, Contractor warrants that such license has been obtained, is valid and in good standing, and that any required bond has been posted in accordance with all applicable laws and regulations.

14.0 FINANCIAL RECORDS

14.1 Contractor shall maintain any and all documents, ledgers, books of account, invoices, vouchers, canceled checks, or records demonstrating or relating to Contractor’s performance of services pursuant to this Contract or evidencing or relating to expenditures and disbursements charged to City pursuant to this Contract. Any and all such documents or records shall be maintained in accordance with generally accepted accounting principles and shall be sufficiently complete and detailed so as to permit an accurate evaluation of the services

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provided by Contractor pursuant to this Contract. Any and all such documents or records shall be maintained for three years from the date of execution of this Contract and to the extent required by laws relating to audits of public agencies and their expenditures. It is expressly understood and agreed that the provisions of this Section will survive termination of this Contract.

14.2 Any and all records or documents required to be maintained pursuant to this Section shall be made available for inspection, audit and copying, at any time during regular business hours, upon request by City or its designated representative. Copies of such documents or records shall be provided directly to the City for inspection, audit and copying when it is practical to do so; otherwise, unless an alternative is mutually agreed upon, such documents and records shall be made available at Contractor's address indicated for receipt of notices in this Contract or the primary location from which services are rendered, whichever is closer.

15.0 OWNERSHIP OF DOCUMENTS

Upon delivery, the work product, including without limitation, all original reports, writings, recordings, drawings, files, and detailed calculations developed under this contract are the property of City. Contractor agrees that all copyrights which arise from creation of the work pursuant to this contract shall be vested in City and waives and relinquishes all claims to copyright or other intellectual property rights in favor of City. City acknowledges that its use of the work product is limited to the purposes contemplated by the scope of Services and that Contractor makes no representation of the suitability of the work product for use in or application to circumstances not contemplated by the scope of Services.

16.0 CONFIDENTIALITY

16.1 Contractor shall treat all information obtained from City in the performance of this Contract as confidential and proprietary to City. Contractor shall treat all records and work product prepared or maintained by Contractor in the performance of this Contract as confidential.

16.2 Contractor agrees that it will not use any information obtained as a consequence of the performance of work for any purpose other than fulfillment of Contractor’s scope of Services. Contractor will not disclose any information prepared for City, or obtained from City or obtained as a consequence of the performance of work to any person other than City, or its own employees, agents or subcontractors who have a need for the information for the performance of Services under this Contract unless such disclosure is specifically authorized in writing by City.

16.3 Contractor’s obligations under this paragraph shall survive the termination of this Contract.

17.0 CONFLICT OF INTEREST REQUIREMENT

Contractor agrees that, to the extent applicable, it shall comply with and be bound by all laws and regulations deriving from the relationship of the Contractor to the City, including the Political Reform Act (Government Codes Section 87100 et seq.) Chapters 2.32 or 2.33 of the Vista Municipal Code, the Community Redevelopment Act (Health & Safety Code 33000 et seq.) and all regulations promulgated thereunder (collectively “Conflict Laws”). As a condition precedent to the formation of this Contract, Contractor warrants and covenants that it is adequately informed

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regarding the obligations and duties imposed by the Conflict Laws and that to the best of Contractor's knowledge and belief, there exists no conflict of interest (under the laws) that would disqualify the Contractor from participation in any decisions arising out of the performance of this Contract. Prior to commencement of any work in the performance of this Contract, Contractor shall comply with any applicable requirements of Chapter 2.32 of the Vista Municipal Code, including any requirement to file a financial disclosure statement with the City Clerk. Contractor further agrees that no employee, agent or subcontractor for Contractor shall perform any work for the City pursuant to this Contract which will violate the Conflict Laws.

18.0 PROHIBITION OF FINANCIAL INTEREST BY CITY OFFICIAL

Contractor warrants and covenants to City that no City Official has or will have any current or future financial interest in this Contract as of the date approved, nor shall Contractor promise, offer, or enter into any written, oral or implied Contract, to provide any financial interest or remuneration of any kind or manner to any City official with respect to this Contract. For purposes of this Section, the term “City Official” shall mean and include any elected or appointed officer of City, any employee of City, or any spouse or financial dependent of a City official or employee. A violation of this provision shall render this Contract null and void and Contractor shall be subject to restitution of all fees or money paid or earned under this Contract.

19.0 DUTY OF INDEMNIFICATION

19.1 To the fullest extent permitted by law, Contractor shall (1) immediately defend and (2) indemnify City, and its directors, officers, and employees from and against all liabilities regardless of nature or type that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of Contractor, or its employees, agents, or subcontractors. Liabilities subject to the duties to defend and indemnify include, without limitation, all claims, losses, damages, penalties, fines, and judgments; associated investigation and administrative expenses; defense costs, including but not limited to reasonable attorneys’ fees; court costs; and costs of alternative dispute resolution (“Duty of Indemnification”). Contractor’s obligations to both defend and indemnify apply unless it is finally adjudicated that the liability or liabilities, in whole or in part, do not arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of Contractor or its employees, agents, or subcontractors. Defense counsel shall be approved by City.

19.2 The review, acceptance or approval of Contractor’s work or work product by any indemnified party shall not affect, relieve or reduce Contractor’s indemnification or defense obligations. This Section survives completion of the services or the termination of this contract. The provisions of this Section are not limited by and do not affect the provisions of this contract relating to insurance.

19.3 Contractor’s costs of defense shall not exceed Contractor’s proportionate percentage of fault as adjudicated by a court of law, as required by California Civil Code section 2782.8.

20.0 INSURANCE AND BONDS

Contractor shall comply with the insurance provisions set forth in Exhibit C.

21.0 SERVICE OF NOTICE

21.1 Any notice, which either Party may desire to give to the other Party, must be in writing and may be given by personal delivery to the Party’s Representative or by overnight

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courier service to the Party’s address set forth in Section 1.0. Notice may also be given by mailing it by registered or certified mail, return receipt requested, to the other Party at the address set forth in Section 1.0. Any notice given by mail will be deemed given 48 hours after such notice is deposited in the United States mail, addressed as provided with postage fully prepaid.

21.2 A Party may change its address by giving notice as provided above, and the changed address shall thereafter be deemed to be the address set forth in Section 1.0.

22.0 SPECIAL PROVISIONS

This Contract is subject to, and Contractor shall comply with, the special provisions referenced in Exhibit E, if any.

23.0 EXHIBITS

All documents referenced as exhibits in this Contract, or referenced in an exhibit to this Contract, are incorporated herein.

24.0 APPLICABLE LAW, VENUE

This Contract shall be construed and enforced under the laws of the State of California. If any action is commenced by any Party to this Contract, such action shall be filed in a court of competent jurisdiction within the County of San Diego, California.

25.0 MODIFICATIONS

This Contract contains the entire agreement, between the Parties and supersedes all prior negotiations, discussions, obligations and rights of the Parties in respect of each other regarding the subject matter of this Contract. There is no other written or oral understanding between the Parties. No modification, amendment or alteration of this Contract shall be valid unless it is in writing and signed by all Parties. [Continued on page 9.]

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26.0 EXECUTION

IN WITNESS WHEREOF; the Parties hereto have executed this Contract as of the Contract Date. “City” CITY OF VISTA, a chartered municipal corporation By: JUDY RITTER, MAYOR ATTEST: KATHY VALDEZ, CITY CLERK By: APPROVED AS TO FORM: DAROLD PIEPER, CITY ATTORNEY By: RISK MANAGEMENT REVIEW: DOLORES GASCON, RISK MANAGER By: APPROVED Darold Pieper 20200203164805

“Contractor” WITTMAN ENTERPRISES, LLC, a California limited liability company By: Name/Title By: Name/Title

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00081660 2 Exhibit A

EXHIBIT A REQUEST FOR PROPOSALS

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December 16, 2019

CITY OF

VISTARFP: Emergency Medical Services Billing Services

Wittman Enterprises, LLC11093 Sun Center DriveRancho Cordova, California 95670www.webillems.com

RFP Contact: Russ HarmsExecutive Director Of Business Development(916) 669-4628 Direct [email protected]

Setting the Standard for EMS Billing

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RFP SECTION 5.1: Organization

Principals ..............................................................................................................1

Non-Collusion Statement ....................................................................................1

RFP SECTION 5.2: Introductions

5.2.1 Letter of Transmittal ....................................................................................2

Proposers Warranty.........................................................................................3

5.2.2 General Information ...................................................................................4

5.2.3 Qualifications and Experience .................................................................16

5.2.4 References (Proprietary and Confidential) ..............................................20

Letters of Recommendation (Proprietary and Confidential)......................21

RFP SECTION 5.3: Scope of Work

Scope of Work Index from RFP .........................................................................26

Project Approach ................................................................................................32

Client Portal ........................................................................................................37

Project Methodology .........................................................................................45

Project Deliverables ...........................................................................................60

5.3.1 Deliverables Schedule .........................................................................60

5.3.2 Work Product ........................................................................................63

5.3.3 Vista Staff and Provider Scope of Work ..............................................63

5.3.4 Cost Proposal .......................................................................................64

5.3.5 Reporting ..............................................................................................69

5.3.6 Certificate of Insurance ........................................................................71

5.3.7 Financial Stability Statement ..............................................................72

5.3.8 Legal and Contract History Statement ...............................................72

5.3.9 Type of Business Entity ........................................................................72

5.3.10 Corporate Status ................................................................................72

5.3.11 Sole Proprietorship Status .................................................................72

5.3.12 W-9 Copy .............................................................................................73

5.3.13 Sample Correspondence ...................................................................73

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APPENDICES

Appendix 1: Reporting, GEMT Reporting, GEMT QAF Reporting .....................I

Appendix 2: Privacy and Security Compliance ........................................XXXIV

Appendix 3: Sample Correspondence ............................................................. XL

Appendix 4: Exceptions .................................................................................. XLV

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City of Vista: RFP: Emergency Medical Services Billing Services I 1

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Wittman Enterprises, LLC is a limited liability company (since 1991) operating out of our single office at 11093 Sun Center Drive | Rancho Cordova, CA 95670.

Principals

CEO .......................................................................................................... Corinne Wittman Wong

President/CFO ..................................................................................................... Walter Imboden

Vice President .......................................................................................................Kathryn Garcia

COO ........................................................................................................................ David Wittman

Non-Collusion Statement

Wittman Enterprises, LLC declares that this bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive; that Wittman Enterprises, LLC has not directly or indirectly induced or solicited any other bidder to put in a false bid; that Wittman Enterprises, LLC has not in any manner, directly or indirectly sought by agreement, communication, or conference with anyone to fix the bid price of Wittman Enterprises, LLC or any other bidder, or to fix any overhead, profit, or cost element of the bid price.


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5.2.1 Letter of Transmittal

Letter from our CEODecember 16, 2019

Thank you for the opportunity to introduce our qualifications and our team to you and provide the City of Vista our RFP response for Ambulance & Paramedic Billing and Collection Services. Since 1991, Wittman Enterprises, LLC has provided our clients complete ambulance and fire billing services in compliance with current local, state, and federal laws and statutes. We follow and exceed currently accepted standards for accurate, consistent, and best EMS billing practices while maximizing revenue recovery, honoring your collections philosophy, and treating each of your patients, citizens, and visitors as our own. We serve over 100 public EMS/Fire clients (10 in the San Diego County area) and are the largest California-based billing company with the client base, patient database, and experience with California departments (and multiple California payers) for the most effective EMS billing and cost recovery program possible.

As an extension of your EMS program, Wittman Enterprises will maintain a strong customer service platform that provides your team with direct phone numbers and real access to all management staff, starting with me. Staff are assigned to your team so that the City has direct access to the person(s) on our team who can most help with whatever situation may arise. Jennifer Gentry (your Client Liaison) and our entire Client Liaison Team is always available to help identify key resources you may use to get the results you need. We use all the resources necessary to provide the best in customer service and collect for our clients: (on average) 10-20% more in net revenue than our competitors.

We recognize the extraordinary depth of your EMS program as described in your RFP and based on our more than 29 years’ experience; and, we look forward to continuing to provide solutions for you moving forward. As the most qualified and experienced EMS biller in California, we want to assure the City that our ultimate focus is on, and has always been based on, the best patient and client service, billing results (accurate and legal billing and most legal, reimbursable revenue), and transparency (Client Portal, Reporting, Month-end-Reporting, KPIs, etc.).

I could not be prouder of the tremendous working relationship we have enjoyed with our EMS Partners over the last 29 years. We have worked together on multiple changes in our industry, on the GEMT/GEMT QAF rollouts and implementations, on ICD-10 conversions, and on many other CMS and industry programs. Thank you for allowing me to introduce our qualifications and commitment to the City and to your EMS/Fire team. We look forward to providing a full response to the evolving needs of your program and our enthusiastic support of it.

My best,

Corinne Wittman-Wong, CEOWittman Enterprises, LLC (established 1991)11093 Sun Center Drive | Rancho Cordova, CA 95670(916) 669-4608 direct line | (855) 611-0056 toll-free | [email protected]

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The undersigned person warrants that:

• She is an officer of Wittman Enterprises, LLC

• She is authorized to offer a proposal in full compliance with all requirements and conditions as set forth in the RFP

• She has fully read and understands the RFP and has full knowledge of the scope, nature, quantity and quality of the work to be performed, and the requirements and conditions under which the work is to be performed

• The proposal is good for 90 days from the date of submission.

BY: ________________________________________________ Corinne Wittman-Wong, CEO Wittman Enterprises, LLC Rancho Cordova, CA 95670 (916) 669-4608 direct line

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g5.2.2 General Information

About Us

Based on your RFP, you are continuing your billing program for ambulance transports and other cost recovery services for EMS you provide. Wittman Enterprises has extensive experience and specializes in the invoicing, categorizing, recording, monitoring, supervising, and managing of ambulance billing and EMS cost recovery systems/services. We bring 29+ years of EMS/Fire billing experience, and with your neighboring communities: San Clemente (since 1996); Oceanside (since 2012); Carlsbad (since 2015); San Marcos (since 2001); Escondido (since 2001); North County (since 2008); Ramona (since 1991); Poway (since 2016); Barona (since 2008); Viejas (since 2009); and Coronado (since 2001). We help each of our individual partners reach and exceed their individual and customized program objectives.

We are pleased that our high standards of performance exceed Vista demands for the following fundamental objectives and minimum services required as listed in your RFP.

• (Since 1991) Wittman Enterprises provides our clients complete ambulance billing services and solutions, accounts receivable management services, and collection services for BLS, ALS, and non-transport services in compliance with current local, state, and federal laws and statutes, in accordance with HIPAA regulations.

• We are dedicated exclusively to the EMS industry and choose to be expert in the EMS billing and collection industry rather than diversify into any other medical billing fields.

• We efficiently and effectively file claims with governmental programs such as Centers for Medicare and Medi-Cal (“CMS”) and the VA, as well as commercial health insurance.

• We follow and exceed currently accepted standards for accurate, consistent, and best EMS billing practices. We are licensed, insured, bondable, and HIPAA compliant for the State of California.

• Wittman Enterprises provides EMS billing and collection services to more than 100 public departments in California from our single Sacramento-area location.

• We will maximize revenue for the City while honoring your collections philosophy and treating each of your patients, citizens, and visitors as our own.

Solutions

Since 1991 Wittman Enterprises has provided products and services specifically designed to assure that EMS Transport, First Responder, and Fire Service providers like the City of Vista are reimbursed in a timely manner for services they provide. Wittman does not farm out these services; we coordinate them all from our single location in Sacramento, CA.

Minimum Time

Maximum Reimbursement

We

Cus

tom

Fit Our Services To M

eet Your EM

S/Fire Billing Needs

.

Solutions include:

• Ambulance Transport Billing and Fire Service Fee Recovery

• ePCR Integration

• First Responder Billing and Collection

• Treat-no-Transport Billing and Collection (Assessments)

• Membership Program Support

• Patient Survey Program Support

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gTogether We Achieve the Extraordinary: Performance History Comparison (Proprietary and Confidential)

Through streamlined efficiency, talented staff, selective automation, and continuous improvement, Wittman has as long record of strong collection returns for our clients on billed charges. Wittman Enterprises generally outperforms our competitors by 10-20% in collections for our EMS partners. Substantial successful and reliable performance in providing our services for public ambulance departments can be seen in all of our client histories; however, please consider the examples of Gross Collected Revenue in the following performance chart.

CLIENTAVERAGE ANNUAL

RUNS GROSS CHARGES

GROSS COLLECTEDREVENUE

Sacramento Metropolitan Fire District(EMS Billing Partners since 2001) 64,006 $142,766,620 $36,632,720

City of Poway (EMS Billing Partners since 2016) 2,226 $2,938,477 $1,290,195 City of Carlsbad (EMS Billing Partners since 2015) 4,473 $5,849,392 $2,494,702 City of Oceanside (EMS Billing Partners since 2012) 9,906 $11,955,159 $3,895,700 City of Escondido (EMS Billing Partners since 2001) 11,178 $21,426,915 $5,419,181

California Strong

We do not believe that any California-based biller will provide as much in actual reimbursement or complete customer service as Wittman Enterprises has historically demonstrated. We have a proven record of collecting 10-20% more than our competitors. Out-of-state billing companies will not be able to arrive at these reimbursements either, due to their lack of billing and collection experience in the State of California and inexperience with the multitude of California payers.

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gCalifornia EMS/Fire Partners (Proprietary and Confidential)

Wittman Enterprises conducts all of our work and coordinates all services from our single location in the Sacramento, California area. All production and patient service activities are conducted at 11093 Sun Center Drive in Rancho Cordova, California.

• North Tahoe

• Vernon • Downey • El Segundo • Hermosa Beach• La Verne • Montclair • Corona • Orange • Santa Ana• Costa Mesa

• Burbank • Glendale • Pasadena • Sierra Madre • Arcadia • San Marino • South Pasadena • Alhambra • Monterey Park • Huntington Beach • Costa Mesa

•

• Happy Camp

• Chester

Southern Trinity •

• Burney

• South Lake Tahoe

• Wittman Enterprises, LLC Headquarters

• San Bernardino County

• Cathedral City

• Indio

• Borrego Springs

Covelo •

Laytonville •

Santa Barbara County •

Avalon •

Monterey County •Salinas •

• Carmel

• Beverly Hills • UCLA • Culver City• West Covina• La Habra Heights• Newport Beach • San Clemente • Loma Linda• San Gabriel• Westminster• Fullerton

• Oceanside • Carlsbad • San Marcos • Escondido • Ramona• Poway• North County• Viejas • Coronado • County of San Diego • Barona Band of Mission Indians

•

Calexio •

••

• City of Sacramento• Folsom• Sac Metro• Cosumnes CSD• Butte County• Penn Valley• South Placer County• Foresthill• Ebbetts Pass• Amador County• Southern Marin County

• Coast Life• Petaluma• South San Francisco• Moraga-Orinda• San Ramon• Albany• Marin County• Ross Valley PA• Corte Madera• South Lake County• Russian River• Anderson Valley• Bodega Bay• Vacaville• Alameda• Berkeley

•

•

••

Coalinga •

• Indian Wells• Rancho Mirage

• Palm Desert

• Rialto

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gSan Diego County Area Footprint (Proprietary and Confidential)

In addition to being the interim billing partner with the City of Vista, Wittman Enterprises has strong contractual and EMS partnerships with 10 other San Diego County-area agencies.

★ Beverly Hills ★ UCLA

★ Culver City

★ Fullerton

★ West Covina

★ San Clemente, CA

★ La Habra Heights

★ Newport Beach

★ San Gabriel

★ Rialto

★ Huntington Beach

★ Barona Band of Mission Indians

★ Burbank★ Glendale

★ Pasadena ★ Sierra Madre★ Arcadia

★ San Marino★ South Pasadena

★ Alhambra★ Monterey Park

★ Vernon

★ Downey

★ El Segundo★ Hermosa Beach

★ La Verne★ Montclair

★ Corona

★ Orange★ Santa Ana

★ Oceanside★ Carlsbad ★ San Marcos

★ Escondido

★ Ramona

★ Poway

★ North County

★ Viejas

★ Coronado ★ County of San Diego

★ Costa Mesa

★ Westminster

★ Anaheim

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gPerformance

With a proven commitment to customer and patient service Wittman Enterprises conducts your business as if your patients were our own. This starts with valuing customer service with everything we have done as a Company since 1991 (living up to our Dedicated Response Time Commitment; providing ongoing and comprehensive Staff Training; availability of our Bilingual Staff; meeting regularly with our partners quarterly, etc.).

We also strive to provide up-to-the minute looks directly into our billing system and multiple ways to view records, reports, and other valuable information through our Client Portal. For ePCR interfacing and ultimate billing accuracy we work closely with most ePCR vendors like ImageTrend to ensure the quality of data we receive on your behalf for the billing process.

Finally, from all of these important areas we constantly monitor the quality of our work on your program through a series of KPIs customized to ensure the success you should expect. We are transparent to the point that our EMS partners have as much access to data and trends as they need to evaluate the success of our team at meeting your goals.

EMS Partner Satisfaction

The City of Vista can count on Wittman Enterprises to continue conducting diligent, regular, and uninterrupted billing and collection services in a professional businesslike manner. Our personal approach and higher levels of service greatly exceed industry standards. Your expectations and overall satisfaction are attained through ongoing and regular training, continuous improvement, and our comprehensive auditing program. Wittman maintains our industry-leading lowest claims-per-staff ratio (generally 30% lower than our competitors) based on upholding the standard of practice our clients expect. Our comprehensive and ongoing training program allows us to continuously improve the business activities that we conduct on behalf of the County and ensure that you continue to receive the maximum legal reimbursement available. We do not strive to be the largest EMS billing company but expect to be the best. The secret to our clients’ successful reimbursement is ultimately the personal attention we apply to each of their accounts. Simply put, it is the dedication to our process that combines the best in technology with the commitment of people to perform the hard work necessary to pursue elusive insurance Payers, successfully appeal Medicare and insurance denials, and work effectively through difficult reimbursement issues such as Medi-Cal cutbacks. The significant efforts we undertake as a commitment to our EMS partners allow us to meet and exceed client expectations (and requirements as set forth in your RFP) and achieve high client/customer satisfaction. We stand behind the work we conduct on behalf of our clients and work closely with each of them to make sure they are completely satisfied with our performance.

Maintaining our Dynamic Workforce

As we discussed in “Workload Accomplishment” (page 32), Wittman Enterprises maintains the lowest claims-per-employee ratio in the industry. Our competitors work with nearly 30% less staff than we do per claim (effectively assigning 30% more work to each of their employees) and collect less for their billing clients. By maintaining our 4,000 to 5,000 claims-per-staff-ratio, we are able to take on significant new growth without necessarily hiring any staff. Should that ratio approach and/or exceed our standard range, we hire and train staff proactively to ensure we are never operating outside of our expected customer satisfaction standards and collected revenue expectations.

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gCompany Profile

Wittman Enterprises conducts all of our work and coordinates all services from our single location in the Sacramento area. We are a Limited Liability Company (California).

Wittman Enterprises, LLC (established 1991)11093 Sun Center DriveRancho Cordova, CA 95670(855) 611-0056 (toll-free)www.webillems.com

OfficersCorinne Wittman-Wong, CEOWalter Imboden, President and CFOKathryn Garcia, Vice PresidentDavid Wittman, COO

Organization

Our staff is divided among four departments: Customer Service (60); Cash Receipts (20); Support Services/Electronic Billing (10); Data Entry (40). All departments are dedicated to the personal attention of our clients and their patients’ needs. Our staff is divided into teams to efficiently address workflow processes and are further divided based on your location. The teams assigned to the City of Vista project are the same teams that service the cities and departments of our San Diego-area clients. The San Diego “pod” has a Pod leader and a team of three to five who scrutinize all individual submitted runs and initiate the billing process. The San Diego pod begins their work after our Electronic Claims Department imports ePCR files and our system automatically scrubs the data before it goes to our Billing Department. This personal attention makes the difference between collecting the “easy” money and pursuing difficult payment situation for maximum legal reimbursement.

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gStaff Availability

All Wittman staff is available in our single Sacramento-Area office during our normal business hours.

JOB TITLE FUNCTION

CEO (1) Compliance and Company Leadership President/CFO (1) Policy, Operations, and Financial Leadership Client Liaison (4) Client bridge to Operations and Administration Division Manager: Insurance (1) Insurance Specialist and Staff Leadership Division Lead: Insurance (2) Insurance Team Day-to-Day Management Insurance Team Staff (21) Ensures that all Insurance/Medicare/Medi-Cal billing is properly billed and collected

Division Manager: Patient Services (1) Patient Services Staff and Procedure Leadership Division Lead: Patient Services (1) Performs administration duties involving client transactions, record-keeping and customer service. Provides direction to staff in the performance of their duties.

Patient Services Team Staff (12) Identifies and resolves patient billing issues

Cash Receipts Supervisor (1) Organizes work processes, methods, and procedures, ensuring efficient accounting of cash receipts Cash Receipts Team Staff (9) Ensures that cash is receipted properly and deposited in a timely manner, and that transactions are recorded accurately

Division Manager: Support Services (1) Supervises and coordinates activities of staff in Support Services department Support Services Staff (12) Performs Electronic Billing to Medicare/Medi-Cal and other payors, mailing, scanning, and PCR processing functions Billing Supervisor (2) Supervises EMS billing staff, month-end closes and reconciliation of patient receivables, aging of collections

Billing Team Lead (2) Oversees staff, workflows, and supports staff

Billing Team Staff (21) Enters PCR information into database with proper medical protocol terminology to produce a clean statement or claim

Auditing Team Lead (1) Organizes weekly focus and provides feedback to team leaders on areas of improvement or focus for ongoing training

Auditing Team Staff (3) Audits and monitors workflows, ensuring processes and quality of work are maintained within each department

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gEMS Billing Project Manager

Jennifer Gentry (CAC, CADS), Client Liaison11093 Sun Center Drive, Rancho Cordova, CA 95670(916) 669-4607 (direct line) • [email protected]

Summary: Jennifer Gentry has been with Wittman Enterprises for 22 years and is part of our Client Liaison team, with the primary responsibility of client

communications, managing client projects from start to finish and providing her clients with a direct contact for any operational or reporting or additional needs. Additionally, Ms. Gentry facilitates the integration of all ePCR systems within our billing system for individual departments. She works directly with each client and their ePCR vendor to ensure the most effective information import possible through a customized mapping process. She is also a co-moderator of our Medicare Compliance Committee and works on our Medicare documentation training program for staff and clients. Prior to joining the Client Liaison team, Ms. Gentry was the data entry and billing manager on our Operations team.

Projects: San Diego County-Area Client Liaison (Proprietary and Confidential) (Barona, Borrego Springs, Carlsbad, Coronado, Escondido, Oceanside, Poway, San Marcos, North County, Ramona, and CSA 17/CSA 69)

Work Performed: Main and regular contact between clients and our operations team; Medicare and Medi-Cal enrollments (Revalidations); Annual Medicare and Medi-Cal Updates; EDI registration and updates; specialized reporting; status and projections reporting; Monthly Account KPI Reviews; client meetings; special projects reporting, special client projects, GEMT/IGT/QAF reporting and project support, ePCR administration and transitions; Documentation Statistics for Client Portal; ePCR Import Electronic Scrubber; Transition/Onboarding of new clients; etc.

Certifications: Certified Ambulance Coder (CAC); Certified Ambulance Documentation Specialist (CADS)

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gStaffing Chart

Contract Management Team

David Wittman, COO (916) 669-4601 [email protected]

Russ Harms, Executive Director of Business Development (916) 669-4628 [email protected]

Joe Balkema, Executive IT Director (916) 669-4620 [email protected]

Corinne Wittman-Wong, CEO (916) [email protected]

Walter Imboden, President/CFO (916) 669-4602 [email protected]

Kathryn Garcia, Vice President (916) 669-4606 [email protected]

Management Team

Jennifer Bump, Division Manager: Insurance Services(916) 669-4612 [email protected]

Heather Montano, Division Manager: Patient Services(916) 669-4627 [email protected]

Nicole Powers, Division Manager: Administrative, Billing, and Cash Services(916) 669-4624 [email protected]

Stephanie Cooper-Noe (CMC, CACO, CAPO, CADS), Client Liaison: GEMT (916) [email protected]

Jennifer Gentry (CAC, CADS), Client Liaison: ePCR (916) 669-4621 [email protected]

Judy Vang (CAC, CADS), Client Liaison: Insurance (916) 669-4613 [email protected]

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gOperations Team/Experience

Jessica Ceccato, Insurance Team Lead .............................................................................12 years

Maya Ruiz, Insurance Team Lead .........................................................................................9 years

Cicely Vera, New Client Insurance Transition Specialist ....................................................5 years

Rachel Troche, Patient Services Team Supervisor ............................................................14 years

Elayne Huff, Lead Patient Services Team Lead ................................................................. 19 years

Celena Posh, Patient Services Team Lead...........................................................................5 years

Austin Boyd (CAC), Billing Team Lead .................................................................................4 years

Chia Chang (CAC), Billing Team Lead ..................................................................................3 years

Angelas Thao (CAC), Billing Team Lead.............................................................................14 years

Sheng Cha, Administrative Services Team Lead ..............................................................13 years

Pakou Vang, Cash Receipts Team Lead ............................................................................. 11 years

Renee Wittman, Cash Receipts Team Lead .......................................................................24 years

Southern California-Area Insurance Team Specialists

Our team of insurance specialists are trained and experienced with their assigned client payors so that they can manage all aspects of submission, payments, and appeals. For our Southern California partners the following specialists provide the practical experience necessary to get you your highest legal reimbursement possible:

Brittany BumpCalifornia commercial and government accounts specialist (VA, Department of Corrections, Blue Shield/Blue Cross of California, Secure Horizons, Pacificare of California, Kaiser, etc.)

Christine MarshallMed-Cal and Medi-Cal HMO accounts specialist

Priscilla JavarCalifornia Medicare and Medicare HMO accounts specialist

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gOrganizational Chart

CEO

Corinne Wittman-Wong

President/CFO

WalterImboden

Vice President

KathrynWolf-Garcia

COO

David Wittman

Executive Director of Business

Development

Russ Harms

Executive Director

(IT)

Joe Balkeman

ProjectManager

DonnaBailey

HumanResourcesManager

IngridJana

Help Desk Analyst II

Rebekah Miller

Help Desk Analyst I

Peter Khang

ClientLiaison

Stephanie Cooper-Noe

ClientLiaison

Jennifer Gentry

ClientLiaison

Judy Vang

LeadCash

Posting

PakouVang

LeadBilling

Division

Austin Boyd

LeadBilling

Division

Angeles Thao

LeadCash

Posting

Renee Wittman

LeadBilling

Division

Chia Change

SupervisorIncoming Call

Division

RachelTroche

Lead Patient Services

Celena Posh


Elayne Huff

Division Manager

Customer Service/Training

JenniferBump

Division Manager

Support Services/ e-Billing

NicolePowers

Division Manager

Customer Service/ Phones

HeatherMontano

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gSubcontracting Partners

InfoSend (Anaheim, CA):Invoicing and mailings exchanged through a secured and HIPAA-compliant method and fully-executed Business Associate Agreement.

Apexon (Southfield, MI):Pre-billing and pre-cash receipt posting data processing exchanged through a secured and HIPAA-compliant method and full-executed Business Associate Agreement.

Change Health (Nashville, TN):HIPAA-compliant electronic insurance eligibility checker (formerly Emdeon, Capario).

Industry Trends and Regulations

Through our regular association with Page, Wolfberg & Wirth, nationally recognized legal experts in EMS legal consulting, the American Ambulance Association, and regular conferences, correspondence, and training opportunities with Medicare and Medi-Cal (among multiple other payers): we are current on all industry issues and changes, remaining proactive with our clients and continually updating them on changes, opportunities, and news that affect their programs.

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g5.2.3 Qualifications and Experience

Qualifications

Wittman Enterprises has customized service innovations to our partners in the EMS transport industry since 1991. We serve more than 125 public EMS partners in the Western United States and are the largest West Coast-based EMS billing company with the client base, patient database, and experience with the San Diego County-Area departments (multiple payers) essential in providing the most effective EMS billing and cost recovery program possible.

29 Years EMS Billing Experience

Wittman Enterprises was founded 29 years ago with the promise of providing expert and personal attention to our EMS partners and their EMS billing programs. This will never change. We provide industry-leading services to our EMS partners to help you continue providing cost-effective programs and responsive services enhancing the quality of life in the City of Vista, while balancing the financial accountability needs of your citizens. With a proven commitment to customer and patient service Wittman Enterprises conducts your business as if your patients were our own. This starts with valuing customer service with everything we have done as a company since 1991 (living up to our Dedicated Response Time Commitment; providing Ongoing and Comprehensive Staff Training; maintaining well-qualified Bilingual Staff; meeting regularly with our partners quarterly, etc.).

• Wittman is dedicated exclusively to the EMS/Fire industry and chooses to be expert in that industry rather than diversify into other medical billing fields.

• Our excellent reputation is gained from professional relationships with providers and third-party payers, as well as from our sensitive yet collection-oriented communications with patients and their representatives.

• We have a long and successful history of meeting and exceeding client expectations and service deadlines.

• From the beginning of your project, we anticipate and manage for you issues such as Medicare compliance and revalidation, reconciliation of payments from legacy billing accounts, responses to legal and other requests, and customization of a reporting program surpassing your specific needs.

• Since our only business is EMS/Fire billing, our specialized staff is dedicated and expertly trained in this field.

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gCustomized Solutions

Often during our work together, new programs are created that require Wittman and our clients to work together to fully scope the new programs as well as price it and establish clear SOPs and expectations to make sure the client-chosen and/or required service additions are successful. These are not cookie cutter items; in fact, they are customized according to the needs of each individual client. In our 29 years in business we have significant experience expanding the scope of work, services, and contract to meet and exceed our EMS partner needs. We assist with recommendations, pricing suggestions, research, resources, information, and overall support to ensure the City of Vista has a PARTNER to help navigate ever-changing waters and regulations. For example:

Emergency Triage, Treat, and Transport (ET3) Model: Wittman Enterprises works with our clients on new programs such as ET3, Community Paramedicine, Alternate Destination, etc., making recommendations and trying to provide as much information and support as possible if and when the client decides on their chosen level of participation. The ET3 is a current program we are helping our clients with, through education and regular updates as well as website content and regular mailings and/or seminars as seen below:

NEWSEmergency Triage, Treat, and Transport (ET3) Model (from CMS.gov) ET3 is a voluntary, five-year payment model that will provide greater flexibility to ambulance care teams to address emergency health care needs of Medicare beneficiaries following a 911 call. Under the ET3 model, the Centers for Medicare and Medi-Cal Services (CMS) will pay participating ambulance suppliers and providers to: 1) transport an individual to a hospital emergency department (ED) or other destination covered under the regulations, 2) transport to an alternative destination (such as a primary care doctor’s office or an urgent care clinic), or 3) provide treatment in place with a qualified health care practitioner, either on the scene or connected using telehealth. Continue reading from CMS.gov (https://innovation.cms.gov/initiatives/et3/)

ET3 Webinar – March 25, 2019 (from NAEMT.org)Join leaders from NAEMT, NAEMSP and IAFC for an informational webinar on the clinical, operational and financial considerations that agencies should be evaluating NOW if they are considering applying to participate in the ET3 model.The ET3 webinar will be held on March 25, 2019 at 1 pm EST. Continue reading from NAEMT.org and complete webinar registration (http://naemt.org/events/et3-webinar)

LINKSEmergency Triage, Treat, and Transport (ET3) Model: CMS.gov (https://innovation.cms.gov/initiatives/et3/)

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gKey Personnel

Corinne Wittman-Wong, Chief Executive Officer

Corinne has been with Wittman Enterprises, LLC for more than 24 years. As CEO she is responsible for the strategic planning and vision of the company. Her strong knowledge of the industry integrates completely with her experience of working in all departments of the company and provides her with a unique perspective on our company’s philosophy and goals. She administers the supervision of our clients’ accounts, and the adherence of policies and procedures set forth by the company, while facilitating and encouraging leadership qualities, innovativeness, and direction of our employees.

Walter Imboden, President/CFO

For 29 years Walter has worked in the EMS billing industry. He oversees all aspects of the day-to-day production and operations of the company, monitoring both production and personnel. He directs the billing and collection processes ensuring adherence to our clients’ contract requirements. He develops office procedures that are designed to enhance and expedite workflow. Over the years while working in every department at Wittman Enterprises, LLC Walter has developed strategic, tactical, and short-term operations that enable him to provide invaluable guidance and training to our department managers.

Kathryn Garcia, Vice President

In her 24 years with Wittman, Kathryn has worked and managed all departments. This provides her the perspective and experience to help the City with any special requests or circumstances. Kathryn oversees the billing team and the cash receipts team. She provides the City with special reports to aid the balancing process for trips, refunds, and deposits. She also creates, reviews and distributes all client month-end reports.

Joe Balkema, Executive Director, IT

Joe brings 25 years of programming experience with C#, VB, ASP, JavaScript, and BBX, along with more than 16 years of SQL knowledge and reporting design. He has installed more than 30 billing systems nationwide. At Wittman he designs multiple client-focused programs and reporting mechanisms, and streamlined our working environment by designing a document management system to go paperless: scanning over 3,000 documents daily.

Stephanie Cooper-Noe, Client Liaison

For more than 21 years Stephanie has provided ambulance billing leadership and customer service to our clients. She develops our Compliance and Documentation Webinars, trains employees and monitors their compliance with the company’s HIPAA program, designs client-specific reports, oversees Medicare Revalidations, and provides the conduit between client finance departments, fire departments, and Wittman Enterprises, LLC. Certifications: Certified Medi-Cal Billing Associate.

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gRuss Harms, Director of Business Development

Russ brings 26 years of management leadership, direction of progressive operations, and the building of strong client partnerships to Wittman Enterprises and our clients. He specializes in organizational development and management, strategic planning, performance management, continuous improvement, business development, leadership development, and change management. Education: Master of Arts, English; Bachelor of Arts, English.

Jennifer Gentry, Client Liaison (ePCR Interface)

Jennifer has been with Wittman Enterprises for over 20 years. She facilitates the integration of ePCR systems with our ZOLL billing system. Jennifer works with each client to ensure that we have the most effective information import possible through a customized mapping process. Jennifer is also the co-moderator of our Medicare Compliance Committee and works on our Medicare documentation training program for staff and clients. Certifications: Certified Ambulance Coder.

Jennifer Bump, Division Manager (Customer Service/Training Coordination)

For more than 14 years Jennifer has been with Wittman Enterprises. She began in Customer Service, working on private insurance accounts as a specialist, working incoming and outgoing calls, and ultimately as the lead over the revenue assurance team. Later she took over as manager of our Customer Service Division. Currently she is a division manager for Customer Service, directing the specialist team working on all governmental payers. She oversees the Quality Assurance Department over cash receipts and all of the Customer Service Department, and coordinates the company training programs.

Heather Montano, Division Manager (Customer Service/Phone Services)

Starting 14 years ago, Heather began as a Customer Service Representative for Wittman Enterprises, working private pay accounts, private insurance accounts, incoming correspondence and incoming calls. Next, she was promoted to Customer Service Department Lead and then Department Supervisor where she handled client concerns and patient billing anomalies and issues. She has extensive knowledge of our Billing Program and Reporting systems. Currently Heather is the Division Manager of the Patient Services Department, overseeing inbound and outbound calls, private correspondence, auditing, and quality assurance for all calls.

Nicole Powers, Division Manager (Support Services/Electronic Billing)

Nicole has been with Wittman for over 16 years. She oversees the receiving and importing of all Patient Care Reports (PCRs), document scanning, and claim submissions (electronic billing) via paper and electronic means to all payers. Nicole continuously streamlines electronic processes and updates automation to ensure appropriate timelines are met to ensure the most timely and efficient reimbursement for our clients.

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g5.2.4 References

(Proprietary and Confidential)

As a single location leader in EMS billing, we encourage you to contact any of our references, including any of our clients that may not be listed for this proposal. We know that hearing about their experiences with Wittman Enterprises will differentiate us from our competition. Wittman Enterprises is eager to begin providing top-notch service to the City of Vista and nurture a strong working partnership.

City of Sacramento(EMS Billing Partners since 2018)Chad Augustin, Deputy Chief Fire Ops/EMS(916) [email protected]

Sacramento Metro Fire District(EMS Billing Partners since 2001)Barbara Law, Assistant Chief/Director of EMS(916) [email protected]

City of Berkeley(EMS Billing Partners since 2019)David Sprague, Assistant Chief(510) [email protected]

City of Oceanside (EMS Billing Partners since 2012)Peter Lawrence, Division Chief(760) [email protected]

City of Escondido(EMS Billing Partners since 2001)Rick Vogt, Fire Chief(760) [email protected]

City of San Marcos(EMS Billing Partners since 2006)Heather Todd, Management Analyst(760) [email protected]

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gLetters of Recommendation (Proprietary and Confidential)

The mission of the Sacramento Fire Department is to protect our community through effective and innovative public safety services.

June 15, 2019

To whom it may concern: Please accept this letter of recommendation on behalf of Witman Enterprises, LLC. The Sacramento Fire Department transitioned to Witman last year after nearly 25 years with the same biller. Witman won the bid after a competitive process and almost instantly, the level of customer service drastically improved. It was apparent that they were a true partner and extension of our agency, rather than just a basic client. One of the things I appreciate most in our partnership with Witman is there level of responsiveness and attention to detail. Over the last eighteen months, I have requested data and documentation for time sensitive requests. In every situation, the request met or exceeded the timeframe and the level of detail was impressive. It is this type of relationship that we were missing and now truly enjoy. The staff at Witman have also assisted us in improving our billing flow and process. The results have been an improved level of reimbursement with massive improvements efficiency. This has allowed us to free up employees formerly tasked with billing duties to do other essential duties. In a time where departments are constantly tasked to do more work without additional personnel, having the ability to utilize staff in other areas was fantastic. Maximizing our cost recovery is essential to the continued existence of our ambulance program. I can confidently say that the staff at Witman is committed to assisting our agency with achieving this task. They met with us and dissected every step of our process and offered recommendations that have proven to be extremely wise and financially sound. The team works hard to maximize collections through excellent customer service, process review and consistency. Please do not hesitate to contact me if you have any questions or require additional information. Chad Augustin Deputy Fire Chief Sacramento Fire Department 916-767-2203

5770 Freeport Blvd., Suite 200 Sacramento, CA 95822-3516 Ph: (916) 808-1300 Fax: (916) 808-1629 www.sacfire.org

Gary Loesch Fire Chief

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997 Cedar Street, Berkeley, CA 94710 Tel: 510.981.5595 Fax: 510.981.5592 E-mail: [email protected]

Department of Fire and Emergency Services Division of Training and EMS Assistant Fire Chief

Date: June 18, 2019 To: State of Hawaii Department of Health From: David Sprague, Assistant Fire Chief Subject: RECCOMENDATION FOR WITTMAN ENTERPRISES LLC

It is my pleasure to provide a summary of our experience with Russ Harms and the whole team at Wittman Enterprises LLC (Wittman).

In 2018 our City engaged in an RFP process for EMS Ambulance Billing Services and related technology to support efficient collection of transport revenue. This was a complex RFP which included the following major components:

Transition of billing services from the current vendor to Wittman in less than 30 calendar days.

3rd party project management vendor to implement the various suite of associated technology products.

3rd party information technology company that would be engaged to configure, deploy and service field hardware through the life of the Contract.

Configuration, training and implementation of a new ePCR system within six months of contract signing.

Trial testing, selection, purchase, imaging, and deployment of 45 Panasonic Toughbook CF-20s to the field.

Managing the equipment selection, purchase and installation through a 3rd party vendor of onboard mobile gateways to support wireless field operations in 25 fire and ems apparatus.

Working in partnership with the City of Berkeley IT department to select and configure a computer storage cart and network switch that would provide our external IT partner network access to monitor and service the CF-20s when they were returned to storage.

Whom it may concern

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gBank Letter of Recommendation

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gRFP SECTION 5.3: Scope of Work

Scope of Work Index from RFP

Submittal of our Proposal is prima facie evidence that we have full knowledge of the requested scope, nature, quality, and quantity of the work to be performed and detailed requirements and conditions under which the work is to be performed. Since 1991 Wittman Enterprises has demonstrated our expertise needed to correctly invoice for the City of Vista’s services to Medicare/Medi-Cal HMO, commercial insurance companies, and private pay individuals, based on the City’s fee schedule. We address the RFP Scope of Services in the following pages of this section.

RFP Section 4.2: Acknowledged and Agreed to Sections

The following sections of RFP Section 4.2 SCOPE OF WORK have been reviewed, acknowledged, and agreed to. References and clarifications for other sections directly follow. 4.2.2 4.2.3 4.2.7 4.2.10 4.2.16 4.2.24 4.2.27 4.2.36 4.2.37 4.2.38 4.2.39 4.2.40 4.2.42 4.2.46 4.2.47 4.2.48 4.2.49 4.2.51 4.2.52 4.2.53 4.2.55 4.2.57 4.2.58 4.2.59

RFP Section 4.2: Index and Additional Content Sections

4.2.1 Acknowledged and Agreed To. For more details please see “Project Methodology”(p. 45) for a complete process summary.

4.2.4 To the best of our ability, we will process any viable backlog work within 30 days of the implementation date. Depending on the volume aging, and viability of accounts, this may be negotiated at a different rate than our RFP proposed rate for new billings and collections.

4.2.5 Acknowledged and Agreed To. Dispute Resolution We recognize that most patients are citizens of your community so our goal is to function

as an extension of the City of Vista. We provide extensive training and look for individuals with the ability to be compassionate and empathetic while efficiently resolving calls. There are managers and directors available at all times to assist if customer issues cannot be resolved to the patient’s expectations by our customer service department. All customer service staff is located in our single Rancho Cordova office. If any complaint received by our patient service department involves care-related concerns, Wittman will contact the City/Fire Department directly for resolution. We manage resolution of any unlikely disputes in accordance with City and HIPAA guidelines. Over the years as an EMS billing partner, Wittman has developed strong rapport with client staff and work closely with them to find quick and equitable resolutions to any patient disputes. We generally dispel any patient concerns or disputes without involving City/Fire personnel.

4.2.6 Acknowledged and Agreed To. For more complete process summaries, please see “Vista Staff and Provider Scope of

Work” (p. 63); “Records Confirmed and Screened for Completeness” (p. 48); “Follow-Up Protocols” (p. 48); and “Identification of Payment Sources” (p. 49).

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4.2.8 Acknowledged and Agreed To. Business Continuity Plan Our Business Continuity Plan allows Wittman to continue conducting our clients’ business

until recovery from an unforeseen disaster or emergency is accomplished. It identifies how we would stay in touch with our clients and with each other, continuing to do our work. The plan 1) documents key personnel and backups, 2) identifies those who can telecommute, 3) documents critical equipment and appropriate off-site backups, 4) identifies critical documents, and 5) identifies contingency equipment options and locations.

Utilizing Veritas Backup Exec software, our electronic computing and storage capabilities are backed up redundantly by a Dell Power Vault 124T with 24 terabytes of storage capacity. Wittman’s network consists of a redundant Raid Ten Array Network Attached Storage, running on two Dell R720 Dual Processor eight core servers on Windows 2012 Server in an active/passive cluster mode. Wittman uses Rescue Net Billing by ZOLL Data Systems. In the event of a catastrophic event, the software is readily available for us to replace. As an added precaution, all backup and system programs are kept offsite. To minimize any potential down time Wittman contracts with Dell Computers for a maximum 4-hour service response time on all of our billing servers. In case of an interruption in Vista’s (or Wittman’s) ability to transmit or receive ePCRs electronically we maintain the ability to receive information through our secured FTP site. Our IpSwitch Secure FTP server is the industry-leader in FTP security. Highlights of this system include:

• Security: Encrypted transfer over SSH/SFTP, SSL/FTPS, and HTTP/HTTPS protocols

• Powerful management administrative control and enforcement

• Automation: Server events can generate alerts and launch workflows

• Compliance: Exceeds stringent security and privacy requirements for secure file transfer

• Ad hoc and schedule interaction: Supports impromptu as well as predefined transfers by people, systems, and processes

• An $800,000 line of credit is available to us for the purchase of necessary equipment, software, and supplies. Regular reviews of the plan and other emergency plans are conducted to ensure current and workable solutions.

4.2.9 Acknowledged and Agreed To. Please see “ePCR Interface” (p. 46); “ePCR Uploading Overview” (p. 46); and ePCR Import

Data Scrubber” (p. 47) for more electronic file information.

4.2.11 Please see “Auditing” (p. 33) for a summary of our auditing processes and history.

We will be responsible for reconciling ePCR files we receive from the City with WATER FireRMS data provided by Vista and/or received from WATER FireRMS. Because we do not access our clients’ CAD systems, we do not include any CAD reconciliation as part of our usual scope of services provided. However, we customize all of our client accounts and are willing to discuss any customizations we are able to provide to the City based on the specifics of your program and our billing system.

4.2.12 Please see the entire “Project Methodology” section (pp. 45-59) for a complete overview of our billing and research processes from receipt of the ePCR through collections on each account.

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4.2.13 Acknowledged and Agreed To. Please see “ePCR Interface” (p. 46); ePCR Uploading Overview” (p. 46); and “ePCR Import

Data Scrubber” (p. 47) for details on how we work with WATER.

Generally, our experience is with the interface between our clients’ ePCR system and our billing system. As billers we are limited to a certain extent as far as having the resources required for managing ePCR and other hardware.

4.2.14 Acknowledged and Agreed To. “Identification of Payment Sources” (p. 49); Medicare Billing” (p. 50); Medi-Cal Billing”

(p. 52); and “Private Insurance Billing” (p. 52), give examples of how we bill all claims electronically whenever possible.

4.2.15 Acknowledged and Agreed To. Please see “Hospital Patient Records Systems” (p. 55) for details regarding receiving

hospital face sheets and other demographics gathering protocols.

4.2.17 Acknowledged and Agreed To. Any modifications to server instruments and HIPAA Notices may be subject to pass-through

fees from our printing partners.

4.2.18 Acknowledged and Agreed To. Please see “EMS Billing Project Manager” (p. 11) for an introduction to our San Diego-area

Client Liaison.

4.2.19 The City of Vista’s Client Liaison—Jennifer Gentry—and Wittman’s entire Client Liaison team, and the ePCR Analyst (and the entire IT team) are all available during normal business hours for any program needs. Please see “Dedicated Response Time Commitment“ (p. 30).

4.2.20 Acknowledged and Agreed To. Wittman Enterprises, LLC provides complementary annual revenue enhancement training

for EMS and financial staff. This includes four (4) hours of teleconference, webinar or ZOOM (Skype)-facilitated training, for Vista general staff, and six (6) hours for EMS/EMS Management. Additional and/or onsite training as requested by the City of Vista will be at a contracted rate of $100 per hour (personnel rate) plus associated travel expenses. Please see “Quality Assurance” (p. 33); and sections on our training programs (pp. 34-35) for more information on maintaining our industry awareness and regular communications.

4.2.21 Acknowledged and Agreed To. Please refer to sections in 4.2.20 above.

4.2.22 Acknowledged and Agreed To. Please refer to “Appendix 2: Privacy and Security Compliance” (p. XXXIV) for a summary of

our policies.

4.2.23 Acknowledged and Agreed To. Our written policies span over two hundred pages in length to address the myriad of

procedures and compliance issues that must be identified, regulated, and enforced. All information is available for City review at any time upon your request. Please see “Continuous Improvement” (p. 36); “Monitoring and Auditing” (p. XXXV); “Auditing” (p. 33); and “100% Auditing and Training” (p. 35), for further details.

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g4.2.25 Acknowledged and Agreed To. Details about our Portal System can be found in “Client Portal” (p. 37); “Collections Portal”

(p. 43); “Patient Portal” (p. 57); and “Additional Portals” (p. 43).

4.2.26 Wittman Enterprises conducts due diligence and maintains a high level of professional standards to effect collections. We only use collection methods that are reviewed by and approved by the City of Vista for conformity with your policies and procedures. We observe debtors’ rights and comply with any and all applicable federal and state laws, including by way of example and not as a limitation, applicable provisions of the Federal Fair Dept Collections Practices Act, Collection Agency Act, and the California Robbins-Rosenthal Fair Debt Collection Agency Act.

We are not a collection agency, however. Wittman Enterprises, LLC is not allowed to follow usual practices associated with third-party collection agencies. Ultimately, we feel that there is a distinct philosophical difference between the services Wittman Enterprises provides our clients and your patients compared to services and methods provided by traditional third-party collection agencies. As such, we strongly suggest that the City is better served having different agencies working on billing and third-party collection agency assignments.

4.2.28 We are aware of government programs that allows tax refunds to be held until patient delinquent accounts are paid. However, as we are not a collection agency, we are unable to file to FTB or IRS on the City’s behalf. We have worked with some of our clients in helping them obtain the necessary information so that they are able to evaluate the viability of participating in any such programs and submitting on their own.

4.2.29 According to the Department of Health and Human Services (CMS), “As of May 22, 2013, [the State of California has] exhausted their Section 1011 funds. Providers located in this state should stop submitting Section 1011 payment requests.” The program officially ended at the end of FY 2016.”

4.2.30 Acknowledged and Agreed To.

Processing FundsMany of our EMS billing partners prefer and we recommend the Live Cash method of processing payments. Payments are sent directly to us, processed and posted to the account, and deposited into the City’s bank account. Due to our meticulous auditing, balancing, and reconciliation processes your monthly reports will balance with your bank statements to the penny. Great care is taken from the opening of correspondence and payment envelopes by a specific group of staff (minimum double custody treatment and handling protocols). Patient accounts are updated and verified for accuracy before any checks are prepared for deposit. In all cases, double-custody procedures are followed so that payments are always within at least two cash receipt staff hands. Finally, we limit processing of payments and remote deposit logins to a maximum of two people to control deposits completely.

Payments made by check are scanned and deposited remotely to your bank account (or directly at the bank by designated personnel if remote banking is not a service your bank provides). Cash payments are handled directly by the president of the company. For Electronic Funds Transfers (“EFT”) required by federal insurance providers such as Medicare, we post Electronic Remittance Advices (“ERA”) to patient accounts immediately upon receipt. Since requirements vary greatly from agency to agency regarding payments and funds received, Wittman Enterprises works closely with the City of Vista to optimize this function during the life of our work together.

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Deposits are made Mondays, Wednesdays, and Fridays of each week, with deposit slip reconciliations emailed to clients usually the same day, but no later than the day after each deposit to the City’s bank account. Monthly closes (and subsequent monthly reporting) occur at a predetermined time agreed up by our clients (whether from a hard close or a soft close, to reflect as many payments as possible prior to closing). All month-end procedures are customized to meet the City’s accounting needs. We invoice our clients for our fees (percentage of the month’s net collected dollar amount) monthly after the month-end close has been completed.


Live Operator AssistancePatient Service Representatives are responsible for the follow-up on private insurance, private pay, and balance-billed accounts. They are responsible for over 10,000 calls weekly to and from patients while processing patient insurance information and working through any patient concerns, needs, or disputes. Our Customer Service Representatives are available Monday through Friday from 6:00 AM to 4:30 PM PST to serve your patient needs. Our toll-free number has multiple lines available for patients, clients, insurance companies, attorneys, and third parties to call for information or to discuss account status. Our system accepts voice mail messages and routes calls to appropriate person and/or voicemail box 24 hours per day. Our phone system was recently upgraded, and our Verizon router replaced and system updated ensuring the most effective solution and intuitive routing of calls for both the City and your patients.

Alternative Language CapabilitiesWittman Enterprises employs several Spanish, Chinese, and Vietnamese-speaking Customer Service Representatives in management and non-management positions. Such valuable resources provide your patients with the highest quality of service possible. On rare occasions, if a patient speaks a language we are not staffed to service, we utilize Language Line Services to assist those customers effectively. Currently, Wittman employs 16 bilingual staff members that are available to assist with calls.

Dedicated Response Time CommitmentWittman Enterprises’ goal is that each client and patient reach a live person when they call into our business office located in Rancho Cordova. If our EMS partners or their patients do not reach a live person during regular business hours, they will be provided the option to leave a voicemail and offered instructions on submitting an email inquiry. Wittman personnel will respond the same day during normal operating or within 24 business hours when that is not possible.

4.2.32 Acknowledged and Agreed To. Please see 4.2.5 for dispute/complaint resolution summary.

4.1.33 Acknowledged and Agreed To. Please see “Monthly Reporting Requirements” (p. 70) and “Final Review: Delinquent

Accounts” (p. 59).

4.2.34 Acknowledged and Agreed To. For more reporting information please see “Clear and Concise Reporting” (p. 69), “Monthly

Reporting Requirements” (p. 70), and “Sample Reports” (Appendix 1: p. I). Additional reports that the City may request will be created at no additional cost, as long as the ePCR export and the billing program track the data required to create any such report(s).

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g4.2.35 Acknowledged and Agreed To. Please see “Sample Reports” (Appendix 1: p. I).

4.2.41 Acknowledged and Agreed To. Please see “Appendix 2: Privacy and Security Compliance” (p. XXXIV).

4.2.43 Acknowledged and Agreed To. Wittman Enterprises processes all customer credit card payments in accordance with

applicable Payment Card Industry (PCI) security requirements.

4.2.44 Acknowledged and Agreed To. For policy summaries please see “Appendix 2: Privacy and Security Compliance” (p. XXXIV)

and “Wittman Enterprises Standards of Conduct” (p. XXXVII).

4.2.45 Wittman Enterprises, LLC complies with all CMS regulations and applicable State Medi-Cal regulations regarding claim submittal and processing. Reductions in Medicare or Medi-Cal reimbursements will be evaluated on a case-by-case basis for compliance and responsibility by Wittman Enterprises and the City of Vista.

4.2.50 As part of the billing and collection services we provide, we make contacts with patients under the name of the billing company for the City of Vista. We are not a collection agency and do not contact patients once their accounts have been deemed as non-collectible and reported to the City as such.

4.2.54 We fully support the City’s submission work required for the GEMT, GEMT QAF, and similar programs by providing current required billing reporting customized for each individual program. Wittman Enterprises does not complete nor file reports on behalf of the City; however, we can recommend contractors who provide such services in tandem with other City Fire Departments.

4.2.56 Acknowledged and Agreed To. For examples, please see “Self-Pay Bill Schedule” (p. 56) and “Billing to Payment Cycle”

(p. 45).





4.3.4 We customize all correspondence as much as possible under the structure of our time-tested standards continuously updated since our start in 1991. Wittman has provided the City samples of our correspondence and can customize where “real estate” and other page limitations allow. Beyond minor alterations to correspondence, modifications to our patient correspondence may be subject to pass-through fees from our printing partners. Please see “Sample Correspondence” (p. 73) for examples of our written communications.




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Project Approach

Workload Accomplishment

Our EMS billing and collection success is tied directly to the ratio of PCRs to the number of quality people assigned to your project. We believe that people are the key to our success. Wittman innovates by fully embracing automated and technological advances while wholly recognizing that our quality service is reliant upon our talented people providing you the best level of service. Our approach provides the lowest claims-per-employee-ratio, generally resulting in 10-20% higher collection rates than our competitors.

Wittman Enterprises works from our single location in the Sacramento, California area at 11093 Sun Center Drive, Rancho Cordova, California. All departments are dedicated to the personal attention of our clients and their patients’ needs. Our staff is divided into teams to efficiently address workflow processes and are further divided based upon your location. Wittman maintains our industry-leading lowest claims-per-staff-ratio (generally 30% lower than our competitors) based on upholding the standard of practice our clients expect. Through training, forecasting, hiring, and expansion of our EMS partner base, we constantly maintain that staffing ratio of approximately 4,000 claims per staff (compared to approximately 8,000-12,000 or more claims per staff for most of our competitors).

For complete project coordination, Wittman’s Client Liaison team is the conduit from you to our operations. We look forward to meeting with City/Fire personnel to discuss the goals of our business partnership, the services we provide, and any other topics required for the quality performance of EMS/Fire cost recovery on behalf of the City of Vista. Jennifer Gentry (Client Liaison) will be your main point of contact. Please remember too that Russ Harms (Director of Business Development), Corinne Wittman-Wong (CEO), and Walter Imboden (President/CFO) are always available to you and your team.

LOWEST

CLAIMS-PER-EMPLOYEE RATIO

=10-20%

Higher Collection Rates Than Our

Competitors

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gQuality Assurance

We ensure compliance with local, state, and federal laws by continually educating ourselves on any changes or differences that may apply between jurisdictions. As a matter of policy, Wittman Enterprises, LLC stays current with any program updates to Medicare and Medi-Cal. Therefore, we pledge to remain responsible and knowledgeable regarding any program updates to Medicare and Medi-Cal for the duration of the contract period. Furthermore, we will inform the City and the public of any significant changes to policies and procedure through emails, newsletters, conference calls, etc.

Auditing In addition to continuous training and quality control protocols, we perform audits continuously with seven independent auditors and a supervisor located in our office. They perform various audits including pre-billed claims, submitted claims, denied claims, etc. Wittman’s internal auditing program scrutinizes all of our work to ensure records are not missing, minimum content criteria is preset, fee schedules are accurate and applied correctly, billing codes are appropriate and itemized charges are captured. Our auditing team reviews thoroughly a minimum 10% of the work that each employee completes during the week. Auditors randomly select accounts for audit based on production reports from the previous week. Our meticulous efforts are designed to ensure compliance (whether we are billing Medicare, MediCal, private insurance, or patients) focusing on every step from initial billing, account follow up, and the posting of payments. Additionally, we audit charges, credits, level of service, schedules, payers, customer service quality and thoroughness, and provide key feedback to customer service representatives and management staff. Each Wittman Enterprises department is evaluated from their own specific auditing form in regards to job functions and their effectiveness at meeting quality, compliance and productivity standards. If any anomalies are identified through our auditing efforts, we devote the necessary resources to pinpoint areas for improvement and revise protocols, retrain staff, and test solutions to avoid future refrains. Finally, all new hire staff are continually audited until their audits regularly reach a consistent 95% success rate. Positive audit results are linked directly to our strong procedures and processes, training, and form our rigorous internal auditing program.

In our 28 years in business Wittman Enterprises, LLC has never received a negative external audit. We keep accurate and up-to-date records of all bills, payments, and correspondence related to billing functions to ensure a positive outcome to any audit and encourage the City, Fire Department, and its authorized agents to inspect and audit all data and records relating to our performance under the contract. Wittman Enterprises is always at your disposal during any audit procedure, ensuring immediate compliance with request for information.

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gTraining and Continuous Education

We participate in a training partnership with the State of California (ET17-0248) that mandates significant training hours and topics to improve skills, accuracy and customer service. Approved topics include Class/Lab/E-learning Hours as follows:

Business Skills

• Business Communication• Business Fundamentals• Customer Service• Data Entry• Standard Operating Procedures

Commercial Skills

• Anatomy• Medical Terminology• ICD-10• New Client Transition• First Responder Clients• Errors and Exceptions Reporting• HIPPA• Medical Billing• Medicare/Medi-Cal• Ambulance Billing• Industry Specific Terminology• Certified Ambulance Coder

Computer Skills

• Zoll• Docuware• Noridian• Novitas

Management Skills (Managers/Supervisors Only)

• Team Building• Leadership• Effective Meetings for Leaders• Decision Making

Wittman Enterprises Training Program: New HiresOur comprehensive and ongoing training program allows us to continuously improve the way we conduct our clients’ business and get you your maximum legal reimbursement available.

Initial Training

Employees begin with a minimum of four weeks training on general concepts required of their position including: our computerized billing system, office and position procedures, ambulance billing rules and regulations, identifying key payers, medical billing best practices, HIPAA, industry standards, customer service, billing Medicare, Medi-Cal, and private insurance. Trainees are not advanced in the training program until they have shown competence in all required areas. If they are unable to show the required competence our clients expect from us, employees are provided extra training opportunities and/or dismissed if necessary.

Secondary Training

The next phase of training runs for at least four weeks, emphasizing the practical portion of the employee’s job and preparing them to conduct their position under direct supervision. At this point in the training the employees “shadow” senior staff as they apply what they have learned in their first four weeks of training. More specialized concepts such as “ALS” and “BLS” are introduced and mastered along with workflow management (organizing and prioritizing), ambulance coding, data entry, translating common industry abbreviations, and working with first responder companies. There is significantly more hands-on training in this section than in the initial training period.

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g100% Auditing and TrainingAfter successfully completing the first eight weeks of training, staff operates independently under direct supervision. During this time, new employees and their work product are 100% audited until the employee exceeds a minimum of 90% error-free performance consistently. Regular one-on-one meetings and training sessions are conducted as needed to assure the minimum amount of human error. After this, our auditing team routinely and randomly audits between 10% and 20% of our staff and their work on a weekly basis.

Specialist ProgramWe develop our long-term and talented staff by expending considerable resources on training and continuous improvement of our employees. Experienced staff demonstrating aptitude toward specialty areas of our work are identified and placed in multiple-function-training to prepare them to work on several teams and continuously expand their knowledge and experience base

Certified Ambulance CodersIn addition to our internal training program, Wittman Enterprises is proud to offer staff members which have been certified by the National Academy of Ambulance Coding, a nationally recognized leader in Certified Ambulance Coding Training. Wittman Enterprises employs and provides regular training for Certified Ambulance Coders (“CACs”). Wittman staff are continually trained under the same exacting standards emphasized in the Coding Certifications. We budget funds annually to certify additional coders to ensure that we constantly have ample certified individuals available to assist with all accounts.

Wittman Enterprises Training Program: Continuous Improvement

Team TrainingEach of our teams meet weekly to go over and document training topics, industry and job-specific updates, staff questions, and SOP reviews. Teams are required to provide an agenda for each meeting and take attendance to verify staff team training and participation for each team meeting. Agenda items typically include but are not limited to the following:

• Case Studies/Best Practices Training• New Client Transition• First Responder Clients• Industry/Job Training and Updates

• CMS Updates Updates• Noridian, Novitas Updates• Coding/ICD-10 Training• Errors and Exceptions Reporting

Continuous EducationWittman Enterprises requires employees to not only stay current on industry and individual job requirements, but to continue to push their learning curve through continuing education and bring our clients the best qualified staff in our industry. For in-house training, attendance is taken and individual HR files are updated to maintain a list of continuing education projects each employee has undertaken. Additionally, outside-house training is documented via program participation and/or CEU certification.

In-House Continuous Education Examples:

• Telephone Doctor: Continuous Customer Service Training

• Business Communications

• The 7 Habits of Highly Effective Managers

Outside Continuous Education Examples:

• Certified Ambulance Coders (CAC) Continuing Education

• New Manager Training

• Project Manager Training

• HIPAA Officer Training

• Medicare and Medi-Cal Billing

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gContinuous Improvement

We view quality assurance as our opportunity to verify that our services regularly meet and exceed our EMS partner expectations. Our internal program follows the Shewhart Cycle’s five steps: Observe, Plan, Do, Check, and Act, to ensure that our professional excellence is inherent in every part of our billing process for our clients. Monitoring KPIs, conducting multiple audits, providing ongoing staff training, and holding regular training meetings (with case studies and more formal training opportunities) helps each of our teams continuously improve the way we conduct our clients’ business.

Key Performance Indicators

Tracking and examining accounts receivable, and Payment Average (revenue) are useful tools helping us judge how “quickly” and efficiently we are getting our clients their maximum and legal reimbursements. This doesn’t work as well as a snapshot in time but rather as a comparison tool from period to period. Additionally, A/R Days are monitored regularly to ensure the most consistent and effective results possible, analyzing how long it takes from the billing date to when we receive payment on your behalf. In this example, the account’s A/R Days are calculated by:

• Getting the Average Charge per Day: last 3 months charges divided by the number of days in those 3 months;

• and Dividing the A/R Balance by the Average Daily Charge, giving us how many days of charges are outstanding.

When the work is being managed appropriately your outstanding A/R should not usually be more than three months of charges. Much of this key information will be provided in your Year-to-Date Revenue Report along with several other Key Performance Indicators (KPIs).

Additionally, our operations director uses department KPIs to analyze trends, performance, and to address any anomalies before they become issues.

Average Charge per Day

$16,379.23

A/R Balance

$1,022,531

A/R Days

62

Billing Department• Trending of Transports

• Month-End Report Comparisons and Reconciliations

Cash Receipts Department• Payments monitored for timeliness and

unusual trends

• Refunds Trending

February

$486,938

March

$529,350

April

$490,601

Total Charges for the 3 Months

$1,506,889

# of Days in this 3 Month Period

92

Customer Service Department Workflow Timeliness• Hospital Data Exchange

• Mail Returns

• Private Mail

• Medicare Signatures

• Missing or incorrect phone numbers

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gClient Portal and Electronic Dashboard

Wittman Enterprises offers secured Internet access to our billing system via our Client Portal, 24 hours a day. No additional software is required for the City of Vista to access the information through our secured server. It is accessed with a secured login that is password protected. Information accessed from the Portal is in real time, allowing authorized City and Fire personnel to view each claim wherever it is in the billing and collection process.

Access to the Client Portal is granted only to pre-authorized City and Fire personnel with permission to view such information and is strictly limited to the City of Vista’s information. All patients may be referenced by name, date of service, incident, and run number. Your staff can print invoices for patients and run reports for their own use. Additionally, the City’s specialized reports can be made available through this site. Our billing software system is Microsoft Windows-based which enables data export by authorized staff for easy manipulation (Excel, PDF, Crystal, etc.). It also allows for a clear and traceable audit trail for initial client verification, billing notification, and phone contact. Moreover, our software automatically updates each individual account detailing date, change, or billing function. All history and noted entries become a permanent record and all charges are maintained for a complete payment history. Finally, the Portal provides an “electronic dashboard,” accessible 24 hours a day that provides a one-screen synopsis of the current state of the EMS billing operation, based on the preferences selected by each Client Portal authorized user.

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TransportsReportingPreferencesStatistics

portal.webillems.com

Main

Log Off

Preferred Company: Witmman Enterprises, LLC

Instructions

The Chart Choices below have been provided to you to see a live snapshot of your data.

Chart Type and Size

Single Panel

Quad Panels

Chart Size: Large

Search Criteria

Start Date: 04/01/2017Start Date: 04/30/2017

Display Options

Update Reset

Primary Payor Categories- By Date Range

Current Payor Categories- By Date Range

Mail Returns- Grouped by Month

Aging - Total Outstanding Dollars As Of Today

Level Of Service – By Date Range

Total # Of Billable Calls (5507)

Leve

ls

Instructions

Drag Chart Choice from the left to the panel below. Drag it back to replace it.

Calls

ALS1

ALS2

ALSD Deceased Patient

Assessment Non Transp.

BLS

0 500 1000 1500 2000 2500 3000

BLSE

First Responder

2487

41

6

435

1

2211

326

Drop Off Facilities – By Date Range


Faci

litie

s

Calls

Mercy San Juan Medical CenterKaiser Hospital- North Sacramento

UC Davis Medical CenterSutter Medical Center-Sacramento

Assessment at SceneKaiser Hospital-Roseville

First Responder OnlyKaiser Hospital-South Sacramento

Sutter Roseville Medical CenterMercy General Hospital-Sacramento

Mercy Hospital-FolsomMethodist Hospital-SacramentoVA Hospital-Sacramento/Mather

Pronounced at SceneSutter Amador Hospital

Sutter Memorial Hospital-SacramentoNone

Dry Run

Aging – Total Outstanding Dollars As Of Today

Total Aging Dollars ($15,850,183.67)

Over 180

121-180

91-120

61-90

31-60

Current

$0.00

$6,000,000.00

$5,000,000.00

$4,000,000.00

$3,000,000.00

$2,000,000.00

$1,000,000.00

Day

s

Dollars

1230817

495449433

391326312

286250

216212

7665

0 200 400 600 800 1000 1200 1400

111

$3,172,339.87

$1,434,161.33

$1,434.411.66

$1,694,877.73

$2,893,598.23

$5,220,803.85

Primary Payor Categories – By Date Range


1

NoneAuto Insurance

CustodyInsurance

Insurance ElelctronicKaiser

Kaiser MedicalKaiser-Medicare

MCal/MCaidMCal/MCaid HMO

MedicareMedicare HMO

OtherPrivate Pay

Workers Compensation

524

1213

263391

176606

268

1151423

701

0 200 400 600 800 1000 1200 1400

1272

12

Payo

r

Calls

Main - Dashboard

Client Portal – Main Dashboard

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gClient Portal – Statistics



Main

Log Off


Search Criteria


Display Options

Update Reset

Instructions

The chart below represents the missing information from the e-PCR for all of the different billing elements.

Main - Dashboard

Total # of ePCRs (5834)

Mis

sin

g

# Of Calls

Last Name

First Name

Signature

Insurance Name

Insurance ID

Patient Address

Patient City

Patient State

Patient Zip Code

Patient Gender

Patient SSN

Patient DOB

Patient Phone

Mileage

Incident Location

Destination

0 1000 2000 3000 4000 5000 6000

335

332

2068

338

516

0

386

382

376

0

1812

356

5654

1150

0

1030

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gClient Portal – Preferences

Instructions

Click the Change Button, then enter your changes and then click on the “SAVE” button. To cancel your changes, click the “CANCEL” button.


Preferences

Log Off


Instructions

If you have more than one company, click on the name that you want as your preferred company.

Instructions

Please select up to 10 charts to display on the Main – Dashboard and click the update button.

Customer Information

Note Name:

Email-Login ID:

Password

Default Tab:

Default Ticket Search

Change

ShowChange

UpdateMain – Dashboard

UpdateDate Of Service

Assigned Companies

Wittman Enterprises, LLC

System Information

Wittman Go Live:

Last Login:

Users Guide:

5/12/2017

6/27/2017

Click Here...

Account Created:

Last Password Reset:

5/12/2017

6/27/2017

Contact Names/Email Links

Account Representative: Heather Montano

Cash Representative: Pakou Vang

Billing Representative: Sharon Haney

Access Levels

Customer Information:

Billing Information:

Trip Notes Information:

Customer History Information:

Services Information:

Diagnosis & Alerts Information:

Trip History Information:

View/Print Statement:

View/Print Invoice:

View/Print Receipt:

View PCR:

View PCR Only:

Collection Agency

Profit Centers Only:

Main Tab:

Statistics Tab:

Reporting Tab:

Transport Tab:

Month End Tab:

Download Tab:

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

No

No

No

No

Chart Choices


Ticket Status – By Date Range

Current Payor Categories – By Date Range



Mail Returns – Grouped By Type


Payment Average – From First Bill To First Payment By Date Range For All Payors

TransportsReportingPreferencesStatisticsMain - Dashboard

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gClient Portal – Reporting



Main

Log Off


Main - Dashboard

Instructions

Select a report to viewbelow and then choose your options and then click Display Report.

Start Date: 04/01/2017 *Required


Report Selector

Activity Summary by Payor Category

Activity Summary by Vehicle

Activity Summary Grouped by Vehicle

Aging Detail by Current Payor

Call Type Count by Patient Age

Cash Receipts Journal by Date Posted

Cash Receipts Journal SubReport

Charge List

Charge Type Detail

Chief Complaint Count by Client Age

Closing Balance Summary

Credit Type Detail

Dry Run Report

Month End Sales Journal Detail

Patients under 18

Ticket Survey by Payor Category

Ticket Survey Detail by Trip Date

Ticket Survey Summary by Trip Date



Charge Type Detail


Dry Run Report

Patients under 18


Report Description

This trip date-based accoounting report, which is grouped by primary payor, displays all charges and credits, as well as balance and average totals.

Search Criteria

Display Options

Display Report Start Over

Report Viewer

Report Run On: 6/29/17 at 3:17:05 PM

Sample Company NameActivity Summary Payor Category: (Date From: 04/01/2017–04/30/2017)

Profit Center: [none]

Payor Category # of Trips Gross Charge Contr. Allow Net Charges Rev. Adj. Payments Write-Offs Refunds Balance Average

Insurance 903 1,621,707.06 30,122.52 1,591,584.54 0.00 996,686.20 275.58 5,008.92 599,631.68 1,762.55

Medicare 2,180 4,430,100.50 3,481,092.99 949,007.51 1,002.97 846,496.07 1,102.32 415.43 100,821.58 435.32

Medi-Cal/Medicaid 1,716 3,064,905.84 2,805,268.64 259,637.20 -0.89 178,183.58 23,009.93 145.67 58,590.25 151.30

Private 707 845,906.94 0.00 845,906.94 2,161.53 27,640.02 46,531.35 0.00 769,,574.04 1,196.47

Custody 1 1,735.91 1,337.77 398.14 0.00 398.14 0.00 0.00 0.00 398.14

Sub-Totals for: [none] 5,507 $9,964,356.25 $6,317,821.92 $3,646,534.33 $3,163.61 $2,049,404.01 $70,919.18 $5,570.02 $0.00 $398.14

Report Courtesy of Wittman Enterprises, LLC Page 1 of 3

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gClient Portal – Transports

Client Portal – Transport Detail

Call Type: ALS1 Advanced Life Support

Priority: Emergency

Transport: Emergency

Dispatch Comments:

ReportingPreferencesStatistics


Main

Log Off


Main - Dashboard Transport DetailTransports


Company Name: Wittman Enterprises, LLC

Customer Name: Powers, Nicole

Address: 123 Jump St.

City, State & Zip: Rocklin, CA 95765

Phone: (916) 232-1234

Date of Birth: 01/22/1982

Service Date: 10/09/15

Incident Number: 1134567

Run Number: 293237

Last 4 of SSN: 6789

Transporting Age: 33

Statement

Invoice

Receipt

Patient Care Report

Print Page

Diagnosis & Alerts Trip Notes Trip History Customer HistoryServices Billing

Facility: Mercy Medical Center - Merced

Address: 301 E 13th St.

City, State & Zip: Merced, CA 95341

Phone: (209) 385-7000

Pick-Up Facility

Facility: Mercy Hospital - Bakersfield

Address: 2215 Truxton Ave.

City, State & Zip: Bakersfield, CA 93301

Phone: (661) 632-5000

Drop-Off Facility

Response Zone: None

Dispatch Zone: None

Zones

Profit Center: None

Profit Center

Run Information

This is a test.



Main

Log Off


Main - Dashboard

Search Options

Date Of Service

Customer Name

Incident Number

Run Number

Social Security Number

Date Of Birth

Search Criteria

Partial (Slower Result Time)

Exact (Faster Result Time)

First Name

Last Name

Display Options

Show Zero Balance Calls

Cancelled Calls Only

Show Tickets Continuously

Display Calls Reset

Search Results

Powers

Job Profit Center Date of Service Run Number Incident Number Customer Name (Last, First) Date of Birth Balance Due

0001-A 2015-10-26 293236 12314567 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-16 293236 12314566 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-09 293236 12314565 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-13 293236 12314564 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-23 303236 12314563 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-16 303236 12314562 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-30 313236 12314561 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-12 313236 12314560 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-04 323236 12314569 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-11 323236 12314568 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-29 323236 12314576 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-19 333236 12314588 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-16 293236 12314566 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-13 293236 12314564 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-16 303236 12314562 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-12 313236 12314560 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-11 323236 12314568 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-19 333236 12314588 POWERS, NICOLE 1982-01-22 $0.00

Page 1 of 2

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gCollections Portal

As part of our Portal System, we have created a Collections Portal for the most commonly requested items from collection agencies based on input from our clients. This portal provides the commonly requested collection agency information, but limits access to only these items for security and HIPAA purposed. From the portal, a collection agency can:

• Review accounts electronically

• Print invoices

• Print Patient Care Reports

• Print 1500 billing forms

The connection is fully secure and available only with authorization from you. Authorized agencies only have access to those accounts sent to them for collection work.

Additional Portals

CREDIT CARD PAYMENT

PORTAL

City of Vista

WittmanEnterprises

CREDIT CARD PAYMENT

PORTAL

CREDIT CARD PAYMENT

PORTAL

All Portals are available 24 hours a day, 7 days a week.

We respond to patient inquiries within one business day.

PATIENT

PORTAL

Provides patients with Portal access. Each invoice,

statement, and letter mailed to patients provide

a website link for them to access, login, provide

insurance information, make a payment, or simply inquire

about their bill.

COLLECTIONS

PORTAL

$$

We have created a Collections Portal for the

most commonly requested items from collection

agencies based on input from our clients. This portal

provides: reviewing accounts electronically, printing

invoices, printing patient care reports, and printing

1500 billing forms.

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gSecure Email

We provide the City access to our Secure Email Program from Axway. It provides multiple tiers of security that can be used individually or in combination to block threats at the DMZ and within the enterprise network, and secure inbound and outbound email traffic at the content and network levels. MailGate SC simplifies management of one comprehensive secure email solution for inbound, outbound and encryption, providing secure file delivery without impacting your current environment.

File Transfer Protocol (FTP) Access

The City has access to our FTP site. We receive email notification anytime reports or other information are uploaded to the site. There is no file size limitation for client uploads.

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Project Methodology

Electronics Claims

Department

• Import and Claim Entry (DAILY)

$$

Billing Department

• Claim Review, Coding and QA/QC (1-3 DAYS)

Transmission Department

• Electronic Claim Submission To All Payors (DAILY)

CustomerService

Department

• Insurance and Private Pay Follow-Up

APPLY NOW

CashReceipts

Department

• Payments Posted (WITHIN 24 HOURS)

City Of Vista

$

REGULATORYCOMPLIANCE

Billing to Payment Cycle

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gePCR Interface

Wittman provides extensive mapping of information with most ePCR systems to ensure they correctly correspond to our ZOLL billing system. There are no requirements or added cost for an electronic interface with Wittman Enterprises, LLC. We have successful mapping experience with multiple ePCR systems as recognized in the chart below. We encourage you to contact our other clients to discuss not only the seamless ePCR interface; but also to discuss our high levels of service as an EMS/Fire billing company.

ePCR Uploading Overview

We work with each individual client to determine the most effective way to transfer the care reports from ePCR programs to our ZOLL billing system. The process generally requires minimal input from individual EMS organizations.

Our Electronic Billing Team reconciles the NEMSIS file with the batch listed on the ePCR system to detect any inconsistencies. Files are then uploaded to our billing system workflows and processed. We utilize ZOLL’s RescueNet billing software and our IT team has worked extensively with ZOLL to ensure that all aspects of our processes operate efficiently with any ePCR system currently in operation. Our time-tested process allows seamless integration with the Water platform or any ePCR program used by the City. Wittman Enterprises has successfully interfaced with many ePCR products for our clients and they are mapped into our ZOLL RescueNet billing program for complete integration and data transfer/delivery.

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gePCR Import Data Scrubber

Using our proprietary pre-billing program, we automatically scrub every ePCR ticket that is sent to us. Through that process we are often able to fill in missing demographics information such as address, insurance coverage and social security information, missing phone numbers, name spelling, changes of address, and mileage checker. Some of the tools we incorporate in our scrub include:

• Melissa Data (address verification to ensure accuracy of patient addresses)

• TransUnion (checks all incidents that do not come with insurance/SSN information. Searches for SSN, address, phone, DOB, double checks spelling of name, etc.)

• Change Health (for incidents that have a SSN, system searches for insurance coverage information)

• Google Maps (Mileage checker)

• NCOALink (checks for patients who may have moved and changed their address with USPS. Any discovered changes are automatically updated to the file before it enters our system)

• Internal Matrix App (proprietary program written to analyze imported data and standardizing data sets to make sure it imports properly into our billing system)

• Internal Validation App (proprietary program written to validate data via logic hooks prior to importing into our billing system)

All New Records are SENT to:

• Melissa Data

• TransUnion

• Change Health

• Google Maps

Step 1 Step 2 Step 3 Step 4 Step 5

All New Records are VERIFIED via NCOALink.

All New Records are ANALYZED via Internal Matrix to Map Client Data.

All New Records are VALIDATED via Internal Application.

R

All New Records are IMPORTEDinto our ZOLL Billing System.

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gRecords Confirmed and Screened for Completeness

All PCRs received by our Billing Team are thoroughly reviewed for treatments and treatment codes, medical condition (ICD-10) codes, medical necessity, appropriateness of charges for services based on services rendered, and overall completeness. Coding with the appropriate payer, patient condition, and charges normally occur within 48 to 72 hours of receipt. PCRs with incomplete information may be referred back to the transporting agency for the missing information, if and when hospital face sheets are not available. Patient accounts with private insurance, Medicare, and Medi-Cal information are billed immediately. If insurance information is not available on the initial call report, additional research is conducted to locate any available insurance. When no insurance can be identified, the patient’s account is then set up for private billing.

Locating and Verifying Insurance

All insurance and third party payer information provided is verified online or by phone. By identifying the correct payer for a patient’s claim before it is ever billed, we consistently keep our percentage of incorrect billings very low. In the event that the incorrect insurance is billed, our customer service representatives contact the patient or receiving hospitals for the correct insurance information. Denials are simply not acceptable.

Follow-Up Protocols

As mentioned above, our comprehensive collection services include working with your receiving hospitals to obtain patient demographics to ensure the highest level of collection possible. We also gather additional information via secured email, VPN, fax, and phone calls to the financial offices of the hospitals or skilled nursing facilities. Wittman Enterprises engages a variety of other processes and resources in the course of following up on accounts with inadequate billing information including:

• Use of Zip Code/Street Directories for obtaining missing/incomplete addresses in addition to our own proprietary address.checker program and MelissaData.com

• Use of Accurint.com for tracing mail returns

• Contacting the EMS Division to locate missing information from Run Reports

• Contacting the patient or family members for billing or insurance information

• Personal contact with the patient or patient’s family via phone or email

• Mailing inquiry forms to the patient

Assignment Authorization

Based on our extensive EMS billing experience, we have found that the most efficient billing and collection programs are a direct result of a strong partnership between Wittman Enterprises and our client. That concept is particularly important when discussing patient signature authorizations. Agencies are not permitted to file claims to Medicare without the signature of the patient, designated guardian, or witnessed declaration that the patient is not able to sign. Recognizing that there are times when obtaining these signatures is simply not feasible; Wittman has developed a solid process in partnership with you, to address missing and invalid signatures. This process includes both education and direct patient contact to obtain required forms. Patient signature authorizations can significantly impact revenue if not diligently pursued in a timely manner.

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gPatient Database

For 29 years we have compiled an extensive Patient Database containing thousands of patient records and demographics with patient historical data. Our San Diego-area database was built piece by piece during our work there since 1991. This comprehensive Patient Database allows us to cross-reference accounts and streamline the billing process in a more efficient and thorough manner. We do this under the strictest HIPAA compliance regulations to ensure proper patient confidentiality.

Identification of Payment Sources

When insurance information is incorrect or incomplete, our Customer Service Representatives work with hospitals and the patient to obtain current and accurate information. After initial patient contact is made, insurance eligibility is verified with the patient still on the phone. This prevents billing delays and allows customer service representatives to inform patients if there are any problems with the insurance information provided.

Wittman electronically bills all Medicare, Medi-Cal, qualified primary and secondary insurance sources, workers compensation, health maintenance organizations, third party liability, benefit programs, and self-insurance programs. Those who do not accept electronic claims are billed via generated paper statements mailed directly to them.

For auto accident-related accounts, we determine from the patient whether they have med-pay through their automobile insurance, we are billing a third party insurer, or if they have retained the services of an attorney. Depending on the patient’s response, we will either bill the patient’s med-pay or private health insurance, bill the responsible party or we will work with the patient’s attorney to set up a lien against their personal injury case. All appropriate follow-up on accounts occurs regularly by specialized personnel in our Patient Service Department.

Wittman Enterprises, LLC has also worked on several large insurance bankruptcies. These bankruptcies have affected the revenue of our clients. Through our efforts, we have been able to obtain for our clients up to 80% of unsecured debt owed by several of these insurance companies. Most of our competitors opt to forego this process as it can take years to settle these cases. It takes many hours of correspondence and re-billing to the bankruptcy courts to net our clients payments that otherwise would have been written off.

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g

OK

CancelCompany: City of Hurst Ambulance

Relationship:

Name:

Source:

Release date: 04/01/2016

X?Add New CMS Signature

Medicare Billing

For incidents where no Medicare insurance information was noted by the paramedic, Wittman Enterprises requests insurance information and an authorization signature from the patient. Once a patient responds to our request(s) for Medicare insurance information, and/or if our electronic scrubber identifies patient Medicare insurance information, we complete the following steps:

Step 1: Our billing team determines the level of service on every PCR we receive, then adds any applicable charges, and evaluates the incident for medical necessity per Medicare guidelines. Step 2: Our billing team electronically confirms Medicare eligibility and updates all newly-provided information to our billing system. We always check eligibility when the patient is over the age of 65 and we have been provided a Social Security Number or Medicare ID. We will also check for eligibility information on the PCR or hospital face sheet when the patient has been identified as a Medicare recipient.

Step 3: Patient signature is added to their account once we have received it from them or if it is provided with the initial incident report.

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gStep 4: All available transport information is either uploaded automatically to the billing system or the biller manually enters/verifies transport information from the PCR.

Step 5: The primary payor is updated in our billing system and Medicare is billed electronically.

OK

Cancel

Medicare Required

Bed Confined Before?

X?Answers to Ambulance Certification Questions for this Trip

Use Default ValuesUse Override Values

Bed Confined After?

Bed Confined During?

Chair Confined During?

Medically Necessary?

Patient moved by Stretcher?

Transported To or For? To nearest facility for care of symptoms/complaints

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gMedi-Cal Billing

The detailed steps for billing Medi-Cal are mostly the same as those for billing Medicare as previously detailed. There is an additional step that is taken in addition to the Medicare Standard Operating Procedure:

• As with Medi-Cal, we check eligibility whenever we are provided the patient’s Social Security Number or Medi-Cal ID. Our billers determine the level of service and add any applicable charges. Once we have received eligibility we clarify whether it is a straight Medi-Cal Plan, or a Medi-Cal HMO plan, and update the payor in our billing system to submit the claim to the proper Medi-Cal payor.

Private Insurance Billing

After a patient responds to our request(s) for insurance information, and/or if our electronic scrubber identifies patient private insurance information, we complete the following steps:

Step 1: The patient writes their insurance information on the correspondence they are returning or; the patient sends a copy of their insurance card.

• Billing team updates all newly-provided information in our billing system

• Billing team electronically confirms eligibility of insurance

• Billing team calls insurances when necessary to verify patient eligibility Step 2: If the patient is confirmed eligible we add the payor to the patient’s account along with their coverage and insurance identification information.

OK

Cancel

Notes

XX??Add New Payor

Payor:

Address:

Apt/Ste/Rm: ATTN: C LAIM SUBMISSIONS

City:

Contact:

Position:

Phone: (000) 000-0000 Ext.____

Coverage:

Source:

Identification:

Group:

Accept Assignment:

Default Schedule:

Secondary Schedule:

Override Default Schedule:

Coverage Verified

Verification Expires

Patient Relationship toGuarantor/Subscriber:

Name:

Address:

Apt/Ste/Rm:

City:

Phone: (000) 000-0000 Ext.____:

Subscriber

This Payor is not valid for this customer for certain date ranges

Add

Edit

Delete

Prior Authorization Approval Numbers

From Until

Add

View

Delete

Show inactive approval numbers

Description Date Range Approval Range Next Approval #

OK

Cancel

XX??Payors

Description Address City

Kaiser Claims EMI/853915 P.O Box 853915 Richardson

Kaiser Engineers Retiree Group 60 Blvd. Of The Allies Pittsburg

Kaiser Fresno Outside Referral 7300 N. Fresno Street Fresno

Kaiser Hawaii Air Transport 80 Mahalani St. Wailuku

Kaiser Hospice Pt Business 12200 Bell Flower Blvd. Downey

Kaiser Hospice Pt Business 1425 S. Main St. Walnut Creek

Show all Show Inactive Add

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gStep 3: The billing department notates the account and changes the primary payor from self-pay to insurance.

Step 4: After double-checking the primary payor, billing team submits bill via keystroke to the correct paying insurance (electronically for those companies providing that method of claim submission, or through the mail for all others).

OK

Cancel

XX??Change Primary Payer

Payor: Bill Patient

Schedule: Culver City Billing Pt

Event: No Bill Sent

OK

Cancel


Payor: Medicare Colorado

Schedule: Mcare Out Of State Electronic

Event: No Bill Sent

Step 3: The billing department notates the account and changes the primary payor from self-pay to insurance.


Denied or Disallowed Claims

Wittman Enterprises pursues every claim and follows through with every denial so that all legitimate revenue is collected on behalf of our clients. Denials are not accepted; in fact, as a policy we appeal all claims where the denial has appeal rights and we determine that an appeal is warranted. Additionally, Wittman demands payment with the appropriate interest from non-compliant insurance companies.

Medicare Denials

Medicare may deny claims for any number of reasons such as a patient without Part B coverage on the date of service, incorrect patient information on the claim, Medicare is a secondary payer, the patient has a Medicare Advantage plan, and many others. Wittman Enterprises actively appeals and processes all denials, making sure our clients get their maximum legal reimbursements. Our thorough process starts with reviewing the denial code and includes:

• Identifying the course of action based on the denial code

• Further researching Medicare Eligibility

• Verifying payer primacy between patient insurance and Medicare coverage

• Locating Medicare Advantage plan coverage

• Reviewing modifiers and codes for accuracy

• Checking EOBs for reported non-covered services or for no Part B coverage

• Billing secondary payers such as insurance and Medi-Cal as necessary

• Correcting information requested on denial and resubmission to Medicare, supplemental insurance, Medi-Cal, and the patient to reflect all necessary changes

• Scheduling a call-back date to follow up on resubmission

• Notating the account so that it reflects up-to-the-minute status of every claim

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gMedi-Cal Denials

Not all Medi-Cal denials are provided to us in the same way. Most are received in traditional Explanation of Benefit (EOB) format where codes are given and definitions for the codes are provided on the EOB. Others are returned in letter format only without codes or any clear reason for the denial. Our procedures for processing Medi-Cal denials include:

• Reviewing EOB/letter to verify if a payment was issued, and to identify the explanation for the listed code. This primary step is key for determining the type of denial received and what course of action to take for ultimate payment.

• Further investigating patient’s Medi-Cal eligibility and modify claim data if necessary.

• Identifying hierarchy of payers. Assuming Medi-Cal is the primary; add appropriate denial code along with any other necessary changes.

• Resubmitting claim to Medi-Cal.

• Scheduling a call-back date to follow up on resubmission.

• Notating the account so that it reflects up-to-the-minute status of every claim.

Insurance Denials

Health Plans and Medical Groups issue denials when all or parts of a claim are not paid. There are several types of denials. Some are issued correctly according to the patient’s insurance policy and/or billing guidelines while others are incorrect due to an error by the health plan when processing the claim. Our standard operating procedures include:

• Verifying whether the denial is based on “Not a Covered Benefit”, “Not Eligible”, “Unable to identify as a Member” or, “Primary Insurance Paid more than Allowed”, for example.

• If there is another billable insurance on file, sending a claim to that insurance, attaching the denial received.

• If there is no other billable insurance on file, contacting the patient to inform them of the denial and request any other insurance information.

• When corrected information is received from the patient, updating the payer information and send a claim and a copy of the PCR to that insurance with the denial received attached.

• When there is no viable insurance policy to bill, no Member or Resident program, converting the claim to private pay and billing directly to the patient.

We have a significant number of Standard Operating Procedures (SOPs) covering numerous scenarios for processing denials for Medicare, Medi-Cal, and Private Insurance. Our SOPs are also available to you for review if you would like a more exhaustive explanation of our various methods.

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gHospital Patient Records Systems

Creating a mutually beneficial partnership with your destination hospitals is a key part of our transition schedule when we begin our work with you. Initial contact is usually started even before the contract has been finalized. Initially, most hospitals elect to exchange data through a fax solution where Wittman submits an information request on a regular basis. Once the information is retrieved, the face sheets are faxed back to Wittman for further processing. This is an effective short-term solution; however, we then work with HIPAA compliance and IT teams at each hospital to attempt to establish a more efficient mode of information transfer. Typically, faxed requests take a minimum of two working days before we might expect to receive the requested information from the hospital. As part of our work with the City of Vista in the past, and as part of this proposal, we are already working with your top receiving hospitals to implement a more effective, streamlined process. Expediting the initial set-up is important and we will continue to work with hospital Health Information Management (HIM) personnel to set up a more efficient option: direct VPN access or scheduled FTP “data dumps.” Both methods ensure regular exchange of information and the retrieval of hospital face sheets in the most expedient way allowed.

Self-Pay Accounts

Surveys from the American Collectors Association indicate that patients are more motivated to make payment from a telephone call than repeated collection notices. However, by combining telephone calls and collection notices, an agency can further increase this effectiveness. We have found this to be true through the personal attention given to our clients and their patients.

The early establishment of contact with the

patient is beneficial in establishing a

working relationship with the patient on an individual level.

Our first call to a private account occurs immediately after data

entry of the incident into the system and automated and/or

manual searches for previous accounts for the same patient have

been completed.

This verification call allow us to determine

if the patient has insurance or any

special circumstances that will make it

difficult to pay the bill in a reasonable

amount of time.

$$

+ =

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gSelf-Pay Bill Schedule

Wittman Enterprises customizes your private bill schedule to reflect the City’s needs. These schedules work in conjunction with our billing program, tracking accounts receivable and assigning them to customer service representatives for making follow-up calls. Following are two examples of customized bill schedules:

Action Time Line

Information Request Letter Immediately

Phone call to patient Within 3-5 Business Days

Hospital Request for Information Within 5-10 Business Days

Send Second Notice At 30 Days

Phone call to patient At 30 Days

Hospital Request for Information Sent At 40 Days

Send Past Due Notice At 45 Days

Phone call to the Patient At 55 Days

Send Final Demand At 70 Days

No Insurance Information Provided – Example Schedule

Action Time Line

Medicare Signature Required: Letter Immediately


Patient signature required Invoice At 35 Days

Patient signature required Past Due Notice At 55 Days


Patient Signature required Final Notice At 70 Days

Patient Signature Required – Example Schedule

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gMail Returns

Correspondence from us to your patients may be returned for various indicated reasons including: no such street; no such number; undeliverable as addressed; attempted not known (address is valid, but the patient apparently doesn’t live there); insufficient address (possibly missing apartment number, suite number, etc.). We complete the following steps to insure every account is being worked appropriately:

• Step 1: Compare address

• Double-check the address on the correspondence with the current address listed in the modify customer screen of the billing system.

• Step 2: Review the account

• Review the account for other possible dates of service

• Review notes to verify where in the billing process the account sits

• Re-check Medi-Cal/Medicare for additional demographic information

• Step 3: Call patient to verify contact information

• Step 4: White Pages reversal of phone number

• Step 5: Review possible alternative addresses

• Step 6: Accurint Check

• Step 7: Review PCR for Pick-Up Address/Patient Address

• Step 8: Cross-Check hospital face sheet/hospital trans

• Step 9: Final patient contact

Patient Portal

For many years Wittman has provided your patients with Portal access. Each invoice, statement, and letter mailed to patients provide a website link for them to access, login, provide insurance information, make a payment, or simply inquire about their bill. This site is available 24 hours a day, 7 days a week. We respond to patient inquiries within one business day.

Patient Payment Options

Wittman Enterprises effects positive collections for the City’s financial requirements while providing compassionate service to your patients—doing everything possible to attain reimbursement for your claims. With that goal, we try to provide as many payment options as possible so that patients have choices of how best to make payments to their accounts. Whether they mail their check payment or credit card billing information, provide their credit card information over the phone, set up a limited installment payment plan, or prefer to access our Credit Card Payment Portal, we make it as simple as possible for patients to submit their payments.

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gCredit Card Portal

Based on your preferences, we provide credit card payment options for your patients who wish to have bill payments processed this way. Patients are informed through our correspondence and our customer service staff how they can make credit card payments to their accounts. Limited Wittman staff is authorized to accept credit card information over the phone and our automated Credit Card Portal allows patients to securely pay their bills using our online reporting module. Additionally, our IT team can provide seamless links so that patients may also connect to the Credit Card Portal through the City of Vista website. Alternatively, several clients provide virtual merchant terminals to us so that we can deposit credit card payments directly into their existing system. Like all of our services, this can be customized to fit the needs of your City and your program.

Credit Card Payment Options

City of Vista

WittmanEnterprises

CREDIT CARD PAYMENT

PORTAL

CREDIT CARD PAYMENT

PORTAL

Installment Payments

For patients unable to pay their full balance owed, Wittman follows your policies in regards to self-pay accounts. This could include minimum payments accepted and the duration of the private pay contract. Based on our experience, we have found that limiting payback duration to one year usually provides the best results for our clients. Patients have the option of making their monthly payments by check or credit card. They may also set up an AutoPay agreement with a signed authorization where payment is automatically withdrawn from their credit card each month.

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gCollection Practices

On average, we send less than 12% of all accounts billed for additional collection efforts. Wittman will provide current reports identifying any non-collectable accounts to be released to your collection agency. As part of our process, we work with your agency and provide them necessary documentation regarding each account.

However, before an account is even considered for referral to collections, the following exhaustive procedures will have been performed:

• Patients will have been cross-referenced by name, social security number, incident pickup or residence address, and date(s) of service through a variety of resources including our extensive patient database.

• The entire regular invoicing cycle will have been completed.

• We will have conducted all appropriate follow-up calls and letters.

• We have identified all available alternate patient contacts.

• We will have completed our skip-tracing processes to locate correct address and telephone information with tools such as Accurint.com, The Haines Directory, MelissaData.com, etc.

• Receiving hospitals will have been contacted for most accurate and current patient demographic information.

• A second verification of Medicare, Medi-Cal, and Private Insurance eligibility is performed.

Hardships, Discounts, and Reductions

In the course of providing our services, Wittman follows the City’s policies. For example, you may waive the ambulance fee if it is found that a patient does not have the financial resources to pay. We notify your department in the case of any situation requiring modification of account balances, pay schedule, referral to collections, or account write off. No adjustment is ever made without prior authorization from you. All adjustments are clearly documented and identified in our regular reporting and documentation. We customize policies at your direction regarding discounts and reductions to meet the City’s requirements. Some of these may include hardships, attorney requests, City employees, or small balance write-offs. In all cases, no discounting decisions or write offs are made without your advanced approval.

Final Review: Delinquent AccountsOnce an account has gone through the billing cycle, an account representative will review the account one final time before placing on collection review. At that point a customer service lead will perform one last review of the entire account to ensure all SOPs were followed throughout the billing cycle. If all efforts have been made and process followed correctly, a write-off report will be submitted to the client contact and, if approved, electronically submitted to the City’s contracted collection agency.

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Project Deliverables

5.3.1 Deliverables Schedule

Implementation TimelimeWittman Enterprises is prepared and qualified to effectively meet all elements describe within the Ambulance Billing Services RFP detailed in the Scope of Services section in accordance with all applicable local, state and federal laws and within the policies of the City of Vista.

If we are fortunate enough to earn your EMS partnership, your transition plan will be customized to meet and exceeded your needs and expectations as our experience has shown that no two transitions are the same. Our transition process is built around five key steps that will be facilitated by your Client Liaison, Jennifer Gentry, and the entire Wittman Project Management Team. It is designed to systematically address all required deliverables for a timely and orderly transition: from Medicare, Medi-Cal, and insurance transfer requirements, to the interfacing of all software systems—all leading to the successful go-live date estimated in the timeline and schedule created with you. As your past and future EMS billing and collections partner, Wittman works closely with you during the operational implementation process ensuring a smooth transition. Regular meetings throughout the transition period focus on the items and tasks necessary for our transition partnership. Ongoing communications include conference calls and regular correspondence ensuring we meet required deadlines from your customized schedule so that your EMS program deadlines are met.

As a result of our business model, you will find that many of our processes are customizable to the needs to the City and Fire Department. Through our 29 years of experience, we have learned that each EMS organization functions differently and has unique expectations and needs. We have elected to not advise you how you must change to meet our needs; instead we have chosen to embrace that uniqueness and develop your billing program to meet your requirements and expectations.

Transition Timeline Estimate

Our billing system is easily customized and we are able to complete set procedures within 48 hours of award of contract. Wittman Enterprises has significant experience in working out old work from numerous billing systems. We are capable of taking on this task immediately upon award and execution of a contract. Billing private insurance and private pay claims starts immediately and we vigorously attempt to collect on all aging account receivables turned over to us. As part of our regular processes we maintain complete account receivables, payment collection, and balance records on each patient. The countdown to “flipping on the billing switch” is completed in the few milestone steps shown below.

STEP 130 Days

STEP 215 Days

STEP 315 Days

STEP 4Go-Live

STEP 56 Months

Welcome,Introductions,Information Gathering

ePCRInterface

Ramping Up

GoLive

Analysis

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STEP 315 Days

Ramping Up• Complete overlapping and remaining tasks from Step 1 and Step 2

• Gather banking information and materials and make necessary transfers of information

• Set up the City’s personnel on Client Portal, FTP site, etc.

• City and vendor ramp-up meetings (as needed)

STEP 4Go-Live

Go-Live• Accept live data via ePCR interface

• Transmit electronic claims to Medicare, Medi-Cal, etc.


STEP 56 Months

Analysis

• Conduct comprehensive process, compliance, and documentation analyses

• As needed, provide the City’s EMS personnel comprehensive billing compliance and documentation training

STEP 215 Days

ePCR Interface

• Mapping and Interfacing between City’s current ePCR (WATER) and Wittman’s billing system.

• Attaining necessary logins, passwords, credentials, permissions

• Testing ePCR interfaces for the System’s EMS Billing Program

• City, vendor, and ePCR ramp-up meetings (as needed)

Reporting Program

• Customizing the City’s Reporting Program

Award of ContractU

Welcome, Introductions, Gather Information• Fully-executed Contract and Business Associates Agreement (BAA)

Gather Information• Gathering of company specifics, demographic information, pay-to address requirements, etc.

Begin Transition Billing Immediately• Completion of transfer documents with Medicare, Medi-Cal, and other insurance

• Assembling of the City’s policies: Add to Wittman department procedures

• Wittman department manager and customer service briefings on the City’s policies and procedures

• Ramp-up meetings (as needed)

STEP 130 Days

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g

Sam

ple Pro

ject GA

NT

T C

hart

City o

f Vista E

MS

Billin

g Tran

sition

Wittm

an E

nterp

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oo

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oe

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g5.3.2 Work Product (please see Cost Proposal Section, p. 67)

• Ambulance Billing and Collections, Notice of Privacy Practices, and Patient Surveys

5.3.3 Vista Staff and Provider Scope of Work

Wittman Enterprises enjoys our regular contact with City and Fire staff for direction on specific accounts, balance adjustments, QA/QI, and other procedures requiring your authorization. Occasionally, when we have exhausted our resources and need help completing missing information, clarifying unclear or incomplete narratives, we may request assistance from our regular City/Fire contacts that are often able to acquire the information from their own resources. However, as your billing partner, Wittman generally does not require additional tasks from City/Fire staff as it is our job to support your billing and reimbursement program.

We are a full-service billing agency that conducts effectively the full range of tasks associated with your ambulance billing. As part of creating and maintaining the most efficient and effective billing system partnership between the provider (City of Vista) and Wittman Enterprises, the following are the basic provider responsibilities generally accepted as current standards of best practice. All programs are customized to meet and exceed the needs of our clients – following as many standards of best practice as practically possible. • Submit necessary transport information, including pay source information and patient condition,

to Wittman Enterprises for billing purposes.

• Forward to Wittman all necessary information relating to patient transport services, payments and patient eligibility.

• Provide clarifications when questions arise regarding documentation.

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g5.3.4 Cost ProposalCost StatementPlease keep in mind that we are committed to competitive fees for our clients; however, we are not typically the cheapest. As part of our business model, we have chosen to charge our clients a fair market rate that allows us to maintain a superior level of service with a staffing level that provides both exceptional collection results and unmatched customer service. Reducing fees to “beat” the competition would mean that we cannot provide the level of customer service and performance on which our company is built. Wittman Enterprises generally outperforms our competitors by 10-20% in net collections to our clients’ bottom line. We will collect more for you than our competitors using our 29-year commitment to putting the right people to the task, doing the job thoroughly and doing it the right way, and at the same time providing the best in client and patient services.

Not Only Cost: Superior Vista Performance (Proprietary and Confidential)

Other agencies may bid at a lower fee; however, we ask that you also evaluate the net revenue received by the City and consider that Wittman’s personal attention to your program considerably increases net revenue to you. For example, the chart below demonstrates how our methods net the City more than our competitors who may charge less in up-front fees.

Wittman Enterprises at 4.25% of net collections

Gross Revenue Collected

$4

$3

$2

$1

$0

MIL

LIO

NS

+3,686,070

Net Revenue to Vista

MinusPayment to Billing Contractor

- $156,658

+$3,529,412

Competitor at 3.00% of net collections

Gross Revenue Collected

$4

$3

$2

$1

$0

MIL

LIO

NS

+$3,133,159

Net Revenue to Vista

MinusPayment to Billing Contractor

- $93,995

+$3,039,164

(estimated to be approximately $490,248 more to the City of Vista than our nearest competitor with significant California billing experience)

(estimated to be approximately $490,248 less to the City of Vista than our nearest competitor with significant California billing experience)

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gClient Performance Comparison (Proprietary and Confidential)

Clie

nt A

vera

ge P

aym

ent

Per T

ran

spo

rt

(Wit

tman

En

terp

rise

s, L

LC)

1,000 –

900 –

800 –

700 –

600 –

500 –

400 –

300 –

200 –

100 –

0 –

$558

CarlsbadSac Metro

$556

Oceanside

$474

Escondido

$498

SanMarcos

$559

SanClemente

$540

Poway

$580

Vista(projected)

$530

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gCompetitor Performance DataWe believe that it is important not only to demonstrate our superior performance over our competitors on behalf of our clients; but, when necessary, to provide specific information to our clients and potential clients regarding other vendors with inconsistent performance results. Consider the following performance chart examples:

CLIENT Collection Increase, Average Collection, by Wittman Enterprises, by Wittman Enterprises, per Claim per Transport

City of Rialto $288.86 (30%) $376.98Former Vendor: R1/Adpi

City of Sacramento $313.37 (27%) $396.59Former Vendor: R1/Adpi

City of South San Francisco $535.98 (48%) $793.15Former Vendor: R1/Adpi

Burney Fire Protection District $202.00 (34%) $516.52Former Vendor: R1/Adpi

Carson City Fire Department $45.00 (10%) $447.57Former Vendor: R1/Adpi

Cosumnes Community Service District $118.00 (20%) $660.63Former Vendor: R1/Adpi

CSA 69 (San Diego County) $48.00 (14%) $409.59Former Vendor: R1/Adpi

North County Fire Protection District $93.00 (18%) $559.71Former Vendor: R1/Adpi

North Tahoe Fire Protection $80.00 (10%) $1,121.67Former Vendor: R1/Adpi

Pasadena Fire Department $50.00 (10%) $498.00Former Vendor: ACS

CLIENT

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gCompetitor Transition Performance DataAs part of our business model, we charge our clients a fair market rate that allows us to maintain a superior level of service with a staffing level that provides both exceptional collection results and unmatched customer service. As an example, please see the chart below that shows two long-term clients who contracted with your current vendor, leaving Wittman Enterprises (for a “lower fee”) and experiencing not only a significant drop in their expected level of response and service but a substantial decrease in net revenue collected. For example, Client #1 lost approximately $30,440,896 in revenue during their contracted time with their new billing contractor. Client #2 has selected Wittman Enterprises to return as their EMS billing Partner in the next few months.

CLIENT 1 (YEAR 1) Wittman Enterprises Intermedix

Rate Charged to Client $17.25 per ticket $12.75 per ticket

Revenue Collected $37,030,484 $34,056,482

Cost in Fees to Client $1,242,000 $882,000

Net Revenue to Client $35,788,484 $33,174,482 (7.8% revenue drop)

CLIENT 2 (YEAR 1) Wittman Enterprises Intermedix

Rate Charged to Client 5.9% of net collections 5% of net collections

Revenue Collected $1,963,296 $1,794,717

Cost in Fees to Client $115,834 $89,735

Net Revenue to Client $1,847,462 $1,704,982 (8.3% revenue drop)

Cost Proposal

Wittman Enterprises, LLC is pleased to offer the City of Vista all billing, collections, financial reporting, and accounts receivable management described in our proposal based on the following fee schedule options. Proposals are valid for 180 days following submission.

Note: Wittman Enterprises, LLC provides complementary annual revenue enhancement training for EMS and financial staff. This includes four (4) hours of teleconference, webinar or ZOOM (Skype)-facilitated training, for Vista general staff, and six (6) hours for EMS/EMS Management. Additional and/or onsite training as requested by the City of Vista will be at a contracted rate of $100 per hour (personnel rate) plus associated travel expenses.

Proposed Fee

4.25% of net collections

Based on Vista’s provided payor mix and current reimbursement rates, a 1% increase

to charged fees may be applied if any insurance reimbursement rate is reduced

at any time during our contract term.

Services

Ambulance Billing and Collections, Notice of Privacy Practices,

and Patient Surveys

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gServiceWe are a full-service billing agency from the point of data entry to the last cent collected. Our fees contain the full range of EMS billing services including:

• Accurate, efficient, and experienced billing staff

• ePCR integration

• Each document confirmed, and screened

• Electronic billing to Participating Payers

• Billing private insurance

• Employee background checks

• Bilingual staff

• Client Liaison team

• Lower claims-per-staff ratio

• Unlimited access to Client Portal

• Insurance finding and pre-verification

• Assignment authorization verification

• Destination hospital contact/patient demographics

• Toll-free number (calls answered by real people)

• Personalized reporting

• Relentless Claim Appeals team

Maximizing CollectionsThrough streamlined efficiency, talented staff, automation, and continuous improvement, Wittman has a long track record of strong revenue returns for our clients. We consider the net percentage collected from the amount billed to be the ultimate standard by which your ambulance billing company should be evaluated. Net collections are those dollars eligible for collection after taking into account Medicare and Medi-Cal contractual write downs. The City of Vista will count on Wittman Enterprises to conduct diligent, regular, and uninterrupted billing and collection services in a professional businesslike manner with superior performance. We believe our personal approach and higher levels of service greatly exceed industry standards. Your expectations and overall satisfaction are attained through ongoing and regular training, continuous improvement, and our comprehensive auditing program.

Immediate availability to patients H No-cost reporting H H Ad Hoc reporting for no additional fee H Instantaneous response to reporting needs H Technological automation H H Hospital connectivity H H Single location with tight HIPAA and compliance controls H Lowest claim-per- staff ratio H Full reconciliation and discrepancy research H Medicare Revalidations H H Membership program support H Patient Satisfaction Survey Management H Reliable Internet-based Portal System: H

• Client Portal H

• Patient Portal H

• Credit Card Portal H

• Collections Portal H Dedicated Client Liaison and Division Manager to your account H

Service Levels Wittman Enterprises

National Competitor

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gCost Proposal Method

• Please see “Not Only Cost: Superior Vista Performance” (p. 64) for a graphic that includes estimated annual costs. Wittman Enterprises will collect more than our competitors—deposit more into the City of Vista’s bank account—essentially making the “low bid” and estimated annual cost insignificant, when more accurately evaluating net revenue based on the total collections deposited directly into the City’s account.

5.3.5 Reporting

Clear and Concise Reporting Our robust reporting is customized to meet your reporting needs and provide complete accountability and transparency for the work we do on your behalf. As indicated in the reporting sections of our proposal, we have hundreds of reports available for your metrics and reporting needs. There is no extra fee for reporting or for Ad Hoc reports designed for your exclusive use. Reports are available from your assigned Division Manager and Client Liaison at any time AND many of them come hard coded in your Client Portal for live and electronic access based on pre-populated fields. Other reports from your program can also be hard coded into your Portal access and be made available via our Client Portal. Please see “Sample Reporting” (p. I) and “GEMT/GEMT QAF Reporting” (p. XXV) for examples of our vast reporting library.

Standard Reporting

The City of Vista will have access to our Client Portal and client reporting system allowing authorized City and EMS/Fire personnel to obtain invoices, account balances, billing reports, and other hands-on account management tools. Daily, monthly, quarterly, annual, and special reporting can be provided in PDF and Excel format. Our reporting system allows interface with Crystal reporting software. For example, Vista’s customized reporting program might include specific details such as:

3 Number of Reports Received 3 Number Billed and Bill Type3 Calls Not Billed 3 Gross Charges3 Contributions Allowed or Write Down 3 Net Charges3 Adjustments 3 Payments3 Refunds 3 Balance Owed3 Number of Bills and Amounts Sent to Collections 3 Pending Claims at Collections3 Write Offs 3 Aging Reports

Reporting LibraryThis is a small sample of our extensive reporting library. In fact, we have well over 200 system-generated reports as well as hundreds of customized reports to meet the reporting needs of all of our clients. Utilizing our in-house programmers, we are able to design reporting programs to fit all of our clients’ needs.

3 Management Summary 3 Ticket Survey Summary by Payer3 Incident Survey Summary by Trip Date 3 Year-To-Date Revenue3 Aging: Current Payer (aging data) 3 Cash Receipts Summary3 Credit Summary 3 Activity Summary by Vehicle3 Activity Summary by Payer 3 Refund Report

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gMonthly Reporting RequirementsOur month-end correspondence with you includes Cash Receipt Reports that reconcile all deposits, receivables, billings, patient accounts, adjustments, dishonest checks, and refunds. All other processes and functions at Wittman Enterprises, LLC are ongoing. Financial and performance reports are detailed and easy to read. On-Demand (ad hoc) reports are our specialty and are provided at a moment’s notice at no additional charge. These reports provide detailed accounting for account adjustments of any type and track revenue by period. Our reports are Accurate and Easy to Read. Robust and Individualized. Accessible.

• A/R Aging Report: This report can be either a detail or summary report based on trip date (date of service), patient, or payer. It can be customized to track a specific payer or payers and date ranges and lists how many ambulance claims are still outstanding for any given time period.

• Ticket Survey Report: Detail or Summary can be run by date of service, payer or patient or combination thereof. Ticket Surveys are used to provide the number of accounts input into the system in a given month and under the payer mix category. This information provides revenue projection information and can be used to verify that all tickets sent have been received.

• Year-to-Date Revenue Report: This report provides a snapshot of the last twelve months at any time. It offers totals in all categories including Medicare and Medi-Cal write-downs, monthly amount of delinquent accounts and refund amounts. It is a very effective performance analysis tool in monitoring our performance as it reflects our ongoing collection rate, both gross and net, for a twelve-month period.

• Management Summary Report: The report is run by fiscal year. It provides an accounting by financial class of total trips and dollars billed each month, with a cumulative year-to-date tracking. It also provides an accounting of the dollars received each month by financial class with a cumulative year-to-date tracking.

• Ad Hoc Reports: On-demand reports are our specialty and are provided at no additional charge. Our billing software collects and tracts numerous data elements whether input manually or electronically downloaded. From the large data field our ad hoc reports are available and on-line for Vista review and can contain month-end and real-time information as required.

Your monthly reports can be emailed, dropped to your FTP mailbox, or sent to you via U.S. Mail – depending on the City’s preferences.

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g5.3.6 Certificate of Insurance

ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?

INSR ADDL SUBRLTR INSD WVD

PRODUCERCONTACTNAME:

FAXPHONE(A/C, No):(A/C, No, Ext):

E-MAILADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBERPOLICY EFF POLICY EXP

TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT

OTHER: $COMBINED SINGLE LIMIT

$(Ea accident)ANY AUTO BODILY INJURY (Per person) $OWNED SCHEDULED

BODILY INJURY (Per accident) $AUTOS ONLY AUTOSHIRED NON-OWNED PROPERTY DAMAGE

$AUTOS ONLY AUTOS ONLY (Per accident)

$

OCCUR EACH OCCURRENCECLAIMS-MADE AGGREGATE $

DED RETENTION $PER OTH-STATUTE ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE $If yes, describe under

E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N

N / A(Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)

CERTIFICATE OF LIABILITY INSURANCEDATE (MM/DD/YYYY)

$

$

$

$

$

The ACORD name and logo are registered marks of ACORD

11/20/2019

(916) 259-6900 (866) 206-8646

Wittman Enterprises LLC11093 Sun Center DriveRancho Cordova, CA 95670

A 2,000,000

X X B6020067350 7/1/2019 7/1/2020 300,000

10,000

2,000,000

4,000,000

4,000,000

EPLI FIDUCIARY 10,000

1,000,000B

X B6020067395 7/1/2019 7/1/2020

2,000,000C

B6020067431 7/1/2019 7/1/2020 2,000,000

10,000

D

X 9161868-2019 7/1/2019 7/1/2020 1,000,000

1,000,000

1,000,000

E Cyber Liability P00100004271102 11/7/2019 Aggregate/Limit 2,000,000

F E&O/Crime/Fiduciary 107019103 1/1/2019 1/1/2020 Each Claim/Agg 2,000,000

The City of Vista, its officers, officials, employees, and volunteers will be named as Additional Insured with respects to General Liability per attached endorsement form number SB146932F. General Liability applies on a Primary and Non Contributory basis per the attached endorsement form number SB146932F. General Liability, Auto Liability and Workers Compensation Waiver of Subrogation applies per the attached endorsement for number SB146932F, CA04441013-to follow, and 10217. Notice of Cancellation applies in favor of the City of Vista per the attached endorsement form number SB147052C.

City of Vista200 Civic Center Dr.Vista, CA 92084

WITTENT-01 JMAHNCKE

Western Elite Insurance Solutions130 Diamond Creek Place, Suite 2Roseville, CA 95747

National Fire Insurance Company of Hartford

Continental Insurance Company

Continental Casualty Company

State Compensation Insurance Fund

AXIS Surplus Insurance Company

Travelers Casualty Insurance Co of Amer

X

11/7/2020

X

X

X

X

X

X

X

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We have been in business since 1991 and remain a financially strong company. Our organization has consistently demonstrated a financially sound position with liquidity ratios higher than bank requirements. We have never been subject to any bankruptcy proceedings in our 29 years in business. Our financial statements have been attached under separate cover. As such, we request that this information be considered Proprietary and Confidential.

In the event that copies of our response to your RFP are requested from the City of Vista through the Freedom of Information Act and/or similar state and local rules, Wittman Enterprises, LLC, respectfully requests that all information provided under the heading “Proprietary and Confidential” be redacted in their entirety from any and all copies provided. The information should be exempt from public disclosure (due to personal financial information and other private facts), for information related to competition and bidding, and for certain trade secrets, commercial or financial information. Its inclusion constitutes Proprietary and Confidential information. Unauthorized release of such confidential information puts us at an unfair disadvantage with future competitors if the information is released to the public in general.

5.3.8 Legal and Contract History Statement

In our 29-year history, Wittman has not experienced any contract termination for any reason; including non-performance, poor performance, or any other reason. We are not currently the subject of any federal, state, local, or any other investigation involving fraudulent or abusive billing practices, now have we been in our 29 years in business. Additionally, Wittman Enterprises, LLC, nor its officers or employees, has never been found guilty of violating procurement laws or been fined for violation of debt collection laws. Specifically, we have had no claims, fines, mediations, arbitrations, litigations, or judgements with which we were involved during our business history.

Additionally, we have never received a negative audit, having significant experience with external audits from CMS, other agencies, and of course our clients. We are always at your disposal during any audit procedure. For example, in 2010, Medicare’s contracted agent conducted a pre-pay audit of the City of Vista’s Medicare program. A large number of claims were reviewed prior to payment and ultimately denied during the audit process. What followed was a two-year appeal process where Wittman (on behalf of our client) appealed findings from the audit on three different occasions and at three different levels of appeal. The final Medicare appeal culminated in a WHOLLY FAVORABLE decision from an Administrative Law Judge (ALJ) agreeing with our appeal for each account in question and ordering proper Medicare reimbursement.

5.3.9 Type of Business Entity

Wittman Enterprises is a limited liability company registered with the Secretary of State of California.

5.3.10 Corporate Status

N/A

5.3.11 Sole Proprietorship Status

N/A

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Give form to therequester. Do NOTsend to the IRS.

Form W-9 Request for TaxpayerIdentification Number and Certification(Rev. November 1999)

Department of the TreasuryInternal Revenue Service

Name (If a joint account or you changed your name, see Specific Instructions on page 2.)

List account number(s) here (optional)

Address (number, street, and apt. or suite no.)

City, state, and ZIP code

Plea

se p

rint o

r ty

pe

For Payees Exempt From BackupWithholding (See the instructionson page 2.)

Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box. Forindividuals, this is your social security number(SSN). However, if you are a resident alien OR asole proprietor, see the instructions on page 2.For other entities, it is your employeridentification number (EIN). If you do not have anumber, see How to get a TIN on page 2.

Social security number

––OR

Requester’s name and address (optional)

Employer identification numberNote: If the account is in more than one name,see the chart on page 2 for guidelines on whosenumber to enter.

–

Certification

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), andI am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the InternalRevenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS hasnotified me that I am no longer subject to backup withholding.

2.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backupwithholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirementarrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you mustprovide your correct TIN. (See the instructions on page 2.)

SignHere Signature � Date �

3. The IRS tells the requester that youfurnished an incorrect TIN, or

4. The IRS tells you that you are subjectto backup withholding because you did notreport all your interest and dividends onyour tax return (for reportable interest anddividends only), or

Purpose of form. A person who isrequired to file an information return withthe IRS must get your correct taxpayeridentification number (TIN) to report, forexample, income paid to you, real estatetransactions, mortgage interest you paid,acquisition or abandonment of securedproperty, cancellation of debt, orcontributions you made to an IRA.

5. You do not certify to the requesterthat you are not subject to backupwithholding under 3 above (for reportableinterest and dividend accounts openedafter 1983 only).

2. You do not certify your TIN whenrequired (see the Part III instructions onpage 2 for details), or

Note: If a requester gives you a form otherthan Form W-9 to request your TIN, youmust use the requester’s form if it issubstantially similar to this Form W-9.

What is backup withholding? Personsmaking certain payments to you mustwithhold and pay to the IRS 31% of suchpayments under certain conditions. This iscalled “backup withholding.” Paymentsthat may be subject to backup withholdinginclude interest, dividends, broker andbarter exchange transactions, rents,royalties, nonemployee pay, and certainpayments from fishing boat operators. Realestate transactions are not subject tobackup withholding.

If you give the requester your correctTIN, make the proper certifications, andreport all your taxable interest anddividends on your tax return, paymentsyou receive will not be subject to backupwithholding. Payments you receive will besubject to backup withholding if:

1. You do not furnish your TIN to therequester, or

Form W-9 (Rev. 11-99)

Part I

Part II

Business name, if different from above. (See Specific Instructions on page 2.)

Cat. No. 10231X

Certain payees and payments areexempt from backup withholding. See thePart II instructions and the separateInstructions for the Requester of FormW-9.

�

Check appropriate box: Individual/Sole proprietor Corporation Partnership Other �

Under penalties of perjury, I certify that:

Part III

Use Form W-9, if you are a U.S. person(including a resident alien), to give yourcorrect TIN to the person requesting it (therequester) and, when applicable, to:

1. Certify the TIN you are giving iscorrect (or you are waiting for a number tobe issued),

2. Certify you are not subject to backupwithholding, or

3. Claim exemption from backupwithholding if you are an exempt payee.

Civil penalty for false information withrespect to withholding. If you make afalse statement with no reasonable basisthat results in no backup withholding, youare subject to a $500 penalty.Criminal penalty for falsifyinginformation. Willfully falsifyingcertifications or affirmations may subjectyou to criminal penalties including finesand/or imprisonment.

PenaltiesFailure to furnish TIN. If you fail to furnishyour correct TIN to a requester, you aresubject to a penalty of $50 for each suchfailure unless your failure is due toreasonable cause and not to willful neglect.

Misuse of TINs. If the requester disclosesor uses TINs in violation of Federal law, therequester may be subject to civil andcriminal penalties.

If you are a foreign person, IRS prefersyou use a Form W-8 (certificate of foreignstatus). After December 31, 2000, foreignpersons must use an appropriate FormW-8.


�

11093 Sun Center Drive

Rancho Cordova, CA 95670

6 8 0 4 5 6 0 2 1

5.3.13 Sample Correspondence

Please see “Appendix 3: Sample Correspondence” (p. XLII) for examples of our letters, invoices, statements, etc.

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City of Vista: RFP: Emergency Medical Services Billing Services I I

Sample Reports

Incident Scrubbing Analytics (Proprietary and Confidential)

Scrubbing Analytics

Year: 2017Sent to Skip Trace/Annually

0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 100,000

Annual Total: 3917

Month: September Reset

Sent to Skip Trace/Monthly

0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 10,000

Monthly Total: 2086

Date Range

Starting Date: 9/1/2017 Today

Ending Date: 9/30/2017

Chart Options

Total: 7472

❏ Address Verification 7083 95%

❏ Address Match 6193 87%

❏ Sent to Skip Trace 2086 28%

❏ No Matches Found 422 20%

❏ Address Found 431 21%

❏ SSN Found 1107 53%

❏ Phone# Found 430 21%

❏ Sent to Clearing House 819 39%

8000

7000

6000

5000

4000

3000

2000

1000

0 September

Total

Address Verification

Address Match

Sent to Skip Trace

No Matches Found

Address Found

SSN Found

Phone# Found

Sent to Clearing House

APPENDICES

Appendix 1: Reporting, GEMT Reporting, GEMT QAF Reporting


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City of Vista: RFP: Emergency Medical Services Billing Services I II

Monthly Ticket Survey

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City of Vista: RFP: Emergency Medical Services Billing Services I III

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City of Vista: RFP: Emergency Medical Services Billing Services I IV

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City of Vista: RFP: Emergency Medical Services Billing Services I V

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City of Vista: RFP: Emergency Medical Services Billing Services I VI

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City of Vista: RFP: Emergency Medical Services Billing Services I VII

Daily Deposits

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City of Vista: RFP: Emergency Medical Services Billing Services I VIII

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City of Vista: RFP: Emergency Medical Services Billing Services I IX

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City of Vista: RFP: Emergency Medical Services Billing Services I X

Mo

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Reven

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Financial Class

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ber ofPercent of

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Total YTDTotal

Payments

Total YTD

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$114,717.6420.19%

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2.29%$283,280.94

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0.61%$45,351.79

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9.12%$209,444.23

15.06%$1,569,078.74

9.13%$231,172.02

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$17,181,415.03100.00%

$568,236.16100.00%

$5,894,401.49100.00%

Managem

ent Summ

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Monthly and Fiscal Year to D

ateH

untington Beach Fire D

ept. June 2019

3/24/2020 C8 Page 107 of 206

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City of Vista: RFP: Emergency Medical Services Billing Services I XIX

Charge Summary by Type of Service/Supply Category Provided

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Year-to-D

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$ 254,798.73

$ 36,253.22

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$ 874,841.50

$ 470,997.74

$ 7,517.37

$ 463,480.37

$ 125,324.84

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9,303.16$

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4,737.24$

463,552.74$

115,140.52$

3,040.97$

694.42$

4,545,080.77$

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414,344.50$

248,572.65$

28,328.49$

6,183.87$

613,556.53$

457,517.83$

-$

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1,620.37$

375.47$

4,607,720.50$

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460,142.29$

297,493.96$

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7,123.97$

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$ 23,501.33

$ 3,660.24

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$ 360,690.06

$ 2,470.35

$ 358,219.71

$ 148,991.93

$ 4,656.60

$ 605.69

$ 4,543,482.60

$ M

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$ 369,953.68

$ 199,149.83

$ 36,333.03

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$ 910,772.04

$ 471,513.57

$ 2,330.56

$ 469,183.01

$ 73,337.07

$ 1,782.71

$ 1,558.74

$ 4,911,510.59

$ A

PRIL '19

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-$

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$ 49,635.80

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GEMT/GEMT QAF Reports (Proprietary and Confidential)

GEMT/QAF/IGT ReportingWith the recent implementation of the California GEMT program, Wittman Enterprises provided leadership throughout the process, working closely with the designers of the program (Sac Metro, Chief Scott Clough, etc.), providing several training opportunities for our clients and designing reports specifically related to the information needed when applying for GEMT and IGT monies.

GEMT Support Timeline: Pre-GEMT Rollout• Worked with Sac Metro and the State, providing transport numbers and calculations to them as

they worked on their cost sheets

• After the bill passed (AB 678) and became GEMT officially, we worked with our California clients through the entire set-up process: attending State-sponsored GEMT instruction meetings; helping provide rough projections of potential GEMT income based on Medi-Cal transport information; sponsored a webinar where Chief Scott Clough answered the most frequently asked questions from our clients about the GEMT

• Set up a section of our website for easy-to-find links and references associated with the GEMT program (please see www.webillems.com/GEMT-Program-Resources/).

• The unofficial “rough” projections required by the State were needed to estimate what each provider was likely going to submit when the official program began. We provided the following unofficial formula to help clients get a rough idea of their numbers:

• Take the total amount of your direct EMS cost and add that to your indirect cost

• Divide that number by your total number of Medi-Cal transports.

• This would give you an average cost of transport

• Multiply the average cost by the number of Medi-Cal transports and submit that as your estimate.

GEMT Support Timeline: Post-GEMT Rollout• Provided customized GEMT reports for participating clients as they filled out their required cost

reports.

• Fielded calls with questions regarding the cost reports and how to use the Wittman reports to help them complete the GEMT cost reports.

• Provided regular email and phone call updates reminding clients when their first cost reports were due and providing them their customized transport reports to help them complete the reports.

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Total Number of MTS Transports

GEMT Total Number of MTS TransportsTrip date IS BETWEEN 07/01/2017 AND 06/30/2018; AND Company IS City of Huntington Beach Paramedic Service

# of Trips

City of Huntington Beach Paramedic Service

12,523(2017-2018)Fiscal Year:

3,186Quarter: 1 (07/01/2017-09/30/2017)

Managed Care 615

Fee For Service 100

Medi-Medi 239

Other 2,232

3,054Quarter: 2 (10/01/2017-12/31/2017)

Managed Care 452

Fee For Service 93

Medi-Medi 256

Other 2,253

3,155Quarter: 3 (01/01/2018-03/31/2018)

Managed Care 486

Fee For Service 88

Medi-Medi 253

Other 2,328

3,128Quarter: 4 (04/01/2018-06/30/2018)

Managed Care 481

Fee For Service 107

Medi-Medi 231

Other 2,309

RescueNet™ Reporting

Page 1 of 1GEMT Cost Report: Schedule 9, Number 8 - MTS Count by Quarter

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Medi-Cal Managed Care GEMT Transports and Summary Detail

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APPENDIX 2: PRIVACY AND SECURITY COMPLIANCE

Privacy And Security ComplianceWith the recent national news that a national ambulance billing company experienced a breach of their security protocols, resulting in the unauthorized attainment and alleged disclosure of HIPAA-protected personal patient information, Wittman Enterprises would like to reassure our valued EMS partners that as a matter of practice we exceed current HIPAA regulation requirements and take every possible precaution to maintain the integrity of private health information.

HIPAA ComplianceOur HIPAA compliance program was designed and audited by David Nevins, former President of the California Ambulance Association, and member of the American Ambulance Association Reimbursement Committee. Additionally, we ensure compliance with local and state laws by continually educating ourselves on any changes or differences that may apply. As a matter of policy, Wittman Enterprises, LLC stays current with any program updates to Medicare and Medi-Cal. Therefore, we pledge to remain responsible and knowledgeable regarding any program updates to Medicare and Medi-Cal for the duration of the contract period. Wittman recognizes the confidential nature of the City’s patient accounts and agrees not to disclose any HIPAA-restricted, protected health information, and to maintain the integrity of transmitted health information transmitted for billing purposes. We also follow carefully the Federal Trade Commission’s rules on identity privacy, “Red Flag Rules,” which require we maintain strict controls aimed at preventing identity theft.

HIPAA-Required Safeguards for Health Information• Your billing associate “agrees to implement administrative, physical, and technical safeguards that

reasonably and appropriately protect the confidentiality, integrity, and availability of e-PHI that it creates, receives, maintains, or transmits on behalf of” you.

• They must “alert [you] of any security incident (as defined by HIPAA Security Rule) of which it becomes aware and the steps it has taken to mitigate any potential security compromise that may have occurred and to provide a report to [you] of any loss of data or other information system compromise as a result of an incident.”

• The Minimum Necessary rule is the basis of HIPAA. It deals with the access of Protected Health Information (PHI) and requires that an employee only have access to the amount of PHI that is needed for them to get their job done as outlined in their regular job description.

Exceeding HIPAA Safeguard RequirementsWittman Enterprises, LLC has developed a fraud and abuse compliance program to be a comprehensive statement of the responsibilities and obligations of all employees regarding submissions for reimbursement to Medicare, Medi-Cal, and other government payers for services rendered by clients of Wittman Enterprises, LLC. We have established, and regularly maintain, control standards and procedures to ensure that private information remains secure.

(PROPRIETARY AND CONFIDENTIAL)

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Adherence to Privacy LawsWittman Enterprises, LLC maintains compliance with all statutes of the California Privacy Protection Act, or the Federal Privacy Requirements, whichever are most stringent. More specifically the following:

• Medical Information, Collection for Direct Marketing Purposes - Civil Code section 1798.91

• A business may not orally or in writing request medical information directly from an individual regardless of whether the information pertains to the individual or not, and use, share, or otherwise disclose that information for direct marketing purposes, without the consent of that patient.

• Medical Information Confidentiality - Civil Code sections 56-56.37

• No provider of health care, health care service plan, or contractor shall disclose medical information regarding a patient of the provider of health care or an enrollee or subscriber of a health care service plan without first obtaining authorization, except if order by a court, board commission or agency for purposes of adjudication, or by subpoena.

• Patient Access to Health Records - Health & Safety Code section 123110

• It is the intent of the Legislature in enacting this chapter to establish procedures for providing access to health care records or summaries of those records by patients and by those persons having responsibility for decisions respecting the health care of others. Every person having ultimate responsibility for decisions respecting his or her own health care also possesses a concomitant right of access to complete information respecting his or her condition and care provided.

Wittman Enterprises Privacy Policies

Responsibility of Managers

It is the responsibility of each manager to ensure that activities in his/her area of responsibility are conducted in accordance with Wittman’s compliance policies.

Employee Education

Wittman Enterprises provides employees rigorous, initial and regular training necessary and appropriate to ensure material compliance with applicable laws.

Employee/Vendor Screening

It is our policy to make reasonable inquiry into the background of prospective employees and vendors. Determinations are made as to whether they have been (a) convicted of a criminal offense related to healthcare; or (b) listed by a federal agency as debarred, excluded or otherwise ineligible for federal program participation. Wittman Enterprises reviews the DHHS/OIG cumulative sanction report accessed on the World Wide Web at IGNet, the web site of the Federal Inspector General.

Monitoring and Auditing

Wittman Enterprises, LLC has adopted an audit policy to assist in its efforts to monitor the accuracy of claims and the security of PHI. We devote such resources as are reasonably necessary to ensure that audits are (1) adequately staffed; (2) by persons with appropriate knowledge and experience to conduct the audits; (3) utilizing audit tools and protocol which are periodically updated to reflect changes in applicable laws and regulations. Additionally, we routinely audit employee desk and cubicles to insure that PHI is being disposed of and/or stored in adherence to company policy. Cell phones and other electronic devices capable of recording or taking pictures are prohibited on the work floor.

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Physical Storage Security

Reports, records, notes, and other PHI-containing files are to be kept in secure areas at all times (locked file cabinets and offices, for example), except when in current use.

Storage and Disposition of Paperwork:• While working, all employees will store HIPAA-sensitive paperwork in file folders on their desks.

• When on break or lunch, employees will store HIPAA-sensitive paperwork in a designated desk drawer away from direct sight.

• For overnight storage HIPAA-sensitive paperwork will be stored in locked cabinets

• Stored files are accessible to authorized clerical personnel, supervisors, and upper management only.

Destruction of Paperwork:• Paperwork will be discarded into designated locked bins.

• Bins are collected bi-weekly and the contents shredded per HIPAA regulations.

Electronic Access and Storage Security: • Secure Server Room with Keypad Entry

• Multi-Layer Hardware/Software Firewalls with Access Rules giving access to only the servers we specify.

• Corporate Anti-Virus.

• Corporate Web Filtering with Anti-Virus and Spam, which are logged and monitored.

• Server Monitoring Tools to manage Disk Capacity, Memory Utilization, and CPU Utilization.

• Email Archiver that stores and monitors all email traffic with a built in policy violation alerts.

OIG Compliance Program Guidance

The OIG’s Compliance Program Guidance for Third-Party Medical Billing Companies is a voluntary set of guidelines intended to help “in developing effective internal controls that promote adherence to applicable federal and state law, and the program requirements of federal, state and private health plans.” Wittman Enterprises, LLC carefully follows applicable recommendations from the report to ensure comprehensive compliance with all appropriate statues and standards of practice as they pertain to Medicare, Medi-Cal, and HIPAA.

Seven Key Elements OIG Compliance Program:

Per the OIG, Wittman’s policies and procedures include the following seven elements:

1. Wittman Enterprises maintains written standards of conduct that have been developed for and are continually updated to reflect clear compliance rules, expectations, training, monitoring, and address potential fraud.

2. Stephanie Cooper-Noe is our chief compliance officer along with Corinne Wittman-Wong. They chair the Compliance Committee that meets quarterly or more frequently as needed addressing changes in compliance policies and recommended standards of practice.

3. All new employees participate in a detailed HIPAA and privacy training program. Additionally, employees receive regular training updates to remain current on all policies and standards of practice.

4. Wittman follows the “Red Flag Rules” which require “whistleblower” protections that encourages the submissions of complaints and observations, with appropriate levels of protection from retaliation for the employee.

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5. The Compliance Officers and Committee are tasked with responding immediately to any allegations of improper/illegal activities and the enforcement of appropriate disciplinary action against employees who have violated internal compliance policies, applicable statues, regulations or federal, state, or private payer health care program requirements. Any such investigations also include the participation of Wittman’s Director of Human Resources.

6. Wittman Enterprises, LLC uses a comprehensive auditing program to regularly monitor individual employee compliance as well as Wittman control policy compliance to identify any deviation from the required policies and procedures.

7. As stated in #5, Stephanie Cooper-Noe and Corinne Wittman-Wong lead the Compliance Committee and lead any appropriate investigations through correction of any systemic problems if they should be discovered.

Wittman Enterprises Standards of Conduct

Our written policies span over two hundred pages in length to address the myriad of procedures and compliance issues that must be identified, regulated, and enforced. Employees receive annual training and are required to sign a new confidentiality statement at the beginning of each calendar year.

Policies include:• Wittman Enterprises, LLC Compliance Policies

• Corporate Compliance Standards

• Management and Organization Policy

• Employee Education Policy

• Employee/Vendor Screening Policy

• Enforcement and Discipline Policy

• Monitoring and Auditing Policy

• Policy on Reporting, Investigating, and Correcting Compliance Problems

• Wittman Enterprises, LLC Medicare and Medi-Cal Billing Compliance Procedures

• Billing Compliance Audits

• New Employee Billing Compliance Audits

• Syllabus for Compliance Training

• HIPAA Business Associate Agreement

Access to Records

Wittman Enterprises ensures that its use, disclosure of and requests for PHI are in accordance with the Minimum Necessary requirements under HIPAA. We make every reasonable effort to limit the amount of PHI that we use, disclose, or request to the Minimum Necessary to accomplish the intended purpose of the use, disclosure or request.

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City of Vista: RFP: Emergency Medical Services Billing Services I XXXVIII

Internal Use

Wittman’s Privacy Officer is responsible for identifying those persons or categories of persons in our workforce who need access to PHI to carry out their duties, and shall, for each such person or class:

• Identify the category or categories of PHI to which access is needed in order for the persons or class to carry out their duties; and

• Identify any conditions that should apply to each person’s or class’ access to PHI.

• Approved personnel shall only have access to PHI when they are on duty. Each department is responsible for overseeing and making reasonable efforts to ensure that personnel under its supervision only obtain access to the limited type of PHI that is required to carry out their duties. All Requests from any department for changes in access to PHI by its personnel shall be directed to the Privacy Officer for approval.

Routine Disclosure to Third Parties

For disclosures that Wittman Enterprises makes on a routine, recurring basis, we may use protocols to limit the PHI disclosed to the Minimum Necessary to achieve the purpose of the disclosure. The Privacy Officer is responsible for ensuring that all departments and functions within the Organization identify disclosures of PHI that they make on a routine, recurring basis. The Privacy Office is responsible for assisting each applicable department to create standard protocols to be applied to reasonably ensure that routine disclosures only include the Minimum Necessary PHI. Protocols under this section must address the following:

• The protocol must set forth the type of PHI that can be disclosed.

• The protocol must identify the types or categories of persons to whom the PHI identified in the protocol can be disclosed.

• The protocol must identify any applicable conditions to providing the disclosure.

Non-Routine Disclosure to Third Parties

All disclosures that are not routine and recurring must be reviewed on an individual basis in accordance with this section. The Privacy Officer, together with the compliance committee, shall be responsible for developing criteria to be applied to analyze non-routine disclosures to determine the Minimum Necessary PHI that can appropriately be disclosed. All non-routine disclosures must be forwarded to the Privacy Officer for review and approval prior to making the disclosure. The Privacy Officer shall be responsible for reviewing each such non-routine disclosure and determining the Minimum Necessary PHI that can be included in the disclosure. Finally, the PHI requested for disclosure by the following entities shall be deemed to be the Minimum Necessary for the stated purpose and do not require individual review by the Privacy Officer:

• Disclosures to a public official in accordance with applicable law, if the public official represents that the information requested is the Minimum Necessary;

• The information is requested by another Health Care Provider, Health Plan, or Health Care Clearinghouse;

• The information is requested by a professional who is a member of Wittman’s workforce or is a Business Associate of Wittman Enterprises for the purpose of providing professional services to the Organization, if the professional represents that the information requested is the Minimum Necessary for the stated purpose(s); or

• A person is requesting PHI for research purposes and he or she has complied with the Organization’s policy on research and provides documentation to that effect.

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City of Vista: RFP: Emergency Medical Services Billing Services I XXXIX

In the event a workforce member believes that a request for a disclosure involving PHI from a person or entity is not the Minimum Necessary, such workforce member must raise his or her concerns with the Privacy Officer. The Officer is responsible for evaluating such requests for disclosure and determining whether it is reasonable for Wittman Enterprises to rely on such request.

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City of Vista: RFP: Emergency Medical Services Billing Services I XL

Appendix 3: Sample Correspondence


MAKE CHECKS PAYABLE TO:

NAME: PLEASE REMIT TO:

SEE REVERSE SIDE FOR ADDITIONAL INFORMATION

Page 1 of 1

02/10/2014 1,797.26

RUN NUMBER:

FOR BILLING INQUIRIES CALL: 1(800) 906-6552

CHECK # COST PER UNIT TOTAL CHARGE

RUN NUMBER:

FINAL NOTICE

RUN NUMBER DUE DATE AMOUNT DUE

AMOUNT PAID$

PLEASE RETURN THIS PORTION WITH YOUR PAYMENT

3000000021 00.0000.0018 21/1WMN0112A

01/12/2014STATEMENT DATE

09/03/2013

PST - 8:00am to 4:30pm

ANEJGOANDLDIBLAIGK

AJGDPIGAHOGONAABLK

AMJPLHDIAIKPAFNCIK

AGBIIKMGMEIPMFHKDK

DDDDDLDLDDLLDDDDDL

QUANTITY DATE

AA1133--224400667744BB

PO BOX 269110SACRAMENTO CA 95826-9110

INCIDENT NO:DATE OF SERVICE:

INCIDENT NO:DATE OF SERVICE:

DESCRIPTION

PO BOX 269110SACRAMENTO CA 95826-9110

Advanced Ambulance Transport 1,148.901 1,148.90Mileage 520.2623 22.62Oxygen 128.101 128.10

This balance is seriously past due. Payment in full or acceptable payment arrangements must be made immediately. Contact ourbilling company within 14 days or further action may be taken. Para preguntas de facturacion en espanol llame a nuestra oficina.

TOTALAMOUNT

DUE1,797.26

DROPOFF LOCATION:

PATIENT:

PICKUP LOCATION

FOR BILLING INQUIRIES CALL 1(800) 906-6552 PST - 8:00am to 4:30pm.You may also submit insurance information at www.webillems.com/secure

CITY FIRE DEPARTMENT

CITY FIRE DEPARTMENT

13-123456

123456709/03/2013

123 ANY STREET

13-123456

ANY WHERE, CA 12345

JANNIE DOE

123456713-123456

123 ANY STREET ANY WHERE, CA 12345 HOSPITAL

PO BOX 269110CITY FIRE DEPARTMENT JANNIE DOE

SACRAMENTO, CA 95826-9110

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City of Vista: RFP: Emergency Medical Services Billing Services I XLI

(800) 906-6552

RE: Date of Service: 04/01/2011

In order to bill for your recent Emergency Medical Service, please fill out the form below and return it to our office as soon aspossible. Please include a front and back copy of your insurance card if possible. We will not be able to bill your

ID# or Member #:

Auto Insurance Name:

Policy #:

Address:

I authorize any holder of Medical information about me to release to Medicare, Medicaid and any insurance, as well as the provider of this service, any information or documentation in their possession needed to determine these benefits or the benefits payable for related services, whether in the past, now or in the future.

Signature of Patient, Parent or Guardian

FOR BILLING INQUIRIES CALL 1(800) 906-6552 Pacific Standard Time - 8:00am to 4:30pm.You may also submit insurance information at http://WWW.WEBILLEMS.COM/SECURE

AADDTTTTTTTTAATTTTAAFFDDAAFFFFAAFFDDDDFFFFTTAATTFFDDFFFFAADDAADDDDAAAATTTTFFTTTTFFTTDDTTTTFFAAFFAAFFTTDDTTDDFFFFTTFFDDTTTTFFFFDDFF

7000000940 01.0005.0106 940/1WMN0517A AUTO SCH 3-DIGIT 926

ANENGOANDLDMFPCKCKAJGDPIGAHOGONFJDLKAMJLLDDFCMPMCDBIIKAOGKGPMPMJMLCDBGIKDDDDDDDLDLDDLDDDDL

Incident Number

Balance Due:

Claim #:

Authorization for release of Medical Information:

Por favor llame a nuestra officina con la informacion de su aseguransa.

Pacific Standard Time - 8:00am to 4:30pmTELEPHONE NUMBER:

INCIDENT NUMBER: RUN NUMBER:

Dear

Date

/958269110108/

Medicare, Medi-Cal/Medicaid, or Health Insurance until we receive this information. Ultimately, you will be held responsible for all charges.

Insurance Name: Health Insurance:

Group #:

Subscriber: Subscriber Date of Birth: / /

Auto Insurance (if applicable):

City: State: Zip: Phone #: ( )

Attorney or 3rd party(ie) Work Comp (if applicable): Attorney Name/Insurance Name:

Phone #: ( ) Contact:

Employers Name (Work Comp):

ID# or Claim #: Address: City: State: Zip:

AA1111--8888550000BB

Print Name

Phone #: ( )

CITY FIRE DEPARTMENTPO BOX 269110SACRAMENTO, CA 95826-9110

11-2345611-098765

ROSE MARTIN CITY FIRE DEPARTMENTPO BOX 269110123 ANY STREET SACRAMENTO, CA 95826-9110

ANY WHERE, USA 12345-1234

11-23456

$1400.00Rose Martin,

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City of Vista: RFP: Emergency Medical Services Billing Services I XLII


ADDRESSEE: PLEASE REMIT TO:


12345678INCIDENT NO.

DESCRIPTION

Page 1 of 1

/958269110108/

12-12345 08/01/2011 75.25

12-12345RUN NO.



RUN NO:

INVOICE


AMOUNT PAID$


7000001234 01.0005.0284 1234/1WMN0705A AUTO MIXED AADC 926


03/10/2011DATE OF SERVICE:

CARD NUMBER

SIGNATURE EXP. DATE

AMOUNT

CREDITCARD CHOICES MASTERCARDVISA

Pacific Standard Time - 8:00am to 4:30pm12-1234512345678INCIDENT NO:03/10/2011DATE OF SERVICE:

* LAST THREE DIGITS ON BACK OF CREDIT CARD.

* SECURITY CODE

JANE DOE123 STREET

QUANTITY DATE

AA1122--1122334455BB

Payment-Check 07/01/2011 -12.62198765432Payment-Check 07/01/2011 -288.38198765432Basic Ambulance Service 1,300.001 1,300.00Mileage 41.403 18.00Cervical Collar 24.001 24.00Body Substance Isolation 20.001 20.00Pulse Ox 15.001 15.00Contractual Allowance -1,024.15

Your insurance has paid their portion of these charges. The balance is your responsibility. If you have supplementalinsurance which covers this amount, or wish to setup payment arrangements, please contact our billing office. Thankyou

TOTALAMOUNT

DUE75.25

PICKUP LOCATION: DROPOFF LOCATION:


JANE DOEPATIENT:


CITY FIRE DEPARTMENTPO BOX 269110

ANY WHERE, USA 12345-1234 SACRAMENTO, CA 95826-9110

123 ANY STREET ANY WHERE, USA 12345-1234 HOSPITAL


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City of Vista: RFP: Emergency Medical Services Billing Services I XLIII





DESCRIPTION

Page 1 of 1

/958269110108/

12-12345 08/01/2011

12-12345RUN NO.



RUN NO:

INVOICE


AMOUNT PAID$


7000001234 01.0005.0284 1234/1WMN0705A AUTO MIXED AADC 926



CARD NUMBER

SIGNATURE EXP. DATE

AMOUNT




* SECURITY CODE

JANE DOE123 STREET

QUANTITY DATE

AA1122--1122334455BB

Basic Ambulance Service 1,300.001 1,300.00Mileage 41.403 18.00Cervical Collar 24.001 24.00Body Substance Isolation 20.001 20.00Pulse Ox 15.001 15.00

TOTALAMOUNT

DUEPICKUP LOCATION: DROPOFF LOCATION:


JANE DOEPATIENT:


1400.40

CITY FIRE DEPARTMENTPO BOX 269110

ANY WHERE, USA 12345-1234SACRAMENTO, CA 95826-9110

123 ANY STREET ANY WHERE, USA HOSPITAL 1400.40

This bill is separate from your hospital bill. Please inform us of any Insurance, Medicare,Medicaid/Medi-Cal. Please contact our billing office at 800-906-6552.


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City of Vista: RFP: Emergency Medical Services Billing Services I XLIV





DESCRIPTION

Page 1 of 1

/958269110108/

12-33333 08/01/2011 20.00

12-33333RUN NO.



RUN NO:

PAST DUE


AMOUNT PAID$


7000000020 01.0001.0027 27/1WMN0705A AUTO SCH 3-DIGIT 956



CARD NUMBER

SIGNATURE EXP. DATE

AMOUNT




* SECURITY CODE

JOHN DOE123 STREET

QUANTITY DATE

AA1122--3333333333BB

Payment-Check 06/13/2011 -787.85Advanced Ambulance Service 1,140.001 1,140.00Mileage 352.0016 22.00Oxygen 60.001 60.00EKG Monitoring 30.001 30.00King Tube 54.001 54.00Supply Charge ALS2 92.001 92.00Contractual Allowance -920.15

This balance is now past due and requires your attention. If you have questions about this balance or need to set up apayment plan, contact our billing office immediately. Para preguntas de facturacion en espanol llame al 1(800)906-6552 yoprima 1.

TOTALAMOUNT

DUE20.00

PICKUP LOCATION: DROPOFF LOCATION:


JOHN DOE PATIENT:

CITY OF FIRE DEPARTMENTPO BOX 269110SACRAMENTO, CA 95628-9110

CITY OF FIRE DEPARTMENTPO BOX 269110

ANY WHERE, USA 12345-1234SACRAMENTO, CA 95628-9110

123 ANY STREET ANY WHERE USA HOSPITAL

CITY OF FIRE DEPARTMENTPO BOX 269110SACRAMENTO, CA 95628-9110

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City of Vista: RFP: Emergency Medical Services Billing Services I XLV

Appendix 4: Exceptions

Contract Exceptions

Other than the exception noted below, we have no exceptions to the Sample Contract at this time (that we are aware of). Respectfully, we request the right to discuss any other issues or non-applicable section discussions that may arise during contract negotiations between the City’s Attorney and ours.

• Indemnification: We believe that all parties in a contract are allowed the privilege of reasonable indemnification and feel that these sections of the contract may not provide Wittman Enterprises, LLC similar protections. For example, it is possible that we might erroneously bill a claim based on information provided to us by the City and yet be held liable for such an erroneous claim. We feel this is a point where constructive negotiation and discussion may be a reasonable request for both parties at a future date.

Collection Agency

We are not a collection agency and therefore not allowed to follow usual practices associated with third-party collection agencies. Ultimately, we feel that there is a distinct philosophical difference between the services Wittman Enterprises provides our clients and your patients compared to services and methods provided by traditional third-party collection agencies. As such, we strongly suggest that the City is better served having different agencies working on billing and third-party collection agency assignments.

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00081660 2 Exhibit B

EXHIBIT B CONTRACTOR’S PROPOSAL

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December 16, 2019

CITY OF

VISTARFP: Emergency Medical Services Billing Services

Wittman Enterprises, LLC11093 Sun Center DriveRancho Cordova, California 95670www.webillems.com

RFP Contact: Russ HarmsExecutive Director Of Business Development(916) 669-4628 Direct [email protected]

Setting the Standard for EMS Billing

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Principals ..............................................................................................................1

Non-Collusion Statement ....................................................................................1

RFP SECTION 5.2: Introductions

5.2.1 Letter of Transmittal ....................................................................................2

Proposers Warranty.........................................................................................3

5.2.2 General Information ...................................................................................4

5.2.3 Qualifications and Experience .................................................................16

5.2.4 References (Proprietary and Confidential) ..............................................20

Letters of Recommendation (Proprietary and Confidential)......................21

RFP SECTION 5.3: Scope of Work

Scope of Work Index from RFP .........................................................................26

Project Approach ................................................................................................32

Client Portal ........................................................................................................37

Project Methodology .........................................................................................45

Project Deliverables ...........................................................................................60

5.3.1 Deliverables Schedule .........................................................................60

5.3.2 Work Product ........................................................................................63

5.3.3 Vista Staff and Provider Scope of Work ..............................................63

5.3.4 Cost Proposal .......................................................................................64

5.3.5 Reporting ..............................................................................................69

5.3.6 Certificate of Insurance ........................................................................71

5.3.7 Financial Stability Statement ..............................................................72

5.3.8 Legal and Contract History Statement ...............................................72

5.3.9 Type of Business Entity ........................................................................72

5.3.10 Corporate Status ................................................................................72

5.3.11 Sole Proprietorship Status .................................................................72

5.3.12 W-9 Copy .............................................................................................73

5.3.13 Sample Correspondence ...................................................................73

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APPENDICES

Appendix 1: Reporting, GEMT Reporting, GEMT QAF Reporting .....................I

Appendix 2: Privacy and Security Compliance ........................................XXXIV

Appendix 3: Sample Correspondence ............................................................. XL

Appendix 4: Exceptions .................................................................................. XLV

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Wittman Enterprises, LLC is a limited liability company (since 1991) operating out of our single office at 11093 Sun Center Drive | Rancho Cordova, CA 95670.

Principals

CEO .......................................................................................................... Corinne Wittman Wong

President/CFO ..................................................................................................... Walter Imboden

Vice President .......................................................................................................Kathryn Garcia

COO ........................................................................................................................ David Wittman

Non-Collusion Statement

Wittman Enterprises, LLC declares that this bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive; that Wittman Enterprises, LLC has not directly or indirectly induced or solicited any other bidder to put in a false bid; that Wittman Enterprises, LLC has not in any manner, directly or indirectly sought by agreement, communication, or conference with anyone to fix the bid price of Wittman Enterprises, LLC or any other bidder, or to fix any overhead, profit, or cost element of the bid price.


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5.2.1 Letter of Transmittal

Letter from our CEODecember 16, 2019

Thank you for the opportunity to introduce our qualifications and our team to you and provide the City of Vista our RFP response for Ambulance & Paramedic Billing and Collection Services. Since 1991, Wittman Enterprises, LLC has provided our clients complete ambulance and fire billing services in compliance with current local, state, and federal laws and statutes. We follow and exceed currently accepted standards for accurate, consistent, and best EMS billing practices while maximizing revenue recovery, honoring your collections philosophy, and treating each of your patients, citizens, and visitors as our own. We serve over 100 public EMS/Fire clients (10 in the San Diego County area) and are the largest California-based billing company with the client base, patient database, and experience with California departments (and multiple California payers) for the most effective EMS billing and cost recovery program possible.

As an extension of your EMS program, Wittman Enterprises will maintain a strong customer service platform that provides your team with direct phone numbers and real access to all management staff, starting with me. Staff are assigned to your team so that the City has direct access to the person(s) on our team who can most help with whatever situation may arise. Jennifer Gentry (your Client Liaison) and our entire Client Liaison Team is always available to help identify key resources you may use to get the results you need. We use all the resources necessary to provide the best in customer service and collect for our clients: (on average) 10-20% more in net revenue than our competitors.

We recognize the extraordinary depth of your EMS program as described in your RFP and based on our more than 29 years’ experience; and, we look forward to continuing to provide solutions for you moving forward. As the most qualified and experienced EMS biller in California, we want to assure the City that our ultimate focus is on, and has always been based on, the best patient and client service, billing results (accurate and legal billing and most legal, reimbursable revenue), and transparency (Client Portal, Reporting, Month-end-Reporting, KPIs, etc.).

I could not be prouder of the tremendous working relationship we have enjoyed with our EMS Partners over the last 29 years. We have worked together on multiple changes in our industry, on the GEMT/GEMT QAF rollouts and implementations, on ICD-10 conversions, and on many other CMS and industry programs. Thank you for allowing me to introduce our qualifications and commitment to the City and to your EMS/Fire team. We look forward to providing a full response to the evolving needs of your program and our enthusiastic support of it.

My best,

Corinne Wittman-Wong, CEOWittman Enterprises, LLC (established 1991)11093 Sun Center Drive | Rancho Cordova, CA 95670(916) 669-4608 direct line | (855) 611-0056 toll-free | [email protected]

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gProposers Warranty

The undersigned person warrants that:

• She is an officer of Wittman Enterprises, LLC

• She is authorized to offer a proposal in full compliance with all requirements and conditions as set forth in the RFP

• She has fully read and understands the RFP and has full knowledge of the scope, nature, quantity and quality of the work to be performed, and the requirements and conditions under which the work is to be performed

• The proposal is good for 90 days from the date of submission.

BY: ________________________________________________ Corinne Wittman-Wong, CEO Wittman Enterprises, LLC Rancho Cordova, CA 95670 (916) 669-4608 direct line

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About Us

Based on your RFP, you are continuing your billing program for ambulance transports and other cost recovery services for EMS you provide. Wittman Enterprises has extensive experience and specializes in the invoicing, categorizing, recording, monitoring, supervising, and managing of ambulance billing and EMS cost recovery systems/services. We bring 29+ years of EMS/Fire billing experience, and with your neighboring communities: San Clemente (since 1996); Oceanside (since 2012); Carlsbad (since 2015); San Marcos (since 2001); Escondido (since 2001); North County (since 2008); Ramona (since 1991); Poway (since 2016); Barona (since 2008); Viejas (since 2009); and Coronado (since 2001). We help each of our individual partners reach and exceed their individual and customized program objectives.

We are pleased that our high standards of performance exceed Vista demands for the following fundamental objectives and minimum services required as listed in your RFP.

• (Since 1991) Wittman Enterprises provides our clients complete ambulance billing services and solutions, accounts receivable management services, and collection services for BLS, ALS, and non-transport services in compliance with current local, state, and federal laws and statutes, in accordance with HIPAA regulations.

• We are dedicated exclusively to the EMS industry and choose to be expert in the EMS billing and collection industry rather than diversify into any other medical billing fields.

• We efficiently and effectively file claims with governmental programs such as Centers for Medicare and Medi-Cal (“CMS”) and the VA, as well as commercial health insurance.

• We follow and exceed currently accepted standards for accurate, consistent, and best EMS billing practices. We are licensed, insured, bondable, and HIPAA compliant for the State of California.

• Wittman Enterprises provides EMS billing and collection services to more than 100 public departments in California from our single Sacramento-area location.

• We will maximize revenue for the City while honoring your collections philosophy and treating each of your patients, citizens, and visitors as our own.

Solutions

Since 1991 Wittman Enterprises has provided products and services specifically designed to assure that EMS Transport, First Responder, and Fire Service providers like the City of Vista are reimbursed in a timely manner for services they provide. Wittman does not farm out these services; we coordinate them all from our single location in Sacramento, CA.

Minimum Time

Maximum Reimbursement

We

Cus

tom

Fit Our Services To M

eet Your EM

S/Fire Billing Needs

.

Solutions include:

• Ambulance Transport Billing and Fire Service Fee Recovery

• ePCR Integration

• First Responder Billing and Collection

• Treat-no-Transport Billing and Collection (Assessments)

• Membership Program Support

• Patient Survey Program Support

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gTogether We Achieve the Extraordinary: Performance History Comparison (Proprietary and Confidential)

Through streamlined efficiency, talented staff, selective automation, and continuous improvement, Wittman has as long record of strong collection returns for our clients on billed charges. Wittman Enterprises generally outperforms our competitors by 10-20% in collections for our EMS partners. Substantial successful and reliable performance in providing our services for public ambulance departments can be seen in all of our client histories; however, please consider the examples of Gross Collected Revenue in the following performance chart.

California Strong

We do not believe that any California-based biller will provide as much in actual reimbursement or complete customer service as Wittman Enterprises has historically demonstrated. We have a proven record of collecting 10-20% more than our competitors. Out-of-state billing companies will not be able to arrive at these reimbursements either, due to their lack of billing and collection experience in the State of California and inexperience with the multitude of California payers.

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With a proven commitment to customer and patient service Wittman Enterprises conducts your business as if your patients were our own. This starts with valuing customer service with everything we have done as a Company since 1991 (living up to our Dedicated Response Time Commitment; providing ongoing and comprehensive Staff Training; availability of our Bilingual Staff; meeting regularly with our partners quarterly, etc.).

We also strive to provide up-to-the minute looks directly into our billing system and multiple ways to view records, reports, and other valuable information through our Client Portal. For ePCR interfacing and ultimate billing accuracy we work closely with most ePCR vendors like ImageTrend to ensure the quality of data we receive on your behalf for the billing process.

Finally, from all of these important areas we constantly monitor the quality of our work on your program through a series of KPIs customized to ensure the success you should expect. We are transparent to the point that our EMS partners have as much access to data and trends as they need to evaluate the success of our team at meeting your goals.

EMS Partner Satisfaction

The City of Vista can count on Wittman Enterprises to continue conducting diligent, regular, and uninterrupted billing and collection services in a professional businesslike manner. Our personal approach and higher levels of service greatly exceed industry standards. Your expectations and overall satisfaction are attained through ongoing and regular training, continuous improvement, and our comprehensive auditing program. Wittman maintains our industry-leading lowest claims-per-staff ratio (generally 30% lower than our competitors) based on upholding the standard of practice our clients expect. Our comprehensive and ongoing training program allows us to continuously improve the business activities that we conduct on behalf of the County and ensure that you continue to receive the maximum legal reimbursement available. We do not strive to be the largest EMS billing company but expect to be the best. The secret to our clients’ successful reimbursement is ultimately the personal attention we apply to each of their accounts. Simply put, it is the dedication to our process that combines the best in technology with the commitment of people to perform the hard work necessary to pursue elusive insurance Payers, successfully appeal Medicare and insurance denials, and work effectively through difficult reimbursement issues such as Medi-Cal cutbacks. The significant efforts we undertake as a commitment to our EMS partners allow us to meet and exceed client expectations (and requirements as set forth in your RFP) and achieve high client/customer satisfaction. We stand behind the work we conduct on behalf of our clients and work closely with each of them to make sure they are completely satisfied with our performance.

Maintaining our Dynamic Workforce

As we discussed in “Workload Accomplishment” (page 32), Wittman Enterprises maintains the lowest claims-per-employee ratio in the industry. Our competitors work with nearly 30% less staff than we do per claim (effectively assigning 30% more work to each of their employees) and collect less for their billing clients. By maintaining our 4,000 to 5,000 claims-per-staff-ratio, we are able to take on significant new growth without necessarily hiring any staff. Should that ratio approach and/or exceed our standard range, we hire and train staff proactively to ensure we are never operating outside of our expected customer satisfaction standards and collected revenue expectations.

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gCompany Profile

Wittman Enterprises conducts all of our work and coordinates all services from our single location in the Sacramento area. We are a Limited Liability Company (California).

Wittman Enterprises, LLC (established 1991)11093 Sun Center DriveRancho Cordova, CA 95670(855) 611-0056 (toll-free)www.webillems.com

OfficersCorinne Wittman-Wong, CEOWalter Imboden, President and CFOKathryn Garcia, Vice PresidentDavid Wittman, COO

Organization

Our staff is divided among four departments: Customer Service (60); Cash Receipts (20); Support Services/Electronic Billing (10); Data Entry (40). All departments are dedicated to the personal attention of our clients and their patients’ needs. Our staff is divided into teams to efficiently address workflow processes and are further divided based on your location. The teams assigned to the City of Vista project are the same teams that service the cities and departments of our San Diego-area clients. The San Diego “pod” has a Pod leader and a team of three to five who scrutinize all individual submitted runs and initiate the billing process. The San Diego pod begins their work after our Electronic Claims Department imports ePCR files and our system automatically scrubs the data before it goes to our Billing Department. This personal attention makes the difference between collecting the “easy” money and pursuing difficult payment situation for maximum legal reimbursement.

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gStaff Availability

All Wittman staff is available in our single Sacramento-Area office during our normal business hours.

JOB TITLE FUNCTION

CEO (1) Compliance and Company Leadership President/CFO (1) Policy, Operations, and Financial Leadership Client Liaison (4) Client bridge to Operations and Administration Division Manager: Insurance (1) Insurance Specialist and Staff Leadership Division Lead: Insurance (2) Insurance Team Day-to-Day Management Insurance Team Staff (21) Ensures that all Insurance/Medicare/Medi-Cal billing is properly billed and collected

Division Manager: Patient Services (1) Patient Services Staff and Procedure Leadership Division Lead: Patient Services (1) Performs administration duties involving client transactions, record-keeping and customer service. Provides direction to staff in the performance of their duties.

Patient Services Team Staff (12) Identifies and resolves patient billing issues

Cash Receipts Supervisor (1) Organizes work processes, methods, and procedures, ensuring efficient accounting of cash receipts Cash Receipts Team Staff (9) Ensures that cash is receipted properly and deposited in a timely manner, and that transactions are recorded accurately

Division Manager: Support Services (1) Supervises and coordinates activities of staff in Support Services department Support Services Staff (12) Performs Electronic Billing to Medicare/Medi-Cal and other payors, mailing, scanning, and PCR processing functions Billing Supervisor (2) Supervises EMS billing staff, month-end closes and reconciliation of patient receivables, aging of collections

Billing Team Lead (2) Oversees staff, workflows, and supports staff

Billing Team Staff (21) Enters PCR information into database with proper medical protocol terminology to produce a clean statement or claim

Auditing Team Lead (1) Organizes weekly focus and provides feedback to team leaders on areas of improvement or focus for ongoing training

Auditing Team Staff (3) Audits and monitors workflows, ensuring processes and quality of work are maintained within each department

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gEMS Billing Project Manager

Jennifer Gentry (CAC, CADS), Client Liaison11093 Sun Center Drive, Rancho Cordova, CA 95670(916) 669-4607 (direct line) • [email protected]

Summary: Jennifer Gentry has been with Wittman Enterprises for 22 years and is part of our Client Liaison team, with the primary responsibility of client

communications, managing client projects from start to finish and providing her clients with a direct contact for any operational or reporting or additional needs. Additionally, Ms. Gentry facilitates the integration of all ePCR systems within our billing system for individual departments. She works directly with each client and their ePCR vendor to ensure the most effective information import possible through a customized mapping process. She is also a co-moderator of our Medicare Compliance Committee and works on our Medicare documentation training program for staff and clients. Prior to joining the Client Liaison team, Ms. Gentry was the data entry and billing manager on our Operations team.

Projects: San Diego County-Area Client Liaison (Proprietary and Confidential) (Barona, Borrego Springs, Carlsbad, Coronado, Escondido, Oceanside, Poway, San Marcos, North County, Ramona, and CSA 17/CSA 69)

Work Performed: Main and regular contact between clients and our operations team; Medicare and Medi-Cal enrollments (Revalidations); Annual Medicare and Medi-Cal Updates; EDI registration and updates; specialized reporting; status and projections reporting; Monthly Account KPI Reviews; client meetings; special projects reporting, special client projects, GEMT/IGT/QAF reporting and project support, ePCR administration and transitions; Documentation Statistics for Client Portal; ePCR Import Electronic Scrubber; Transition/Onboarding of new clients; etc.

Certifications: Certified Ambulance Coder (CAC); Certified Ambulance Documentation Specialist (CADS)

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gStaffing Chart

Contract Management Team

David Wittman, COO (916) 669-4601 [email protected]

Russ Harms, Executive Director of Business Development (916) 669-4628 [email protected]

Joe Balkema, Executive IT Director (916) 669-4620 [email protected]

Corinne Wittman-Wong, CEO (916) [email protected]

Walter Imboden, President/CFO (916) 669-4602 [email protected]

Kathryn Garcia, Vice President (916) 669-4606 [email protected]

Management Team

Jennifer Bump, Division Manager: Insurance Services(916) 669-4612 [email protected]

Heather Montano, Division Manager: Patient Services(916) 669-4627 [email protected]

Nicole Powers, Division Manager: Administrative, Billing, and Cash Services(916) 669-4624 [email protected]

Stephanie Cooper-Noe (CMC, CACO, CAPO, CADS), Client Liaison: GEMT (916) [email protected]

Jennifer Gentry (CAC, CADS), Client Liaison: ePCR (916) 669-4621 [email protected]

Judy Vang (CAC, CADS), Client Liaison: Insurance (916) 669-4613 [email protected]

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gOperations Team/Experience

Jessica Ceccato, Insurance Team Lead .............................................................................12 years

Maya Ruiz, Insurance Team Lead .........................................................................................9 years

Cicely Vera, New Client Insurance Transition Specialist ....................................................5 years

Rachel Troche, Patient Services Team Supervisor ............................................................14 years

Elayne Huff, Lead Patient Services Team Lead ................................................................. 19 years

Celena Posh, Patient Services Team Lead...........................................................................5 years

Austin Boyd (CAC), Billing Team Lead .................................................................................4 years

Chia Chang (CAC), Billing Team Lead ..................................................................................3 years

Angelas Thao (CAC), Billing Team Lead.............................................................................14 years

Sheng Cha, Administrative Services Team Lead ..............................................................13 years

Pakou Vang, Cash Receipts Team Lead ............................................................................. 11 years

Renee Wittman, Cash Receipts Team Lead .......................................................................24 years

Southern California-Area Insurance Team Specialists

Our team of insurance specialists are trained and experienced with their assigned client payors so that they can manage all aspects of submission, payments, and appeals. For our Southern California partners the following specialists provide the practical experience necessary to get you your highest legal reimbursement possible:

Brittany BumpCalifornia commercial and government accounts specialist (VA, Department of Corrections, Blue Shield/Blue Cross of California, Secure Horizons, Pacificare of California, Kaiser, etc.)

Christine MarshallMed-Cal and Medi-Cal HMO accounts specialist

Priscilla JavarCalifornia Medicare and Medicare HMO accounts specialist

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gOrganizational Chart

CEO

Corinne Wittman-Wong

President/CFO

WalterImboden

Vice President

KathrynWolf-Garcia

COO

David Wittman

Executive Director of Business

Development

Russ Harms

Executive Director

(IT)

Joe Balkeman

ProjectManager

DonnaBailey

HumanResourcesManager

IngridJana

Help Desk Analyst II

Rebekah Miller

Help Desk Analyst I

Peter Khang

ClientLiaison

Stephanie Cooper-Noe

ClientLiaison

Jennifer Gentry

ClientLiaison

Judy Vang

LeadCash

Posting

PakouVang

LeadBilling

Division

Austin Boyd

LeadBilling

Division

Angeles Thao

LeadCash

Posting

Renee Wittman

LeadBilling

Division

Chia Change

SupervisorIncoming Call

Division

RachelTroche


Celena Posh


Elayne Huff

Division Manager

Customer Service/Training

JenniferBump

Division Manager

Support Services/ e-Billing

NicolePowers

Division Manager

Customer Service/ Phones

HeatherMontano

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gSubcontracting Partners

InfoSend (Anaheim, CA):Invoicing and mailings exchanged through a secured and HIPAA-compliant method and fully-executed Business Associate Agreement.

Apexon (Southfield, MI):Pre-billing and pre-cash receipt posting data processing exchanged through a secured and HIPAA-compliant method and full-executed Business Associate Agreement.

Change Health (Nashville, TN):HIPAA-compliant electronic insurance eligibility checker (formerly Emdeon, Capario).

Industry Trends and Regulations

Through our regular association with Page, Wolfberg & Wirth, nationally recognized legal experts in EMS legal consulting, the American Ambulance Association, and regular conferences, correspondence, and training opportunities with Medicare and Medi-Cal (among multiple other payers): we are current on all industry issues and changes, remaining proactive with our clients and continually updating them on changes, opportunities, and news that affect their programs.

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g5.2.3 Qualifications and Experience

Qualifications

Wittman Enterprises has customized service innovations to our partners in the EMS transport industry since 1991. We serve more than 125 public EMS partners in the Western United States and are the largest West Coast-based EMS billing company with the client base, patient database, and experience with the San Diego County-Area departments (multiple payers) essential in providing the most effective EMS billing and cost recovery program possible.

29 Years EMS Billing Experience

Wittman Enterprises was founded 29 years ago with the promise of providing expert and personal attention to our EMS partners and their EMS billing programs. This will never change. We provide industry-leading services to our EMS partners to help you continue providing cost-effective programs and responsive services enhancing the quality of life in the City of Vista, while balancing the financial accountability needs of your citizens. With a proven commitment to customer and patient service Wittman Enterprises conducts your business as if your patients were our own. This starts with valuing customer service with everything we have done as a company since 1991 (living up to our Dedicated Response Time Commitment; providing Ongoing and Comprehensive Staff Training; maintaining well-qualified Bilingual Staff; meeting regularly with our partners quarterly, etc.).

• Wittman is dedicated exclusively to the EMS/Fire industry and chooses to be expert in that industry rather than diversify into other medical billing fields.

• Our excellent reputation is gained from professional relationships with providers and third-party payers, as well as from our sensitive yet collection-oriented communications with patients and their representatives.

• We have a long and successful history of meeting and exceeding client expectations and service deadlines.

• From the beginning of your project, we anticipate and manage for you issues such as Medicare compliance and revalidation, reconciliation of payments from legacy billing accounts, responses to legal and other requests, and customization of a reporting program surpassing your specific needs.

• Since our only business is EMS/Fire billing, our specialized staff is dedicated and expertly trained in this field.

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gCustomized Solutions

Often during our work together, new programs are created that require Wittman and our clients to work together to fully scope the new programs as well as price it and establish clear SOPs and expectations to make sure the client-chosen and/or required service additions are successful. These are not cookie cutter items; in fact, they are customized according to the needs of each individual client. In our 29 years in business we have significant experience expanding the scope of work, services, and contract to meet and exceed our EMS partner needs. We assist with recommendations, pricing suggestions, research, resources, information, and overall support to ensure the City of Vista has a PARTNER to help navigate ever-changing waters and regulations. For example:

Emergency Triage, Treat, and Transport (ET3) Model: Wittman Enterprises works with our clients on new programs such as ET3, Community Paramedicine, Alternate Destination, etc., making recommendations and trying to provide as much information and support as possible if and when the client decides on their chosen level of participation. The ET3 is a current program we are helping our clients with, through education and regular updates as well as website content and regular mailings and/or seminars as seen below:

NEWSEmergency Triage, Treat, and Transport (ET3) Model (from CMS.gov) ET3 is a voluntary, five-year payment model that will provide greater flexibility to ambulance care teams to address emergency health care needs of Medicare beneficiaries following a 911 call. Under the ET3 model, the Centers for Medicare and Medi-Cal Services (CMS) will pay participating ambulance suppliers and providers to: 1) transport an individual to a hospital emergency department (ED) or other destination covered under the regulations, 2) transport to an alternative destination (such as a primary care doctor’s office or an urgent care clinic), or 3) provide treatment in place with a qualified health care practitioner, either on the scene or connected using telehealth. Continue reading from CMS.gov (https://innovation.cms.gov/initiatives/et3/)

ET3 Webinar – March 25, 2019 (from NAEMT.org)Join leaders from NAEMT, NAEMSP and IAFC for an informational webinar on the clinical, operational and financial considerations that agencies should be evaluating NOW if they are considering applying to participate in the ET3 model.The ET3 webinar will be held on March 25, 2019 at 1 pm EST. Continue reading from NAEMT.org and complete webinar registration (http://naemt.org/events/et3-webinar)

LINKSEmergency Triage, Treat, and Transport (ET3) Model: CMS.gov (https://innovation.cms.gov/initiatives/et3/)

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gKey Personnel

Corinne Wittman-Wong, Chief Executive Officer

Corinne has been with Wittman Enterprises, LLC for more than 24 years. As CEO she is responsible for the strategic planning and vision of the company. Her strong knowledge of the industry integrates completely with her experience of working in all departments of the company and provides her with a unique perspective on our company’s philosophy and goals. She administers the supervision of our clients’ accounts, and the adherence of policies and procedures set forth by the company, while facilitating and encouraging leadership qualities, innovativeness, and direction of our employees.

Walter Imboden, President/CFO

For 29 years Walter has worked in the EMS billing industry. He oversees all aspects of the day-to-day production and operations of the company, monitoring both production and personnel. He directs the billing and collection processes ensuring adherence to our clients’ contract requirements. He develops office procedures that are designed to enhance and expedite workflow. Over the years while working in every department at Wittman Enterprises, LLC Walter has developed strategic, tactical, and short-term operations that enable him to provide invaluable guidance and training to our department managers.

Kathryn Garcia, Vice President

In her 24 years with Wittman, Kathryn has worked and managed all departments. This provides her the perspective and experience to help the City with any special requests or circumstances. Kathryn oversees the billing team and the cash receipts team. She provides the City with special reports to aid the balancing process for trips, refunds, and deposits. She also creates, reviews and distributes all client month-end reports.

Joe Balkema, Executive Director, IT

Joe brings 25 years of programming experience with C#, VB, ASP, JavaScript, and BBX, along with more than 16 years of SQL knowledge and reporting design. He has installed more than 30 billing systems nationwide. At Wittman he designs multiple client-focused programs and reporting mechanisms, and streamlined our working environment by designing a document management system to go paperless: scanning over 3,000 documents daily.

Stephanie Cooper-Noe, Client Liaison

For more than 21 years Stephanie has provided ambulance billing leadership and customer service to our clients. She develops our Compliance and Documentation Webinars, trains employees and monitors their compliance with the company’s HIPAA program, designs client-specific reports, oversees Medicare Revalidations, and provides the conduit between client finance departments, fire departments, and Wittman Enterprises, LLC. Certifications: Certified Medi-Cal Billing Associate.

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gRuss Harms, Director of Business Development

Russ brings 26 years of management leadership, direction of progressive operations, and the building of strong client partnerships to Wittman Enterprises and our clients. He specializes in organizational development and management, strategic planning, performance management, continuous improvement, business development, leadership development, and change management. Education: Master of Arts, English; Bachelor of Arts, English.

Jennifer Gentry, Client Liaison (ePCR Interface)

Jennifer has been with Wittman Enterprises for over 20 years. She facilitates the integration of ePCR systems with our ZOLL billing system. Jennifer works with each client to ensure that we have the most effective information import possible through a customized mapping process. Jennifer is also the co-moderator of our Medicare Compliance Committee and works on our Medicare documentation training program for staff and clients. Certifications: Certified Ambulance Coder.

Jennifer Bump, Division Manager (Customer Service/Training Coordination)

For more than 14 years Jennifer has been with Wittman Enterprises. She began in Customer Service, working on private insurance accounts as a specialist, working incoming and outgoing calls, and ultimately as the lead over the revenue assurance team. Later she took over as manager of our Customer Service Division. Currently she is a division manager for Customer Service, directing the specialist team working on all governmental payers. She oversees the Quality Assurance Department over cash receipts and all of the Customer Service Department, and coordinates the company training programs.

Heather Montano, Division Manager (Customer Service/Phone Services)

Starting 14 years ago, Heather began as a Customer Service Representative for Wittman Enterprises, working private pay accounts, private insurance accounts, incoming correspondence and incoming calls. Next, she was promoted to Customer Service Department Lead and then Department Supervisor where she handled client concerns and patient billing anomalies and issues. She has extensive knowledge of our Billing Program and Reporting systems. Currently Heather is the Division Manager of the Patient Services Department, overseeing inbound and outbound calls, private correspondence, auditing, and quality assurance for all calls.

Nicole Powers, Division Manager (Support Services/Electronic Billing)

Nicole has been with Wittman for over 16 years. She oversees the receiving and importing of all Patient Care Reports (PCRs), document scanning, and claim submissions (electronic billing) via paper and electronic means to all payers. Nicole continuously streamlines electronic processes and updates automation to ensure appropriate timelines are met to ensure the most timely and efficient reimbursement for our clients.

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gRFP SECTION 5.3: Scope of Work

Scope of Work Index from RFP

Submittal of our Proposal is prima facie evidence that we have full knowledge of the requested scope, nature, quality, and quantity of the work to be performed and detailed requirements and conditions under which the work is to be performed. Since 1991 Wittman Enterprises has demonstrated our expertise needed to correctly invoice for the City of Vista’s services to Medicare/Medi-Cal HMO, commercial insurance companies, and private pay individuals, based on the City’s fee schedule. We address the RFP Scope of Services in the following pages of this section.

RFP Section 4.2: Acknowledged and Agreed to Sections

The following sections of RFP Section 4.2 SCOPE OF WORK have been reviewed, acknowledged, and agreed to. References and clarifications for other sections directly follow. 4.2.2 4.2.3 4.2.7 4.2.10 4.2.16 4.2.24 4.2.27 4.2.36 4.2.37 4.2.38 4.2.39 4.2.40 4.2.42 4.2.46 4.2.47 4.2.48 4.2.49 4.2.51 4.2.52 4.2.53 4.2.55 4.2.57 4.2.58 4.2.59


4.2.1 Acknowledged and Agreed To. For more details please see “Project Methodology”(p. 45) for a complete process summary.

4.2.4 To the best of our ability, we will process any viable backlog work within 30 days of the implementation date. Depending on the volume aging, and viability of accounts, this may be negotiated at a different rate than our RFP proposed rate for new billings and collections.

4.2.5 Acknowledged and Agreed To. Dispute Resolution We recognize that most patients are citizens of your community so our goal is to function

as an extension of the City of Vista. We provide extensive training and look for individuals with the ability to be compassionate and empathetic while efficiently resolving calls. There are managers and directors available at all times to assist if customer issues cannot be resolved to the patient’s expectations by our customer service department. All customer service staff is located in our single Rancho Cordova office. If any complaint received by our patient service department involves care-related concerns, Wittman will contact the City/Fire Department directly for resolution. We manage resolution of any unlikely disputes in accordance with City and HIPAA guidelines. Over the years as an EMS billing partner, Wittman has developed strong rapport with client staff and work closely with them to find quick and equitable resolutions to any patient disputes. We generally dispel any patient concerns or disputes without involving City/Fire personnel.

4.2.6 Acknowledged and Agreed To. For more complete process summaries, please see “Vista Staff and Provider Scope of

Work” (p. 63); “Records Confirmed and Screened for Completeness” (p. 48); “Follow-Up Protocols” (p. 48); and “Identification of Payment Sources” (p. 49).

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4.2.8 Acknowledged and Agreed To. Business Continuity Plan Our Business Continuity Plan allows Wittman to continue conducting our clients’ business

until recovery from an unforeseen disaster or emergency is accomplished. It identifies how we would stay in touch with our clients and with each other, continuing to do our work. The plan 1) documents key personnel and backups, 2) identifies those who can telecommute, 3) documents critical equipment and appropriate off-site backups, 4) identifies critical documents, and 5) identifies contingency equipment options and locations.

Utilizing Veritas Backup Exec software, our electronic computing and storage capabilities are backed up redundantly by a Dell Power Vault 124T with 24 terabytes of storage capacity. Wittman’s network consists of a redundant Raid Ten Array Network Attached Storage, running on two Dell R720 Dual Processor eight core servers on Windows 2012 Server in an active/passive cluster mode. Wittman uses Rescue Net Billing by ZOLL Data Systems. In the event of a catastrophic event, the software is readily available for us to replace. As an added precaution, all backup and system programs are kept offsite. To minimize any potential down time Wittman contracts with Dell Computers for a maximum 4-hour service response time on all of our billing servers. In case of an interruption in Vista’s (or Wittman’s) ability to transmit or receive ePCRs electronically we maintain the ability to receive information through our secured FTP site. Our IpSwitch Secure FTP server is the industry-leader in FTP security. Highlights of this system include:

• Security: Encrypted transfer over SSH/SFTP, SSL/FTPS, and HTTP/HTTPS protocols

• Powerful management administrative control and enforcement

• Automation: Server events can generate alerts and launch workflows

• Compliance: Exceeds stringent security and privacy requirements for secure file transfer

• Ad hoc and schedule interaction: Supports impromptu as well as predefined transfers by people, systems, and processes

• An $800,000 line of credit is available to us for the purchase of necessary equipment, software, and supplies. Regular reviews of the plan and other emergency plans are conducted to ensure current and workable solutions.

4.2.9 Acknowledged and Agreed To. Please see “ePCR Interface” (p. 46); “ePCR Uploading Overview” (p. 46); and ePCR Import

Data Scrubber” (p. 47) for more electronic file information.

4.2.11 Please see “Auditing” (p. 33) for a summary of our auditing processes and history.

We will be responsible for reconciling ePCR files we receive from the City with WATER FireRMS data provided by Vista and/or received from WATER FireRMS. Because we do not access our clients’ CAD systems, we do not include any CAD reconciliation as part of our usual scope of services provided. However, we customize all of our client accounts and are willing to discuss any customizations we are able to provide to the City based on the specifics of your program and our billing system.

4.2.12 Please see the entire “Project Methodology” section (pp. 45-59) for a complete overview of our billing and research processes from receipt of the ePCR through collections on each account.

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4.2.13 Acknowledged and Agreed To. Please see “ePCR Interface” (p. 46); ePCR Uploading Overview” (p. 46); and “ePCR Import

Data Scrubber” (p. 47) for details on how we work with WATER.

Generally, our experience is with the interface between our clients’ ePCR system and our billing system. As billers we are limited to a certain extent as far as having the resources required for managing ePCR and other hardware.

4.2.14 Acknowledged and Agreed To. “Identification of Payment Sources” (p. 49); Medicare Billing” (p. 50); Medi-Cal Billing”

(p. 52); and “Private Insurance Billing” (p. 52), give examples of how we bill all claims electronically whenever possible.

4.2.15 Acknowledged and Agreed To. Please see “Hospital Patient Records Systems” (p. 55) for details regarding receiving

hospital face sheets and other demographics gathering protocols.

4.2.17 Acknowledged and Agreed To. Any modifications to server instruments and HIPAA Notices may be subject to pass-through

fees from our printing partners.

4.2.18 Acknowledged and Agreed To. Please see “EMS Billing Project Manager” (p. 11) for an introduction to our San Diego-area

Client Liaison.

4.2.19 The City of Vista’s Client Liaison—Jennifer Gentry—and Wittman’s entire Client Liaison team, and the ePCR Analyst (and the entire IT team) are all available during normal business hours for any program needs. Please see “Dedicated Response Time Commitment“ (p. 30).

4.2.20 Acknowledged and Agreed To. Wittman Enterprises, LLC provides complementary annual revenue enhancement training

for EMS and financial staff. This includes four (4) hours of teleconference, webinar or ZOOM (Skype)-facilitated training, for Vista general staff, and six (6) hours for EMS/EMS Management. Additional and/or onsite training as requested by the City of Vista will be at a contracted rate of $100 per hour (personnel rate) plus associated travel expenses. Please see “Quality Assurance” (p. 33); and sections on our training programs (pp. 34-35) for more information on maintaining our industry awareness and regular communications.

4.2.21 Acknowledged and Agreed To. Please refer to sections in 4.2.20 above.

4.2.22 Acknowledged and Agreed To. Please refer to “Appendix 2: Privacy and Security Compliance” (p. XXXIV) for a summary of

our policies.

4.2.23 Acknowledged and Agreed To. Our written policies span over two hundred pages in length to address the myriad of

procedures and compliance issues that must be identified, regulated, and enforced. All information is available for City review at any time upon your request. Please see “Continuous Improvement” (p. 36); “Monitoring and Auditing” (p. XXXV); “Auditing” (p. 33); and “100% Auditing and Training” (p. 35), for further details.

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g4.2.25 Acknowledged and Agreed To. Details about our Portal System can be found in “Client Portal” (p. 37); “Collections Portal”

(p. 43); “Patient Portal” (p. 57); and “Additional Portals” (p. 43).

4.2.26 Wittman Enterprises conducts due diligence and maintains a high level of professional standards to effect collections. We only use collection methods that are reviewed by and approved by the City of Vista for conformity with your policies and procedures. We observe debtors’ rights and comply with any and all applicable federal and state laws, including by way of example and not as a limitation, applicable provisions of the Federal Fair Dept Collections Practices Act, Collection Agency Act, and the California Robbins-Rosenthal Fair Debt Collection Agency Act.

We are not a collection agency, however. Wittman Enterprises, LLC is not allowed to follow usual practices associated with third-party collection agencies. Ultimately, we feel that there is a distinct philosophical difference between the services Wittman Enterprises provides our clients and your patients compared to services and methods provided by traditional third-party collection agencies. As such, we strongly suggest that the City is better served having different agencies working on billing and third-party collection agency assignments.

4.2.28 We are aware of government programs that allows tax refunds to be held until patient delinquent accounts are paid. However, as we are not a collection agency, we are unable to file to FTB or IRS on the City’s behalf. We have worked with some of our clients in helping them obtain the necessary information so that they are able to evaluate the viability of participating in any such programs and submitting on their own.

4.2.29 According to the Department of Health and Human Services (CMS), “As of May 22, 2013, [the State of California has] exhausted their Section 1011 funds. Providers located in this state should stop submitting Section 1011 payment requests.” The program officially ended at the end of FY 2016.”


Processing FundsMany of our EMS billing partners prefer and we recommend the Live Cash method of processing payments. Payments are sent directly to us, processed and posted to the account, and deposited into the City’s bank account. Due to our meticulous auditing, balancing, and reconciliation processes your monthly reports will balance with your bank statements to the penny. Great care is taken from the opening of correspondence and payment envelopes by a specific group of staff (minimum double custody treatment and handling protocols). Patient accounts are updated and verified for accuracy before any checks are prepared for deposit. In all cases, double-custody procedures are followed so that payments are always within at least two cash receipt staff hands. Finally, we limit processing of payments and remote deposit logins to a maximum of two people to control deposits completely.

Payments made by check are scanned and deposited remotely to your bank account (or directly at the bank by designated personnel if remote banking is not a service your bank provides). Cash payments are handled directly by the president of the company. For Electronic Funds Transfers (“EFT”) required by federal insurance providers such as Medicare, we post Electronic Remittance Advices (“ERA”) to patient accounts immediately upon receipt. Since requirements vary greatly from agency to agency regarding payments and funds received, Wittman Enterprises works closely with the City of Vista to optimize this function during the life of our work together.

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Deposits are made Mondays, Wednesdays, and Fridays of each week, with deposit slip reconciliations emailed to clients usually the same day, but no later than the day after each deposit to the City’s bank account. Monthly closes (and subsequent monthly reporting) occur at a predetermined time agreed up by our clients (whether from a hard close or a soft close, to reflect as many payments as possible prior to closing). All month-end procedures are customized to meet the City’s accounting needs. We invoice our clients for our fees (percentage of the month’s net collected dollar amount) monthly after the month-end close has been completed.


Live Operator AssistancePatient Service Representatives are responsible for the follow-up on private insurance, private pay, and balance-billed accounts. They are responsible for over 10,000 calls weekly to and from patients while processing patient insurance information and working through any patient concerns, needs, or disputes. Our Customer Service Representatives are available Monday through Friday from 6:00 AM to 4:30 PM PST to serve your patient needs. Our toll-free number has multiple lines available for patients, clients, insurance companies, attorneys, and third parties to call for information or to discuss account status. Our system accepts voice mail messages and routes calls to appropriate person and/or voicemail box 24 hours per day. Our phone system was recently upgraded, and our Verizon router replaced and system updated ensuring the most effective solution and intuitive routing of calls for both the City and your patients.

Alternative Language CapabilitiesWittman Enterprises employs several Spanish, Chinese, and Vietnamese-speaking Customer Service Representatives in management and non-management positions. Such valuable resources provide your patients with the highest quality of service possible. On rare occasions, if a patient speaks a language we are not staffed to service, we utilize Language Line Services to assist those customers effectively. Currently, Wittman employs 16 bilingual staff members that are available to assist with calls.

Dedicated Response Time CommitmentWittman Enterprises’ goal is that each client and patient reach a live person when they call into our business office located in Rancho Cordova. If our EMS partners or their patients do not reach a live person during regular business hours, they will be provided the option to leave a voicemail and offered instructions on submitting an email inquiry. Wittman personnel will respond the same day during normal operating or within 24 business hours when that is not possible.

4.2.32 Acknowledged and Agreed To. Please see 4.2.5 for dispute/complaint resolution summary.

4.1.33 Acknowledged and Agreed To. Please see “Monthly Reporting Requirements” (p. 70) and “Final Review: Delinquent

Accounts” (p. 59).

4.2.34 Acknowledged and Agreed To. For more reporting information please see “Clear and Concise Reporting” (p. 69), “Monthly

Reporting Requirements” (p. 70), and “Sample Reports” (Appendix 1: p. I). Additional reports that the City may request will be created at no additional cost, as long as the ePCR export and the billing program track the data required to create any such report(s).

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g4.2.35 Acknowledged and Agreed To. Please see “Sample Reports” (Appendix 1: p. I).

4.2.41 Acknowledged and Agreed To. Please see “Appendix 2: Privacy and Security Compliance” (p. XXXIV).

4.2.43 Acknowledged and Agreed To. Wittman Enterprises processes all customer credit card payments in accordance with

applicable Payment Card Industry (PCI) security requirements.

4.2.44 Acknowledged and Agreed To. For policy summaries please see “Appendix 2: Privacy and Security Compliance” (p. XXXIV)

and “Wittman Enterprises Standards of Conduct” (p. XXXVII).

4.2.45 Wittman Enterprises, LLC complies with all CMS regulations and applicable State Medi-Cal regulations regarding claim submittal and processing. Reductions in Medicare or Medi-Cal reimbursements will be evaluated on a case-by-case basis for compliance and responsibility by Wittman Enterprises and the City of Vista.

4.2.50 As part of the billing and collection services we provide, we make contacts with patients under the name of the billing company for the City of Vista. We are not a collection agency and do not contact patients once their accounts have been deemed as non-collectible and reported to the City as such.

4.2.54 We fully support the City’s submission work required for the GEMT, GEMT QAF, and similar programs by providing current required billing reporting customized for each individual program. Wittman Enterprises does not complete nor file reports on behalf of the City; however, we can recommend contractors who provide such services in tandem with other City Fire Departments.

4.2.56 Acknowledged and Agreed To. For examples, please see “Self-Pay Bill Schedule” (p. 56) and “Billing to Payment Cycle”

(p. 45).





4.3.4 We customize all correspondence as much as possible under the structure of our time-tested standards continuously updated since our start in 1991. Wittman has provided the City samples of our correspondence and can customize where “real estate” and other page limitations allow. Beyond minor alterations to correspondence, modifications to our patient correspondence may be subject to pass-through fees from our printing partners. Please see “Sample Correspondence” (p. 73) for examples of our written communications.




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Project Approach

Workload Accomplishment

Our EMS billing and collection success is tied directly to the ratio of PCRs to the number of quality people assigned to your project. We believe that people are the key to our success. Wittman innovates by fully embracing automated and technological advances while wholly recognizing that our quality service is reliant upon our talented people providing you the best level of service. Our approach provides the lowest claims-per-employee-ratio, generally resulting in 10-20% higher collection rates than our competitors.

Wittman Enterprises works from our single location in the Sacramento, California area at 11093 Sun Center Drive, Rancho Cordova, California. All departments are dedicated to the personal attention of our clients and their patients’ needs. Our staff is divided into teams to efficiently address workflow processes and are further divided based upon your location. Wittman maintains our industry-leading lowest claims-per-staff-ratio (generally 30% lower than our competitors) based on upholding the standard of practice our clients expect. Through training, forecasting, hiring, and expansion of our EMS partner base, we constantly maintain that staffing ratio of approximately 4,000 claims per staff (compared to approximately 8,000-12,000 or more claims per staff for most of our competitors).

For complete project coordination, Wittman’s Client Liaison team is the conduit from you to our operations. We look forward to meeting with City/Fire personnel to discuss the goals of our business partnership, the services we provide, and any other topics required for the quality performance of EMS/Fire cost recovery on behalf of the City of Vista. Jennifer Gentry (Client Liaison) will be your main point of contact. Please remember too that Russ Harms (Director of Business Development), Corinne Wittman-Wong (CEO), and Walter Imboden (President/CFO) are always available to you and your team.

LOWEST

CLAIMS-PER-EMPLOYEE RATIO

=10-20%

Higher Collection Rates Than Our

Competitors

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gQuality Assurance

We ensure compliance with local, state, and federal laws by continually educating ourselves on any changes or differences that may apply between jurisdictions. As a matter of policy, Wittman Enterprises, LLC stays current with any program updates to Medicare and Medi-Cal. Therefore, we pledge to remain responsible and knowledgeable regarding any program updates to Medicare and Medi-Cal for the duration of the contract period. Furthermore, we will inform the City and the public of any significant changes to policies and procedure through emails, newsletters, conference calls, etc.

Auditing In addition to continuous training and quality control protocols, we perform audits continuously with seven independent auditors and a supervisor located in our office. They perform various audits including pre-billed claims, submitted claims, denied claims, etc. Wittman’s internal auditing program scrutinizes all of our work to ensure records are not missing, minimum content criteria is preset, fee schedules are accurate and applied correctly, billing codes are appropriate and itemized charges are captured. Our auditing team reviews thoroughly a minimum 10% of the work that each employee completes during the week. Auditors randomly select accounts for audit based on production reports from the previous week. Our meticulous efforts are designed to ensure compliance (whether we are billing Medicare, MediCal, private insurance, or patients) focusing on every step from initial billing, account follow up, and the posting of payments. Additionally, we audit charges, credits, level of service, schedules, payers, customer service quality and thoroughness, and provide key feedback to customer service representatives and management staff. Each Wittman Enterprises department is evaluated from their own specific auditing form in regards to job functions and their effectiveness at meeting quality, compliance and productivity standards. If any anomalies are identified through our auditing efforts, we devote the necessary resources to pinpoint areas for improvement and revise protocols, retrain staff, and test solutions to avoid future refrains. Finally, all new hire staff are continually audited until their audits regularly reach a consistent 95% success rate. Positive audit results are linked directly to our strong procedures and processes, training, and form our rigorous internal auditing program.

In our 28 years in business Wittman Enterprises, LLC has never received a negative external audit. We keep accurate and up-to-date records of all bills, payments, and correspondence related to billing functions to ensure a positive outcome to any audit and encourage the City, Fire Department, and its authorized agents to inspect and audit all data and records relating to our performance under the contract. Wittman Enterprises is always at your disposal during any audit procedure, ensuring immediate compliance with request for information.

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gTraining and Continuous Education

We participate in a training partnership with the State of California (ET17-0248) that mandates significant training hours and topics to improve skills, accuracy and customer service. Approved topics include Class/Lab/E-learning Hours as follows:

Business Skills

• Business Communication• Business Fundamentals• Customer Service• Data Entry• Standard Operating Procedures

Commercial Skills

• Anatomy• Medical Terminology• ICD-10• New Client Transition• First Responder Clients• Errors and Exceptions Reporting• HIPPA• Medical Billing• Medicare/Medi-Cal• Ambulance Billing• Industry Specific Terminology• Certified Ambulance Coder

Computer Skills

• Zoll• Docuware• Noridian• Novitas

Management Skills (Managers/Supervisors Only)

• Team Building• Leadership• Effective Meetings for Leaders• Decision Making

Wittman Enterprises Training Program: New HiresOur comprehensive and ongoing training program allows us to continuously improve the way we conduct our clients’ business and get you your maximum legal reimbursement available.

Initial Training

Employees begin with a minimum of four weeks training on general concepts required of their position including: our computerized billing system, office and position procedures, ambulance billing rules and regulations, identifying key payers, medical billing best practices, HIPAA, industry standards, customer service, billing Medicare, Medi-Cal, and private insurance. Trainees are not advanced in the training program until they have shown competence in all required areas. If they are unable to show the required competence our clients expect from us, employees are provided extra training opportunities and/or dismissed if necessary.

Secondary Training

The next phase of training runs for at least four weeks, emphasizing the practical portion of the employee’s job and preparing them to conduct their position under direct supervision. At this point in the training the employees “shadow” senior staff as they apply what they have learned in their first four weeks of training. More specialized concepts such as “ALS” and “BLS” are introduced and mastered along with workflow management (organizing and prioritizing), ambulance coding, data entry, translating common industry abbreviations, and working with first responder companies. There is significantly more hands-on training in this section than in the initial training period.

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g100% Auditing and TrainingAfter successfully completing the first eight weeks of training, staff operates independently under direct supervision. During this time, new employees and their work product are 100% audited until the employee exceeds a minimum of 90% error-free performance consistently. Regular one-on-one meetings and training sessions are conducted as needed to assure the minimum amount of human error. After this, our auditing team routinely and randomly audits between 10% and 20% of our staff and their work on a weekly basis.

Specialist ProgramWe develop our long-term and talented staff by expending considerable resources on training and continuous improvement of our employees. Experienced staff demonstrating aptitude toward specialty areas of our work are identified and placed in multiple-function-training to prepare them to work on several teams and continuously expand their knowledge and experience base

Certified Ambulance CodersIn addition to our internal training program, Wittman Enterprises is proud to offer staff members which have been certified by the National Academy of Ambulance Coding, a nationally recognized leader in Certified Ambulance Coding Training. Wittman Enterprises employs and provides regular training for Certified Ambulance Coders (“CACs”). Wittman staff are continually trained under the same exacting standards emphasized in the Coding Certifications. We budget funds annually to certify additional coders to ensure that we constantly have ample certified individuals available to assist with all accounts.

Wittman Enterprises Training Program: Continuous Improvement

Team TrainingEach of our teams meet weekly to go over and document training topics, industry and job-specific updates, staff questions, and SOP reviews. Teams are required to provide an agenda for each meeting and take attendance to verify staff team training and participation for each team meeting. Agenda items typically include but are not limited to the following:

• Case Studies/Best Practices Training• New Client Transition• First Responder Clients• Industry/Job Training and Updates

• CMS Updates Updates• Noridian, Novitas Updates• Coding/ICD-10 Training• Errors and Exceptions Reporting

Continuous EducationWittman Enterprises requires employees to not only stay current on industry and individual job requirements, but to continue to push their learning curve through continuing education and bring our clients the best qualified staff in our industry. For in-house training, attendance is taken and individual HR files are updated to maintain a list of continuing education projects each employee has undertaken. Additionally, outside-house training is documented via program participation and/or CEU certification.

In-House Continuous Education Examples:

• Telephone Doctor: Continuous Customer Service Training

• Business Communications

• The 7 Habits of Highly Effective Managers

Outside Continuous Education Examples:

• Certified Ambulance Coders (CAC) Continuing Education

• New Manager Training

• Project Manager Training

• HIPAA Officer Training

• Medicare and Medi-Cal Billing

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gContinuous Improvement

We view quality assurance as our opportunity to verify that our services regularly meet and exceed our EMS partner expectations. Our internal program follows the Shewhart Cycle’s five steps: Observe, Plan, Do, Check, and Act, to ensure that our professional excellence is inherent in every part of our billing process for our clients. Monitoring KPIs, conducting multiple audits, providing ongoing staff training, and holding regular training meetings (with case studies and more formal training opportunities) helps each of our teams continuously improve the way we conduct our clients’ business.

Key Performance Indicators

Tracking and examining accounts receivable, and Payment Average (revenue) are useful tools helping us judge how “quickly” and efficiently we are getting our clients their maximum and legal reimbursements. This doesn’t work as well as a snapshot in time but rather as a comparison tool from period to period. Additionally, A/R Days are monitored regularly to ensure the most consistent and effective results possible, analyzing how long it takes from the billing date to when we receive payment on your behalf. In this example, the account’s A/R Days are calculated by:

• Getting the Average Charge per Day: last 3 months charges divided by the number of days in those 3 months;

• and Dividing the A/R Balance by the Average Daily Charge, giving us how many days of charges are outstanding.

When the work is being managed appropriately your outstanding A/R should not usually be more than three months of charges. Much of this key information will be provided in your Year-to-Date Revenue Report along with several other Key Performance Indicators (KPIs).

Additionally, our operations director uses department KPIs to analyze trends, performance, and to address any anomalies before they become issues.

Average Charge per Day

$16,379.23

A/R Balance

$1,022,531

A/R Days

62

Billing Department• Trending of Transports

• Month-End Report Comparisons and Reconciliations

Cash Receipts Department• Payments monitored for timeliness and

unusual trends

• Refunds Trending

February

$486,938

March

$529,350

April

$490,601

Total Charges for the 3 Months

$1,506,889

# of Days in this 3 Month Period

92

Customer Service Department Workflow Timeliness• Hospital Data Exchange

• Mail Returns

• Private Mail

• Medicare Signatures

• Missing or incorrect phone numbers

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gClient Portal and Electronic Dashboard

Wittman Enterprises offers secured Internet access to our billing system via our Client Portal, 24 hours a day. No additional software is required for the City of Vista to access the information through our secured server. It is accessed with a secured login that is password protected. Information accessed from the Portal is in real time, allowing authorized City and Fire personnel to view each claim wherever it is in the billing and collection process.

Access to the Client Portal is granted only to pre-authorized City and Fire personnel with permission to view such information and is strictly limited to the City of Vista’s information. All patients may be referenced by name, date of service, incident, and run number. Your staff can print invoices for patients and run reports for their own use. Additionally, the City’s specialized reports can be made available through this site. Our billing software system is Microsoft Windows-based which enables data export by authorized staff for easy manipulation (Excel, PDF, Crystal, etc.). It also allows for a clear and traceable audit trail for initial client verification, billing notification, and phone contact. Moreover, our software automatically updates each individual account detailing date, change, or billing function. All history and noted entries become a permanent record and all charges are maintained for a complete payment history. Finally, the Portal provides an “electronic dashboard,” accessible 24 hours a day that provides a one-screen synopsis of the current state of the EMS billing operation, based on the preferences selected by each Client Portal authorized user.

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Main

Log Off


Instructions

The Chart Choices below have been provided to you to see a live snapshot of your data.

Chart Type and Size

Single Panel

Quad Panels

Chart Size: Large

Search Criteria


Display Options

Update Reset

Primary Payor Categories- By Date Range

Current Payor Categories- By Date Range

Mail Returns- Grouped by Month

Aging - Total Outstanding Dollars As Of Today



Leve

ls

Instructions

Drag Chart Choice from the left to the panel below. Drag it back to replace it.

Calls

ALS1

ALS2

ALSD Deceased Patient

Assessment Non Transp.

BLS

0 500 1000 1500 2000 2500 3000

BLSE

First Responder

2487

41

6

435

1

2211

326



Faci

litie

s

Calls

Mercy San Juan Medical CenterKaiser Hospital- North Sacramento

UC Davis Medical CenterSutter Medical Center-Sacramento

Assessment at SceneKaiser Hospital-Roseville

First Responder OnlyKaiser Hospital-South Sacramento

Sutter Roseville Medical CenterMercy General Hospital-Sacramento

Mercy Hospital-FolsomMethodist Hospital-SacramentoVA Hospital-Sacramento/Mather

Pronounced at SceneSutter Amador Hospital

Sutter Memorial Hospital-SacramentoNone

Dry Run


Total Aging Dollars ($15,850,183.67)

Over 180

121-180

91-120

61-90

31-60

Current

$0.00

$6,000,000.00

$5,000,000.00

$4,000,000.00

$3,000,000.00

$2,000,000.00

$1,000,000.00

Day

s

Dollars

1230817

495449433

391326312

286250

216212

7665

0 200 400 600 800 1000 1200 1400

111

$3,172,339.87

$1,434,161.33

$1,434.411.66

$1,694,877.73

$2,893,598.23

$5,220,803.85



1

NoneAuto Insurance

CustodyInsurance

Insurance ElelctronicKaiser

Kaiser MedicalKaiser-Medicare

MCal/MCaidMCal/MCaid HMO

MedicareMedicare HMO

OtherPrivate Pay

Workers Compensation

524

1213

263391

176606

268

1151423

701

0 200 400 600 800 1000 1200 1400

1272

12

Payo

r

Calls

Main - Dashboard

Client Portal – Main Dashboard

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gClient Portal – Statistics



Main

Log Off


Search Criteria


Display Options

Update Reset

Instructions

The chart below represents the missing information from the e-PCR for all of the different billing elements.

Main - Dashboard

Total # of ePCRs (5834)

Mis

sin

g

# Of Calls

Last Name

First Name

Signature

Insurance Name

Insurance ID

Patient Address

Patient City

Patient State

Patient Zip Code

Patient Gender

Patient SSN

Patient DOB

Patient Phone

Mileage

Incident Location

Destination

0 1000 2000 3000 4000 5000 6000

335

332

2068

338

516

0

386

382

376

0

1812

356

5654

1150

0

1030

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gClient Portal – Preferences

Instructions

Click the Change Button, then enter your changes and then click on the “SAVE” button. To cancel your changes, click the “CANCEL” button.


Preferences

Log Off


Instructions

If you have more than one company, click on the name that you want as your preferred company.

Instructions

Please select up to 10 charts to display on the Main – Dashboard and click the update button.


Note Name:

Email-Login ID:

Password

Default Tab:

Default Ticket Search

Change

ShowChange

UpdateMain – Dashboard

UpdateDate Of Service

Assigned Companies


System Information

Wittman Go Live:

Last Login:

Users Guide:

5/12/2017

6/27/2017

Click Here...

Account Created:

Last Password Reset:

5/12/2017

6/27/2017

Contact Names/Email Links

Account Representative: Heather Montano

Cash Representative: Pakou Vang

Billing Representative: Sharon Haney

Access Levels

Customer Information:

Billing Information:

Trip Notes Information:

Customer History Information:

Services Information:

Diagnosis & Alerts Information:

Trip History Information:

View/Print Statement:

View/Print Invoice:

View/Print Receipt:

View PCR:

View PCR Only:

Collection Agency

Profit Centers Only:

Main Tab:

Statistics Tab:

Reporting Tab:

Transport Tab:

Month End Tab:

Download Tab:

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

No

No

No

No

Chart Choices


Ticket Status – By Date Range

Current Payor Categories – By Date Range



Mail Returns – Grouped By Type


Payment Average – From First Bill To First Payment By Date Range For All Payors

TransportsReportingPreferencesStatisticsMain - Dashboard

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Main

Log Off


Main - Dashboard

Instructions

Select a report to viewbelow and then choose your options and then click Display Report.



Report Selector

Activity Summary by Payor Category

Activity Summary by Vehicle

Activity Summary Grouped by Vehicle

Aging Detail by Current Payor


Cash Receipts Journal by Date Posted


Charge List

Charge Type Detail

Chief Complaint Count by Client Age


Credit Type Detail

Dry Run Report

Month End Sales Journal Detail

Patients under 18

Ticket Survey by Payor Category


Ticket Survey Summary by Trip Date



Charge Type Detail


Dry Run Report

Patients under 18


Report Description

This trip date-based accoounting report, which is grouped by primary payor, displays all charges and credits, as well as balance and average totals.

Search Criteria

Display Options

Display Report Start Over

Report Viewer

Report Run On: 6/29/17 at 3:17:05 PM

Sample Company NameActivity Summary Payor Category: (Date From: 04/01/2017–04/30/2017)

Profit Center: [none]

Payor Category # of Trips Gross Charge Contr. Allow Net Charges Rev. Adj. Payments Write-Offs Refunds Balance Average

Insurance 903 1,621,707.06 30,122.52 1,591,584.54 0.00 996,686.20 275.58 5,008.92 599,631.68 1,762.55

Medicare 2,180 4,430,100.50 3,481,092.99 949,007.51 1,002.97 846,496.07 1,102.32 415.43 100,821.58 435.32

Medi-Cal/Medicaid 1,716 3,064,905.84 2,805,268.64 259,637.20 -0.89 178,183.58 23,009.93 145.67 58,590.25 151.30

Private 707 845,906.94 0.00 845,906.94 2,161.53 27,640.02 46,531.35 0.00 769,,574.04 1,196.47

Custody 1 1,735.91 1,337.77 398.14 0.00 398.14 0.00 0.00 0.00 398.14

Sub-Totals for: [none] 5,507 $9,964,356.25 $6,317,821.92 $3,646,534.33 $3,163.61 $2,049,404.01 $70,919.18 $5,570.02 $0.00 $398.14

Report Courtesy of Wittman Enterprises, LLC Page 1 of 3

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gClient Portal – Transports

Client Portal – Transport Detail

Call Type: ALS1 Advanced Life Support

Priority: Emergency

Transport: Emergency

Dispatch Comments:

ReportingPreferencesStatistics


Main

Log Off


Main - Dashboard Transport DetailTransports


Company Name: Wittman Enterprises, LLC

Customer Name: Powers, Nicole

Address: 123 Jump St.

City, State & Zip: Rocklin, CA 95765

Phone: (916) 232-1234

Date of Birth: 01/22/1982

Service Date: 10/09/15

Incident Number: 1134567

Run Number: 293237

Last 4 of SSN: 6789

Transporting Age: 33

Statement

Invoice

Receipt

Patient Care Report

Print Page

Diagnosis & Alerts Trip Notes Trip History Customer HistoryServices Billing

Facility: Mercy Medical Center - Merced

Address: 301 E 13th St.

City, State & Zip: Merced, CA 95341

Phone: (209) 385-7000

Pick-Up Facility

Facility: Mercy Hospital - Bakersfield

Address: 2215 Truxton Ave.

City, State & Zip: Bakersfield, CA 93301

Phone: (661) 632-5000

Drop-Off Facility

Response Zone: None

Dispatch Zone: None

Zones

Profit Center: None

Profit Center

Run Information

This is a test.



Main

Log Off


Main - Dashboard

Search Options

Date Of Service

Customer Name

Incident Number

Run Number

Social Security Number

Date Of Birth

Search Criteria

Partial (Slower Result Time)

Exact (Faster Result Time)

First Name

Last Name

Display Options

Show Zero Balance Calls

Cancelled Calls Only

Show Tickets Continuously

Display Calls Reset

Search Results

Powers

Job Profit Center Date of Service Run Number Incident Number Customer Name (Last, First) Date of Birth Balance Due

0001-A 2015-10-26 293236 12314567 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-16 293236 12314566 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-09 293236 12314565 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-13 293236 12314564 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-23 303236 12314563 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-16 303236 12314562 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-30 313236 12314561 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-12 313236 12314560 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-04 323236 12314569 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-11 323236 12314568 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-29 323236 12314576 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-19 333236 12314588 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-16 293236 12314566 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-13 293236 12314564 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-16 303236 12314562 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-12 313236 12314560 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-11 323236 12314568 POWERS, NICOLE 1982-01-22 $0.00

0001-A 2015-10-19 333236 12314588 POWERS, NICOLE 1982-01-22 $0.00

Page 1 of 2

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gCollections Portal

As part of our Portal System, we have created a Collections Portal for the most commonly requested items from collection agencies based on input from our clients. This portal provides the commonly requested collection agency information, but limits access to only these items for security and HIPAA purposed. From the portal, a collection agency can:

• Review accounts electronically

• Print invoices

• Print Patient Care Reports

• Print 1500 billing forms

The connection is fully secure and available only with authorization from you. Authorized agencies only have access to those accounts sent to them for collection work.

Additional Portals

CREDIT CARD PAYMENT

PORTAL

City of Vista

WittmanEnterprises

CREDIT CARD PAYMENT

PORTAL

CREDIT CARD PAYMENT

PORTAL

All Portals are available 24 hours a day, 7 days a week.

We respond to patient inquiries within one business day.

PATIENT

PORTAL

Provides patients with Portal access. Each invoice,

statement, and letter mailed to patients provide

a website link for them to access, login, provide

insurance information, make a payment, or simply inquire

about their bill.

COLLECTIONS

PORTAL

$$

We have created a Collections Portal for the

most commonly requested items from collection

agencies based on input from our clients. This portal

provides: reviewing accounts electronically, printing

invoices, printing patient care reports, and printing

1500 billing forms.

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gSecure Email

We provide the City access to our Secure Email Program from Axway. It provides multiple tiers of security that can be used individually or in combination to block threats at the DMZ and within the enterprise network, and secure inbound and outbound email traffic at the content and network levels. MailGate SC simplifies management of one comprehensive secure email solution for inbound, outbound and encryption, providing secure file delivery without impacting your current environment.

File Transfer Protocol (FTP) Access

The City has access to our FTP site. We receive email notification anytime reports or other information are uploaded to the site. There is no file size limitation for client uploads.

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Project Methodology

Electronics Claims

Department

• Import and Claim Entry (DAILY)

$$

Billing Department

• Claim Review, Coding and QA/QC (1-3 DAYS)

Transmission Department

• Electronic Claim Submission To All Payors (DAILY)

CustomerService

Department

• Insurance and Private Pay Follow-Up

APPLY NOW

CashReceipts

Department

• Payments Posted (WITHIN 24 HOURS)

City Of Vista

$

REGULATORYCOMPLIANCE

Billing to Payment Cycle

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gePCR Interface

Wittman provides extensive mapping of information with most ePCR systems to ensure they correctly correspond to our ZOLL billing system. There are no requirements or added cost for an electronic interface with Wittman Enterprises, LLC. We have successful mapping experience with multiple ePCR systems as recognized in the chart below. We encourage you to contact our other clients to discuss not only the seamless ePCR interface; but also to discuss our high levels of service as an EMS/Fire billing company.

ePCR Uploading Overview

We work with each individual client to determine the most effective way to transfer the care reports from ePCR programs to our ZOLL billing system. The process generally requires minimal input from individual EMS organizations.

Our Electronic Billing Team reconciles the NEMSIS file with the batch listed on the ePCR system to detect any inconsistencies. Files are then uploaded to our billing system workflows and processed. We utilize ZOLL’s RescueNet billing software and our IT team has worked extensively with ZOLL to ensure that all aspects of our processes operate efficiently with any ePCR system currently in operation. Our time-tested process allows seamless integration with the Water platform or any ePCR program used by the City. Wittman Enterprises has successfully interfaced with many ePCR products for our clients and they are mapped into our ZOLL RescueNet billing program for complete integration and data transfer/delivery.

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gePCR Import Data Scrubber

Using our proprietary pre-billing program, we automatically scrub every ePCR ticket that is sent to us. Through that process we are often able to fill in missing demographics information such as address, insurance coverage and social security information, missing phone numbers, name spelling, changes of address, and mileage checker. Some of the tools we incorporate in our scrub include:

• Melissa Data (address verification to ensure accuracy of patient addresses)

• TransUnion (checks all incidents that do not come with insurance/SSN information. Searches for SSN, address, phone, DOB, double checks spelling of name, etc.)

• Change Health (for incidents that have a SSN, system searches for insurance coverage information)

• Google Maps (Mileage checker)

• NCOALink (checks for patients who may have moved and changed their address with USPS. Any discovered changes are automatically updated to the file before it enters our system)

• Internal Matrix App (proprietary program written to analyze imported data and standardizing data sets to make sure it imports properly into our billing system)

• Internal Validation App (proprietary program written to validate data via logic hooks prior to importing into our billing system)

All New Records are SENT to:

• Melissa Data

• TransUnion

• Change Health

• Google Maps

Step 1 Step 2 Step 3 Step 4 Step 5

All New Records are VERIFIED via NCOALink.

All New Records are ANALYZED via Internal Matrix to Map Client Data.

All New Records are VALIDATED via Internal Application.

R

All New Records are IMPORTEDinto our ZOLL Billing System.

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gRecords Confirmed and Screened for Completeness

All PCRs received by our Billing Team are thoroughly reviewed for treatments and treatment codes, medical condition (ICD-10) codes, medical necessity, appropriateness of charges for services based on services rendered, and overall completeness. Coding with the appropriate payer, patient condition, and charges normally occur within 48 to 72 hours of receipt. PCRs with incomplete information may be referred back to the transporting agency for the missing information, if and when hospital face sheets are not available. Patient accounts with private insurance, Medicare, and Medi-Cal information are billed immediately. If insurance information is not available on the initial call report, additional research is conducted to locate any available insurance. When no insurance can be identified, the patient’s account is then set up for private billing.

Locating and Verifying Insurance

All insurance and third party payer information provided is verified online or by phone. By identifying the correct payer for a patient’s claim before it is ever billed, we consistently keep our percentage of incorrect billings very low. In the event that the incorrect insurance is billed, our customer service representatives contact the patient or receiving hospitals for the correct insurance information. Denials are simply not acceptable.

Follow-Up Protocols

As mentioned above, our comprehensive collection services include working with your receiving hospitals to obtain patient demographics to ensure the highest level of collection possible. We also gather additional information via secured email, VPN, fax, and phone calls to the financial offices of the hospitals or skilled nursing facilities. Wittman Enterprises engages a variety of other processes and resources in the course of following up on accounts with inadequate billing information including:

• Use of Zip Code/Street Directories for obtaining missing/incomplete addresses in addition to our own proprietary address.checker program and MelissaData.com

• Use of Accurint.com for tracing mail returns

• Contacting the EMS Division to locate missing information from Run Reports

• Contacting the patient or family members for billing or insurance information

• Personal contact with the patient or patient’s family via phone or email

• Mailing inquiry forms to the patient

Assignment Authorization

Based on our extensive EMS billing experience, we have found that the most efficient billing and collection programs are a direct result of a strong partnership between Wittman Enterprises and our client. That concept is particularly important when discussing patient signature authorizations. Agencies are not permitted to file claims to Medicare without the signature of the patient, designated guardian, or witnessed declaration that the patient is not able to sign. Recognizing that there are times when obtaining these signatures is simply not feasible; Wittman has developed a solid process in partnership with you, to address missing and invalid signatures. This process includes both education and direct patient contact to obtain required forms. Patient signature authorizations can significantly impact revenue if not diligently pursued in a timely manner.

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gPatient Database

For 29 years we have compiled an extensive Patient Database containing thousands of patient records and demographics with patient historical data. Our San Diego-area database was built piece by piece during our work there since 1991. This comprehensive Patient Database allows us to cross-reference accounts and streamline the billing process in a more efficient and thorough manner. We do this under the strictest HIPAA compliance regulations to ensure proper patient confidentiality.

Identification of Payment Sources

When insurance information is incorrect or incomplete, our Customer Service Representatives work with hospitals and the patient to obtain current and accurate information. After initial patient contact is made, insurance eligibility is verified with the patient still on the phone. This prevents billing delays and allows customer service representatives to inform patients if there are any problems with the insurance information provided.

Wittman electronically bills all Medicare, Medi-Cal, qualified primary and secondary insurance sources, workers compensation, health maintenance organizations, third party liability, benefit programs, and self-insurance programs. Those who do not accept electronic claims are billed via generated paper statements mailed directly to them.

For auto accident-related accounts, we determine from the patient whether they have med-pay through their automobile insurance, we are billing a third party insurer, or if they have retained the services of an attorney. Depending on the patient’s response, we will either bill the patient’s med-pay or private health insurance, bill the responsible party or we will work with the patient’s attorney to set up a lien against their personal injury case. All appropriate follow-up on accounts occurs regularly by specialized personnel in our Patient Service Department.

Wittman Enterprises, LLC has also worked on several large insurance bankruptcies. These bankruptcies have affected the revenue of our clients. Through our efforts, we have been able to obtain for our clients up to 80% of unsecured debt owed by several of these insurance companies. Most of our competitors opt to forego this process as it can take years to settle these cases. It takes many hours of correspondence and re-billing to the bankruptcy courts to net our clients payments that otherwise would have been written off.

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OK

CancelCompany: City of Hurst Ambulance

Relationship:

Name:

Source:

Release date: 04/01/2016

X?Add New CMS Signature

Medicare Billing

For incidents where no Medicare insurance information was noted by the paramedic, Wittman Enterprises requests insurance information and an authorization signature from the patient. Once a patient responds to our request(s) for Medicare insurance information, and/or if our electronic scrubber identifies patient Medicare insurance information, we complete the following steps:

Step 1: Our billing team determines the level of service on every PCR we receive, then adds any applicable charges, and evaluates the incident for medical necessity per Medicare guidelines. Step 2: Our billing team electronically confirms Medicare eligibility and updates all newly-provided information to our billing system. We always check eligibility when the patient is over the age of 65 and we have been provided a Social Security Number or Medicare ID. We will also check for eligibility information on the PCR or hospital face sheet when the patient has been identified as a Medicare recipient.

Step 3: Patient signature is added to their account once we have received it from them or if it is provided with the initial incident report.

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gStep 4: All available transport information is either uploaded automatically to the billing system or the biller manually enters/verifies transport information from the PCR.

Step 5: The primary payor is updated in our billing system and Medicare is billed electronically.

OK

Cancel

Medicare Required

Bed Confined Before?

X?Answers to Ambulance Certification Questions for this Trip

Use Default ValuesUse Override Values

Bed Confined After?

Bed Confined During?

Chair Confined During?

Medically Necessary?

Patient moved by Stretcher?

Transported To or For? To nearest facility for care of symptoms/complaints

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The detailed steps for billing Medi-Cal are mostly the same as those for billing Medicare as previously detailed. There is an additional step that is taken in addition to the Medicare Standard Operating Procedure:

• As with Medi-Cal, we check eligibility whenever we are provided the patient’s Social Security Number or Medi-Cal ID. Our billers determine the level of service and add any applicable charges. Once we have received eligibility we clarify whether it is a straight Medi-Cal Plan, or a Medi-Cal HMO plan, and update the payor in our billing system to submit the claim to the proper Medi-Cal payor.

Private Insurance Billing

After a patient responds to our request(s) for insurance information, and/or if our electronic scrubber identifies patient private insurance information, we complete the following steps:

Step 1: The patient writes their insurance information on the correspondence they are returning or; the patient sends a copy of their insurance card.

• Billing team updates all newly-provided information in our billing system

• Billing team electronically confirms eligibility of insurance

• Billing team calls insurances when necessary to verify patient eligibility Step 2: If the patient is confirmed eligible we add the payor to the patient’s account along with their coverage and insurance identification information.

OK

Cancel

Notes

XX??Add New Payor

Payor:

Address:

Apt/Ste/Rm: ATTN: C LAIM SUBMISSIONS

City:

Contact:

Position:

Phone: (000) 000-0000 Ext.____

Coverage:

Source:

Identification:

Group:

Accept Assignment:

Default Schedule:

Secondary Schedule:

Override Default Schedule:

Coverage Verified

Verification Expires

Patient Relationship toGuarantor/Subscriber:

Name:

Address:

Apt/Ste/Rm:

City:

Phone: (000) 000-0000 Ext.____:

Subscriber

This Payor is not valid for this customer for certain date ranges

Add

Edit

Delete

Prior Authorization Approval Numbers

From Until

Add

View

Delete

Show inactive approval numbers

Description Date Range Approval Range Next Approval #

OK

Cancel

XX??Payors

Description Address City

Kaiser Claims EMI/853915 P.O Box 853915 Richardson

Kaiser Engineers Retiree Group 60 Blvd. Of The Allies Pittsburg

Kaiser Fresno Outside Referral 7300 N. Fresno Street Fresno

Kaiser Hawaii Air Transport 80 Mahalani St. Wailuku

Kaiser Hospice Pt Business 12200 Bell Flower Blvd. Downey

Kaiser Hospice Pt Business 1425 S. Main St. Walnut Creek

Show all Show Inactive Add

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gStep 3: The billing department notates the account and changes the primary payor from self-pay to insurance.


OK

Cancel


Payor: Bill Patient

Schedule: Culver City Billing Pt

Event: No Bill Sent

OK

Cancel


Payor: Medicare Colorado

Schedule: Mcare Out Of State Electronic

Event: No Bill Sent

Step 3: The billing department notates the account and changes the primary payor from self-pay to insurance.


Denied or Disallowed Claims

Wittman Enterprises pursues every claim and follows through with every denial so that all legitimate revenue is collected on behalf of our clients. Denials are not accepted; in fact, as a policy we appeal all claims where the denial has appeal rights and we determine that an appeal is warranted. Additionally, Wittman demands payment with the appropriate interest from non-compliant insurance companies.

Medicare Denials

Medicare may deny claims for any number of reasons such as a patient without Part B coverage on the date of service, incorrect patient information on the claim, Medicare is a secondary payer, the patient has a Medicare Advantage plan, and many others. Wittman Enterprises actively appeals and processes all denials, making sure our clients get their maximum legal reimbursements. Our thorough process starts with reviewing the denial code and includes:

• Identifying the course of action based on the denial code

• Further researching Medicare Eligibility

• Verifying payer primacy between patient insurance and Medicare coverage

• Locating Medicare Advantage plan coverage

• Reviewing modifiers and codes for accuracy

• Checking EOBs for reported non-covered services or for no Part B coverage

• Billing secondary payers such as insurance and Medi-Cal as necessary

• Correcting information requested on denial and resubmission to Medicare, supplemental insurance, Medi-Cal, and the patient to reflect all necessary changes

• Scheduling a call-back date to follow up on resubmission

• Notating the account so that it reflects up-to-the-minute status of every claim

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gMedi-Cal Denials

Not all Medi-Cal denials are provided to us in the same way. Most are received in traditional Explanation of Benefit (EOB) format where codes are given and definitions for the codes are provided on the EOB. Others are returned in letter format only without codes or any clear reason for the denial. Our procedures for processing Medi-Cal denials include:

• Reviewing EOB/letter to verify if a payment was issued, and to identify the explanation for the listed code. This primary step is key for determining the type of denial received and what course of action to take for ultimate payment.

• Further investigating patient’s Medi-Cal eligibility and modify claim data if necessary.

• Identifying hierarchy of payers. Assuming Medi-Cal is the primary; add appropriate denial code along with any other necessary changes.

• Resubmitting claim to Medi-Cal.

• Scheduling a call-back date to follow up on resubmission.

• Notating the account so that it reflects up-to-the-minute status of every claim.

Insurance Denials

Health Plans and Medical Groups issue denials when all or parts of a claim are not paid. There are several types of denials. Some are issued correctly according to the patient’s insurance policy and/or billing guidelines while others are incorrect due to an error by the health plan when processing the claim. Our standard operating procedures include:

• Verifying whether the denial is based on “Not a Covered Benefit”, “Not Eligible”, “Unable to identify as a Member” or, “Primary Insurance Paid more than Allowed”, for example.

• If there is another billable insurance on file, sending a claim to that insurance, attaching the denial received.

• If there is no other billable insurance on file, contacting the patient to inform them of the denial and request any other insurance information.

• When corrected information is received from the patient, updating the payer information and send a claim and a copy of the PCR to that insurance with the denial received attached.

• When there is no viable insurance policy to bill, no Member or Resident program, converting the claim to private pay and billing directly to the patient.

We have a significant number of Standard Operating Procedures (SOPs) covering numerous scenarios for processing denials for Medicare, Medi-Cal, and Private Insurance. Our SOPs are also available to you for review if you would like a more exhaustive explanation of our various methods.

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gHospital Patient Records Systems

Creating a mutually beneficial partnership with your destination hospitals is a key part of our transition schedule when we begin our work with you. Initial contact is usually started even before the contract has been finalized. Initially, most hospitals elect to exchange data through a fax solution where Wittman submits an information request on a regular basis. Once the information is retrieved, the face sheets are faxed back to Wittman for further processing. This is an effective short-term solution; however, we then work with HIPAA compliance and IT teams at each hospital to attempt to establish a more efficient mode of information transfer. Typically, faxed requests take a minimum of two working days before we might expect to receive the requested information from the hospital. As part of our work with the City of Vista in the past, and as part of this proposal, we are already working with your top receiving hospitals to implement a more effective, streamlined process. Expediting the initial set-up is important and we will continue to work with hospital Health Information Management (HIM) personnel to set up a more efficient option: direct VPN access or scheduled FTP “data dumps.” Both methods ensure regular exchange of information and the retrieval of hospital face sheets in the most expedient way allowed.

Self-Pay Accounts

Surveys from the American Collectors Association indicate that patients are more motivated to make payment from a telephone call than repeated collection notices. However, by combining telephone calls and collection notices, an agency can further increase this effectiveness. We have found this to be true through the personal attention given to our clients and their patients.

The early establishment of contact with the

patient is beneficial in establishing a

working relationship with the patient on an individual level.

Our first call to a private account occurs immediately after data

entry of the incident into the system and automated and/or

manual searches for previous accounts for the same patient have

been completed.

This verification call allow us to determine

if the patient has insurance or any

special circumstances that will make it

difficult to pay the bill in a reasonable

amount of time.

$$

+ =

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gSelf-Pay Bill Schedule

Wittman Enterprises customizes your private bill schedule to reflect the City’s needs. These schedules work in conjunction with our billing program, tracking accounts receivable and assigning them to customer service representatives for making follow-up calls. Following are two examples of customized bill schedules:

Action Time Line

Information Request Letter Immediately


Hospital Request for Information Within 5-10 Business Days

Send Second Notice At 30 Days


Hospital Request for Information Sent At 40 Days

Send Past Due Notice At 45 Days

Phone call to the Patient At 55 Days

Send Final Demand At 70 Days

No Insurance Information Provided – Example Schedule

Action Time Line

Medicare Signature Required: Letter Immediately


Patient signature required Invoice At 35 Days

Patient signature required Past Due Notice At 55 Days


Patient Signature required Final Notice At 70 Days

Patient Signature Required – Example Schedule

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gMail Returns

Correspondence from us to your patients may be returned for various indicated reasons including: no such street; no such number; undeliverable as addressed; attempted not known (address is valid, but the patient apparently doesn’t live there); insufficient address (possibly missing apartment number, suite number, etc.). We complete the following steps to insure every account is being worked appropriately:

• Step 1: Compare address

• Double-check the address on the correspondence with the current address listed in the modify customer screen of the billing system.

• Step 2: Review the account

• Review the account for other possible dates of service

• Review notes to verify where in the billing process the account sits

• Re-check Medi-Cal/Medicare for additional demographic information

• Step 3: Call patient to verify contact information

• Step 4: White Pages reversal of phone number

• Step 5: Review possible alternative addresses

• Step 6: Accurint Check

• Step 7: Review PCR for Pick-Up Address/Patient Address

• Step 8: Cross-Check hospital face sheet/hospital trans

• Step 9: Final patient contact

Patient Portal

For many years Wittman has provided your patients with Portal access. Each invoice, statement, and letter mailed to patients provide a website link for them to access, login, provide insurance information, make a payment, or simply inquire about their bill. This site is available 24 hours a day, 7 days a week. We respond to patient inquiries within one business day.

Patient Payment Options

Wittman Enterprises effects positive collections for the City’s financial requirements while providing compassionate service to your patients—doing everything possible to attain reimbursement for your claims. With that goal, we try to provide as many payment options as possible so that patients have choices of how best to make payments to their accounts. Whether they mail their check payment or credit card billing information, provide their credit card information over the phone, set up a limited installment payment plan, or prefer to access our Credit Card Payment Portal, we make it as simple as possible for patients to submit their payments.

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gCredit Card Portal

Based on your preferences, we provide credit card payment options for your patients who wish to have bill payments processed this way. Patients are informed through our correspondence and our customer service staff how they can make credit card payments to their accounts. Limited Wittman staff is authorized to accept credit card information over the phone and our automated Credit Card Portal allows patients to securely pay their bills using our online reporting module. Additionally, our IT team can provide seamless links so that patients may also connect to the Credit Card Portal through the City of Vista website. Alternatively, several clients provide virtual merchant terminals to us so that we can deposit credit card payments directly into their existing system. Like all of our services, this can be customized to fit the needs of your City and your program.

Credit Card Payment Options

City of Vista

WittmanEnterprises

CREDIT CARD PAYMENT

PORTAL

CREDIT CARD PAYMENT

PORTAL

Installment Payments

For patients unable to pay their full balance owed, Wittman follows your policies in regards to self-pay accounts. This could include minimum payments accepted and the duration of the private pay contract. Based on our experience, we have found that limiting payback duration to one year usually provides the best results for our clients. Patients have the option of making their monthly payments by check or credit card. They may also set up an AutoPay agreement with a signed authorization where payment is automatically withdrawn from their credit card each month.

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gCollection Practices

On average, we send less than 12% of all accounts billed for additional collection efforts. Wittman will provide current reports identifying any non-collectable accounts to be released to your collection agency. As part of our process, we work with your agency and provide them necessary documentation regarding each account.

However, before an account is even considered for referral to collections, the following exhaustive procedures will have been performed:

• Patients will have been cross-referenced by name, social security number, incident pickup or residence address, and date(s) of service through a variety of resources including our extensive patient database.

• The entire regular invoicing cycle will have been completed.

• We will have conducted all appropriate follow-up calls and letters.

• We have identified all available alternate patient contacts.

• We will have completed our skip-tracing processes to locate correct address and telephone information with tools such as Accurint.com, The Haines Directory, MelissaData.com, etc.

• Receiving hospitals will have been contacted for most accurate and current patient demographic information.

• A second verification of Medicare, Medi-Cal, and Private Insurance eligibility is performed.

Hardships, Discounts, and Reductions

In the course of providing our services, Wittman follows the City’s policies. For example, you may waive the ambulance fee if it is found that a patient does not have the financial resources to pay. We notify your department in the case of any situation requiring modification of account balances, pay schedule, referral to collections, or account write off. No adjustment is ever made without prior authorization from you. All adjustments are clearly documented and identified in our regular reporting and documentation. We customize policies at your direction regarding discounts and reductions to meet the City’s requirements. Some of these may include hardships, attorney requests, City employees, or small balance write-offs. In all cases, no discounting decisions or write offs are made without your advanced approval.

Final Review: Delinquent AccountsOnce an account has gone through the billing cycle, an account representative will review the account one final time before placing on collection review. At that point a customer service lead will perform one last review of the entire account to ensure all SOPs were followed throughout the billing cycle. If all efforts have been made and process followed correctly, a write-off report will be submitted to the client contact and, if approved, electronically submitted to the City’s contracted collection agency.

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Project Deliverables

5.3.1 Deliverables Schedule

Implementation TimelimeWittman Enterprises is prepared and qualified to effectively meet all elements describe within the Ambulance Billing Services RFP detailed in the Scope of Services section in accordance with all applicable local, state and federal laws and within the policies of the City of Vista.

If we are fortunate enough to earn your EMS partnership, your transition plan will be customized to meet and exceeded your needs and expectations as our experience has shown that no two transitions are the same. Our transition process is built around five key steps that will be facilitated by your Client Liaison, Jennifer Gentry, and the entire Wittman Project Management Team. It is designed to systematically address all required deliverables for a timely and orderly transition: from Medicare, Medi-Cal, and insurance transfer requirements, to the interfacing of all software systems—all leading to the successful go-live date estimated in the timeline and schedule created with you. As your past and future EMS billing and collections partner, Wittman works closely with you during the operational implementation process ensuring a smooth transition. Regular meetings throughout the transition period focus on the items and tasks necessary for our transition partnership. Ongoing communications include conference calls and regular correspondence ensuring we meet required deadlines from your customized schedule so that your EMS program deadlines are met.

As a result of our business model, you will find that many of our processes are customizable to the needs to the City and Fire Department. Through our 29 years of experience, we have learned that each EMS organization functions differently and has unique expectations and needs. We have elected to not advise you how you must change to meet our needs; instead we have chosen to embrace that uniqueness and develop your billing program to meet your requirements and expectations.

Transition Timeline Estimate

Our billing system is easily customized and we are able to complete set procedures within 48 hours of award of contract. Wittman Enterprises has significant experience in working out old work from numerous billing systems. We are capable of taking on this task immediately upon award and execution of a contract. Billing private insurance and private pay claims starts immediately and we vigorously attempt to collect on all aging account receivables turned over to us. As part of our regular processes we maintain complete account receivables, payment collection, and balance records on each patient. The countdown to “flipping on the billing switch” is completed in the few milestone steps shown below.

STEP 130 Days

STEP 215 Days

STEP 315 Days

STEP 4Go-Live

STEP 56 Months

Welcome,Introductions,Information Gathering

ePCRInterface

Ramping Up

GoLive

Analysis

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STEP 315 Days

Ramping Up• Complete overlapping and remaining tasks from Step 1 and Step 2

• Gather banking information and materials and make necessary transfers of information

• Set up the City’s personnel on Client Portal, FTP site, etc.


STEP 4Go-Live

Go-Live• Accept live data via ePCR interface

• Transmit electronic claims to Medicare, Medi-Cal, etc.


STEP 56 Months

Analysis

• Conduct comprehensive process, compliance, and documentation analyses

• As needed, provide the City’s EMS personnel comprehensive billing compliance and documentation training

STEP 215 Days

ePCR Interface

• Mapping and Interfacing between City’s current ePCR (WATER) and Wittman’s billing system.

• Attaining necessary logins, passwords, credentials, permissions

• Testing ePCR interfaces for the System’s EMS Billing Program

• City, vendor, and ePCR ramp-up meetings (as needed)

Reporting Program

• Customizing the City’s Reporting Program

Award of ContractU

Welcome, Introductions, Gather Information• Fully-executed Contract and Business Associates Agreement (BAA)

Gather Information• Gathering of company specifics, demographic information, pay-to address requirements, etc.

Begin Transition Billing Immediately• Completion of transfer documents with Medicare, Medi-Cal, and other insurance

• Assembling of the City’s policies: Add to Wittman department procedures

• Wittman department manager and customer service briefings on the City’s policies and procedures

• Ramp-up meetings (as needed)

STEP 130 Days

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g5.3.2 Work Product (please see Cost Proposal Section, p. 67)

• Ambulance Billing and Collections, Notice of Privacy Practices, and Patient Surveys

5.3.3 Vista Staff and Provider Scope of Work

Wittman Enterprises enjoys our regular contact with City and Fire staff for direction on specific accounts, balance adjustments, QA/QI, and other procedures requiring your authorization. Occasionally, when we have exhausted our resources and need help completing missing information, clarifying unclear or incomplete narratives, we may request assistance from our regular City/Fire contacts that are often able to acquire the information from their own resources. However, as your billing partner, Wittman generally does not require additional tasks from City/Fire staff as it is our job to support your billing and reimbursement program.

We are a full-service billing agency that conducts effectively the full range of tasks associated with your ambulance billing. As part of creating and maintaining the most efficient and effective billing system partnership between the provider (City of Vista) and Wittman Enterprises, the following are the basic provider responsibilities generally accepted as current standards of best practice. All programs are customized to meet and exceed the needs of our clients – following as many standards of best practice as practically possible. • Submit necessary transport information, including pay source information and patient condition,

to Wittman Enterprises for billing purposes.

• Forward to Wittman all necessary information relating to patient transport services, payments and patient eligibility.

• Provide clarifications when questions arise regarding documentation.

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g5.3.4 Cost ProposalCost StatementPlease keep in mind that we are committed to competitive fees for our clients; however, we are not typically the cheapest. As part of our business model, we have chosen to charge our clients a fair market rate that allows us to maintain a superior level of service with a staffing level that provides both exceptional collection results and unmatched customer service. Reducing fees to “beat” the competition would mean that we cannot provide the level of customer service and performance on which our company is built. Wittman Enterprises generally outperforms our competitors by 10-20% in net collections to our clients’ bottom line. We will collect more for you than our competitors using our 29-year commitment to putting the right people to the task, doing the job thoroughly and doing it the right way, and at the same time providing the best in client and patient services.

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g

Cost Proposal

Wittman Enterprises, LLC is pleased to offer the City of Vista all billing, collections, financial reporting, and accounts receivable management described in our proposal based on the following fee schedule options. Proposals are valid for 180 days following submission.

Note: Wittman Enterprises, LLC provides complementary annual revenue enhancement training for EMS and financial staff. This includes four (4) hours of teleconference, webinar or ZOOM (Skype)-facilitated training, for Vista general staff, and six (6) hours for EMS/EMS Management. Additional and/or onsite training as requested by the City of Vista will be at a contracted rate of $100 per hour (personnel rate) plus associated travel expenses.

Proposed Fee

4.25% of net collections

Based on Vista’s provided payor mix and current reimbursement rates, a 1% increase

to charged fees may be applied if any insurance reimbursement rate is reduced

at any time during our contract term.

Services

Ambulance Billing and Collections, Notice of Privacy Practices,

and Patient Surveys

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gServiceWe are a full-service billing agency from the point of data entry to the last cent collected. Our fees contain the full range of EMS billing services including:

• Accurate, efficient, and experienced billing staff

• ePCR integration

• Each document confirmed, and screened

• Electronic billing to Participating Payers

• Billing private insurance

• Employee background checks

• Bilingual staff

• Client Liaison team

• Lower claims-per-staff ratio

• Unlimited access to Client Portal

• Insurance finding and pre-verification

• Assignment authorization verification

• Destination hospital contact/patient demographics

• Toll-free number (calls answered by real people)

• Personalized reporting

• Relentless Claim Appeals team

Maximizing CollectionsThrough streamlined efficiency, talented staff, automation, and continuous improvement, Wittman has a long track record of strong revenue returns for our clients. We consider the net percentage collected from the amount billed to be the ultimate standard by which your ambulance billing company should be evaluated. Net collections are those dollars eligible for collection after taking into account Medicare and Medi-Cal contractual write downs. The City of Vista will count on Wittman Enterprises to conduct diligent, regular, and uninterrupted billing and collection services in a professional businesslike manner with superior performance. We believe our personal approach and higher levels of service greatly exceed industry standards. Your expectations and overall satisfaction are attained through ongoing and regular training, continuous improvement, and our comprehensive auditing program.

Immediate availability to patients H No-cost reporting H H Ad Hoc reporting for no additional fee H Instantaneous response to reporting needs H Technological automation H H Hospital connectivity H H Single location with tight HIPAA and compliance controls H Lowest claim-per- staff ratio H Full reconciliation and discrepancy research H Medicare Revalidations H H Membership program support H Patient Satisfaction Survey Management H Reliable Internet-based Portal System: H

• Client Portal H

• Patient Portal H

• Credit Card Portal H

• Collections Portal H Dedicated Client Liaison and Division Manager to your account H

Service Levels Wittman Enterprises

National Competitor

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gCost Proposal Method

• Please see “Not Only Cost: Superior Vista Performance” (p. 64) for a graphic that includes estimated annual costs. Wittman Enterprises will collect more than our competitors—deposit more into the City of Vista’s bank account—essentially making the “low bid” and estimated annual cost insignificant, when more accurately evaluating net revenue based on the total collections deposited directly into the City’s account.

5.3.5 Reporting

Clear and Concise Reporting Our robust reporting is customized to meet your reporting needs and provide complete accountability and transparency for the work we do on your behalf. As indicated in the reporting sections of our proposal, we have hundreds of reports available for your metrics and reporting needs. There is no extra fee for reporting or for Ad Hoc reports designed for your exclusive use. Reports are available from your assigned Division Manager and Client Liaison at any time AND many of them come hard coded in your Client Portal for live and electronic access based on pre-populated fields. Other reports from your program can also be hard coded into your Portal access and be made available via our Client Portal. Please see “Sample Reporting” (p. I) and “GEMT/GEMT QAF Reporting” (p. XXV) for examples of our vast reporting library.

Standard Reporting

The City of Vista will have access to our Client Portal and client reporting system allowing authorized City and EMS/Fire personnel to obtain invoices, account balances, billing reports, and other hands-on account management tools. Daily, monthly, quarterly, annual, and special reporting can be provided in PDF and Excel format. Our reporting system allows interface with Crystal reporting software. For example, Vista’s customized reporting program might include specific details such as:

3 Number of Reports Received 3 Number Billed and Bill Type3 Calls Not Billed 3 Gross Charges3 Contributions Allowed or Write Down 3 Net Charges3 Adjustments 3 Payments3 Refunds 3 Balance Owed3 Number of Bills and Amounts Sent to Collections 3 Pending Claims at Collections3 Write Offs 3 Aging Reports

Reporting LibraryThis is a small sample of our extensive reporting library. In fact, we have well over 200 system-generated reports as well as hundreds of customized reports to meet the reporting needs of all of our clients. Utilizing our in-house programmers, we are able to design reporting programs to fit all of our clients’ needs.

3 Management Summary 3 Ticket Survey Summary by Payer3 Incident Survey Summary by Trip Date 3 Year-To-Date Revenue3 Aging: Current Payer (aging data) 3 Cash Receipts Summary3 Credit Summary 3 Activity Summary by Vehicle3 Activity Summary by Payer 3 Refund Report

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gMonthly Reporting RequirementsOur month-end correspondence with you includes Cash Receipt Reports that reconcile all deposits, receivables, billings, patient accounts, adjustments, dishonest checks, and refunds. All other processes and functions at Wittman Enterprises, LLC are ongoing. Financial and performance reports are detailed and easy to read. On-Demand (ad hoc) reports are our specialty and are provided at a moment’s notice at no additional charge. These reports provide detailed accounting for account adjustments of any type and track revenue by period. Our reports are Accurate and Easy to Read. Robust and Individualized. Accessible.

• A/R Aging Report: This report can be either a detail or summary report based on trip date (date of service), patient, or payer. It can be customized to track a specific payer or payers and date ranges and lists how many ambulance claims are still outstanding for any given time period.

• Ticket Survey Report: Detail or Summary can be run by date of service, payer or patient or combination thereof. Ticket Surveys are used to provide the number of accounts input into the system in a given month and under the payer mix category. This information provides revenue projection information and can be used to verify that all tickets sent have been received.

• Year-to-Date Revenue Report: This report provides a snapshot of the last twelve months at any time. It offers totals in all categories including Medicare and Medi-Cal write-downs, monthly amount of delinquent accounts and refund amounts. It is a very effective performance analysis tool in monitoring our performance as it reflects our ongoing collection rate, both gross and net, for a twelve-month period.

• Management Summary Report: The report is run by fiscal year. It provides an accounting by financial class of total trips and dollars billed each month, with a cumulative year-to-date tracking. It also provides an accounting of the dollars received each month by financial class with a cumulative year-to-date tracking.

• Ad Hoc Reports: On-demand reports are our specialty and are provided at no additional charge. Our billing software collects and tracts numerous data elements whether input manually or electronically downloaded. From the large data field our ad hoc reports are available and on-line for Vista review and can contain month-end and real-time information as required.

Your monthly reports can be emailed, dropped to your FTP mailbox, or sent to you via U.S. Mail – depending on the City’s preferences.

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g5.3.6 Certificate of Insurance

ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?

INSR ADDL SUBRLTR INSD WVD

PRODUCERCONTACTNAME:

FAXPHONE(A/C, No):(A/C, No, Ext):

E-MAILADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBERPOLICY EFF POLICY EXP

TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT

OTHER: $COMBINED SINGLE LIMIT

$(Ea accident)ANY AUTO BODILY INJURY (Per person) $OWNED SCHEDULED

BODILY INJURY (Per accident) $AUTOS ONLY AUTOSHIRED NON-OWNED PROPERTY DAMAGE

$AUTOS ONLY AUTOS ONLY (Per accident)

$

OCCUR EACH OCCURRENCECLAIMS-MADE AGGREGATE $

DED RETENTION $PER OTH-STATUTE ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE $If yes, describe under

E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N

N / A(Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)

CERTIFICATE OF LIABILITY INSURANCEDATE (MM/DD/YYYY)

$

$

$

$

$

The ACORD name and logo are registered marks of ACORD

11/20/2019

(916) 259-6900 (866) 206-8646

Wittman Enterprises LLC11093 Sun Center DriveRancho Cordova, CA 95670

A 2,000,000

X X B6020067350 7/1/2019 7/1/2020 300,000

10,000

2,000,000

4,000,000

4,000,000

EPLI FIDUCIARY 10,000

1,000,000B

X B6020067395 7/1/2019 7/1/2020

2,000,000C

B6020067431 7/1/2019 7/1/2020 2,000,000

10,000

D

X 9161868-2019 7/1/2019 7/1/2020 1,000,000

1,000,000

1,000,000

E Cyber Liability P00100004271102 11/7/2019 Aggregate/Limit 2,000,000

F E&O/Crime/Fiduciary 107019103 1/1/2019 1/1/2020 Each Claim/Agg 2,000,000

The City of Vista, its officers, officials, employees, and volunteers will be named as Additional Insured with respects to General Liability per attached endorsement form number SB146932F. General Liability applies on a Primary and Non Contributory basis per the attached endorsement form number SB146932F. General Liability, Auto Liability and Workers Compensation Waiver of Subrogation applies per the attached endorsement for number SB146932F, CA04441013-to follow, and 10217. Notice of Cancellation applies in favor of the City of Vista per the attached endorsement form number SB147052C.

City of Vista200 Civic Center Dr.Vista, CA 92084

WITTENT-01 JMAHNCKE

Western Elite Insurance Solutions130 Diamond Creek Place, Suite 2Roseville, CA 95747

National Fire Insurance Company of Hartford

Continental Insurance Company

Continental Casualty Company

State Compensation Insurance Fund

AXIS Surplus Insurance Company

Travelers Casualty Insurance Co of Amer

X

11/7/2020

X

X

X

X

X

X

X

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g5.3.7 Financial Stability Statement

We have been in business since 1991 and remain a financially strong company. Our organization has consistently demonstrated a financially sound position with liquidity ratios higher than bank requirements. We have never been subject to any bankruptcy proceedings in our 29 years in business. Our financial statements have been attached under separate cover. As such, we request that this information be considered Proprietary and Confidential.

In the event that copies of our response to your RFP are requested from the City of Vista through the Freedom of Information Act and/or similar state and local rules, Wittman Enterprises, LLC, respectfully requests that all information provided under the heading “Proprietary and Confidential” be redacted in their entirety from any and all copies provided. The information should be exempt from public disclosure (due to personal financial information and other private facts), for information related to competition and bidding, and for certain trade secrets, commercial or financial information. Its inclusion constitutes Proprietary and Confidential information. Unauthorized release of such confidential information puts us at an unfair disadvantage with future competitors if the information is released to the public in general.

5.3.8 Legal and Contract History Statement

In our 29-year history, Wittman has not experienced any contract termination for any reason; including non-performance, poor performance, or any other reason. We are not currently the subject of any federal, state, local, or any other investigation involving fraudulent or abusive billing practices, now have we been in our 29 years in business. Additionally, Wittman Enterprises, LLC, nor its officers or employees, has never been found guilty of violating procurement laws or been fined for violation of debt collection laws. Specifically, we have had no claims, fines, mediations, arbitrations, litigations, or judgements with which we were involved during our business history.

Additionally, we have never received a negative audit, having significant experience with external audits from CMS, other agencies, and of course our clients. We are always at your disposal during any audit procedure. For example, in 2010, Medicare’s contracted agent conducted a pre-pay audit of the City of Vista’s Medicare program. A large number of claims were reviewed prior to payment and ultimately denied during the audit process. What followed was a two-year appeal process where Wittman (on behalf of our client) appealed findings from the audit on three different occasions and at three different levels of appeal. The final Medicare appeal culminated in a WHOLLY FAVORABLE decision from an Administrative Law Judge (ALJ) agreeing with our appeal for each account in question and ordering proper Medicare reimbursement.

5.3.9 Type of Business Entity

Wittman Enterprises is a limited liability company registered with the Secretary of State of California.

5.3.10 Corporate Status

N/A

5.3.11 Sole Proprietorship Status

N/A

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g5.3.12 W-9 Copy

Give form to therequester. Do NOTsend to the IRS.

Form W-9 Request for TaxpayerIdentification Number and Certification(Rev. November 1999)

Department of the TreasuryInternal Revenue Service

Name (If a joint account or you changed your name, see Specific Instructions on page 2.)

List account number(s) here (optional)

Address (number, street, and apt. or suite no.)

City, state, and ZIP code

Plea

se p

rint o

r ty

pe

For Payees Exempt From BackupWithholding (See the instructionson page 2.)

Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box. Forindividuals, this is your social security number(SSN). However, if you are a resident alien OR asole proprietor, see the instructions on page 2.For other entities, it is your employeridentification number (EIN). If you do not have anumber, see How to get a TIN on page 2.

Social security number

––OR

Requester’s name and address (optional)

Employer identification numberNote: If the account is in more than one name,see the chart on page 2 for guidelines on whosenumber to enter.

Certification

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), andI am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the InternalRevenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS hasnotified me that I am no longer subject to backup withholding.

2.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backupwithholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirementarrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you mustprovide your correct TIN. (See the instructions on page 2.)

SignHere Signature � Date �

3. The IRS tells the requester that youfurnished an incorrect TIN, or

4. The IRS tells you that you are subjectto backup withholding because you did notreport all your interest and dividends onyour tax return (for reportable interest anddividends only), or

Purpose of form. A person who isrequired to file an information return withthe IRS must get your correct taxpayeridentification number (TIN) to report, forexample, income paid to you, real estatetransactions, mortgage interest you paid,acquisition or abandonment of securedproperty, cancellation of debt, orcontributions you made to an IRA.

5. You do not certify to the requesterthat you are not subject to backupwithholding under 3 above (for reportableinterest and dividend accounts openedafter 1983 only).

2. You do not certify your TIN whenrequired (see the Part III instructions onpage 2 for details), or

Note: If a requester gives you a form otherthan Form W-9 to request your TIN, youmust use the requester’s form if it issubstantially similar to this Form W-9.

What is backup withholding? Personsmaking certain payments to you mustwithhold and pay to the IRS 31% of suchpayments under certain conditions. This iscalled “backup withholding.” Paymentsthat may be subject to backup withholdinginclude interest, dividends, broker andbarter exchange transactions, rents,royalties, nonemployee pay, and certainpayments from fishing boat operators. Realestate transactions are not subject tobackup withholding.

If you give the requester your correctTIN, make the proper certifications, andreport all your taxable interest anddividends on your tax return, paymentsyou receive will not be subject to backupwithholding. Payments you receive will besubject to backup withholding if:

1. You do not furnish your TIN to therequester, or

Form W-9 (Rev. 11-99)

Part I

Part II

Business name, if different from above. (See Specific Instructions on page 2.)

Cat. No. 10231X

Certain payees and payments areexempt from backup withholding. See thePart II instructions and the separateInstructions for the Requester of FormW-9.

�

Check appropriate box: Individual/Sole proprietor Corporation Partnership Other �

Under penalties of perjury, I certify that:

Part III

Use Form W-9, if you are a U.S. person(including a resident alien), to give yourcorrect TIN to the person requesting it (therequester) and, when applicable, to:

1. Certify the TIN you are giving iscorrect (or you are waiting for a number tobe issued),

2. Certify you are not subject to backupwithholding, or

3. Claim exemption from backupwithholding if you are an exempt payee.

Civil penalty for false information withrespect to withholding. If you make afalse statement with no reasonable basisthat results in no backup withholding, youare subject to a $500 penalty.Criminal penalty for falsifyinginformation. Willfully falsifyingcertifications or affirmations may subjectyou to criminal penalties including finesand/or imprisonment.

PenaltiesFailure to furnish TIN. If you fail to furnishyour correct TIN to a requester, you aresubject to a penalty of $50 for each suchfailure unless your failure is due toreasonable cause and not to willful neglect.

Misuse of TINs. If the requester disclosesor uses TINs in violation of Federal law, therequester may be subject to civil andcriminal penalties.

If you are a foreign person, IRS prefersyou use a Form W-8 (certificate of foreignstatus). After December 31, 2000, foreignpersons must use an appropriate FormW-8.


�

11093 Sun Center Drive

Rancho Cordova, CA 95670

5.3.13 Sample Correspondence

Please see “Appendix 3: Sample Correspondence” (p. XLII) for examples of our letters, invoices, statements, etc.

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00081660 2 Exhibit C, Page 1 of 3

EXHIBIT C INSURANCE REQUIREMENTS

Contractor shall procure and maintain for the duration of the contract, [and for x years thereafter,] insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder by the Contractor, his agents, representatives, employees, or subcontractors. Nothing in these provisions shall limit Contractor’s Duty of Indemnification.

MINIMUM SCOPE AND LIMIT OF INSURANCE

Coverage shall be at least as broad as:

1. Commercial General Liability (“CGL”): Insurance Services Office Form CG 00 01 covering CGL on an “occurrence” basis, including products, completed operations, property damage, bodily injury, and personal & advertising injury with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this Project/location or the general aggregate limit shall be twice the required occurrence limit.

2. Automobile Liability: Insurance Services Office Form Number CA 0001 covering Code 1 (any auto), with limits no less than $2,000,000 per accident for bodily injury and property damage.

3. Workers’ Compensation insurance as required by the State of California, with Statutory Limits, and Employers’ Liability insurance with a limit of no less than $1,000,000 per accident for bodily injury or disease.

Contractor shall also provide the additional coverages checked below and at least as broad as:

4. Professional Liability, with limits no less than $1,000,000 per occurrence or claim, and $2,000,000 policy aggregate.

If the Contractor maintains higher limits than the minimums shown above, City requires and shall be entitled to coverage for the higher limits maintained by the Contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City.

Deductibles and Self-Insured Retentions

Any deductibles or self-insured retentions must be declared to and approved by City. At the option of City, either: the Contractor shall cause the insurer shall reduce or eliminate such deductibles or self-insured retentions as respects City, its officers, officials, employees, and volunteers; or the Contractor shall provide a financial guarantee satisfactory to City guaranteeing payment of losses and related investigations, claim administration, and defense expenses.

Other Insurance Provisions

The insurance policies are to contain, or be endorsed to contain, the following provisions:

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1. The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of with respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such work or operations and automobiles owned, leased, hired, or borrowed by or on behalf of the Contractor. General liability coverage can be provided in the form of an endorsement to the Contractor’s insurance (at least as broad as ISO Form CG 20 10, CG 11 85 or both CG 20 10 and CG 20 37 forms if later revisions used), unless otherwise approved in advance by City.

2. For any claims related to this Project, the Contractor’s insurance coverage shall be primary insurance as respects City, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by City, its officers, officials, employees, and volunteers shall be excess of the Contractor’s insurance and shall not contribute with it.

3. Each insurance policy required by this clause shall provide that coverage shall not be canceled, except with notice to City.

Claims Made Policies

If any coverage required is written on a claims-made coverage form:

1. The retroactive date must be shown, and this date must be before the execution date of the contract or the beginning of contract work.

2. Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of contract work.

3. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a retroactive date prior to the contract effective, or start of work date, the Contractor must purchase extended reporting period coverage for a minimum of five (5) years after completion of contract work.

4. A copy of the claims reporting requirements must be submitted to City for review.

Acceptability of Insurers

Insurance is to be placed with insurers with a current A.M. Best rating of no less than A: VII, unless otherwise acceptable to City.

Waiver of Subrogation

Contractor hereby agrees to waive rights of subrogation which any insurer of Contractor may acquire from Contractor by virtue of the payment of any loss. Contractor agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation. The Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of City for all work performed by the Contractor, its employees, agents and subcontractors.

Verification of Coverage

Contractor shall furnish City with original certificates and amendatory endorsements, or copies of the applicable insurance language, effecting coverage required by this contract. All certificates and endorsements are to be received and approved by City before work

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commences. However, failure to obtain the required documents prior to the work beginning shall not waive the Contractor’s obligation to provide them. City reserves the right to require complete, certified copies of all required insurance policies, including endorsements, required by these specifications, at any time.

Subcontractors

Contractor shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Contractor shall ensure that City is an additional insured on insurance required from subcontractors. For CGL coverage, subcontractors shall provide coverage with a format least as broad as CG 20 38 04 13.

Special Risks or Circumstances

City reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other circumstances.

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00081660 2 Exhibit D

AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS [Labor Code §§ 1720, 1771.1, 1773.8, 1775, 1776, 1777.5, 1813, 1860, 1861, 3700]

NOT APPLICABLE TO THIS CONTRACT

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00081660 2 Exhibit E

EXHIBIT E SPECIAL PROVISIONS

This Contract is subject to the following provisions, if checked: 1. State of California grant conditions, as attached. 2. Federal grant conditions, as attached. 3. Other conditions, as attached.

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